#581 Bob's Your Uncle

Sasha is Australian, in her mid 20s and has been living with type one diabetes since she was young.

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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 Hello friends Hello friends Hello friends hello friends. Hello darkness my old friend

Hello friends and welcome to episode 581 of the Juicebox Podcast. On today's show, I'll be speaking with Sasha, who is Australian in her mid 20s and has been living with type one diabetes since she was a young person. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. I want to remind you to check out the private Facebook group it is completely free always will be Juicebox Podcast type one diabetes over 17,000 members. The diabetes pro tip and defining diabetes episodes are fan favorites. If you're looking for management ideas about type one diabetes, check out diabetes pro tip.com. Have you considered filling out the survey AT T one D exchange.org. Forward slash juicebox? Well, if you have type one diabetes, or you're the caregiver of someone with type one, and you're a US citizen, you can it'll just take a few minutes. And with that very little bit of effort you will have helped someone with type one diabetes

this show is sponsored today by the glucagon that my daughter carries G voc hypo Penn Find out more at G voc glucagon.com. Forward slash Juicebox. Podcast is also sponsored by the Contour Next One blood glucose meter. You can find out more at contour next one.com forward slash juicebox.

Sasha 1:57
Okay, so my name is Sasha, I'm 25 years old. I live in Melbourne, Australia, and I have type one diabetes.

Scott Benner 2:07
I'm so happy for how many people in Australia listened to the podcast. So it's exciting to me. How did you find Yeah,

Sasha 2:16
I heard quite a few episodes recently with Australians on there. And that was surprised as well.

Scott Benner 2:22
Yeah, I am. I mean, the first time I was just like, oh, this is neat. Didn't mean like it was like, I don't know, finding an ice cream flavor I'd never seen before. But then, you know, the second and the third time that people actually wanted to be on and watching the downloads in the country. It's a I think it's one of the top three countries for the podcast. So it's always very consistent. You guys are always very nice to me. So thank you.

Sasha 2:47
For Thank you. No, please,

Scott Benner 2:49
don't be silly. I was just gonna forget the first time that someone contacted me and said they needed help or something. And we're wondering if we could talk and I said, Yeah, sure. Like, you know, here's my number. And she's like, I can't call it's too expensive. And I was like, where are you? And she said, Australia, and we ended up doing it through FaceTime audio, I think. Which was surprisingly good. Like, is that how you? Do you guys do that? A lot

Sasha 3:18
of you? No, no, not really. I mean, I think over he is mostly just WhatsApp, WhatsApp. Gotcha. Yeah, I think that's the common on.

Scott Benner 3:29
Okay. And so is it just incredibly expensive to make a phone call?

Sasha 3:35
I mean, if you if you're calling from overseas, or making a phone call to overseas then yes, but not not within the country?

Scott Benner 3:43
No. Oh, yeah. I didn't think you lived on Mars like I was. So tell me about when you were diagnosed? How old are you?

Sasha 3:53
I was nine, nine.

Scott Benner 3:56
She saved 25. Now? Yes. Be prepared to be really impressed. Was that 16 years ago? How long 1718 2020 230 My God. I am on top of things this morning. So a very long time ago. And while you were living in Australia?

Sasha 4:14
No, actually, I was living in France.

Scott Benner 4:17
How does that happen? Tell me more about that.

Sasha 4:20
So my dad is Australian and my mom is fresh. I was born in Australia, but I grew up in France. So from the age of three to 18, I was living in France, so I was actually diagnosed in Switzerland. Were your

Scott Benner 4:36
parents together? Yes. Okay. That makes it more interesting that you're back in Australia. Like I want to ask more questions, but I also feel like it's going to come out during the story. I don't know where to go with this. Alright, let's just let's start there, where we're in France that you live

Sasha 4:54
right next to the Swiss border. So just on the other side of Geneva.

Scott Benner 4:59
Okay. Hey. And so your, your parents, where did they get together?

Sasha 5:06
They met in France in my dad was working over there when he was younger

Scott Benner 5:11
was working. Okay. Periscope, how were they young when they got married?

Sasha 5:17
Um, I think they're in the early 30s.

Scott Benner 5:21
That's Do you think that's yeah.

Sasha 5:26
I mean, yes and no. It's like, I feel like if you ask an 18 year old is 30 Young, they'll be like now that's old. But I'm 25 and I'm starting to cross over there. I feel like it's not that old.

Scott Benner 5:42
guy wasn't asking you to defend your own fear about getting old. I was trying to figure out this 30 was old to you. Are you nervous?

Sasha 5:51
Uh, I was a little bit at first, but yeah,

Scott Benner 5:54
you're good. Okay. Excellent. Yes. Great. Yeah. I don't want you to be nervous. So, alright, so you're a young kid. You're growing up the entire time, I guess in Geneva. And or right by Geneva. You said? Yeah. Okay. Do you speak French? Yes, I do. Like rock solid. If you went over there, people wouldn't be like, that's an Australian girl pretending to be French

Sasha 6:15
like, yeah. Wow. Yeah. They wouldn't be able to tell. That's so

Scott Benner 6:20
cool. So I'm gonna depress you just very quickly. Okay, turn the lights off. It's time to go to bed.

Sasha 6:28
You want me to say that in French? Yeah. Do it. Italian Yeah. That is pushy.

Scott Benner 6:35
I don't think he had time to Google that. So that sounds pretty legitimate. Okay. So, okay, so you grow up? Were you strictly French speaking or does your dad speak French?

Sasha 6:46
He does. But most of the time I speak French with my mom in English with my dad.

Scott Benner 6:50
That's so cool. I don't think you imagine that as being otter, like in an interesting way. But it is. I mean, to me at least I think that's pretty amazing. Alright, so were you diagnosed in French? Yes, I was. Excellent. Did that have any impact on it? Because I asked the person recently if they were diagnosed in Spanish, and she felt like it had an impact. Meaning that once she reached English speech, speaking, doctors, they were more specific with her. I don't know why she thought that. But I'm asking you because she said that.

Sasha 7:26
I'm not in that sense. But I think that when I want to move to Australia, when I was 18, I then I think just the transition was strange. With everything, not just diabetes, just learning how to, you know, just learning the slang in another language. Like I knew the language, but I didn't know how to talk about diabetes in English.

Scott Benner 7:51
Oh, that's interesting. So is that would that mostly become an issue between you and a physician? Are you want to parent Where did that?

Sasha 8:03
Probably mostly physician physicians. Okay. Yeah.

Scott Benner 8:07
Did you? Did you find the physicians helpful? And are they more helpful in one country than the other? I think that'd be about the same. The same. Yeah. Was it helpful?

Sasha 8:22
Not particularly North.

Scott Benner 8:26
Australia's where King Kong lives, right? Uh, what? What do you mean, the giant gorilla that came to New York in the 40s and took that woman up to the top of the Empire spa?

Sasha 8:43
He was Australia.

Scott Benner 8:44
I don't know why it's not. But I imagine in my mind that it is so bad. Yeah. Because I mean, you have the giant spiders already. So I swear to you that I think it might be genetic. Because if you asked me, Do you want to go to Australia? I'd be like, Yes, that sounds amazing. What about the giant spiders? Am I gonna be okay, would be my next question. I don't think I've ever said that out loud in front of anybody. And my son who's 21 And you know, travels way more than I did when he was younger. When I was younger. Somebody asked him about Australia the other day and he said, What about this fight? Are they just everywhere? The way I imagined just are they on the roof of your like house and crawling through your living room right now and everything?

Sasha 9:27
Probably, but I don't think that's because there's more spiders in Australia. I think that's just because insulation here is terrible. And this, you know, cracks underneath underneath the doors. So the spine has come in.

Scott Benner 9:39
No kidding. It's a construction issue you believe. Yeah, yeah, pretty much. Are you calling out Australians right now and their construction practices? Oh, yeah. No kidding. That's interesting. I know you're being a little funny, but I think you mean it. So.

Sasha 9:55
Oh, yeah, I definitely mean that.

Scott Benner 9:59
Are your doors square Are they like swing? Well, or do they get stuck? Or is it that bad?

Sasha 10:05
I don't I don't know what the what the deal is. But it's just it's just not good.

Scott Benner 10:12
That's hilarious. All right. So you said in your note that you left the hospital in France with a pump? Yes, I did. So you know, you've never done injections. Sorry, have you ever done MDI injections?

Sasha 10:29
I have. But I saw I, I went on a pump immediately. And then, probably about seven or eight years later, I got sick of the pump. And then I started MDI, but I hadn't actually, I had actually never done an injection in the hospital. Or maybe I had, but like they're in a teddy bear or an orange or something.

Scott Benner 10:50
So it's an interesting, so you use the pump exclusively for I mean, a long time into your into your mid late teens. Right? And then you just decide I'm not wearing a pump anymore. Was it? Like a harrowing experience to give yourself an injection the first time?

Sasha 11:09
Yeah, kind of, yeah, I've kind of felt like a warrior. I remember, I mean that they were probably a few times while I was on a pump, where I had to give myself an injection, you know, from failed sites or whatnot. But I had always relied on my parents to do that, because I was always too scared. Yeah, but I decided to come off it because I, you know, being a teenager, I just didn't like having to, you know, having the pump connected to me all the time and having it visible by other people. And I think I was also never really taught how to use it properly. So I'm sorry. Now, I didn't understand, you know, Temp Basal rules and things like that. Gotcha. So you're encouraged to use those.

Scott Benner 12:02
So the pump for you was basically just a way to not have to give injections all day long. And, yeah, pretty much. What kind of pump? Was it back then?

Sasha 12:13
A, one of the early maytronics.

Scott Benner 12:16
Gotcha. And are you MDI right now as I'm talking to you?

Sasha 12:21
No, I have a Medtronic pump. That is actually weirdly looking. It's very similar to the one I have left the hospital with that diagnosis. Because it's the only one that is loopable in Australia.

Scott Benner 12:37
Okay, now we're getting to it. How long did you inject?

Sasha 12:45
From what I was, like, 16, and two to three years ago,

Scott Benner 12:53
what made you switch back?

Sasha 12:56
I'm actually listening to your podcast and reading the reading a bunch of books about diabetes, essentially, and learning that there's a lot more you can do with pumps, then I had probably previously thought,

Scott Benner 13:13
huh, well hold on a second. Well, I talked directly to Medtronic in case they're listening. See, there, I sold one for you. It wasn't like usual when people come on and say I hate my Medtronic pump this one much better for you guys. Right. You know, they're listening. Anyway. That's nice. So you wanted to loop? Yes. Gotcha. And you can't get on the pods in Australia? No. Right. Am I understanding now? Yes, excellent. Okay. So you find the podcast a couple of years ago? Would you consider your management much different today than it was two years ago? Or did you begin to work in a different way? Even sooner than that?

Sasha 13:54
I think I had. Well, growing up, I think my doctors always told me, I was doing a great job. And I think, I think mainly because I was, you know, I wasn't purposely not bolusing or anything like that. I think my agency back then Well, it's probably like, in the 80s or so. Like, it wasn't terrible, but it wasn't amazing either. And then, and then I started becoming more interested in learning about it. I think I probably saw found a couple of groups on Facebook, around diabetes. And then I started listening to your podcast and reading books and just being more interested in knowing more about it because I feel like I had I hadn't been taught really the basics. And so after that, my A once he came way down, and I started reading the book by Gary Schneider. Yep. And so I discovered I found your podcast around that time. And so I think reading the book and listening to you talk about similar ideas kind of helped cement it all together. And essentially, I think the podcast was a bit of a daily reminder of, you know, don't forget to Pre-Bolus sort of thing.

Scott Benner 15:22
Gotcha. That's really cool. I, when I hear people talk about that, that makes me happy. Because that's a that's an impact from the podcast that I did not imagine when I was making it. But I hear from people a lot about just adults living with type one who just need to be reminded and need to hear it over and over and don't have somebody to talk to about I mean, who really, you don't I mean, like, even if you had like a best friend with diabetes, you wouldn't talk about diabetes every day. So that's really cool. Can I ask you something? Do you see because you're in an interesting space, you're in your mid 20s. So you've crested How do I say this? There's this part of life. Like when you took off your pump until when you decided to probably pay closer attention in that space. That's a real like, teenage rebellion. Space, right? Like, it's, it's not uncommon. It's not like you're, you're the only one that it happened to, although you wouldn't think of it that way at the time, but when you were like, I don't want to wear this pump. You wouldn't like have a conscious thought, like, I'm 16. And I'm rebelling against something. Just you know, you just feel like I don't want this pump. And then early 20s. If you like, it's interesting. If I asked you right now, do you think you'll ever have kids? Yeah, you're right. If I would have asked you when you were 19? Do you think you'll ever have kids? What would you say?

Sasha 16:45
I probably would give them the same answer. But without much thought,

Scott Benner 16:51
Ah, I say, I always find that there's that like, early 20s time, where people are just like, don't really consider much beyond themselves. I guess. Like, it's a real exciting time. Like, I'm young, and I'm entering the world, and I'm doing this thing. And it's not till you usually get into your mid like 2526 where you start thinking like, I wonder if there's more to this. You know, it's just it's very interesting, that kind of swing through there. And I'm so glad you can't see me because for some reason, I'm swinging my hands back and forth. I caught myself doing it. And I was like, no one can see this edit still feels ridiculous. Sorry. And I know apologizing for your part. But it's a really interesting space. Like it is. If I told you you were the 50th person that told me that right around that 23 age, you were like, I wonder if I should be like, doing a better job. It's it's just such a common space for it to hit people. It's very interesting. Were you in school in that time? College?

Sasha 17:50
Yes, university.

Scott Benner 17:51
Do you call it University? I was gonna say,

Sasha 17:54
yeah, yeah, no one really call it school. College.

Scott Benner 17:57
No, say it again.

Sasha 18:00
University. No, no, I

Scott Benner 18:02
mean, you said something that I just didn't understand. Nobody calls it school or college. Oh,

Sasha 18:06
yeah. Nobody really calls it school or college. Yeah. Yeah.

Scott Benner 18:10
I know. I just love it when you guys say that also like it. If you got hurt. And you went to the big building where they take care of people, you'd go to what?

Sasha 18:20
The hospital?

Scott Benner 18:21
Oh, see, you said, Ah, why did you say that? You ruined the whole thing. Sasha. Nevermind, this interview is over. Is it? Is it the British that say hospital and not the hospital? It's Oh, I don't know. Maybe? I've heard that. Yeah, I think it's in the UK where they just say I went I went to hospital or something. I don't know. It sounds odd. Well, yeah. That's my point. There. Their steering wheels are on the wrong side of the car. They don't know what they're doing.

Sasha 18:52
And that was an adjustment as well.

Scott Benner 18:55
Where are your steering wheels? You're, you're all cool. Right on the left? Where I'm left. Yeah, you know, chillin over there. You got to be able to hit the giant spiders before they get you. It's just like Whack a Mole. I would just imagine you running around with the hammer just killing things that are trying to kill you all day. Is it like that?

Sasha 19:12
I mean, I always check the spot as big before I go to the bathroom.

Scott Benner 19:16
I have to say, Wait, do you?

Sasha 19:20
Yeah, just because like I found a couple of homespun in there couple months ago. Okay, so every time I go in now, I just have a look at the ceiling before I sit on the toilet.

Scott Benner 19:30
I appreciate you saying that very much. Because I get notes from people who are like, you know, you just boil things down to the least common denominator and everything in Australia is not going to kill you. Everything in Australia is going to kill you. It's horrible. It's like it's it's a it's a it's it's an island. Nothing can get off of it. You guys are trapped there. You realize that right?

Sasha 19:50
Yeah, well, especially with COVID. Now we're even more trapped than we were before.

Scott Benner 19:53
Exactly. And the real shame of it is the spiders don't get COVID If they did, maybe. I don't know they'd be nicer maybe they just wouldn't feel well, they'd be like, let me leave you alone. I'm just not up to it today, you know? Yeah. Bite me on your ass while you're trying to you know it's not right. Okay, so have you ever looked at a kangaroo and thought I could take that thing and want to take a run at it? Oh no, no, that kill you right those things are nasty

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Sasha 24:02
I mean, you get the friendly ones. And then you get the other side of the spectrum while they can get really nasty.

Scott Benner 24:10
Have you ever flipped the news on at night and heard a story about a rampaging kangaroo?

Sasha 24:18
Yeah, actually, I saw one the other day about three or four kangaroos who walked into a bottle store. Like a bottle shop. A bottle store. A bottle shop? Yes. So where they buy? They sell liquor?

Scott Benner 24:33
Oh, that's what I thought. Okay, sorry. That was a phrase I didn't know. And they walked in. And then the first one, they start telling a joke or because that sounds like the beginning of a joke for kangaroos walk into a bolo shop. And it's not. Did they like go nuts?

Sasha 24:50
Oh, I don't know. I just saw that news article just like that and All right, next thing

Scott Benner 24:55
Sasha I have to tell you that when I say something completely ridiculous and people Oh no, that's happened. I feel like I won something. I don't know. Like, I raised my hands over my head like I finished a race when you were like, Yeah, I see. I've seen that before. I was like, Yes, I know crazy things happen in the world. Why didn't nobody talk about, like, in my mind, you should get on here and go, Hey, Scott, before we get started, did you know that for kangaroos went into a bottleshop think that would be the most important thing to me if I was you. My brain works differently, I believe. Okay, we're getting lost here in the diabetes stuff, but it's okay. We'll find our way. You also, you know, you heard me say, are you nervous? And you won't Yeah, I'm not nervous, as I've done this many, many times. But it does take me a while for me to hear your accent. Right. Right. Okay. So it takes me like, I have to settle into it so that it bounces through my head and I can think while you're talking. I know that might sound strange to people, but I'm not as a I don't want anybody to laugh. But I'm not as good at this when people have thicker, thicker or, or more difficult accents. And Australians trail away in their words sometimes. Like the words disappear, as you're saying them, you wouldn't know this, because you don't hear yourself. Just like I don't hear myself when I say water.

Sasha 26:16
i Yeah, no, no, that's true, actually. Because when I first moved here, I, I didn't have as strong of an accent as I do now. And I, I would I would actually struggle on the standing

Scott Benner 26:31
like Australians, but you hear it now. Okay.

Sasha 26:35
Yeah, because I'm used to it. And I think I've, you know, joined them in the sense I have. But when I moved here I was, yeah, people were confused about my accent because I think I had a mix of black, British and American, a little bit of Australian. Yeah, somewhere. It's just interesting,

Scott Benner 26:53
because you're like, somewhere, and it just kind of goes away, like and so my brains like, What is she saying? Oh, she's saying where I hear it. Now. My brother in law is from Scotland. And when he's talking, all I hear is Ay ay ay ay ay, ay. Like, I just hear noises. I don't even hear words like there are times that I understand the first couple of words, he says, and then I just assume the rest of what he's saying. And then not along where it feels appropriate. He never hears this. There are things I know he thinks he's told me that I don't have any frame of reference for so sorry, Jim, if you're listening?

Sasha 27:30
Yeah, I've done that before. Don't worry. I'm just like, I think everyone does it.

Scott Benner 27:34
Right. He makes this point then he's like, I, I'm like, I don't know what that means. Now, I'm only laughing because I can hear him in my head. I should get a room I'm gonna do next time I'm with I'm just going to get him to say, I'll read him a sentence and have him repeat it back into a recorder and I'll bring it back so you guys can hear it. But you're not gonna understand a damn word. He's saying. That's, it's just really cool. Anyway, I'm getting used to your to your speech pattern. So I'm doing okay. Now. MDI lube, and I'm gonna find it my question. Okay. So I remember back when you said, the doctors were telling you, you're doing well. And I think that's important for doctors to like, listen to, and I now know, there are enough of them listening. Like you guys really have to pay attention to this. Just because Sasha saw a doctor who some people were doing, you know, a one season attends doesn't mean her eight is terrific. You know, like you, you have to stop judging people against each other. Like, I oh, this person has a seven, you're doing great. Well, that person might want a six or a five. And what happened to you when you were told you were doing great? You just accepted? Yeah,

Sasha 28:48
I yeah, I believe them. And for a long time. I think I was in. I think I was in denial, actually. Because everyone was telling me how great I was doing. And so to anyone who'd asked me or Hey, what's that on your hip? I'd be like, Oh, it's an insulin pump. I've got diabetes, but I'm fine. Like, everything's fine. sort of thing. Yeah. And, and it was when I found out about CGM, and I tried one. I was like, Oh, hang on. I'm not fine.

