Podcast Episodes

The Juicebox Podcast is from the writer of the popular diabetes parenting blog Arden's Day and the award winning parenting memoir, 'Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad'. Hosted by Scott Benner, the show features intimate conversations of living and parenting with type I diabetes.

Filtering by Category: Dexcom