Scott Benner 29:22
Right. Yeah, you mix. Listen. It's a weird thing, right? Like, you're trying to balance, kindness, and empathy. But at the same time, you have to see yourself as a parent of somebody with diabetes, if you're a doctor, like you're trying to help them grow up with it. So it's, you know, if you send your kid out to play a sport, and they suck, are you benefiting them by telling them, they're great? And so I guess if it's a kid who's never really going to play this game throughout their life, and you just want them to feel like oh, I tried and I did. Okay. Hey, that's fine. But there are some people who want to excel and telling them that they're doing great when they're not the holds them back. So you have to figure out who you're talking to, before you say your thing. And it sounds like sounds like you would have been able to reach for more, if you thought there was more to reach for.

Sasha 30:21
Yeah, I think so. It's about balance, right? Like, you gotta, like, I'm not saying they shouldn't tell you, you're doing a great job, but they should definitely still be telling you. Hey, like, there's a lot more that you could be doing. Let's talk about it.

Scott Benner 30:36
Yeah, it all doesn't have to happen in one second. It could have been incremental. It could have been like, Hey, you're doing terrific. I bet you though, if you Pre-Bolus Jamil here, maybe this would happen. I'm fascinated by the Pre-Bolus. Same thing. I think I always will be. I think Pre-Bolus thing knocks a point off your agency, you know about and yeah, the people don't take the time to explain it. So that you could try, like even just Pre-Bolus Singh, half the meal. Like even if you were having 50 carbs, and I said just Pre-Bolus 25 of them and putting the other 25 When you eat. We make a huge difference.

Sasha 31:14
Yeah, I totally agree. I mean, when I first heard about it, I think it was in, in one of the books I was reading, and I brought it up to my inner and I was like, I mean, I read this, like, what, what do you think? And she was like, oh, no, we don't usually tell you guys to do that. Because then you go low. Alright,

Scott Benner 31:38
we don't usually tell you guys, because it's a lot of work for us to explain it to you. So why don't you just have poor health instead? Okay, see you next time. Thanks for coming. We appreciate the money. I'm gonna go buy a car with it. Thanks, doc. big help to me. Hopefully one day I'll be able to drive a car if I can see. No thanks to you. It just really is. It's kind of interesting. And also, I've never said this before, Sacha. But I'm gonna say it here. I'm freaked out that Pre-Bolus thing is even a word. Like why do you need a word for doing something correctly? Like you drive a car? Right? Yeah. Okay. Do you step on the brake? The split second before you're about to hit something? Or do you brake prior to getting to the thing?

Sasha 32:30
Yeah, you brake prior.

Scott Benner 32:31
Do you think we should call it pre braking?

Sasha 32:36
That's a good point. I've never thought about

Scott Benner 32:38
why. That's how insulin works. So when you tell somebody to count your carbs, start eating and Bolus, you're you've started off explaining the incorrect way to use insulin. Like we've somehow because because so many people out of fear have told people to use insulin incorrectly. We have to have a name for how to do it correctly. To talk people into it. It has to sound fancy. And by the way, whoever came up with Pre-Bolus That is a very basic term. It's so lame. And I mean, basic the way the kids would say, You know what I mean? Like, you could have come up with something better, like we should have, it should have a fancier name is what I'm saying. Like pre what would you call it? I don't know. I hadn't thought about it before Sasha, no, you're gonna put me on the spot like this. Jesus? I don't know. We'll have a contest. And we'll have somebody come up with a name for I don't know, I don't know. I mean, it's just, it's not you're not Pre-Bolus thing. You're Bolus thing. And if the insulin takes a half an hour to start working, or 20, or whatever it is, well, then Damn it. That's, that's not a special thing. That's the way it's supposed to happen. Again, it's not called pre braking. It's, it's your braking, you're stopping your car. So I don't know. Like, that just never makes sense to me. I've never articulated it before. But I'm upset that it. It got put into practice incorrectly. And so that we had to then talk people into doing it correctly. I don't know. It's bothersome to me. But anyway, you went to the doctor with the book. And you were like, Hey, Gary says I should probably Pre-Bolus at the doctor's like, No, we don't do that.

Sasha 34:17
Yeah, pretty much.

Scott Benner 34:18
What did you do then?

Sasha 34:21
Oh, I went home and did it anyway. I think that you have to, right. I mean, if if they're not willing to talk you through the ideas that you just found out about? Then you got to take it into your own hands. I guess.

Scott Benner 34:38
You don't have to tell me specifically but what do you do for a living?

Sasha 34:42
I'm a student. Okay. That didn't

Scott Benner 34:45
help me. Damn it. There's my story. Alright, well, I'll just make something up instead. Sasha students. Alright, hold on. We'll get back to you in a second. I'm just saying imagine being feckless at your job. Like imagine getting up every morning and knowing you're gonna get Have people half of the information? Or some of it, but not all of it? And that when they come to you and say, Hey, I learned this other thing, you would go? Yeah, I wouldn't think about that. If I was you. That's you, anyone who's doing that should look inward. Because there are people in front of you who are looking for help. And you're, you're telling them, it doesn't exist, and then they go out and find it. And then somehow, you're still able to look them in the face and tell them it doesn't exist. I think what happened to you around that is horrible. Really, and I'm not over exaggerating, I think it's lazy. And it's malpractice, in my opinion. So

Sasha 35:39
anyway, and I think it happens to a lot of people,

Scott Benner 35:41
I think it happens to most people,

Sasha 35:43
and, and it makes it normal. So you know, if then you're the odd one out who actually does get all of the proper advice that you need to succeed. Then every everyone is like, whoa, like, where did you come from?

Scott Benner 35:59
And by the way, if you're a doctor, and you're hearing this that makes you upset, just tell people how to handle themselves, and the podcast won't exist anymore. And I won't have anywhere to talk. So there you go, I won't have to, I won't be able to talk about you anymore. Meanwhile, I don't want to obviously, there are a lot of great doctors too. That's certainly the truth. But, you know, just this thing. I think we've gotten to the point where somehow this little story about what happened to you is so commonplace, that we're not outraged by it the way we should be. Your doctor was unwilling to tell you how insulin works. It's the key of how you're staying alive. It's the key to your long term health success. It's the key to your short term health success. It's it's it's a lot. And we're just like, Oh, it doesn't matter. You don't need to know that part. So I'm sorry.

Sasha 36:50
Oh, I was gonna say actually, I always wondered whether I had missed out on some information because I moved. So because I went, I went from going to a doctor, in you know, in the pediatric ward in Geneva, to the adult clinic in a different country. I thought, well, maybe I just missed the transition there. And the information got lost on the way.

Scott Benner 37:18
So like, this really important thing you needed to know was going to be the next thing they told you. But you happen to move in that time. And now it's gone. You missed that opportunity.

Sasha 37:29
Yeah, I mean, I still wonder, maybe that, you know, there's, you know, they give you like, a couple of sheets of paper, or like some kind of like independence package, or whatever you want to call it before you turn 18 to be able to go out and do it on your own.

Scott Benner 37:46
And that actually stuck with you, like there's so see that there's another example of what this does to people. There's this feeling of incomplete that lives in you in an anxious way. Like, I wonder if I'm like, I know, I must be missing something. Or maybe I am like, no one should have to feel that way. around something as knowable as managing insulin. It's, it's not an unknowable thing. It's not it's not like a it's not a big surprise when it goes right for people. And just okay, when it doesn't go, right. Like it's, I don't know, I think that people should have options. And if they can't, if they can't live up to them with good direction, that's a shame. And there should be ways to help those people as well. But everyone else shouldn't suffer. Because you think most people aren't going to figure this out. So we'll just let them all live like this. It's very, um, it's terrible. It is what it is. But I was gonna ask you what you're going to school for? Because I mean, 25 Sounds like you're going to be a brain surgeon. You don't?

Sasha 38:51
Well, actually, math surgeon. So I'm, I'm doing my PhD in, in metabolic neuroscience, and I work with animals.

Scott Benner 39:02
Metabolic neuroscience. What have you just been a you propping me up to this conversation? Sasha, what's going on here? That sounds really like I don't I'm not sure if I know how to spell metabolic. It's got to be in a in there somewhere right near the near the B. No. It's right now. Of course I am. I don't know what you just said. You just said I'm a Space Ranger and I'm trying to figure out what metabolic Doros Jesus I can't find the letters. But Google doesn't even know it's a thing

Sasha 39:41
trying to understand how the brain controls metabolism.

Scott Benner 39:47
Oh, that's important to me. Seriously, I some belly fat I want to go Why are you is that what are you just working on that for me? Or is it for other things too? What do you what What's the idea behind learning about this?

Sasha 40:02
No, it's for other things as well. Um, part of my actually part of my PhD is about understanding how insulin works in the brain, and how it affects not only metabolic functions, so things like blood glucose, as we all know, but also behavior. So that would be like mood and anxiety and depression and memory and those kinds of things.

Scott Benner 40:33
Yeah. So you when, when you hear me talking about like, people getting to feel the way they're supposed to feel that must mean more to you than it does to other people, then?

Sasha 40:45
Yeah, I guess, I think it's, it's an interesting thing, because when you when you say insulin, to the general population, they automatically think blood glucose. And of course, that's, that is what the first thing you should be thinking of. But insulin also has a whole lot of other functions in the brain. So we know that, you know, if you if you disrupt the function of insulin signal in the brain, that can cause issues that can cause depression that can cause anxiety. And a lot of those things can be independent of the effects on blood glucose, which is really interesting.

Scott Benner 41:29
Okay. When it goes far as to impact Alzheimer's and other brain functions like that, or no?

Sasha 41:38
Yeah, definitely. Alzheimer's is known as type three diabetes. So what happens in the brain is pretty similar to what you would see in Alzheimer's. Really? Yeah,

Scott Benner 41:53
I feel like you're going to talk about things I'm not going to be able to understand, but I'm still going to try. So what is like in your mind? What do you hope to learn? or figure out? And why is it important?

Sasha 42:12
So what I've just described here is just one part of my project of my PhD. But essentially, I'm looking at a specific area of the brain and trying to understand how it takes in information about your metabolism. So are you in a calorie deficit? Are you in a calorie excess eye? Is your blood glucose low? Is your local girth high? How does it take in how does your brain take in that information? And then is able to tell you, Okay, this is the behavior that we're going to perform now. Based on that information,

Scott Benner 42:56
and the behavior could be anything from, like something that I see like maybe a person feels hungry because they've got too much insulin in their body. And so they overeat.

Sasha 43:08
Yeah, for example, right? So it could be around food, but it could also be around your mood. So are you going to be more anxious? Are you going to feel depressed?

Scott Benner 43:23
And are those things impacted by more or less insulin?

Sasha 43:30
Well, it gets a bit complicated.

Scott Benner 43:33
Well, the whole thing's a bit complicated. I googled metabolic neuroscience and nothing pops up. Just like Google's like, Hey, you must be you must be talking to somebody smarter than you. Because I don't know what you're talking about here. It's how so so like, so let's pick one thing? Let's pick? I don't know, we'll pick depression for a second. So how would insulin impact depression?

Sasha 44:01
Oh, so I'm not looking at depression specifically. But there are studies showing that if you if, for example, you delete the insulin receptor in the brain. It mean it the effects that that has. So if you do that in mice, you see that these mice then become more anxious and more depressed. In certain specific scenarios.

Scott Benner 44:30
specific scenarios like,

Sasha 44:32
well, if you test them, so we do behavioral tests with the animals to test certain things. So for example, you put the mouse in an open arena, with a big light on top, we know that the mice are afraid of open spaces because they're afraid of potential predators. So then you have a look at where the mice the mouse is going to spend the most of its time and you can analyze that and say, Well, how spending most of its time in the corners of the arena or in the center. And so if it's spending more time in the center, then it's not as anxious.

Scott Benner 45:11
And you can actually see that there's a correlation between that and this insulin receptor. Yes. Wow. Can you impact the receptor?

Sasha 45:21
You can delete it. Sorry. That's, that's what I've been doing for the past few months.

Scott Benner 45:27
So when you take that, so you're taking the receptor away? Do you do it with pharma circles?

Sasha 45:35
With with genetically encoded viruses,

Scott Benner 45:41
okay, so there's a virus that goes in and deletes this on. That's amazing, first of all, and and now you take that away, and that makes the mice more anxious. So you see them in the corners more? Yes. Is there a way to bolster that so that they're braver and sit in the middle and just sunbathe under the light?

Sasha 46:06
That would be cool. I don't know. At this point, I don't know.

Scott Benner 46:11
Right. But that's the kind of things you're trying to, to learn about.

Sasha 46:16
Yes, that's just trying to learn how how it works.

Scott Benner 46:20
Right. So this receptor, is that is it? Are you at the point where you can say, is it overworking and that's making them anxious? Like, should they not be as anxious as they are? Like, they I'm assuming that you're looking for some way for this to translate into like people at some point, like you're not just trying to perfect the mouse population of the planet, unless these mice can kill spiders? And then, of course, let us weaponize them immediately. But

Sasha 46:50
I mean, that would be incredibly scary.

Scott Benner 46:53
Well, you need to be able to pee and peace. Can you imagine if you just had like a little mouse that you released? Nevermind, we're getting down the wrong road? So like, I'm like, what's the impact for people? Like? Are you trying to figure out why people are like, how much impact this has on depression, anxiety, things like that?

Sasha 47:12
Yes, that's one aspect of it. So there are people showing that if you use insulin intranasally so in the nose, that can alleviate some of the effects of depression and anxiety

Scott Benner 47:30
instead of using an injected insulin?

Sasha 47:34
Yes. So essentially bypassing the effect on blood glucose,

Scott Benner 47:38
by effectively. Oh,

Sasha 47:42
yeah. So if you inject it in your blood, if you just get an injection under the skin, then it's going to obviously affect your blood glucose, right? It's going to drop. But if you put it up your nose, depending I think, depending on the dose, or I don't know too much about that. But it's just a study of it. And I thought it was really interesting. But yeah, essentially, you're kind of you don't have that big drop in blood glucose, but you do still have the effects in the brain. And that seems to be showing that people generally tend to feel better. They have more self confidence, they feel less stressed.

Scott Benner 48:21
No kidding. And we should say not to do that. Right. Like because, like, please don't try that. Okay, thank you.

Sasha 48:29
Thank you this at home.

Scott Benner 48:31
It's not like it's not like a thing that like everyone could do. This isn't a controlled lab situation, etc. And one study that's in credible though, so is the see the whole thing, Sasha and if I'm an idiot, you'll stop me. And you'll sound incredibly bright doing it because you have your accent. But I just think of when you look around and you see people who are some are overweight, some are underweight, some people struggle with one thing, some people have anxiety, some people don't. To me, it's all fine tuning inside of your body that we don't understand how to tune right, like we do our best with diet and exercise and supplements, you know, you know, I can bring my vitamin D up with a supplement, like that kind of thing. But there is if there were, if there were knobs on your back there, there would be a fine tuning that would work better for your body than often the fine tuning that you got from nature. Am I right about that in a really strange way?

Sasha 49:33
Um, I guess you guess I think that's a very complicated question. Oh, no,

Scott Benner 49:38
it's incredibly complicated. But if if you could plug a computer into me and somehow magically had readings for all of my settings, where everything was where my iron level is, and and you know, function of my liver and all this and you could just turn knobs and perfect them. Then there would be a more harmonious, like physical life for me if you could do that. And I mean, is that like the end goal of all this is to fine tune people at some point.

Sasha 50:12
Right? I mean, yeah, I guess like if you think about it in terms of, you know, potential therapies for obesity, diabetes and psychiatric disorders, but I think that's way down

Scott Benner 50:26
the line. Oh, no, I don't like, uh, yeah,

Sasha 50:28
I mean, um, yeah, of course, yeah. I'm just, I'm just my, what I'm doing is really just trying to understand how it works.

Scott Benner 50:37
No, no, I mean, yeah, you're in the infancy of something that if we get to the end of it would be a millennium from now, probably. But I mean, it's not, it doesn't make it untrue. That, you know, I could pull any random person off the street and give them a blood test. And while they might be, quote, unquote, in range, they still maybe could benefit from a little more of one thing a little less of another. And that I just think that, how do I mean this, you know, when you see somebody who's just like, jacked up, and they're just like, in amazing shape, and you look at them, and you think like, Oh, my God, I would never be in shape like that. And they're just, they're rock hard. And they everything looks like it works for them. And they go to run, and they run off like a cheetah. And they're not, they're not winded when it's over. And you just think, well, they just want some sort of a genetic lottery. You know what I mean? Like, and then you see another person who doesn't have that ability. That person didn't do anything wrong, or different. You know what I mean? They were just born like everybody else. And I don't know, it's always occurred to me, it's a deeper thought. And it's a little, like, maybe we should have mushrooms to talk about it. I don't know. But just, it just seems to me like, there's an obvious unfairness to being alive. And sometimes when when people like you were looking at stuff like this, I think, Wow, maybe one day, they'll figure out how to turn one of those knobs, you know, anyway, I think it's really cool.

Sasha 52:01
I think I think that's a comforting way for people to think about it. But I think that the environment effects a lot of it. Like obviously, genes, you know, some people, quote unquote, and better genes than others. But how you live, I think, is underrated. Yeah, just where you are and how it affects? Yeah.

Scott Benner 52:27
Like, we could take two babies, and they can be exactly the same. And I can put one of those babies in a middle income household, it's got radon, and I could put one of those babies in an upper income household that doesn't have radon. And if we track them, their health would probably go in two different directions.

Sasha 52:48
Yeah, yeah, exactly. And like you were describing them, God would ricotta ABS will, you know, that person? Obviously, didn't get there. In you know, a couple of days.

Scott Benner 53:01
It's interesting. I, so I like what you just said, when you said, I think people could find that comforting. It felt like what you said was Scott, you're a child, and you think like a child. You were trying to be polite.

Sasha 53:15
Okay, no, I did not mean that. He didn't mean that I was

Scott Benner 53:17
certain that you were like, Hey, idiot. Stop, stop dreaming. That's not how it's gonna work. And I know, a listen, I understand it probably never going to work like that. But it just, it's interesting to think that in a perfect world, it could. I mean, listen, you, you know, you have type one diabetes, they check your vitamin D level. Right. And that's something they don't do for most people.

Sasha 53:46
I actually don't think I've ever had that checked.

Scott Benner 53:48
Really? This Australia's let you down? You should have that checked.

Sasha 53:53
Yeah, I mean, I do take it most days. I do take a supplement most days, but I don't think I've ever had it checked.

Scott Benner 53:59
Okay. Alright, let's have that done. Our next bloodwork because a lower vitamin D level is can be more common with people with type one. Just imagine that like that simple thing, like taking a supplement everyday of vitamin D that could improve your life. And you wouldn't even know to think of it that way. And then think of all the the back say that is true. Say you taking vitamin D would improve your life, but then you go to the store and buy like some crappy vitamin D supplement that doesn't work as well as it should. And so you still don't get the benefit. Like there's so many barriers to success along like everything. I don't know you're making me sad about I don't know how this is happening. I'm so sorry. No, no. I feel like I'm in a sadness matrix. It just it um I think it's from doing the podcast like it. It's sad to me that some people They'll not know how to Pre-Bolus their insulin. It's sad to me to think that your vitamin D level could be lower and it could be impacting your life or that I just saw a person. The other day, who I know is listening to the podcast for a long time, has been struggling with something that was clearly thyroid related, that they didn't realize was thyroid related until they listened to the podcast about the fibroid and then thought, Oh, well, I have those symptoms, I should check. And they checked, and now they're on their way, you know, to getting it fixed. But without a podcast episode would have never thought that the problems they were having were thyroid related. So imagine that imagine you're low on energy, gaining weight. Moody, like all these things are happening to you. But no one will ever figure out your thyroid until you get so sick, that you land at a hospital and they do so many tests. And eventually somebody goes, Oh, look how high their TSH is there they have Hashimotos. It's, that part makes me sad. And I think that might be specifically because of my job. Because I don't think most people think of illness as that. But I always think like there's something you could see or do if you knew to see or do it, it would save you the time. And to meet the times what's most important, like this time that this person spent not feeling well, is lost. And that that bothers me more than anything else. And it has nothing to do with what you're going to school for. But this is where your what your life has led me. So anyway, I'm sorry. I feel like

Sasha 56:40
no, no, I do understand what you mean. Yeah. Um, I think I think it's hard as well, because you don't I think a lot of people, especially at the start after diagnosis, they're not necessarily in the right mindset to absorb all that information anyway. So even if you tell them they might, you know, not remember or not see it as important,

Scott Benner 57:04
right. And that's why it's important to have doctors that don't look at your eight a one C and go doing great Sasha, go get them kit. You need somebody to say how you feeling? Oh, I feel a little tired. Really? Okay, let's figure out why not just have you tried cutting back on potato chips? Like I mean, sure, potato chips, probably not great. But, you know, like, there's never, I guess until you meet a really thoughtful doctor, you don't recognize what it means to not have one. And like, I was lucky enough to meet a woman named Allie Benito who came on and did the thyroid episode, specifically, but she's also my, my, my family, anybody in my family who has a thyroid issue, she's their doctor, and to see somebody, know what they're doing, and be able to test levels and infer things from them and make adjustments to medication, like a ninja, and not make it take eight or nine months for you to feel better. Like that adjustment time when you see your doctor be like, well, let's just try a little more a little like you're ruining people's lives. If you don't know what you're doing like that. Like, let's throw a dart and see if it hits. You're just you're still in days and weeks and months from people and they could get they could get frustrated and just stop trying. And so it's amazing to have someone who can kind of like, like, just dial in right away and know what to do. And I mean, I know every every person can't be like that. But everybody should. Everyone deserves a doctor like that. I guess. They think your story somehow made me upset. It's not your fault. How far off? are you apologizing to me? Stop it. What did you so what do you do with this degree? Like once you get this thing? You get a job somewhere? And what do you what are you hoping to do?

Sasha 58:58
That's a very loaded question. Because I'm asking myself that every day. I don't know. I honestly don't know. I'm, I've got about six to nine months left to be able to finish this PhD. And afterwards, I'm not sure but I am interested in potentially going into clinical trials. Not necessarily anything to do with insulin in the brain. But yeah, working with animals is a very specific job. I feel like I don't always agree with everything that's going on there. So I I don't aspire to work with animals for the rest of my life.

Scott Benner 59:44
Okay, because of how they're treated during testing.

Sasha 59:49
Yeah, yeah, pretty much and I think I also became a vegetarian a couple years ago. So I feel like that doesn't really align with that.

Scott Benner 59:59
How do you handle the spiders now? He's trying to shoo them out the window

Sasha 1:00:05
Okay, spiders are different though. Long in my heart

Scott Benner 1:00:12
there's a level to this vegetarianism for you have any line, the line forms right around a spider near your butt. I got you I level things not you I'd never eat a chicken, but I will squish you. I see I listen, you're not going to get me to argue with you.

Sasha 1:00:37
Oh, look, it's also because, you know, when you when you work with animals, you don't really have a, you don't necessarily have a nine to five Monday to Friday job. You are required to, you know, go in on the weekends and check that they're okay. And I just don't want that kind of responsibility.

Scott Benner 1:00:54
You want your weekends to yourself? Yeah, yeah. What do you do on the weekend?

Sasha 1:01:00
Uh, honestly, it sounds really sad, but I just work.

Scott Benner 1:01:04
Oh, so that's what you're trying to avoid? Like? Exactly. So you want the things you imagine people do on the weekends? That's right, right. Are you going to stay in Australia? Or do you want to go back to France?

Sasha 1:01:17
Um, I think I will go back eventually, in the next few years.

Scott Benner 1:01:22
Interesting. Where's the healthcare system better? For you? Ah,

Sasha 1:01:28
I, I don't know, actually, because I never lived in France as an adult. So I wasn't privy to all of that, you know, insurance healthcare kind of information. For it sounds, I think I think Australia's overall pretty good because a lot of a lot of a lot of things are subsidized, especially insulin, and things like you know, needles and insulin pump consumables and that sort of thing. But, but it is very sad. That CGM is not covered by anyone and Australia.

Scott Benner 1:02:09
Sounds like they're making progress on that. But it's slow.

Sasha 1:02:13
Yeah, it is very slow. I think now, anyone under 21 years of age, or pregnant or thinking of becoming pregnant is able to get CGM for free. But that's it.

Scott Benner 1:02:30
Are you using one? Well, you are obviously because you're looping. So, but you're using the Medtronic one.

Sasha 1:02:37
No, I'm on G six.

Scott Benner 1:02:39
Oh, I'm sorry, the Dexcom and then the Medtronic pump this loopable. Got it? Yes.

Sasha 1:02:46
I'm, I agree with you. I'm not a fan of Medtronic. To be honest. I, I only went to the to the Medtronic one because that's the only one that's loopable. But before that I was using tandem.

Scott Benner 1:02:57
Yeah. i Well, hopefully, they're not listening anymore. Because you said something nice earlier, I don't want them to hear this. And I don't want people who love their, their, their Medtronic pumps to be mad at me, which has happened in the past. So I don't need that. Although it led to a great interview. If you've never heard it, I'll try to find it for you but and tell you privately, because I don't have the information right now. But one time Jenny and I were talking about Medtronic pumps, and Jenny didn't like using it, and didn't have like glowing things to say about it. And then I got this very passionate note from a guy who was like, who loved his pump. And was he was clearly mad. And then I was just like, hey, alright, cool, like, come on the podcast and tell me about it, then we had a great conversation. So it was a it was really interesting. But it was interesting to see that someone felt like that pump meant more to him than it wasn't just an object. Like it was it was a really important thing to him. And he felt like defending its honor was really it was kind of it was amazing, actually, to watch it all play out. And I'm so glad that I didn't just ignore his note or, you know, and when I was younger, I just wanted to like argued with him for fun, but I didn't. I just was like instead let me talk to you and see what's going on here. Anyway, whatever pump you Yes, amazing if it's working for you,

Sasha 1:04:17
i Yes, I can relate to that. I remember being a kid when I first got that pump i i walked out of the hospital with that pump, but I was never actually asked if I wanted to use it. Yeah, or if I wanted to do MDI, but I kept it for so long. And I remember they were trying to push me to get, you know, the newest version, and I was like, No, this is fine. I like this one. Like, I don't like change. Like, this is my palm like I'm keeping it. So yeah, I can relate to to that person that you were talking to. It makes

Scott Benner 1:04:51
me wonder about how because Arden's used on the pod, her whole life and it's disposable. I wonder if it feels differently To her, like, I wonder if it doesn't like she has no real connection to it because the thing that every three days she throws away. Like, I wonder if that like psychologically, yes, a difference or not? I don't know. I'm really like, in my own head this morning. Maybe it was too early for us to do this. I don't know. For me, it's super late for you. But it's I don't know why I'm, I feel like, you know what I'm saying? Okay, sounds like I'm high today. I'm like, like, what about this? Do you think? Just, I'm just very worried about this today for some reason. I'm sorry. If i How are your expectations so far? Is this like, Are you like, God, we didn't talk about any of the things I want to talk about. Are we doing okay?

Sasha 1:05:43
No, no, this has been good. Has it really? Well,

Scott Benner 1:05:47
I can't tell sometimes. Like, I'm having a good time. That's my only measuring stick. Like when I get done. I'm like how I like that. And then I think other people like it, too. But I don't know. It's a crapshoot. I don't actually know any of you who are listening. So it's just my best guess for what's interesting. Like I found this incredibly interesting. So, okay, are you dating at all? Yes, you've okay, even with school? That's possible. And with your weekends taken up?

Sasha 1:06:19
Yes, I've been with my boyfriend for almost three years now.

Scott Benner 1:06:22
Is that boy gonna go to France with you? If you go to France? That's the plan. Wow. He likes you. Okay. All right. Does he speak French?

Sasha 1:06:35
No, he doesn't. I see him trying to tell him to stop. So French lessons on the side. I took

Scott Benner 1:06:42
three years of French Sasha in high school. I know Neph is nine.

Sasha 1:06:49
That's all Yeah, that's no French.

Scott Benner 1:06:51
Yeah, I don't think so. either. That's all I got out of that. I sat in that room for three years thinking, Do not call on me. Please do not call him. Please, please, please don't ask me a question. I was not good at it. I don't think I have the capacity to learn other languages. But it's a my daughter talks about, like when she's younger, she's like, I want to go too fast. She wants to go to school for fashion. And so she talks about New York and France. And she's like, you know, when she was longer? Like if I want to go to school in France, could I? And I'm like, Yeah, of course. Meanwhile, I don't know how to pay for that. And I have no idea if that's actually possible. But what I've learned is that most people, things people say don't actually happen anyway. So it's better just to be positive. Like, yeah, of course you can. But I don't know what she would do if she got there. And, you know, couldn't speak any French? What would you do? Like, what is your? Good?

Sasha 1:07:51
I feel like if you actually move there, you have no choice but to learn it.

Scott Benner 1:07:56
Yeah, you don't know me, I would walk around. Just be the rest of my life. Gandia Has anyone ever noticed you'd be saying this in French? But you know, just you'd be like, do you ever notice that guy? Scott never talks to anybody? It's because I would just be going I don't understand anything. Anyone say? I just I don't know, my brain doesn't do that. Like it wouldn't hear you say a word and hold the thing and eventually learn the word. I mean, maybe it would, but I have no confidence that what I guess I should say.

Sasha 1:08:27
And I think I think most people think about it like that. If they're just trying to learn it in their home country. It's obviously a lot more difficult. But if you are by yourself in a different country, I think that eventually you just kind of learn it somehow.

Scott Benner 1:08:44
How long do you think it'll take your boyfriend before? He's, like, you know, can get by?

Sasha 1:08:52
Oh, tough question. I don't know. You see Australia, right? Yes, yes.

Scott Benner 1:09:00
Would you feel any pressure if you moved him to France to stay with him? Even if you didn't like him anymore? Because you took him to France?

Sasha 1:09:11
Well, I wouldn't take them. I wouldn't take him if I didn't like him.

Scott Benner 1:09:15
No, I understand. That's not what I'm asking you. Hold on Sasha. This is gonna be fun. Don't let me ruin your life though. Okay, stop me if it's getting that. What if you get there? And a couple of years from now. You're like, this boy. Tired of him. Okay. But then your next thought is I moved him from Australia to France. I can't break up with him.

Sasha 1:09:32
See what I'm saying? Yeah, yeah, seriously.

Scott Benner 1:09:36
Just be careful. Okay. When you're when you're mid 20s Nothing makes sense. But you feel like when I was 25 I was like, I understand everything. And then when I was 30, I was like, Oh, my God was 25. I might have been like, like, stupid. So and now I'm 50 and I think I was 40 I was an idiot. So just that keeps happening. Anyway, I don't want to see the guy abandoned in France. That's only speaking seven words and one of them being baguette. You know, they mean, and he's just like, staying alive on bread.

Sasha 1:10:06
I mean, hey, that's all you need, right?

Scott Benner 1:10:09
Don't you wish? Okay, I'm sorry. This has nothing to do with anything. But how come French people eat so much more bread and aren't heavier?

Sasha 1:10:18
I don't know. I'm right. Yeah. I've had a lot of people make that comment to me in Australia. And I don't know.

Scott Benner 1:10:28
Like, if I just moved to France, can I eat more carbs? And I'll be okay. Some to do with how far you are from like, the, the equator

Sasha 1:10:39
maybe it's jeans? Oh, portion sizes? I don't know.

Scott Benner 1:10:42
You know, I'm realizing now because I'm an idiot about most things that France and where I am is probably fairly equivalent distances from the equator. So the joke doesn't even work. But at least I could figure that out reasonably quickly. But no, I'm a bit seriously. Yeah, like, that's fascinating. Like, there's bread with everything, right?

Sasha 1:11:01
Yeah, yeah, pretty much and wine

Scott Benner 1:11:03
and cheese. And if I like that I'd weigh 500 pounds. That seems unfair. Right, do I have to go to France with you? Just to find out if I can eat breaking. Imagine if I showed up and I was like, Alright, let's do this. Sasha, where's the bread? And then like, Okay, have a great time. No, two weeks into it. You'd be like, Scott, you're you're blowing up like a balloon. You have to stop. I'd be 20 pounds heavier. In a week and a half. Trust me. That's amazing. Okay, uh, how is he? So you're right now, I want to finish up with this. So you're looping. Where's your a onesie right now?

Sasha 1:11:43
Um, it's under six.

Scott Benner 1:11:45
Good for you. It's lovely. And prior to that, and was loop. So was the podcast reminded you of things. It sounds like Gary's book got you thinking about it. The podcast kind of the focus for you. The podcast acts as a reminder for you, you learn about loop from the show. And what's the progress of your agency through that time period.

Sasha 1:12:10
I think the biggest change was just getting a CGM and being able to see what my blood sugar was doing in between meals, and that brought it down from like, I think seven to six. Gotcha. All like six and a half around there. Yeah. And, and then getting the pump and looping allowed me to not, I guess not stress about it as much. I feel like when I got this is something I heard a lot of people talk about, but I am when I get first got the CGM. I was just stressed all the time about it. Because obviously, you know, everything is in real time. And you're, you're getting stressed about the direction of the arrows.

Scott Benner 1:12:57
Maybe you should snort some insulin.

Sasha 1:13:04
I'll try that next time.

Scott Benner 1:13:05
As you were saying that my brains like oh god, she's walking right into a joke about the insulin and the nose thing. This is fantastic. It's weird to have to have to to have to have a conversation and direct entertainment at the same time. Like sometimes my brains thinking about two things at once. Maybe I could learn French. But it's just like I was I was really amazed by what you were saying. Yeah, at the same time, I was like, Can I just joke about this them not talk about the joke, but I've broken the third wall down a while ago with you so it doesn't matter anymore. Wow. Okay, so you so that you see your you see your blood sugar's at first. It's anxious to be able to see them. But do you still feel like that now?

Sasha 1:13:54
No, or not as much at

Scott Benner 1:13:57
least we've helped you with that. Because why you're not afraid of Lowe's as much.

Sasha 1:14:03
I was never really afraid of Lowe's. I was more afraid of heights actually. Because, you know, I've ever seen telling you, yeah, if I want CS above a certain number, your feet will fall off or something.

Scott Benner 1:14:19
Okay, but they never said hey, if your blood sugar gets too low, you'll pass out.

Sasha 1:14:24
No interest. I

mean, it was it was kind of implied. But yeah, it didn't seem it didn't seem like as big of an issue because you know, you just eat and Bob's your uncle.

Scott Benner 1:14:42
So two things. First of all, that's interesting, because what it proves is whatever mind set you put somebody in, is where they are. That's where they started. So you, you somebody didn't start off by making you scared of being alone and so you weren't. Right. That's amazing. Did you just say Bob, your uncle? Or did I completely misunderstand you? Your uncle, Bob's your uncle? So that's the same. Yeah. I have no frame of reference for that.

Sasha 1:15:16
It's, you're like, everything's, everything's fine. Like, that's, that's the way it is. sort of thing. That's what it means. All right,

Scott Benner 1:15:25
hold on. Bob's your uncle is a phrase commonly used in Ireland, the United Kingdom in the Commonwealth countries. That means and there it is, or, and there you have it, or it's done. Typically someone says it to conclude a set of simple instructions, or when a result is reached. Bob's your uncle. Gotcha. When you said that I thought I was having a stroke. It was like, Oh, I'm not hearing words anymore. You're sort of reaching for water. I'm like, mid hydrated, maybe I'm dehydrated. And then I thought I'm gonna let it go. And then I'm like, no, no, I gotta find out what that what just happened there. Okay. And so that's just that's just what it is. It is what it is. Gotcha. It is what it is what it is. Okay. Um, I might start saying that I'm making a note here. Also, by the way, congratulation. You named your episode. Great. Bob's your uncle. That's okay. So but but my, my original point, I'm sorry, I'm keeping you long. Are you okay? Yeah, that's fine. Okay. My original point back there was that if a doctor gets you, the first thing they make you afraid of, is the thing you're going to be afraid of? Like, because it seems like they must know something. And it's the beginning, right? So you're like, well, there's this learned person here, who obviously knows way more about diabetes than I do. And this is what they've told me to be afraid of, my feet are gonna fall off, if I let my blood sugar be too high. That's the vibe you got. And you know, if a doctor says, Look, if you get low, you're going to drop dead, you know, that. And that's the vibe you get from somebody, then you avoid the lows. And so by avoiding the lows, you really are making your blood sugar higher, but by being told to avoid the highs, even though you kind of didn't really know what you were doing a whole lot, you still had an A one C in the sevens, which is not bad. You know what I mean? So there's something about that. That was, I think that makes sense. Like when I I'll say on here, like, you know, the saying that most people get is it's better to be high than low. But what I say is, I'd rather stop a lower falling blood sugar than fight with a high one. And I think that, just that, that idea. I haven't said this on the podcast in a long time. But that's my mantra around diabetes, I'd rather stop a low or falling blood sugar, then fight with a high one, if you just come from that perspective, every day. It's an A one C in the sixes. It's just a perspective, it's a perspective thing. So I think it's important about how people talk to you and what they choose to make you aware of. And moreover, maybe it's not good to make people afraid of things, wouldn't it be better just to give them a working knowledge of it? And and then some tools to, to access them? That's how I feel.

Sasha 1:18:26
Yeah, I agree with that. And I think, I think in that sense, looping is is really great, or any kind of algorithm that you can use, because not only is going to is it going to prevent your lows and prevent you from you know, having to stuff your face all the time. But it's also going to start doing the work for you, when you when it sees you going high. So you don't have to wait as long to to act and hopefully the high is not as high later on.

Scott Benner 1:18:59
And I think as the years go on, and we have more time with it, the company should make the stopping of the high blood sugars with the algorithm more aggressive. Because it does need to be pretty aggressive. You can't just you know, you can't do you can't do a slight Basal increase when you know, when you're suddenly 125 Diagonal up because you missed on your meal Bolus by 20 carbs. Like that's not gonna, I mean, it might keep you under 200 But it's not gonna. It's not gonna just bring your right back again. So as that gets and loop those that are using what version of loop are using

Sasha 1:19:36
I'm not using the automatic small boluses okay,

Scott Benner 1:19:39
why? Alright, so you're you're just adjusting Basal for you. Yeah, it is. Arden's is the auto Bolus one. It's really cool. It's just like you can mess up in 10 minutes later, you get a diagonal up arrow and the things like more here I'll give you more. It's it's still could be more aggressive. But It's, it's, uh, it's amazing, it's a, it's a window into what I think retail, retail available systems are going to be, you know, in the coming years, I'm just super excited to for everybody's to be on the market and for people to learn how to use them. Because I think for most people, they're going to be incredible improvements. So, you know, now if you've got a five, five, a one C, you might not want that. But if you're a person walk around with an eight and a half and slapping an algorithm pump on, you could bring you to a mid six, or even i Six, it's a big improvement for you. Out of nowhere, you know,

Sasha 1:20:36
honestly, if even if you have a low A one C, it's, it's still going to be an improvement, maybe not in a numbers, but the mental load.

Scott Benner 1:20:48
I agree with you. Like there may be people who are willing to say, look, I have a five, five, but I'm going to switch to this algorithm and not have to worry about this as much and have a six, three, and just be like, hey, whatever this is trading a little bit here. I also think, and I'm excited to get Omnipod, five for Arden so I can really find out. But I also think there's going to be ways to do I want to say manipulate, I think there's going to be ways to use the insulin within the algorithm that will lead to the lower a one sees even lower than what the algorithm is shooting for through the F like through the FDA guidelines. I'm not certain, but I'm excited to try it. So I think it's possible because you hear people manipulate control IQ, right? With tandem and and get better outcomes than I think what the algorithms written for so there's got to be a way I'm, I can't wait. And and especially as Arden's leaving for college, I love loop, but Arden's not gonna build a app on her laptop. I don't think you know what I mean? Like, I'm trying to imagine her away at university. And she, you know, like, hey, my app needs to be rebuilt. I'll do it. Like, I'm not certain. That's her vibe.

Sasha 1:22:05
It's a big commitment. Yeah. And I think if you're not if you're not involved from the get go, it's kind of hard to just forced into it later.

Scott Benner 1:22:14
Yeah. I listen, I barely understand it. And there are people who helped me when I like, help me please. Like and that's just, you know, I get it. I know those people because the podcast or I don't think I'd, I mean, honestly, you heard me say enough. After three years of French that's not even correct. Like, the one thing I think I know isn't even right. So he imagined me like learning the loop out like stuff wouldn't go well. This is the thing right here. Talking about killing spiders. And whether or not you can kick kangaroos asked like stuff like that. It's more my speed. So isn't it weird now that you've talked to me in person that I end up that I understand diabetes in the way I do? Right? Yeah, makes sense? No, does it just feel like you just met like a homeless person who like understands rocket science? You're like, Wait, I don't understand, like, how did you end up in this situation? If you know how to get a rocket into space? Like there's this one thing I'm really good at and everything else. I'm just very average, I guess.

Sasha 1:23:16
I think you're very good at making parallels. With your random everyday examples that happened to you.

Scott Benner 1:23:26
It really is my only skill. Please don't tell people it makes me seem very basic. Which

Sasha 1:23:31
I No, no, I didn't. I didn't say that was your skill. But I did say it was a skill,

Scott Benner 1:23:35
it might be my skill. It might be my only skill that I hear something. And that I have so much trouble understanding it that I just turn it into a pictogram in my head. And then I can in a fun way, describe it to you in a way where you can remember it. Like it works in this scenario. But like, imagine if you and I were dating, and like something came up that I didn't understand that I started telling some long s3 to get to the point you'd be like, Oh my god, I gotta get rid of the sky. Don't you think that you think my wife downstairs is like right now? It's gonna come explain something to me. It's gonna take way more words than you. Do you know that? I don't think of you as the age you are because of your accent.

Sasha 1:24:24
Really? Yeah. Sound old.

Scott Benner 1:24:27
It's just older. It's there's something about the British and or Australian vibe. That makes you feel like you're in your 30s you own your home and you've got stuff together.

Sasha 1:24:37
Oh, man, I wish

Scott Benner 1:24:42
it could just be me. But that's how it feels to me. Like I have to I've had to remind myself that you're 25 a number of times while you're talking.

Sasha 1:24:53
That's okay. That makes me feel better actually.

Scott Benner 1:24:55
Does it really? Yeah. Why do you think

Sasha 1:24:59
it's so As a compliment, if you sound more mature than you are, right,

Scott Benner 1:25:04
you seem together to me. But I don't know if you're not going to get off this podcast and like, do a line of coke and then drink a fifth of whiskey. I'm like, I don't know who you really are, don't me like, but in this conversation, you plus your Australian like, I feel like you're gonna go outside with a bat and just like Murad or something. That's probably not really what Australia is like, right?

Sasha 1:25:25
No, not really. I mean, if you live out in the bush, maybe

Scott Benner 1:25:31
I have no perspective. I almost made it to Australia one time. There's a group of type ones that wanted to bring me down there to give a talk. And we just couldn't pull the finances together because of the long trip and everything and the expense. But I was excited to try it. But I don't think it's ever gonna happen because I'm old. And now everybody does everything over zoom anyway. You know, so

Sasha 1:25:54
Oh, I mean, Coronavirus ever has an end, I reckon you'd be able to pull it off. I think honestly, there's a lot of people. As you said, there's a lot of Australians listening to the podcast, I think, I think it would be really useful.

Scott Benner 1:26:10
If I had, I'm gonna end with this session. Because I have to let you go. Because it's 1222 where you are. And I assume you have to get up in the morning. If I had like a big pile of money, and I didn't know what to do it like if somebody came along and was like, Scott, we think you're doing a great job with the podcast, here's $2 million to do whatever you want to help people with type one. I do you think that part of what I would do would be to travel to like some places to just talk. I don't want to talk to doctors and people who talk to people about diabetes, I'd love to explain to them, like the what I found works, talking to people. And there's some places that have supported the podcast. So greatly like I would love to visit. Australia is definitely one of them. The United Kingdom is really supportive of the podcast, like I'd love to go there. It's got a very interesting following in South Africa. The show, which is always really interesting to me, and then I just would love to just bop around the United States and, you know, do a talk and go and see if we couldn't help some people and get people talking about diabetes in a different way and get doctors thinking about stuff. Beyond just what's easy in the moment and lumping everybody together into one pile and least common denominator. You know, teaching I'd love to talk about that a little bit, but I'm just gonna keep doing it here. Because like you said Coronavirus and money, etc. But I'm really thrilled you found the show and that it's helped you at all, like you've really sound like your your life's on its way. It's cool. You feel good?

Sasha 1:27:45
Yeah, yeah.

Scott Benner 1:27:47
Good for you. Are you more hopeful about your life than you were five years ago?

Sasha 1:27:54
With diabetes, diabetes? Yeah. Yeah, I think I think as you said, as, as those algorithms keep getting better and better. I'm just, you know, hoping that one day I'll find the perfect one that suits my lifestyle.

Scott Benner 1:28:14
Keep looking, because, um, yeah, seriously, like, don't get don't get complacent. I think there's a fine line between not being complacent and not switching just to switch. You know what I mean? Like, you don't just like just don't get a new pump. Like because a new like, you know, some people are like, oh, a new phone, and they just get it. Like, you know, but don't stop looking. And I think really believe that this stuff's going to get better and better as time goes on. And I hope the companies listening are it would be nice if they did the same thing. If they didn't just say, well, this is good. We've improved things for people good enough. Like if they really just pushed forward to see what what they could do and be brave about it. You know, there's, there's people out there who already know how to do this stuff. Like, you don't have to reinvent the wheel. Go find them. And bring it bring this stuff to the masses. That'd be really cool. Yeah, yeah. All right. Well, I really appreciate you doing this. You were terrific. I was silly. And I appreciate you putting up with me. So thank

Unknown Speaker 1:29:20
you. Well, thank you for having me.

Scott Benner 1:29:24
Oh, I'm sorry. I feel like I want to apologize to you. I don't know what that means. I guess we'll find out when I listen back and edit it later. I'll be like, Oh, I did. I did. Oh, that girl apology. I don't know. No, no, no. Are you sure? Okay, good. Yeah. A huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Kaipa pen at G Vogue glucagon.com Ford slash juicebox. You spell that GVO ke GL you see ag o n.com. Forward slash juicebox. Fun fact, this show was also almost called rampaging kangaroo. There's a lot of quality opportunities here to name the podcast. Hey, I'd like to thank the Contour Next One blood glucose meter and remind you to go to contour next one.com forward slash juicebox

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#579 The Harvey Gamage

Lindsay has type 1 diabetes and she sailed on the Harvey Gamage as a teen.

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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 579 of the Juicebox Podcast

Alright, so Lindsay's been on the podcast before she came on and did a how we eat episode. And at the very end of it, she said something and I just thought, Oh God, I gotta have her back on. And I did, and I loved it. And I hope you do too. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. Have you been looking for the diabetes pro tip episodes? Well, they begin in Episode 210 right there in your podcast player. And you can also find a list of them at Juicebox Podcast calm you click on the top it says diabetes pro tip and that actually takes you to diabetes pro tip.com Which I guess you could just type in if you wanted to. But it's all Juicebox Podcast calm if you want it just some redundancy there. Actually at that link you can also find the defining diabetes episodes great reviews of the podcast and so much more. Be honest with me are you dying to know what the episode title means? You're gonna find out oh my god Lindsey story is a Nana's.

This show is sponsored today by the glucagon that my daughter carries. G voc hypo pen. Find out more at G Vogue glucagon.com forward slash juicebox just like to take one moment to thank everybody who's bought me a cup of coffee at buy me a coffee.com forward slash Juicebox Podcast and tell you about the new members. Grace, Ashley, Amanda, Jess, Kate, Diane, someone who calls themselves someone that's not a real name. Su Yoli Sarah, Amy, Steven. Connie. Anna. Laura Marinda. Melanie, another someone. Corey, Jessica. Nancy, Sue, Shannon, Marilyn, Allison, Larissa, Melissa, Leah, blue, Julie, Daniel, Jennifer. And Jeanette. Thank you all so much for supporting what I do at buy me a coffee.com forward slash Juicebox Podcast.

Lindsay 2:28
Alright, I am Lindsay. I am from New Jersey, born and raised still living here. At this time, I'm 34 years old and I've been type one diabetic since I was six. I also have celiac disease. I've been celiac since I was a teenager. And I'm currently wearing Omni pod and Dexcom.

Scott Benner 2:57
And you and I have already recorded together. Yes. Okay. Is that live? It is right?

Lindsay 3:03
No, yeah, yes. That came out. Oh, gosh, I don't even remember maybe in January, okay.

Scott Benner 3:10
And at the very end of recording, I remembered thinking it's a shame that this was about like she eats and celiac and everything because there were so much like kind of richness to your story that we just didn't touch upon. And I think I might have like half jokingly said you should come back on it. We'll talk about that. And you were like, Okay, so here I am. And here you are. Let's first make sure I can tell people where to hear you talk about your you said celiac since and you paused for a second. And I was like if she picks a date that rhymes with celiac. That's it. But then, instead, you're like teens, and my brain was rushing. I was like, What? What? Year rhymes with celiac? There isn't one right? I just wanted to I wanted there to be one so badly when you started saying that. Just now I was like, Oh, this is gonna be amazing. And then

Lindsay 4:03
I guess I could say, I've been gluten free since

Scott Benner 4:07

93. That would be amazing. Was it 2003? Um, no. And I'm just trying to do the math in my mind. I can't I can't figure that out right now. Like there was I don't know how to explain to everyone that it was only a 10th of a second. But in my mind, it was a year. And I was like I could I could feel myself like closing my eyes and I was praying and I was like, Oh my God, she's gonna say something, it rhymes. And then I'm gonna have an episode title and everything instead. Nothing like that. You were not helpful at all.

Unknown Speaker 4:42
I'm sorry, I couldn't give you the title.

Scott Benner 4:45
You're sorry. I'm sorry that you're sorry. And I can't figure out what episode it is like, Oh, I know why it's because I'm like, because I'm an idiot. That might be why looking in the completely wrong place instead of just doing what I know I can do very quickly. Oh,

Lindsay 5:04
the episode number you know it. I could Well, hold on let me look. Let's see if I can find it.

Scott Benner 5:11
I'm gonna find it before you know. You're probably good about it because I guess

Lindsay 5:16
all right, I got it. It's 439

Scott Benner 5:20
Wait, how did you get before me? I'm in a system that lists all Oh, I didn't hit enter. That's how

Lindsay 5:29
damn it. Oh, that's that. Yeah, that'll do it.

Scott Benner 5:33
Damn Hey, you were 439 Got it? Anyway, there's a number of how we eat episodes. There's vegan carnivore plant based gluten free low carb. Bernstein should be out by the time you hear this, and a number of others. So people come on and they talk about, you know, different reasons why they have to eat different ways. And and Lindsay was nice enough to do that about gluten free. So but today that's not we're going to talk about what we're going to talk about today. Is your like a pirate or something?

Lindsay 6:06
Not Not quite.

Scott Benner 6:07
Can you just go with it for a second? What are you doing?

Lindsay 6:09
Yeah, sure. Yeah, I've done a lot of pirate type things. I guess you could say?

Scott Benner 6:15
Of course. Yeah. All right. So let's just give a little brief overview. First, you were diagnosed with type one when? When I was six years old, so 9092 92? How old are you now? 3434. When you were on the gluten free episode, I tried to your boyfriend about not asking you to marry him. But

Lindsay 6:35
yes, that's how that's happened. It just happened about two weeks ago. Congratulations. Thank you for super excited,

Scott Benner 6:44
oh, this is the best time. I'm so happy. Enjoy this part. This is like when you decide to buy a car and order it. And it takes a while for it to come. And so you get to live in this space where you haven't had to pay for it. And it hasn't broken down yet. So you're just like, Oh my God, that's the best. I'm gonna get this car. And it's so cool. I'm gonna love it. And then yeah, yeah. Live in this.

Lindsay 7:04
That's a good comparison. I mean, everybody's so happy. Everybody is just texting and calling. And it's just it's so great.

Scott Benner 7:14
A world of possibilities. Yes, really? Yes. It won't be for 20 some years before one of your children cheat treat you horribly after you've devoted your entire life to them? Well, we'll figure it out. Oh, are you well, don't worry. You absolutely well, what what made him? I mean, can I take any credit for this? I guess is where I'm going. Like, did you get off the podcast and say like, Hey, a stranger over microphone told me you really should ask me.

Lindsay 7:44
He knew that you are giving him some. You're making some jokes during the podcast. And that's unfortunately that I can't give you any credit for it. But you know, it's been something that we've been we've been talking about for quite some time. So it really just was about timing. And we had a bunch of stuff to get done. financially. We're just working on our home and doing a lot. So we actually were away. We went down to Florida. And he proposed on the beach. Yeah,

Scott Benner 8:19
way better than you pretending that it was my my doing. The real story. The real story is much better. Although this episode has the possibility of being you could have set gluten free since 93. Yes, I am a pirate. And by the way, you are the reason we're getting married. I guess we would have more excitement if that was any of that was true. But

Lindsay 8:41
yeah, that would be just awesome. I, I approve of that.

Scott Benner 8:46
So you what kind of management do you use right now pumping or injecting? Yep.

Lindsay 8:50
So I've been on AMI pod. Since almost since they came out. I actually don't remember what year it was. But I think I had my trial pod in somewhere about 2006 2007. So it was still pretty new. And yeah, I've been on it since. Love it. I have really no complaints. Prior to that I was all obviously all MDI. And I also were Dexcom. A little bit newer to the Dexcom community I started last January 2020. It really took me a while to kind of come to terms with the fact that I was going to have two things attached to me. And I hear a lot of people say that. It's just especially I think for women. It's a thought and it just for for whatever reason it took me a while to be like alright, I'm gonna do this and I did and I'm never looking back.

Scott Benner 9:55
That's excellent. Now I am amazed that you have Omni pod back when it was bigger. Oh yeah, other people who have been through that Arden was but I always thought on the pop is incredibly small. And then one day they actually made it smaller. And I was like, Oh, look at that.

Lindsay 10:10
Yes. Oh, that was an amazing transition. I couldn't even believe because it was. It's significantly smaller from the original one, right? In terms of, you know, insulin pumps, so, yeah, that was that was awesome.

Scott Benner 10:26
So, the, I'm gonna ask about the Dexcom for a second, though. So adding a second device. So the first device was okay, because it took away shots. Is that right? Yeah. Okay, so you're like, alright, I'll make this trade in my head. I don't have to do injections anymore. But then the second one, you can't really know the benefit of it till you live with it. I guess. Like people can explain to you like, you know, I try. You know, every other episode, you hear me go like, the Dexcom, G six, blah, blah. And I say all these things about they're absolutely amazing, but they still just sound like they sound salesy. You know what I mean? Like, do you want to do this anymore? You want until you don't have to do it anymore? You're like, Oh, fantastic, you know,

Lindsay 11:04
yeah, takes away. So many of those obligations. I'm testing, obviously, I still test occasionally, from time to time to double check and do whatever I need to do. But it also adds so much. It just, it gives you such a clear picture as to how things affect your blood sugar, which to me was absolutely priceless. I would wear another like I would wear five of them, if that's what I had to do to get that information. Because, you know, if you're active and you're running and working out and you love to eat and you eat food, it's amazing to see how things affect you. Yeah. And it's really priceless. It is

Scott Benner 11:46
you had you'd had diabetes just long enough through enough different moments in your life. To really appreciate it. Once you saw it. It seemed absolutely. That's why I can't say enough that I just interviewed a gentleman yesterday from the United Kingdom. And he was talking about CGM, and he had had diabetes for longer than you longer than a lot of people. His perspective was really, really amazing. So I feel like you're right in that space, too. Awesome. Yeah. So. So you're like, you're a real adult, like, you live with the guy that you're going to get married to now and you're not like, not like me, like running around like 20 something or like, I'm gonna get married, like you're, you like have jobs and oh, yes, right, right. But we do. But how do you end up? How do I end up feeling at the end of the last episode that I really missed out by not asking you about sailing and things like that? Like, how did that start for you? And is that still part of your life now?

Lindsay 12:44
So there's so many things that I've done, just like adventurous things throughout my life. And a lot of them I would say at the moment, right, right here and now. They're probably not a huge part of my life anymore. Except for one, which would be running and long distance running. But yes, I've been sailing since I've been a little kid. I spent a ton of time on the water, sailing and fishing. I spent four and a half months on a Semester at Sea during high school. That's a whole other that's a conversation we

Scott Benner 13:23
can have with you want to die right now. I don't understand any of that. Like you're in New Jersey. So you're near the ocean that I understand. But you're in high school Semester at Sea. We're not in a real high school. Was it like

Lindsay 13:37
no, I was so I'm from can I say where I'm from

Scott Benner 13:42
your life. You can say whatever you want. Yeah, I'm from Point

Lindsay 13:44
Pleasant. So it is a beach town. And I went to high school play pleasant borough High School. So totally normal high school public school. When I was a freshman, I had I saw an ad for this program called Ocean classroom. And it was through a College up in New England out of Maine. And I said Gosh, this is something that I would just love to do. I I always felt in high school. There was just something more out there. I was always just looking for something else. And looking for the next adventure next challenge however you want to put it. So I clipped the article and brought it to my parents and I said I'm interested in this let's Can we look into it. So after a couple weeks of researching and talking to ocean classroom, we really decided that yeah, I'm going to do this and it was something that my my parents had to pay for. There was tuition but I got high school credit for it so it's totally accredited program. And I spent January to the end of May on A 131 foot wooden schooner called the Harvey Gammage. We sailed over 5000 miles up. Actually, we started in the Caribbean. We spent about two months in the Caribbean, and then sailed up east coast to as far north as Maine. And then we ended in Boston and we made stops all along the way. Okay, I

Scott Benner 15:20
have a lot of questions. Yeah. Your parents really wanted to get ready. That's the first thing. You're a problem.

Lindsay 15:27
No, I was not. I was that an only child? That extra money are there. They're great. I mean, they were super supportive. And I'm sure people are like, Oh my gosh, so spoiled. It's not like that. I don't

Scott Benner 15:41
feel like that. I feel like it's more than supportive animal. I'm just mesmerized by how old you are. I'm trying to think of Arden 1617 As a junior than she was 1516 as a sophomore that made her 14 Like, were you 14 or 15 years old at that point?

Lindsay 15:56
Yeah, I was. It was 2003. So I was I should have been about 15. I think.

Scott Benner 16:04
And were you with other students? Or do you now have like a 65 year old husband? Like what is happening? Exactly?

Lindsay 16:11
Yes, I was with other students. So we had to, there were 23 students on the ship. I was one of 23. And they were all from all over the United States. We had students, a majority of them were from the East Coast, of course, from New England. So there were there was like a big grouping of people from Massachusetts, Maine, Connecticut, New Hampshire. And then we had a couple people, I think we had a person from Florida, Alaska, Montana. So all total strangers, we all had to go through an application process. So we applied and waited for an acceptance and we we got it and we basically got booklets of information. This is what we need you to do. This is what you have to do this what you have to pack. There was a lot of communication for preparation beforehand. And then we flew down to St. Thomas got on the boat and basically took off

Scott Benner 17:15
and it's a working boat or it wasn't like a pleasure cruise, right?

Lindsay 17:19
Oh, no, it was not a pleasure cruise. It was totally Yeah, it was a working schooner we we had three shifts. So we would have you know a watch B watch and see watch.

Scott Benner 17:37
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Lindsay 18:25
And then, of course we had we had a crew who also doubled as our instructors. So we had a fully staffed crew. I honestly I should have looked into this, but I think there were probably about 10 or 11 of them. And then it was us. So yeah, we we worked every aspect of the ship sails, rigging, deck duties, cleaning, cooking, navigation, celestial navigation, steering every single part of this boat we were a part of. And there were no showers. So we spent, you know, you can imagine two months in the Caribbean. It's you're on the ocean. It's so salty and humid and just absolutely. I mean, just super uncomfortable. We would literally just jump over the side of the boat, get some salt water sudsing shampoo and take a shower that way. Occasionally, I'm talking maybe like once a week.

Scott Benner 19:34
Is there any is there any chance that a boat tricked your parents into paying them to use you as free labor?

Lindsay 19:44
I think there's a possibility.

Scott Benner 19:46
Because this pre internet like when you said you researched it like you meant you made phone calls and read brochures and stuff, right?

Lindsay 19:53
Yeah, this was like ancient times, right?

Scott Benner 19:55
You didn't go on Reddit and say like, Hey, does anybody know if this is just the elaborate way to steal my kid like nothing like Yeah,

Lindsay 20:02
yeah, it was it was totally. I read about it in a magazine. And everything. Yeah, everything was done via mail and we had email, obviously. But, um, yeah, nothing really online, you can't go to any forums or anything like that. So,

Scott Benner 20:18
wow, that seems like such a leap of faith to me. But I guess at that moment, it wasn't really.

Lindsay 20:24
It was, um, it was something that is life changing. Yeah, I would imagine. It's when you're going through it. And I had, I had so many difficult times, as much as I loved traveling and, and doing exciting things and seeing new things and getting out of my comfort zone. I was homesick a lot. I mean, it was not comfortable. So it's like, oh, gosh, I wish I could just go and take a shower and get in my bed. And but every single one of those moments that those struggles, just built upon itself. And by the time I left it, I just was like, I could do anything. That's how I felt. And from that point forward, that's literally how I feel every day, and how I live my life.

Scott Benner 21:15
Did any of the kids like? Like, what would happen if you gave up? Could you just know,

Lindsay 21:20
I think there's certain circumstances that you know, they don't want you to do that. Obviously, they don't want you to give up and, and go home and forget about it. Because part of the experience is pushing through those times. That's how you become, you know, a better person, I guess, but I'm sure Yeah, I'm sure if it was something you were really struggling or just not well, or, obviously if it's affecting your health or something like that. Yeah, of course. I mean, you could you could leave any time. Um, but I we didn't have we had nobody.

Scott Benner 22:00
One of the tight like, tie a tire to your ass and throw you in the water. Like, I mean, how do you leave? You leave a boat? They like?

Lindsay 22:06
Yeah, you don't. I mean, and a lot of those countries, we were in almost every island in the Caribbean. And so many of them are really like third world world countries. Some won't have internet, some barely have actually one of them had just gotten electricity. Maybe a year before we we were there. So yeah, there's really not an easy way. And of course, not a cheap way to get back. So that's another hurdle to

Scott Benner 22:35
tell me what year this was again. This is 2003. Wow, see, when you're telling the story, it feels like it feels like you're gonna say, Oh, this was 1982. You don't I mean, like, but this was not that long ago.

Lindsay 22:48
It wasn't that long ago. Um, well, I mean, when I think about it now I'm like, Wow, I can't believe 2003 was 20. It feels like yeah, it doesn't feel like it's been that long. But no, in reality, it's not. It's not that long.

Scott Benner 23:00
Wait till you start having the experience where you see a little advertisement. And it's like, your favorite movie from when you were 19. Like it's the 25th anniversary of Pulp Fiction like Well, no, it isn't.

Unknown Speaker 23:13
This is not true. Stop.

Scott Benner 23:18
You don't want it? Yeah, trust me. It's not fun. No, but Okay, so. So you have diabetes. Mm hmm. Alright, so let's then 2003 What's your management like, then?

Lindsay 23:32
I was MDI. And when I got on the ship, when I started, I was using humor blog and NPH. And insulin, I guess that was the long longer acting insulin. So I was mixing insulins and testing and taking shots that way. And I distinctly remember, at some point, about halfway through the trip, we were somewhere along the east coast of the United States in port. And we had gotten some kind of correspondence saying, we want, we want Lindsay to switch to link to Lantis. And everybody was like, Who the hell's? Why that we're in the middle of a Semester at Sea, who wants to change the medication? And, you know, it's just like, at that time, I was like, well, what's the worst that can happen? You know, let's, let's give it a shot. You know, maybe, maybe I won't jump off the side of the boat the first day that I'm going on Lantis and, you know, put myself in a super vulnerable position, but we did it halfway through and that was, that was great. I mean, that opens up a little bit more flexibility and just management.

Scott Benner 24:44
I have to imagine that people listening right now who are like, like, oh, I want to switch insulins but I you know, is Fiat's that much different than you people are in your houses making this decision here at home on land. He was 15 on a boat, basically being worked to death praying that she wasn't about to be sold into, you know, child slavery. And, and you oh my god, and they're just like, let's go from old timey insulin dough a fast acting insulin, which works completely differently than the insulin you were on prior.

Lindsay 25:23
Yeah, yeah, totally different. I didn't have much information on it. I remember somebody telling me it was like, more like having an insulin pump. Right. So it offered a lot, a lot longer coverage for that, that Basal? But, I mean, I had no idea. And and, yeah, I mean, if people are listening, and they're like, Oh, should I do this? Should I not do this? Well, I mean, maybe maybe you should try it, because you can do it. You can tie it

Scott Benner 25:54
up and get on a boat, and then do it when you're 15. Like, yes, this see badass person who's with me today? Because I That's fast. And there is no one listening. I would not change Arden's insulin while she was away from me. Yeah, like, I just wouldn't, but there was, wow. And your parents didn't just like send you a tax, they had to like contact a place where they knew you were going to be once you were on lay.

Lindsay 26:22
Yeah, so we had a pretty, I guess, pretty antiquated system of communication. The boat had a satellite phone, and the boat could make calls for really anything. But we tried to avoid doing that if at all possible. So most of the communication was done through mail. And people could send us letters or information or postcards or anything. And the boat would have designated mail pickup spots at certain locations that was available. So we got a lot of I got a lot of postcards and things from friends and family. And I am I also sent back I had a, like an old school camcorder with me. And I sent back videos of just certain things that I was doing on the on the ship, which actually my high school played for the entire school. Most mornings before class started. So that's that was kind of cool.

Scott Benner 27:21
We call those Proof of Life videos, by the way. Yes. Still alive. Did you have to hold up a newspaper? I mean, where would you get a newspaper? But hey, was this whole thing? Was it a big hookup?

Lindsay 27:37
How

Scott Benner 27:38
well you know, like working in a restaurant?

Lindsay 27:41
No, it wasn't it was? No,

Scott Benner 27:45
I'm pretty young at 15. I'm just wondering if you didn't turn into like, like, teenage Caligula or something like that. You guys were working this boat?

Lindsay 27:54
No, it totally did not. And yeah, I mean, I was I was one of the youngest. We had a lot of students who were juniors and seniors. So there were their kids were a little bit older. But the entire thing was super professional. And super. I don't wanna say regimented. But it has to be when you're working a shift and you're working together, you have to have pretty strict rules and guidelines and things to follow, or else people just gonna lose it.

Scott Benner 28:30
Well, no, I mean, obviously, things have to happen. I know, next to nothing about being on the ocean, but I'm assuming things have to happen. Or boats go in wrong directions or bad things happen with water being where they're not supposed to be. And stuff like that,

Lindsay 28:44
right? Oh, yeah. Yeah, for sure. Yeah, a lot of a lot of safety things, a lot of a lot of protocol and a lot of learning. I mean, we learned so much we spend a lot of our time in in class and class would consist of us sitting up on the deck together, learning about math, science, English, history, but all kind of location based. So if we were in a certain Island, we would be learning some sort of history about that location. If we were doing math, we would be doing celestial navigation, with a Sexton and, you know, all sorts of different other tools. So yeah, that was a big part of it, too, because we were getting credit for it. So we have to learn.

Scott Benner 29:34
That's really I find this absolutely mesmerizing, and I'm googling, like schooner and things like that, so I can see what you're like. Did you ever have to shoot a cannonball? Anybody?

Lindsay 29:45
Actually, we did. We had a small cannon. Um, we didn't shoot cannonball. But we did have a small cannon that we would shoot off if, like one of our sister ships was nearby. There were a couple different ceremonies that that would be appropriate for and I don't remember what they were. But, um, yeah, we did all all sorts of stuff.

Scott Benner 30:09
I interject for a second for everybody who heard me ask the question and then thought in your head. That's such a stupid question, Scott. Don't be silly. I got an answer out of that. So this is why you ask stupid questions, because at some point, someone's gonna like, oh, yeah, we had a cannon. Because I didn't think you had a cat. And when I asked you that, just the boat looks like a pirate ship. So, you know, yeah. i Okay. See, this is for five months. Is that right?

Lindsay 30:36
Almost. Yeah, it was about four and a half months. Yep. You get

Scott Benner 30:41
back. Does everything about being a kid seem trivial now? Yes. Okay. So, I mean, I would imagine, right, like you had seen and done things that just aren't gonna happen again, I would think Tuesday in social studies, you'd be like, Oh, this Yeah. Okay. Just set an expectation up for life to be vigorous and challenging.

Lindsay 31:08
Absolutely. It. It always. It pushed everything out. So I was like, wow, I could literally do, I could do anything. And if you've ever seen the movie, Castaway, he's, he's on the island. He makes it he gets home. And he's like, playing with like the light switch or something in the bedroom. He's like, he doesn't know what to do with himself. Right? He's been totally immersed in this environment. That took so much just adaptation and so much mental fortitude. And then all of a sudden, it's like, oh, we have electricity. Like, yeah, we have running water, we have a shower. I have clean sheets. And it sounds kind of silly. But it's even after four and a half months, it was a little bit of a readjustment. Getting back home,

Scott Benner 32:01
I would imagine I missed the first thing. I wondered, when when you told me how long it was, I felt like a week or two is a is you know, like a fun vacation. But once two months, turns into three months turns into four months. Now, this is what you're doing. And I imagine things have came up during that time, that we're not exactly, you know, I'm sure they were powerless to some degree and needed to be dealt with. And then I mean, and then cleaning your room and doing the laundry probably seems pretty.

Lindsay 32:32
Yeah. Yeah. And it, it really, it put it put it into perspective for me. And I'm sure a lot of people will agree for people who are in the military that are deployed, and see combat and deal with all sorts of different things or anything like that any any kind of situation where you're, you're away, you're working hard, you're pushing the limits, and especially people who are away for so long, and then they come back. I mean, I couldn't even imagine if I was if I was gone for four years. Right? Um, I adjustment must be absolutely incredible.

Scott Benner 33:08
Because that boat, that boat starts to become home. Absolutely. Yeah. And all the things that you have to do and the people you do it with. It's it's the quick adaptation is kind of one of the great things about being a person is it how quickly you can adapt to things if you if you are willing and or and or don't have the opportunity to say no to it. Yeah. You know, just can't fight it. Really, I guess is the idea.

Lindsay 33:33
You can't fight it. You have to adapt. And yeah, that's what we're trying to do. And, and we all do it. We all can do it with a little bit of, I guess, training of the brain and just you know, dealing with it. And yeah, you'll make it through. Absolutely.

Scott Benner 33:50
So what did that lead to? Then? What what's the next adventure you took after that?

Lindsay 33:55
So I after that, I can't think of a specific adventure right after that.

Scott Benner 34:02
You go to bars or anything? No, I

Lindsay 34:04
did not. Do not not yet. Um, after that, though, I had so much see time. And that's time actually documented time on the ocean. I went and got my captain's license from the US Coast Guard. So it took a little while I also had to, I had to take classes, I had to go through a lot of different training. And I did that with the help of you know, being able to sail here and knowing a lot of people with boats here in New Jersey. So I did that. I when I was 18 Yeah 18 I got my my first captain's license. It's called a six pack license so you can take out six people for hire on a limited size boat. And then when I was 19, I ended up upgrading to what's called 100 ton masters captain's license. And that was awarded to me as well, because I had so much time and experience on the water. And that was something that I mean, diabetes related, dealing with the United States Coast Guard and their application process, being a diabetic was actually really difficult. Um, it was quite a task.

Scott Benner 35:27
Lots of proving and reproving and doctor's notes and things like that, or,

Lindsay 35:32
yeah, yeah. So, I mean, they're giving you a piece of paper that is saying that you are responsible for lives of, you know, so many people up to 100 nautical miles out to sea, and they want to know that you're not going to go low and pass out. They want to know that your vision is where it should be. And there's a lot of risk in in doing that for them. And I do understand that. But I was successful. In doing that I actually had to provide all of my medical records from when I was a kid up until that point, and just write endless amounts of blood sugar logs and explanations and everything.

Scott Benner 36:18
What did you end up doing with the license? Did you start fishing the oceans? Or

Lindsay 36:23
no, no, I didn't know I actually, I still have it. I still have it. I still, I still record my sea time. Anytime I'm out. I still, you know, keep a record of it. So that's how I keep my license active. But I don't have a career doing pirate things. Just I sell real estate.

Scott Benner 36:41
Was it just one of those? I sell real estate? Was it just one of those things that you had the time and you were a kid, and it was another thing to try to accomplish? And so you just kept it's almost like playing soccer your whole life and then one day just going I'm not gonna play soccer anymore.

Lindsay 36:57
Yeah, I definitely wanted to it was a huge accomplishment that I wanted to, you know, really gone. And just to prove it, I there was also a point in time where I thought well, maybe maybe I could do something like this for living. I'd love I love to teach sailing. I would love to have a business like that, you know, something along those lines, but I never ended up doing anything like that. And at this point, it's something that I have a decent amount of knowledge about. That will only make me a better boater. You know, like, if I'm out with a friend or on on our future sailboat that we wish to get. Um, it just it only adds to the, you know, feeling of being able,

Scott Benner 37:42
I think it's amazing to have comfort level around something like that. I don't think I'm if I'm gonna be honest, let me think. I don't think I'm comfortable more than about. I'm gonna say 40 yards off the coast. Yeah, that's pretty good. Yeah, that's about where my comfort level ends. Like when you said you jumped in the water to bathe. I was like, why would anyone do

Lindsay 38:07
it's such a weird thing to because you're like, wow, it's it could be so deep underneath your your feet.

Scott Benner 38:12
Sharks. That's all I was really thinking. So, yeah, how many people have you seen killed by sharks?

Lindsay 38:20
None. Really? Okay. Yeah. I don't want I don't want to see No,

Scott Benner 38:24
no, no, I just imagined happened every day. Like one of the kids felt like oh, there goes Jill. Boom. There she goes. She Oh, Hi, Jill. I understand. That's not how it works. It's just that unknown darkness thing is yeah, oh, yeah. A little more than my brain can can wrap itself around. I actually thought I was gonna die very close to St. Thomas once while snorkeling because you said you flew into St. Thomas. So once or twice in my life I vacationed in St. John, which is an island right nearby with my sunlight were snorkeling. And this mass came at us. And I'm I'm not over exaggerating that the mass looked like it might be 25 or 30 feet across and high. And it was kind of round and I thought, Oh, I didn't know animal this big existed. We're all gonna die. And it was coming at us. And we were like, you know, he was younger, but I'll say he was clutching me, but you know, maybe I was holding on to him as well. And, and but it was a school of puffer fish. But at a slight distance. It looked like one mass. Now once it came past me, I was like, this is beautiful. Yeah. And they're adorable. And then I soaked it in and we swam with them for a little bit and I got right back to the beach.

Lindsay 39:38
Yeah, well, yeah, that's that's scary. You don't know what's out there.

Scott Benner 39:43
What's what I'm saying? So you just take that's how dirty you had to be to jump in the waters. But I'm thinking like, this is worth it. I'm getting in. You kind

Lindsay 39:51
of Yeah, you have to. But it is it's something like you really don't have to. I mean, you could you'd be fine. If you didn't shower like every day now I'm charging everyday now, but oh, now

Scott Benner 40:03
you're up on it now. Oh, yeah. Oh, yeah. Well, yeah.

Lindsay 40:07
The trip turned me into like, a little bit of a princess if we travel and like I only want a really nice hotel, it's got to have a really nice bathroom.

Scott Benner 40:16
Yeah, I'm not cleaning out my bits in the ocean again. Thank you. Were you an anomaly on that trip as far as medical issues? or were there other people?

Lindsay 40:27
Somewhere? Yeah, I was the only type one. I'm not sure. I think they have had several type ones through the years. But yeah, I was the only one on our trip. And, you know, of course, there were a couple other people who had to take prescription medication from time to time for whatever migraines or something like that. But other than that, yeah, I was, I was working with one of the crew. Her names charity, she was an amazing woman, she was an RN, and also somebody who had spent a lot of time on the Water Sailing. And she and I work together every day, I would go and meet her and test and she would keep track of everything. And she would help me just kind of manage as best as possible. And I don't think I had any real issues. With management I did. I never had any serious lows or serious highs, it was all pretty, pretty well done, I guess,

Scott Benner 41:28
even with the transition to the other insulin. Mm hmm. Yeah, it's this company still, like they still do this?

Lindsay 41:34
Yeah, they do. And I actually follow them on Instagram, they, they just posted today that they were right off of our coast, right off of the New Jersey coast. So they do shorter term trips. They'll do like a trip from Florida to Maine. And they'll do it a lot faster than our trip was done maybe in like the course of a month or so. But they take high school and college kids out. For all these experiences.

Scott Benner 42:04
Do you think that a lot of these people turn into people who work on the water as adults? Or is this just like a floating hippie commune for kids? Exactly?

Lindsay 42:15
Um, that's a really good question. So I'm sure a lot of people are kind of driven to do something like that. If you love being on the ocean, if you love living near the ocean, then yeah, you may end up doing something that involves that. But I know just from keeping, keeping in touch with a lot of the people that I was on the on the boat with. One works for a sailing magazine, one's a professional skier. A lot of people have, you know, financial positions and all sorts of different stuff. So it's cool to see everybody, you know, doing their own thing. And I feel like, all of those people are also all out doing new stuff. They're they're not staying in a comfort zone. They're always kind of looking for the next thing,

Scott Benner 43:02
right? That's really fascinating. I genuinely can't wrap my head around it. But I think that's just how I grew up, you know. So everything you've said so far, in my mind makes you eligible to be institutionalized. But, but it's fascinating, and I really, I, there's part of me that wishes that it sounded to me like oh, my gosh, yes, let's do something like that right away. Yeah. But um, it's, you've always been like that.

Lindsay 43:33
Yeah, yeah. And I, honestly, I think I have that sort of drive and curiosity from being a type one. I just diagnosed at six years old. It literally almost meant nothing to me. I was like, Okay, this is this is life now, whatever. And it's always presented challenges that I've obviously had to overcome. And in doing that, it's kind of the same concept. All right, well, we made it through that lets you know, what's the next thing and then it becomes just things become normal. Not I don't wanna say problems, but any kind of like next. Next adventure. Next challenge is the same premise

Scott Benner 44:21
speed bumps, right? Something happens, you're just like, Okay, we'll take care of this. And then we'll go to the next thing. And I but that one takes a special person. I mean, somebody who's, I don't know fine tuned for that kind of experience, because there are plenty of people who would get diabetes when they were six and grow up and just be burdened by it the entire time. Why did your parents do anything? It's so hard for me to imagine your parents as being valuable because it seems like they were just like, What are you want to do? Yeah, sure, go by. But I'm sure they weren't like that. Like what did they do for your diabetes? In your room? Oh

Lindsay 44:56
my gosh, my mom, both my mom and dad Were super involved in, in my care. They weren't, they never hovered over me. So they never, you know, they weren't ever like, oh, you need to report back to me about this. And that never was it like that. But somehow they found a balance of just being able to guide me, I guess even as a six year old. So, yeah, my mom was involved with getting my friends involved, and, you know, helping helping me figure out the right ways, and the wrong ways to do things and, you know, solving those problems.

Scott Benner 45:37
Um, back then, though, really, it was I end up saying this a lot. But like, it's if once he gets dizzy, make sure she eats something like it was that kind of thing. Regular and mph days, right? Yeah.

Lindsay 45:48
Yeah, it was, it was Yeah. You know, do you not feel right? If you don't feel right, you have to go down to the nurse or tell your friends. And you know, just say something. Don't wait until you can say something. And, yeah, when you're so little. And I don't know if this is all kids. I really don't I don't we don't have children of our own yet. But I was so little. And I was like, alright, well, that that sounds fine to me, I'll do that. It wasn't like, I didn't want to do it. I always wanted to try and just be better. And learn as much as I quit about it. And I've, there's there were times in my life, especially as a teenager, where I was like, I don't I hate this, like, I don't want to do this anymore. We all we all get get to that spot. But um, you know, it would work itself out. And then you're like, Okay, I know, I need to do this. Do you think I'm gonna die?

Scott Benner 46:54
Yeah, there's a good reason. Do you think that the the ideas that are used now for management, they're more specific, and the outcomes are more easily tracked through things like variability in a one C and stuff like that? Do you think that it was easier as a child because that wasn't part of it? Yes, yeah. And the expectation was, just, it's it's kind of, it's interesting, because it's, it's one of those ideas that gives one hand takes away the other because it's easier because they didn't have the ability to to be finer with, with decisions. And at the same time, many more people were having worse long term outcomes because of it. Yeah, but you got to just go out on that boat. Like it was nothing.

Lindsay 47:44
Yeah. And that goes for everything. When I was little, when I think back about it. Um, there was there, you weren't given a lot of details. So even if I was testing six or seven times a day, which was probably pretty normal. Yeah. You weren't given the whole picture. And in not getting the whole picture, you're, you're okay with what you're seeing, then it's, it's done. You don't have to think about it anymore. So there's a lot less stress and kind of, there's a little bit of more detachment to that. Those specifics, but now, I mean, I'm checking my Dexcom all the time. Every day, I couldn't even tell you how many times I check it in the day, my endocrinologist asked me when I go to see her and I'm like, I don't know maybe 100 I have no idea. It's a lot.

Scott Benner 48:37
You got to get your we got to get your alarm somewhere where you can where you don't look if it's not beeping, so when

Lindsay 48:44
I turned my alarms off, and I just I mean, I have my my goal range pretty tight. But I turned my alarms off and I just I just look takes it takes a millisecond look alright on

Scott Benner 48:57
just stay in it like that. And that and that's good for you. So if it works, then it works. And that's perfect. Yeah, yeah, no kidding. Okay, ready? Let's make up a scenario. You and this boy, make a baby. It grows up. 15 years old. It has diabetes. It's wearing a CGM, an insulin pump and your made up son or daughter says, I want to go to St. Thomas get on a boat and then sail back to Maine. I'm going to be gone for five months. You go. Yes, sir.

Lindsay 49:34
Be honest. So I we would obviously discuss it together. But I would feel confident in that happening.

Scott Benner 49:47
How are you keeping some cold on a boat?

Lindsay 49:51
Oh, that's a good question we had what did we have? We had some kind of refrigeration system I'm

Scott Benner 50:00
thinking and I think generator the boat, maybe

Lindsay 50:03
we did we had a generator. But I think my insulin was actually just kept in a cooler bag that we changed out the, like freezer packs to as much as we needed to.

Scott Benner 50:17
Okay, so you were on top of that as well. That probably felt a little dire right because of it. I mean, you must have thought if it gets warm, it's going on where am I going to get more from?

Lindsay 50:28
So I don't think I was actually thinking about that at that time.

Scott Benner 50:33
Is it? Is it possible? I should call this this episode? Ignorance is bliss.

Lindsay 50:38
Yeah. Totally. I don't think I'm sure. My parents thought about that. And, and the crew and the, you know, the nurse.

Scott Benner 50:50
I gotcha.

Lindsay 50:51
I'm sure it was planned out.

Scott Benner 50:52
Yeah, not you. I got I thought in my mind, it was tied to a fish. And then, and then the fish was tied to the boat. And then that's, I don't know why you'd have to put the fish in the line. I just that's how it was in my head. And, you know, I guess because of the Little Mermaid, I thought maybe the fish would just stay with you keep the insulin in a cooler part of the ocean and come up when you wouldn't have been. In my cartoon that's out happens.

Unknown Speaker 51:17
I love it.

Scott Benner 51:18
I've watched that. Of course you would. But I'm trying to imagine putting art in I think the five months thing. Okay. Right, I can figure that out. The distance thing? Okay. In my mind is the boat part. Right? No, that's not sensible. But that's the part that sticks with me.

Lindsay 51:44
Yeah, I don't, I don't blame you. I mean, that that's a huge variable. But it's still, you're still gonna manage basically the same way. You're still gonna do the best you can and be mindful and use the tools that you have. And, you know, it's, it'd be different if somebody was like, I'm going to put you on a on a desert island with, you know, limited supplies. All right, well, that's probably not going to work. But yeah, it can be done. And you know, if we have a baby, who's type one, like the thought of that doesn't really scare me. And although that may change, right now, if I think about it, it's just like another challenge, right? So we need to we need to figure this out. And we will cool.

Scott Benner 52:42
If all I can think during this whole thing is about all the people I've seen over all of the years, say like we're going on vacation, I'm so scared. I don't know what the and they're going to Disney or they're going to you know, yeah, we're going to the beach for two days. I'm so worried about diabetes, and you're just like, I got on a boat. I was there for five months. You know, I couldn't really wash myself. Anyway. It was fine.

Lindsay 53:11
Yeah, we did. We did fine. We did the best we could and that's it.

Scott Benner 53:16
Really great message in this that that I hope is coming through you know, and and what it left you with and it's carried with you? It seems like your whole life like that there's this idea that nothing had happened to you that you couldn't figure out because you got put into a situation where you had to learn a bunch of stuff you didn't know why you were basically abandoned on a floating Deathtrap because seriously for anyone who doesn't think boat and then their next thought isn't boat could leak all die. I don't understand your thought process. That would be in anything though. Oh, sure. plane plane gets hold on it. I die. No, no, I've gone through all of it. Don't worry car car crashes into something. I don't worry. I've got it all worked out. I'm not saying live a life of fear. I'm just saying I've been on a ship. I've been out in the ocean. I've you know, I've been in airplanes. I will go on an airplane again very soon. You know that? I'm not scared. I don't do it. But it's if that's the first thing you don't consider while you're considering the grand scheme of it. I don't get people who don't do that. Like the ocean is endless. It goes so far. There's really no and there's no oxygen there. I don't know if anyone knows that or not. There's no

Lindsay 54:36
zero. Yeah, it is quite daunting.

Scott Benner 54:40
I can't wait for you to have a kid who's like real timid and like scare everything.

Lindsay 54:46
Well, we're we're getting a puppy. I'm in a couple of weeks. And we're like, you know, we're going to get this dog out to the beach and on the kayak and anywhere in the pool and with any kind of situation so that we can have a you know, a dog who's a companion for adventures?

Scott Benner 55:09
I think that's a lovely idea. I think so. Everyone should start with a test dog.

Lindsay 55:15
Yeah. Before before the kid.

Scott Benner 55:17
Yeah. I don't know your Do you think you want? Do you want children?

Lindsay 55:22
Yeah, we do. Probably not right away, although I am 34. So I know, you know, time maybe a little bit. Yeah, on my side,

Scott Benner 55:32
you got to be careful. I will tell you a daunting story of me planting a bush this week. And my hamstring being tight for three days afterwards. So you're very little time left? Oh, no. Oh, it was that bad? Well, I mean, I had to bend over a number of times. So

Lindsay 55:53
yeah, that's tough. Oh, you

Scott Benner 55:55
have no idea. And it got so like, two days after, I want to be clear. I was outside all day bending over not just for one bush. But that's doesn't make the story much better. But like a day or so later, it was just so tight. And I said to our No, Mike, I'm gonna lay down on the floor. Oh, yeah. Put your knee into my hamstring. Yes, bullshit. And as much as I scream, don't stop. Just just keep going. And by the time it was over, I was just like, wailing like a five year old. Like Stop, stop, stop. She's like, you told me not to stop. I was like, Get off.

Lindsay 56:37
Better now. And

Scott Benner 56:38
that really actually helped it a lot. Yeah, sorry. Good. Yeah. You know, and some people use like little massage guns. I just I used the massage Arnie. I was like, hey, yeah, jam it in there until I can't feel it anymore. Nope. Yeah. Okay. Anyway, my point is, you're gonna get old fast. And in the last, like, in the run up to 50 it happens really quickly. Yeah, all right. Yeah. And you got like a nine year old and he's like, I want to get up early. And then I'm gonna do this. I'm gonna do that. You're gonna be like, um, I used to be on I once. I can't leave me alone. Oh, no. Anyway, I'm sure it'll be fine. You're probably in much better shape than I mean, obviously, most people are in better shape than me. But I assume that you are. Well, you run right, like a lunatic?

Lindsay 57:23
Oh, yeah. Definitely a huge part of my life. Definitely huge part of my diabetic life. started running about 11 years ago, I woke up one day, I was like, I don't like my body, I, you know, I need to lose a couple of pounds. I just I want to feel better. So I just started running. And from that point, I kept going. And eventually you hit a certain point in running where you get in shape, and it becomes a little bit easier and then easier, and it just really just builds on itself. And it's it's therapeutic for me. And it's great for bringing sugars down. It's great for my management, stress levels, whatever. There's a billion different things.

Scott Benner 58:17
You're like two story shy being Forrest Gump.

Lindsay 58:22
So last year, I Well, actually, I've run I've run a lot of different races. But I I've run a couple of full marathons. Actually three of them the New Jersey marathon, I've done three times. And then last year, when COVID started in March, I was stressed, I was worried about my business and you know, just it was stressful. So I just went out and I ran, and I ran my own marathon alone 26.2 miles on May 17. And it was absolutely amazing.

Scott Benner 59:01
The Lindsay Invitational

Lindsay 59:03
It was literally just me. And it was awesome. There was nobody, nobody there. Nobody knew. Nobody cheering me on. And it was super cool. Oh, how long does that take? That took me just under four hours. It was about three hours and 54 minutes.

Scott Benner 59:24
And you didn't make you weren't telling people you're trying to see you're you're old enough that you didn't try to turn it into an Instagram account and get rich. You're just like, I'm gonna go for a run. Nobody else no see this.

Lindsay 59:37
Did it? I just told a couple of close friends just in case like so they knew I was out.

Scott Benner 59:43
Somebody could come find you if need be. Yeah,

Lindsay 59:45
yeah, just just in case. Um, but yeah, and I actually met my mom. Halfway through. She met me for some some energy gels and water and stuff. But other than that, I didn't tell anybody and then I got back and you know, of course I posted on social media then but, um, yeah, it was, it was awesome. And those things are totally, totally attainable for anybody as a type one diabetic.

Scott Benner 1:00:11
See, I'm what I'm hearing is young people need to hear is that everyone doesn't need to know what you're doing all the time. No one cares. Just go do your thing. And, and it's just as fulfilling when no one knows that you did it. Right.

Lindsay 1:00:23
It was more fulfilling doing it. In that in that setting? Okay. I mean, it was just, I went out, I didn't have a plan. I didn't have nobody knew. And it was like relaxing. Of course, it was difficult. I mean, three, almost four hours of running is difficult. But it was it was amazing. And I'm so glad I did it.

Scott Benner 1:00:48
Yeah. Okay, that's really cool. Did it carry you for a while through the the anxiety of like, Is nobody will? I'm assuming nobody was buying or selling their house, the beginning of COVID?

Lindsay 1:00:59
It did. Absolutely. I had a little well, I had a lot more time off. So that's why I was I was really able to do that and kind of trained for it a little bit. Yeah, absolutely helped. It helped to keep my mind busy. And when I'm sure runners agree. When you're out running, sometimes your mind just shuts off. Sometimes you're solving problems. Sometimes you're whatever, talking to yourself. But it's so yeah, I handled a lot of the stress through that those experiences. And then of course, it wasn't quite like totally dead, the real estate market, but um, towards the beginning of May last year, things really, really started to get busy. And it's just gotten absolutely busier and busier since then

Scott Benner 1:01:47
say now, right? Like this is it's approaching, like, would be considered a bubble at some point, right?

Lindsay 1:01:53
Yeah, it is. Um, it is. It's incredibly competitive. There's not enough homes on the market. And it's just gotten to the point where it's, it's just, it's crazy. I don't I don't know if it's really ever been like this. I

Scott Benner 1:02:08
spoke to a realtor recently, which was just coincidentally, but he told me that he sold a house that he described as terrible. And I was like, okay, he was just no one deserves that to live in this house. I was like, all right. He said, I sold it for $420,000. And yeah, to a person coming, trying to like escape the city. They were trying to get out of Brooklyn, I think. And he said the guy came, saw the house and said, Okay, and just gave him a check for it. Like it was just like that. And they he paid like 20% over what the other offer was. And the guy just kept reiterating. He goes, No one should have to live in this house. And I was like, okay, goes bad house bad house. And I was like, Yes, he is. But everything's so expensive right now. And the people who want to get out of the city really want to get out of the city. And they have money. Because you know, I mean, this is this is a person who I mean, for clarity is the person who apparently bought a foreign $20,000 house, and it was like a steal for them. Yeah, they were like, oh, here, take it out of the right pocket of my pants. Like, give me kind of like that, right? But still, the guys like the house is just a disaster. He goes, I don't even know what we'll do with it. Oh, my God. I was like, okay, yeah, but he wanted it that bad. So that's what's happening. People are just getting way more money. But the problem is if I decide, Oh, I'll sell my house make a bunch of money. I still have to go buy another house. And then I'm gonna overpay for that house. Yeah,

Lindsay 1:03:37
that's, that's a problem. That's a problem as far as just getting somebody avoiding somebody being homeless. If somebody wants to sell and make a lot of money. Yeah, they're going to be paying a lot of money for their new home. But they also the the mortgage interest rates are so low. So although you're paying a premium, your payment may not always reflect that your monthly payment. Yeah, it's, it's, it's incredible. I mean, it's just I'd love to see studies on this, in the future, just how this thing happened. And a lot of these people, there's a lot of people here who are moving from the city. But a lot of my clients are people who were quarantined, who are home, they're working from home, they're trying to work out at home, and they're like, Man, this house sucks. We need a new house.

Scott Benner 1:04:27
They want more space, or or yeah, we're stuff. We refinance during the I don't know why my voice just broke like that. But we refinance during COVID and opted to keep our payment the same and knock yours off. Okay, so yeah, that was you know, but there was such an interest rate reduction, that without my without my payment moving. I think we knocked seven years off the mortgage. That's amazing. Yeah. So it's like, Alright, let's do that. You know? Yeah. Good for you. Something good is gonna come out of this. Absolutely. So I was like, Alright, let me do that. But yeah, I'm fascinated by that idea, because I guess you could sell and then rent until everything goes the other way and then take advantage of somebody disastrous decision during the bubble, which sounds horrible, but I guess that's the only real way to make money on the sale and not lose it on the purchase.

Lindsay 1:05:19
Yeah, rentals are tough now to run. I'm sure like, New Jersey's probably the highest price. Everything rental sales, you name it. I mean, people are probably listening from around the country saying 420,000 will get you like a mansion.

Scott Benner 1:05:35
Yeah, there's someplace here. Yeah. knows this stuff's expensive. And doesn't New Jersey to have that weird law. Like if you sell your house and leave the state don't have to pay a penalty.

Lindsay 1:05:47
Yes, and no. There's a lot of stipulations to that. Um, yeah, I mean, whole other conversation. But yeah, there's

Scott Benner 1:05:56
no way around it. Cuz I am gonna get the hell out of here at some point. Are you I know you were born here, but I wasn't.

Unknown Speaker 1:06:04
Where do you want to go?

Scott Benner 1:06:05
somewhere warm, but not, but not humid, somewhere where it won't snow and where I have some sort of access to the ocean for my wife. Okay, so I don't care where that is to be perfectly honest, as long as it fulfills those ideas. Sounds good to me. So I mean, I would move to, like, if I was a wealthy person, I would move to a place like Wyoming in the summer, and then I would bug the hell out of there before it froze over and go somewhere else. Like if I had like, a perfect scenario would be like, I'm sure all of us. I'm saying this. Like, I'm special. I would like to chase the weather if I could. But I also I also when I think of that, in my head, I go until I get so old that one day, I'm just like, oh, I'll just sit here and freeze. Never mind. I don't feel like making the trip. Forget about it. You have no idea what's about to happen in the next 15 years.

Lindsay 1:06:55
Oh, gosh, it sounds it sounds tough.

Scott Benner 1:06:59
I it's not? Yeah, it's not unpleasant. I like being older. Better than I like being younger. Okay, but I would like to be able to shape how I felt when I was younger, into my knowledge from when I was older. That makes sense. Yeah. And I don't know, that's not gonna happen. So I'm just gonna wither away with all these thoughts in my head. Oh, no.

Lindsay 1:07:22
You're doing amazing things. So I should be proud of yourself.

Scott Benner 1:07:25
Oh, you're very nice. i That's I appreciate that. Thank you. Of course. I'm gonna let you out of this. I appreciate you doing this twice with me. I think you might be the only one I've ever done something twice with but you float on a boat for five months. I was like, That can't be something we don't find out more about. So I think you're I think you're kind of amazing for doing that. Oh my gosh, yeah. Oh, even though i i imagine at that age, you didn't think so? Right? You just thought like, this is cool when I don't have to go to high school for five months.

Lindsay 1:07:56
Yeah, kind of. Yeah.

Scott Benner 1:07:58
It was more amazing than you thought. So.

Lindsay 1:08:01
Well, thank you so much. I'm glad to be back. And I appreciate again, everything that you're doing with the podcast. It's it's awesome.

Scott Benner 1:08:09
And the Facebook page. Isn't that nice? How nicely Yeah, we got a little something a little bonus out of the podcast on that Facebook page. Yeah, yeah. I'm pretty thrilled that there. It is. So repetitive for me. It's not for other people. It is for me, like because new people come in and they ask questions and like, there's this little bit of me, you should see me like, I'll see it pop up. And I'll think I'm going to answer that if no one else does. But oh my God, I hope someone else answers this. Because I am not a full time like, like, I'm not Dear Abby, you know what I mean? Like, you, you. There's so much traffic in there. There is it could be. And I looked at it the other day, like I looked in on it a couple of times other day. And I was like, Oh, look, somebody got celebrating a sec, congratulations. I see a question I can answer fully with one I'll answer. Sometimes I see questions where I'm like, Oh, I could I could ask another question that would make people think a little bit like I'll do stuff like that. But I realized the other day, like I can't keep up with this page. Like it's just it would be a full time job. Like you'd have to pay somebody to stare at it 24 hours a day, to keep up with what's happening on it. It's really fascinating. So that's awesome. It perpetuates itself and keeps itself alive. So I'm happy Absolutely. But anyway, I appreciate you appreciating

it a huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Kaipa pen at G Vogue glucagon.com Ford slash juicebox you spell that GVOKEGLUC AG o n.com. Forward slash juice box. I want to thank everybody again for buying me a cup of coffee and buying me a coffee dot com forward slash Juicebox Podcast and also want to remind you that the diabetes pro tip and other episodes are all listed for you right there at Juicebox Podcast comm just scroll down it's all there. Alright, here comes the music

the Harvey Gammage No kidding, right? Just put their kid on a schooner. It's like a boat made out of wood and just like hey, good luck. Don't I can't I can't get enough of this story. I should say something meaningful here. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. How was that pretty good.

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#578 Allergic to Insulin Part II

Dr. Bonnie McCann-Crosby, MD is here to talk about a potential work around for severe insulin allergies.

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
Hello friends, welcome to episode 578 of the Juicebox Podcast.

You may remember episode 504 allergic to insulin where a young girl from cannula came on to talk about how she was really like viciously allergic to her fast acting insulin, her mealtime insulin. And we talked all about how she worked it out. Well, a little later, I heard from a doctor in Texas who had a patient who was also suffering from the same thing. And a lot has happened since I talked to that doctor, I'm going to tell you about it here. And she's going to tell you about what they did, and how they took care of the problem. It's kind of fascinating. You're gonna love it. And I think in a couple of months, I'm going to get this doctor's patient on to talk about what they learned, which is different than what the first person learned for Oh my Wait, do you hear? 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. We're becoming bold with insulin. Hey, so far this month, we've added like 140 people to the T one D exchange registry, have you taken the survey yet have to be a US citizen. But after that, it's T one D exchange.org. Forward slash juicebox take you less than 10 minutes. This episode of The Juicebox Podcast is sponsored by touched by type one, please go check them out at touched by type one.org or on Facebook, and Instagram. Today's show is also sponsored by the Dexcom G six continuous glucose monitor, you're going to want to go to dexcom.com forward slash juicebox to get started today. Head over there right now get the CGM technology that my daughter wears. It's absolutely amazing.

Bonnie M. McCann-Crosby, MD 2:03
Hi, I'm Bonnie McCann Crosby. I'm one of the pediatric endocrinologist at Texas Children's Hospital in Houston, Texas. Thanks for having

Scott Benner 2:12
me. No, thank you for doing this. I appreciate it very much. Let's see if I've got this right. I put up an episode with Stacia, right, and she's allergic to insulin. And I talked to her about like, you know, like, everything she went through, and it was really kind of fascinating. I didn't realize how impactful I mean, I guess I didn't even realize it could happen but but that she's allergic to this insulin couldn't use it had to get this specific kind of, I forget, like injection port or pump site or something like that from Germany, and they weren't gonna make them much longer and the insulins like $14,000 a year, and I think this is a pretty good encapsulation of that. That whole thing, but then I got an email from you. And I don't know how that happened. So you fill that part in for me?

Bonnie M. McCann-Crosby, MD 3:03
Yeah, no. Um, so I obviously see a lot of pediatric patients with type one and get to chatting with the parents, and a lot of them had mentioned your podcast and how they really enjoy it. And so I was like, well, I'll check out an episode. And the episode I first happened to listen to was the one with Sacha and the insulin allergy. And got me to thinking about other cases that I'd seen similarly, which is why I reached out to kind of get more information.

Scott Benner 3:36
Cool. So it is complete happenstance that, so I'm assuming that, you know, some of the people who listen to the show, they hockey a little bit about the podcast, right? And they're just, they, I'm assuming they say you got to listen like they, they give you the wholesale. And then finally you're like, I'm gonna listen. And then you land on an episode. Boom, out of the gate. And you're like, Oh, I've seen this before with some of my other patients.

Bonnie M. McCann-Crosby, MD 4:02
Yeah, it was. It was crazy. Actually. I was like, Wow, I can't I can't believe this is the episode first one I actually listened to.

Scott Benner 4:10
Did it make you wonder what secrets are in the other ones?

Bonnie M. McCann-Crosby, MD 4:14
It has? Definitely.

Scott Benner 4:17
So you listen to that. And you think you have current? I know we can't speak about your patients specifically. Although although it looks like maybe one of them might come on the show. But but so you had somebody who you were thinking up right when you saw this like somebody who you're treating currently,

Bonnie M. McCann-Crosby, MD 4:33
yeah, no, I and, you know, patients with similar reactions to Sasha significant allergic reactions, skin reactions, and things like that and just trying to think about other ways to to treat these patients and because this is very rare, and not a lot is known about what to do in these situations.

Scott Benner 4:57
So So highlighted for me A person who has this allergy injects the insulin what happens? Generally?

Bonnie M. McCann-Crosby, MD 5:04
Yeah, so I mean, in patients with these kind of allergies, you know, they can get significant like skin reactions where it's almost like major hives, you know, huge raised area, red on the skin. Extremely large, extremely painful. And, of course, you know, this is every time you inject, right, and so if you imagine, you know, if you're on multiple injections a day, every single time you give an injection, you've got these huge reactions, and they last for days. So this is not just, you know, it's it's done within a few minutes or an hour, it's it's days later still dealing with these consequences from each shot, so and incredibly painful, incredibly frustrating. And then, you know, what can happen is you're not getting absorption of the insulin, right. And so blood sugars are through the roof high difficult to control, increased risk of DKA, because you're not getting, you know, the life saving drug that you need to keep blood sugars in check.

Scott Benner 6:06
So aside from the fact that they're having a terrible reaction to the insulin, I guess the inflammation is stopping the uptake of the insulin as well. Yes, yes. Okay. So now, so then it, does that force them to use more, which increases the reaction?

Bonnie M. McCann-Crosby, MD 6:21
Absolutely. Absolutely. In You know, oftentimes, you know, we're talking, you know, very, very tight insulin to carb ratios, and just nothing is really working. I mean, we're talking like one to two, one to three, insulin to carb ratio.

Scott Benner 6:36
So what do you do? Like, I mean, kind of walk me through, like, pick any of your patients in your head, I don't need to know their name or their details, but the first time you see this, how do you how do you try to help them?

Bonnie M. McCann-Crosby, MD 6:48
Well, um, you know, we try different types of insulins, obviously, if one is not working, you want to kind of go through all the other options. So if Humalog is not working, okay, let's try Novolog. Let's try a pea dry, let's try, you know, fiasco, let's try any different type of insulin, to see if that will work and create a similar or less, you know, less similar response, you know, and that can even prove challenging as they're going through this. And so, you know, oftentimes, we'll get our allergy and immunology colleagues involved as well to see if there's anything we can do, potentially topically, like, like a steroid cream, or even orally, like anti histamine, anything that can kind of mitigate the reaction, minimize it. And so that's kind of the starting place for these type of cases.

Scott Benner 7:42
So there are there are different levels, like are there some people who you can treat like with a topical, something that that keeps it reasonable? Or, but we're not talking about that right now? We're talking about, like, really extreme cases?

Bonnie M. McCann-Crosby, MD 7:55
Yeah. You know, and, of course, you know, there's a lot of people that do have like skin sensitivity to, you know, maybe a little bit of an air area around the injection. And it's more common, of course, with like adhesives, with pumps and things like that. And then, you know, yes, you can do topical things. But when you get to the level where, you know, you've got significant, you know, inflammation and a reaction to that level, you know, you got to start thinking, Okay, what, what else are we going to do long term, right? Because even if a person were to become, you know, tolerating a new insulin for a little while, that doesn't necessarily mean they're not going to develop a new reaction, right? So you still have to monitor and maybe they're doing okay for a little bit, and then potentially, they could have another reaction later on to a new insulin. So it's definitely a challenge to try to figure out like, what's the long term game plan for this these cases?

Scott Benner 8:49
What are the most extreme things that you've seen happen to people's like day to day life because of this?

Bonnie M. McCann-Crosby, MD 8:57
I mean, you know, DKA is obviously the most extreme, right, because, you know, they're not getting absorption, they're in the hospital multiple times, in, you know, blood sugar's run in three hundreds plus all the time, and you don't have a lot of reserve, right. So, you know, if you are missing, at least even like a fraction of absorption, you're going to be at higher risk to go into decay. And then, you know, just on a day to day basis, I mean, you know, think about it, if you are having pain every single time you inject insulin you become maybe you don't want to inject your insulin, right, maybe you become kind of depressed because every single time you do this, it's causing excruciating pain over and over and over and over again, and there's not really a good, you know, other solution for you. And so that, I mean, that's the worst part of it, I think, is a psychological aspect.

Scott Benner 9:55
I would imagine too, it could lead to eating issues like oh yeah, refuse Right. And so

Bonnie M. McCann-Crosby, MD 10:02
it may you know it, you know, patients may choose to kind of carb restrict or you know, more keto, but that, you know, in growing children is obviously a concern, right, they need, you know, certain amount of carbs to grow and so that that definitely becomes challenging.

Scott Benner 10:21
So, I want to just be clear, like stopping here for a second for people listening, like my daughter doesn't like vs burns her right? Like if she wears a pump with the Aspen and for a couple days, she says the spot is sore, like so we just say okay, like she doesn't her body doesn't tolerate something about vs very well. But that's that's not what we're talking about, like, about like, significant severe things to the point where if you go back to Episode 504, and listen to the conversation with Sasha, like, she's having all of the issues that that Bonnie's describing now, like, and I feel like I should be calling you Dr. McCann Crosby. How do you want me to talk to you? What do you want me to does? Either way, it doesn't matter. I'm gonna go with Bonnie. So I hear just enough Texas and you're you're making me feel very comfortable. So this is a big deal. And and the stuff that that that Bonnie is describing here is super real, like people not eating there. It can't get their blood sugar's down, ending up in DKA. Like and not in, there's no end of it. Not going to stop for them. I don't want to give the whole thing away about 504 in case people want to listen to it, but oh god, Bonnie, this isn't Can you hold on one second? Um, so yeah, this never happens. But hold on, yeah. Are you using insulin? If you are, wouldn't it be great to see what it's doing. And I mean, by what it's doing, I mean, what it's doing to your blood sugar. Don't you want to know how quickly your blood sugar is moving. And in what direction? You can you know, with the Dexcom, G six continuous glucose modeler, speed, direction, and number, all at the touch of a button, really, you could just open up your Dexcom receiver and there's the information you need, or you can use your phone as a receiver. My daughter uses her iPhone. Let me pull up her blood sugar for you right now. Interesting. 123 is her blood sugar. And I can see it starting to come down. Right, so she's eaten recently, a higher carb meal. That's kind of sticking to her a little bit. But I can see the insulin working. And I can see it's crazy. I'm just looking at the graph. And I can see her blood sugar kind of bending, right, like it's a little stable. And now it's sort of curving down. It's it's telling me that the Bolus we use this working and you can see all this as well on your Android or Apple phone. I'm a follower of my daughter, she can have up to 10 My wife is also following that would leave eight more nurses family members well meeting people on the block. I don't know you whoever you want, you can let whoever you want follow. You also don't have to let anyone follow it's completely up to you. Dexcom is going to tell you the things that you need to know to make great decisions with insulin, speed direction and location of your blood sugar are you 88 unstable for 88 and falling big difference right 88 and stable Whoo, all good falling might need some carbs going up might need some insulin. All right in front of you on this easy to understand graph. It's just a line it kind of just just flows into the future up down stable and soon after using it you just get a vibe for it. You know how it works and you can kind of be ahead of the diabetes roller coaster instead of you know hair back and screaming and always riding it dexcom.com Ford slash juicebox I can't I cannot I cannot tell you properly I don't think what a big, big big impact it's made on my daughter's health and mine. Before I go I want to remind you to check out touched by type one.org It's a wonderful organization doing things for people living with type one diabetes that are just so heartwarming, you have to see them yourself and you can at touched by type one.org also on their Facebook and Instagram pages Alright, now we'll get back to Bonnie I know I was the one that interrupt this episode. I'll tell you guys when it's appropriate why I've been getting a lot of calls. While I've been making the podcast lately but not right now. For now let's get back to Bonnie she's going to explain how they took care of this problem for her patient. It's legit amazing.

I'm really sorry Bonnie, I had take a phone call, which I apologize for. Okay, so we now understand completely like what this the impact of this is, and that you really don't have any recourse or you didn't you thought had any recourse as a physician, these people still need insulin, they're going to have these reactions like trying to, you know, treat what happens next isn't fixing the problem. It's just kind of quelling, you know, symptoms that as bad as they are, right. And so, when you contacted me, you were just looking to speak to Sasha's family, right?

Bonnie M. McCann-Crosby, MD 15:33
Yeah, just to kind of hear their experience and kind of different things that they had tried in the past and how things were going for them currently.

Scott Benner 15:44
And after speaking with them, what did anything strike you to try? Or where did you think you were left?

Bonnie M. McCann-Crosby, MD 15:50
Well, you know, her case is, is certainly very unique. And you know, in her case, they ended up with the the Daya port system, which required a lot of planning and time invested, because it is only available in Europe. And apparently, they had to fly this German surgeon over to Canada, and you know, he had to train them how to put this thing in, and then the upkeep and everything like that is is quite expensive for the ongoing supplies and the insulin. And, you know, it's it's definitely a lot and you know, you know, reaching out, I did reach out about diapers in the US, but that is, you know, very, very complicated and requires FDA approval, which of course, takes a lot of time, right. And so, just kind of thinking about other ways for these patients. In one, one thing came to mind, which is technically not FDA approved for people younger than 18. But is the inhaled insulin, a Frezza? And yeah, so that's kind of, you know, honestly, your podcast was kind of just opened my mind into thinking about different ways to treat patients with these insulin allergies. And, and that kind of led me down towards the Frezza pathway.

Scott Benner 17:19
When you thought that, did you then think I'm a genius, afterwards? Because that's what

Bonnie M. McCann-Crosby, MD 17:23
No, no, this was actually, you know, you know, these, these discussions are never made, you know, just with one with me, right? So it was kind of my whole, my whole team, were kind of talking about these situations, and what else could we try? And so it was a team.

Scott Benner 17:37
All right. Okay, Bonnie, everybody's hurt. Yes, man. Okay, everybody helped. I understand, like, yeah, fake credit from anybody. But I'm just saying, I would have been like, Oh, my God, I'm a genius. So to kind of, like, tease this out a little further to make sense of it. If if a person who's allergic to their injected insulin, gets it through this port, it magically doesn't, it doesn't bother them anymore, right? It becomes then the problem of the expense and the difficulty, right, and that there's a certain kind of insulin that you use with the port. That's not it's very expensive and not covered by insurance, etc. So right, right, right. But but the takeaway from that should be if you can bypass the subcutaneous delivery, somehow, they're not having a reaction. Right? So when you think a Frezza is, is the molecule sold, so different, that it doesn't make you think, Oh, God, what if we spray insulin in their throat? And they have a reaction in their throat?

Bonnie M. McCann-Crosby, MD 18:37
No, that's, that's a definite concern. And so, um, yeah, because it, you know, it is, it is human insulin, right? It's the same and it's just not being injected into subcutaneous tissue, obviously, it's inhaled, which is, you know, brings about its own concerns, which we can kind of get into, when we talk about how one would kind of initiate this in a patient with a concern for insulin allergy,

Scott Benner 19:01
I would imagine you find the flesh on them that is most likely inside of their mouth and spray it on it and see what happens. Is that what you did, yeah, so

Bonnie M. McCann-Crosby, MD 19:09
um, you know, in these cases, you would definitely want to get allergy and immunology Doctor involved, to be able to kind of help monitor for reactions. And so I think, you know, first would be to kind of try a little bit of a local area in the mouth and just kind of see like, how that goes. And then, when you're really going to do first dose, true inhalation you really need it monitored, right, in a clinic, with an allergist who can be prepared with, you know, epinephrine, and anything that is needed in case we have an anaphylactic reaction in the lungs, right like that. So that's, that's the big concern, obviously. So it needs to be done in a very carefully monitored situation.

Scott Benner 20:00
Were you there when it happened?

Bonnie M. McCann-Crosby, MD 20:02
I was there. Not in the, you know, not in the room. But, you know, I'm there in the clinic when when these things are done. So yes.

Scott Benner 20:12
What was the story? was the concern? All was it as great as what if we have to like, tube this person? Like couldn't have gotten that bad? Like it was at your expectation that it could have went anywhere from Hey, this could work? Yeah, we might have to assist them in breathing.

Bonnie M. McCann-Crosby, MD 20:27
Yeah, I mean, you have to, you have to plan for the worst, right? Like hope for the best plan for the worst in these cases, because you just you don't know what's gonna happen. And so, you know, and, again, has to be very closely monitored.

Scott Benner 20:40
You just described being married. I don't know if you're married or not. But oh, I am. Yeah. For the worst hope for the best. It also applies to raising children and buying a dog. So it really does. It applies to everything. So I'm like, I'm so I'm fascinated. So this patient, you had one in mind that you were going to try it with first, I imagine. Right? Okay, this person comes in. And what happens? I mean, you they have, I mean, do you have it? Is that how they like What's the word for how Yeah,

Bonnie M. McCann-Crosby, MD 21:11
it's inhaled? Yeah. I mean, it's like, like an asthma inhaler. So you know, you can kind of have a device, kind of, just breathe it in your mouth, right? Just inhale it. That's how it works

Scott Benner 21:23
for they took in some carbs. And then you were like, Alright, here we go.

Bonnie M. McCann-Crosby, MD 21:26
Yeah, that's how it how it's done. Wow.

Scott Benner 21:29
Like the almost like a last meal situation. would have been like, yeah, this goes upside down. I want to have something really good. So okay, I mean, like, what happened?

Bonnie M. McCann-Crosby, MD 21:45
I mean, you know, again, I can't I can't say specific details, of course, but, you know, overall, good response. And no emergencies occurred. So

Scott Benner 21:57
yeah. So they were able to inhale the phrase, is it a phrase or a phrase? It's a Frezza. And they did not have any like, but like pain, bumpy bumps, bubbling, anything that was happening on the on their skin with the other insulin just didn't know. Wow, that must have felt amazing. For them to you for I mean, I would imagine everybody's just running around thrilled. Yeah. Can you has this made a significant impact on this specific person's life?

Bonnie M. McCann-Crosby, MD 22:27
I mean, again, I can't really speak to

Scott Benner 22:30
tell me where was it a was it a improvement? Yes. I

Bonnie M. McCann-Crosby, MD 22:35
mean, overall, yes. Okay.

Scott Benner 22:36
Are there still issues? No, no. Wow, you were just being very careful to protect people's information. Okay. Excellent. So Wow. So you fixed it, Bonnie? And your friends, everybody who helped? I understand. Don't worry. Yeah, yeah. Wow. So then do you look back at other people, like you start going through records and finding other people this has happened to in the past? And like, what's your next feeling after you accomplish that?

Bonnie M. McCann-Crosby, MD 23:01
No, definitely. I mean, if there, you know, Are there cases that come up? We're gonna keep this kind of treatment in mind? Because, you know, I think it's a viable option. Now, of course, you know, this does not replace long acting, right, this is only short acting therapy here. So you have to make sure that, you know, these patients can be on a long acting, of course, so whether that be Lantus, Joseba, Basal, or like whatever, but you have to make sure that they can also tolerate a long acting that we don't have a reaction to, you know, obviously,

Scott Benner 23:35
in this very, in this specific situation that we're not being very specific about, could that person tolerate along I think insulin? Yes. So what do you think it is about the shorter acting insulin that they can't take? Do you think it's a preservative or something? They have you ever looked into what what they're allergic to?

Bonnie M. McCann-Crosby, MD 23:52
Yeah, I mean, it's possible it is a preservative and I and we haven't tested you know, specifically but it there's got to be something in in that short acting that that these these patients are obviously reacting to, but because maybe it's just something some reaction, you know, within the skin, but yeah.

Scott Benner 24:18
And it doesn't matter like like you said, a PG or Novolog, fiasco, whatever, you tried the same reaction. Wow, that's crazy. So but that thing doesn't exist in even in the modern Basal lecture Seba.

Bonnie M. McCann-Crosby, MD 24:37
You're not sure you know, everyone is there. Yeah. I mean, I think there's different ones that are there different preservatives and each one so I mean, I think you just you have to try each one to see which one they're not reacting to. So, you know, we were able to find one long acting that did work without any issues.

Scott Benner 24:56
Would you share that or can you know, okay, Well, if I get the person on it, I'm sure they'll be able to tell me. I'm sure they will. That's amazing. Oh, wow. Like seriously? Like, is this one of those like, this is what I became a doctor for moments. I like to think so. Yeah, no kidding. I mean, that's just such a big shift for someone like me really, like, just boil it down to it's, it's, oh my gosh, you have diabetes, you're gonna have to take insulin every day for the rest of your life ups. You're allergic to insulin, sorry. Like, where do you like there's nowhere to go? Like, so there's people are torturing, they're torturing themselves with this insulin because it's their only option. How many people do you think you've seen with this issue? Well, first of all, how long you've been practicing? And then how long do you think you've seen? How many people do you think you've seen?

Bonnie M. McCann-Crosby, MD 25:44
So I've been practicing for six and a half years now. I mean, this is extremely rare. You don't? This is not this is not common. I mean, this is like a I mean, it's it's like you're lucky if you see a case in your lifetime, probably.

Scott Benner 26:02
It's not or unlucky, I guess I should say, it's not even a thing like like, since then when you when you meet a person who's newly diagnosed, you don't think in the back of your mind? And I hope you're not allergic to it just right.

Bonnie M. McCann-Crosby, MD 26:14
It's just it's not really, it's just not these are not common things, of course.

Scott Benner 26:19
Okay. Wow. And so do you? Do you know of a handful of patients like this? Or? Not even? Not even? So are you on here today hoping that people will hear about this? And in case it's they've been touched by this problem?

Bonnie M. McCann-Crosby, MD 26:35
Yeah, I mean, I think the big thing is that, you know, this is an option, right? And, and if we are stuck in a position where we can't really get the diapers, or that's not really a feasible option, then this may be an alternative. That is a lot cheaper. And, you know, potentially, you know, life saving, honestly, it's less

Scott Benner 26:56
and less, just less of an encumbrance. Which right, you don't need an extra thing when you like, you already have diabetes, you don't need more stuff, you know, right. I, so I have to ask you, because that's just how it occurs to me. I mean, I remember when I first came on the market, and people said, Are you gonna try this with your daughter? And I said, I'm not real comfortable with her inhaling something and putting it into her lungs? And I don't know anything about it. I want to be clear. I couldn't, you know, and I'm not I'm not making a judgment. I'm not saying that. There's any studies, I'm just saying that from a knee jerk reaction as a parent, I was like, No, thanks. But do you prescribe it? Generally speaking, in your practice? No, you don't

Bonnie M. McCann-Crosby, MD 27:36
know. Well, and I think, you know, to kind of explain, there are some limitations with it, right. So it only comes in certain unit cartridges, there's a four unit, an eight unit and a 12 unit cartridge. So in littles, you know, who are on I don't know, half a unit with meals, or you're really trying to get precise with the dosing, you can't like, you have to be on a high enough dose that you're on able to take at least four as a minimum, right. And the other issue is that it does not last as long, as you know, say homolog, Novolog. And so they may need in between meals, potentially a correction dose to, you know, to bring down potentially a high postprandial and the dosing, it is different, slightly different. So usually, when you go from human log, or Novolog are one of the other injectables to a Frezza, you're going to be on 20% Higher, potentially dosing on a Frezza than you were on short acting. So it does have some limitations. And then, of course, it's not really, it's not studied in kids. So it's not FDA approved in kids less than 18. So you do have to get, you know, special approval, if you do have a patient with an insulin allergy. And then the other thing to keep in mind is just, you know, you can't use it in a person that has an underlying lung issues such as asthma, right? That could be a bad thing, right? So they have to have healthy lungs, and then you do have to monitor lung function over time to make sure that it doesn't change once you're doing an inhaled drug like this for a period of time. So that's recommendations to get, you know, lung function studies, when you're on this medication.

Scott Benner 29:36
Gotcha. Did you do one initially, so you had a baseline? Cannot say, oh, but would be a good idea, right? Yes. Yeah, just say, I gotcha. I will tell you that I know of a handful of adults who listen to the podcast who use it and really like it. So I'm not I'm not unaware of it. And I just, I don't know, it seems like did you have well, I guess you didn't have that polling the side of you because this was it right. You were down? Yeah, this was the option. Yeah. Wow. It's just amazing that it worked.

Bonnie M. McCann-Crosby, MD 30:08
Yes, absolutely. Yeah.

Scott Benner 30:09
I mean, just it's i It's miraculous, you know what I mean, there's, I think it's because I have the experience of having talked to Sasha for an hour and listening, you know, from like, a young girl, and she, you know, explaining how it's impacted her life. And I follow her on. I think I follow her on social media now. And just to see kind of the lightness that exists in her life now, like, she acts, she's acting her age, and she looks happy and everything. And it's just a really kind of amazing idea. So are you worried about it? lung function wise? Like, take up? Take out for a second? This is what had to be done? Are you concerned?

Bonnie M. McCann-Crosby, MD 30:48
No, I mean, I think as long as you're monitoring, you know, if any changes come up there, I mean, we're gonna you know, you'd have to kind of figure out what's, what's the next plan, but I'm in a, you know, people with healthy lungs going forward? I think. I'm not I'm not super concerned.

Scott Benner 31:08
Hey, I have a question. I didn't ask. Not that you would want to do this. But you try regular an MPH. When you are going through all the different?

Bonnie M. McCann-Crosby, MD 31:16
I mean, yeah, you have I mean, if you're gonna go to a Frezza, you have to try the other ones. Everything you little

Scott Benner 31:20
You tried. Okay, I just went, Yeah, did everything. Yeah. Wow. Oh, my God, I am not asking you anything. I should be asking you because I'm a little overwhelmed how excited I am about this. I didn't expect I'd be so elated by the conversation. But is there anything I'm not asking that you think should be added here?

Bonnie M. McCann-Crosby, MD 31:40
No. I mean, I think I think it's really important, especially, you know, if if someone comes in and does have an allergy, a true allergy, I mean, you have to think about this as a viable option. And I, and I'm glad that you know, it is right, in anything that can be life changing and, and help people not be in pain all the time. Like, this is huge. So

Scott Benner 32:06
So is it. Is it fair to say, Bonnie, that if if somehow magically, five people walk into your office today, they all had that level of allergic reaction to injected insulin? You would say, Well, let's try this. That seems like the viable and maybe only next step?

Bonnie M. McCann-Crosby, MD 32:22
Yeah. I mean, I think it is, I think it is, I mean, short of, you know, going to Germany and getting a diet for right now. I mean, I think that's probably the best best option. If you've exhausted all the other, you know, short acting insulins, I mean, this is a this is definitely an option. But of course, you know, it does, like I said, require getting a prior authorization just in kids. Right. But, but yeah, definitely

Scott Benner 32:50
remind me, and I went over it real quickly at the beginning, but part of the problem with the port was that the company might not be making it anymore, or is that correct? And then, and they insulin was like, literally like 14,000 in cash a year.

Bonnie M. McCann-Crosby, MD 33:02
I don't remember how much it was, but it was, it was very expensive. And even, you know, the, the maintenance of the diapers itself, like all the supplies that you need, and things have to be replaced every year, and it is costly.

Scott Benner 33:15
What is the what is the port do? How does it? Is it like a metal spike? Oh, you know,

Bonnie M. McCann-Crosby, MD 33:22
I don't know exactly what it I don't know, it kind of it looks, it's hard to hard to describe, you can look at the website and see like in a better picture than probably what I can describe. But it basically, you have this little port that goes into the peritoneal cavity, like in your, you know, in your abdomen, and, and then you've got a connection that connects from that port on the inside, to the outside where you've got an insulin pump running and, and pumping insulin. And it's an older version of an insulin pump. I can't honestly cannot remember the name of the company that makes it but they don't make that pump anymore. So but but that's the one that connects with the diet board.

Scott Benner 34:10
It's a ton of hurdles. And I guess if there's, I mean, if you've only seen one in your six year career, and I've had people reach out to me, I have not having a lot of luck getting them scheduled on the show for some reason. But there's like a handful of people who all know each other who have this happening with their kids. And I think they heard episode 504. And then they reached out I have been trying to book them, but I'm not having a ton of success. But I mean, even at that I reach a fair amount of people and that I only heard back from four people was is pretty telling, you know, oh, yeah, yeah, yeah. So companies aren't in the business of I mean, I know it sounds harsh, but companies aren't in the business of making things that four people can use.

Bonnie M. McCann-Crosby, MD 34:50
You know, right. Right. It's

Scott Benner 34:51
true becomes a comes in an issue. Can I ask you a couple of other questions before I let you Yeah, cool. Absolutely. How do you handle I like this You're I was looking at you online. It's not creepy at all. It was just to get ready for this. Do you see yourself as a person who treats thyroid disorders in and out of the box? Way? Are you? Are you very by the book?

Bonnie M. McCann-Crosby, MD 35:14
I mean, I think we have obviously, like evidence based guidelines that we follow, right? And you know, sometimes you, you know, every case is unique, right? So if a patient has a specific need, you may have to kind of think outside the box, potentially, I would say that, in general, I follow the the guidelines, and if there's something that is an outlier, then you have to kind of alter and kind of figure out what's best for that patient.

Scott Benner 35:40
So like, if I came in, and I was like, Hey, here's my nine year old, we'll call him Jimmy, and Jimmy's tired all the time and can't pick his head up off the floor. He's like a puddle. But it's TSH is two and a half, you give you give him a thyroid replacement hormone?

Bonnie M. McCann-Crosby, MD 35:54
Probably not.

Scott Benner 35:55
Okay, what's the number you're looking for?

Bonnie M. McCann-Crosby, MD 35:58
So, I mean, in general, we, you know, my practice is if the TSH is above 10, or the free T four is below the normal reference range, those are my now everybody's different. So right, like if I've started a little bit lower TSH levels, but those are the kind of the general guidelines

Scott Benner 36:19
when that happens. And I don't I'm not setting this up to be an indictment of you. I'm trying to understand the bigger picture if the if the practice or the hospital if that's the the treating rule, then did the physicians not have a lot of autonomy?

Bonnie M. McCann-Crosby, MD 36:32
Oh, no, they

Scott Benner 36:33
do. They do. Thank you. Yeah. All right. I just I was wondering, I, we have a really popular episode with a with a fibroid doctor, who, you know, talks about treating the symptoms, not the number. And, and then a lot of people run into trouble when they go back to their doctors, and they're like, Hey, this is my kid, His hair's falling out, and he can't stand up and be like, oh, is TSH is only five. And then eventually, they get to somebody who gives them the, the hormone and the kid pops back up like a fresh flower afterwards. So I was just, I was just wanting, I was looking for, like a real like, like, outside of the I know, that's not what we're talking about. I just wanted to like have like a top line reaction from you so that people could understand what's happening when they go to the to the doctor?

Bonnie M. McCann-Crosby, MD 37:19
Yeah, I mean, I think you've got guidelines for a reason. Right? But then, you know, every case is different, right? It's, I think you have to look at it on a case by case basis, and then, you know, come up with an individualized treatment plan. So I mean, you know, I would say those are my usual guiding numbers. Right. But, you know, there have been times where things you start at a slightly lower TSH level, you know, so, you know, you just have to kind of take each case individually.

Scott Benner 37:45
Can I ask you what made you want to be an endocrinologist? Oh,

Bonnie M. McCann-Crosby, MD 37:48
man, yeah. Um, I was a biochemistry major, in undergrad, and endocrine, to me, there's a lot of biochemistry involved. And there's a lot of, I love the feedback loops. And, you know, from the hormones, and I loved also just the continuity. You know, you're seeing patients from sometimes, you know, itty bitty all the way through graduating high school, and I loved being a part of their lives for that long, and the subject matter was just super interesting to me. And I liked the fact that, you know, if you were missing a hormone, I could give it back to you. Right, I could treat it and I felt like it was actually making a difference.

Scott Benner 38:32
That's excellent. So no, there's no type one in the family or anything like that. You just know, you're just a science based person to decide. Yeah, that's, that's really cool. Okay, I have a question that maybe you can uniquely answer. Sure. You're in your position, and you're helping a person, and they get up the nerve to say to you, hey, I don't know what happens. They get this like Rocky in a one scene, you go, this is amazing. You're doing great. And they say, I listened to a podcast. What's your first reaction the first time you hear that?

Bonnie M. McCann-Crosby, MD 39:04
I mean, I'm pretty open minded when it comes to that. So I'd say Okay, tell me what podcast you're listening to. And, you know, so I would be interested to know, like, what they learned, and maybe I can learn something

Scott Benner 39:18
that is very progressive. You Thank you. I just I would assume that the I mean, I'm putting myself in my shoes. I know, this is crazy. But I would if I was you. I'd be like, Oh my God, these people on the internet. And so, but I mean, so it happens once you're interested. How many times do you think somebody has brought it up to you

Bonnie M. McCann-Crosby, MD 39:41
has brought up what sorry?

Scott Benner 39:43
No, no, I'm so sorry. Like, how many different families do you think have said, I listened to this podcast?

Bonnie M. McCann-Crosby, MD 39:48
Your podcast? Yeah. Gosh, I want to say I mean, a handful, probably. Four or five? Yeah, I mean, it's definitely I hear about it on a regular basis.

Scott Benner 40:02
That's so cool. Do you have any questions? For me? Do you have like, do you want to know anything? Like why? Like you? I don't know. Maybe you might be like, No, Scott, I'm done. Now I've talked about the thing, we're finished. But no, no thing that like springs to mind. Like,

Bonnie M. McCann-Crosby, MD 40:19
No, I'm just, I'm super, you know, I hear really good things about about your podcasts. And I'm really glad that you're doing what you're doing. And I think, you know, being an advocate for families, for for kiddos with type one, and you know, I think it's great. I don't know that I didn't prepare any specific questions. So,

Scott Benner 40:42
so my thought I'm sorry, I have caught you off guard. It's, uh, but my my thought like, I'm trying to imagine you in that situation where somebody comes in, like literally says, like, I mean, I get my correspondence is pretty consistent. It happens constantly, all day long. So I've gotten three today that almost if you if you read them quickly, you think they were the same note, you know, my son's nine years old. My endo says they've only ever had three people with an N A one C and the fives, it's the stable. You know, I told him about the podcast, blah, blah, blah. Like, I just like, I would wonder like, what is the person saying, dude, like, like, what is like they're listening to this like, like, voice come through their earphones. They're coming back to me with a five, five a one. See the kids eaten whatever he wants. There's not a bunch of lows. Like what? Like, do you wonder if we're like doing like, you know, like, satanic chants on the podcast or stuff like, like the like, what is it? You don't mean? Like, what? What does that make you feel? Like? Like, even now? Like, how does that? Like,

Bonnie M. McCann-Crosby, MD 41:49
I definitely am not concerned that you're

Scott Benner 41:53
the most ridiculous thing I can think of? I'm sorry.

Bonnie M. McCann-Crosby, MD 41:56
No, I mean, I guess Yeah. I mean, what, um, and I honestly, I, you know, I have only listened to one of your podcasts. So I mean, I'm, I am actually kind of curious. Now. You know, what, what kind of things do you tell families with type one,

Scott Benner 42:13
I feel like I've bullied you into this body, but I'm doing it anyway. Okay, let's do it. Let's go there. So, to me, it's a it's, it's very simple and very complex at the same time. So the simple part is this. You have to get your Basal right first, then you have to learn how to Pre-Bolus insulin. And then you have to learn the different impacts of foods and be flexible about their dosing. And then after that, that's it. It's just flexibility. It's not staring at high blood sugar's it's, you know, it's just then that gets into the bigger thing, like the simplicity is right there. It's, it's Basal Pre-Bolus glycemic load index. And, and then it's bigger picture stuff. So that you begin to have these moments where things happen, and you can react so quickly to them, because you just know, and I think that's why a podcast format works. Because you just keep listening, and things just get in your head. And then suddenly, instead of like, Oh, God, I don't know what to do. You just do this thing. You take this step without almost without even thinking about it. And I think that it's, I've seen, the feedback that I've gotten is so consistent, that I would tell you that most of the people who've been listening to this show for more than six months, are probably with very little effort have a n a one C in the sixes and the ones that really like kind of pay a little extra attention or in the fives, no diet restrictions, no problem. And it's awesome. Yeah, and it really is just so anyway, I realized at one point that we were having these big conversations, and you'd have to listen to this hour to pull out like three nuggets which, which actually works, it's a great way for people to, like you don't mean like when you sit people down you go, here's 20 bullet points, and we're gonna learn them all. Like, that's nobody does that. Right? Right. So they absorb all these ideas. But eventually, I realized that like, there's a whole system here. So I contacted a friend of mine, who is I mean, she's had diabetes for well over 30 years, she's a CTE, which I know they don't call themselves CDs anymore. There's something else. And she she came on and helped me do specific drill down episodes on ideas. So now there's like this 20 episode series called diabetes pro tip. It kind of lives inside of the podcast. I would tell you, you listen to that. You're a one season the fives. Nice. That's it. And it's nice, absolutely free. I would never charge money for it. So that's awesome ads on the podcast, but I would never ask anybody to I just don't think the learning how to use insulin should cost you money. You don't I mean, so. Yeah. I love that. Yeah. i That to me, like that's the it's the whole thing. It's giving people it's giving people kind of, I don't know, agency over themselves right now. The the feeling that they can make a change instead of waiting three months, and then putting you in the unfair position of going here, look at all these graphs, what do you think is wrong? Like? Right, that kind of thing?

Bonnie M. McCann-Crosby, MD 45:13
Right. And I think I mean, that's that's the, you know, I love what you said about giving agency. I mean, I think we want to empower our families, our patients, and I think, you know, we want them to be successful. And I hate for them to sorry. I don't know I, I hate you know, this idea when you come in to see your endo and and you get kind of beat down for your agency. It's just a number, right? Like, but I love that you're empowering them to be successful. Right? And it's not as complex as it seems to be.

Scott Benner 45:51
Yeah, it's, it's actually, once you see the big picture, it's kind of like the I know, we're so I'm old at this point. But it's like The Matrix, like it's the spot. It's the point where you're like, oh, I can just stop these bullets in the air. Like, none of this is real, you know, you have that vibe that I think you come into diabetes. And the game is moving so much more quickly than you can follow it. You look like a high school quarterback in a professional football game. Right, right. And then all of a sudden, just like they talk about what some of the greats like the game slows down, and you can suddenly see the whole field and your decision making is just ahead of the game. Right. And I just think so much about I think that being ahead of diabetes is important. Like I think that playing from behind or chasing blood sugars is a fool's errand, like you need to write make a decision that impacts something so that at least you know that what happened next, you did. In fact, instead of having that feeling of like, I have no idea what's happening here. Like, like, and you get lost,

Bonnie M. McCann-Crosby, MD 46:54
right. And I mean, so often, you know, I always, you know, I feel like, you know, people are chasing their tails with blood sugars and all this, but no, and I think if you're proactive about it, I mean, that just sets you up for success. Absolutely. Yeah.

Scott Benner 47:08
No, it really is a, it. It's not I don't think diabetes ever is easy. No, I think you can get so good at it that it could feel easy. And I think that's an important distinction, like it is a really difficult thing. But you know, just, sometimes you have to look at it very micro. And sometimes you have to look at it macro. And a lot of times people get it flip flopped. I'll tell you one thing that I see super common is that people will have, I don't know, say they need a Basal rate of a unit an hour, but their doctor has them at point six. So then they make these aggressive Bolus is at meals because these meals are always spiking. Right? They don't Pre-Bolus Because nobody tells them to so they're there. They put in too much insulin for the meal at the wrong time. They spike way up and an hour and a half or two hours later, they crash down they get low and they have to correct it. Correct. Then they bring a coaster. Yeah. And you bring that graph to your doctor, your CD or whomever and you say, Look, I'm getting low after meals, and they always take away the Basal instead of looking and saying well, I bet you like look overnight here. Your blood sugar's one. It's pretty stable overnight. It's yeah, 170. If we made your Basal higher, I wonder if we could find stability at 90. And if great if we did that, I wonder how much easier it would be to Bolus for the Beals, right? And then we would balance the meal insulin better not find a low later. But somehow just seeing low to them means take away insulin. And it's backwards. It's sometimes backwards. But

Bonnie M. McCann-Crosby, MD 48:38
I agree. I mean, I think if you don't know. And that's why you like for me, I have to know like, what is the pattern? Like? When are you dosing? What are you? I mean, it's everything right? But if you don't understand the pattern, you're just looking at numbers. Yeah, it's up to you. You may say, okay, oh my gosh, the mealtime coverage is too much and back off, but that's not the right answer. So, no, you're absolutely right. You have to know what is the backstory, right? What's happening.

Scott Benner 49:07
There's a tug of war that happens in meals between the carbs and the insulin. And the biggest mistake I think we let people make is we we yell go when we when we push the button, you know, on the on the on the insulin at the same time we start eating which was extensively gives the carbs a head start. Oh, yeah. And then everything's just a mess, right? It doesn't matter if you use the right amount of insulin, if you use it at the wrong time. It's not going to work.

Bonnie M. McCann-Crosby, MD 49:32
That's 100% True. And I you know, Pre-Bolus Singh, is huge. And you know, it's something that I definitely stress in my practice is realist Pre-Bolus and they come back and they start doing it and you see the difference on the Dexcom and you're like, oh, wow, look, you're not spiking after meals anymore. It's amazing. It makes a huge difference.

Scott Benner 49:53
That's it's such a nice feeling to see people when they when they kind of crest that hill and they get it all of a sudden had a an episode go up actually, I had an episode go up today from a lady from Texas. Her episode is called crazy mom from Texas, which is just a name she gave herself. So I'm in the clear. But she's a person who reached out to me through social media and I ended up helping her kind of privately like just texting with her once in a while and asking her questions. That's about a year ago now. So, six months after I spoke to her, we recorded the episode and now six months later, the episodes up. And she texted me today. And she's like, look at my graph. And she sent me a 24 hour graph that's never below 80 or above 130. Amazing. She's like you, like, taught me how to do all this? And like, oh, my gosh, your text messages? Wow. So I just think it's, I think it's infinitely doable. And I I hope that the people that people count on have the nerve to tell them about the tools that they need instead of, you know, and and don't chastise them when they figure something out, because that is a big problem. People figure out on their own, they go back to their doctor, their doctor is like, you can't do that. Like, dude, it works look great. You know, they're like, oh, you can't do that. Like, I can't do like, and then they take their pumps from they change all their settings, and they walk out in the parking lot and put them all back again. Like yeah, yeah. What are we doing?

Bonnie M. McCann-Crosby, MD 51:16
Right? No, I hear you. I hear you.

Scott Benner 51:18
Where are you from originally? Because you're not from Texas originally. Right?

Bonnie M. McCann-Crosby, MD 51:22
You know that you notice that? No, I'm from Michigan originally. Yeah,

Scott Benner 51:25
you have like that upper midwest thing. But you you've you've used like one or two colloquialisms that told me you've been in Texas for a little bit. Really? Well. I

Bonnie M. McCann-Crosby, MD 51:35
have been here since I've been here since I was 12. And that was a long time ago. So yeah,

Scott Benner 51:39
you felt real mix like your your your accents. Cool. So that's it, Bonnie, we did it. Awesome. There's nothing I didn't forget to ask you are that you didn't forget to say then you can go back to your life.

Bonnie M. McCann-Crosby, MD 51:52
I think we're good.

Scott Benner 51:59
I want to thank Bonnie for coming on and sharing all of this. I also want to thank touched by type one for sponsoring the episode and you know what else Dexcom are also sponsors and they deserve a thank you as well. You can head over to dexcom.com forward slash juice box to find out more about the Dexcom G six continuous glucose monitor and get started today and learn more about touched by type one on their website touched by type one.org. They're also right there on your Instagram and Facebook feeds. Check them out, give him a follow. I want to thank you all for listening and let you know that I'll be back very soon with another episode of The Juicebox Podcast

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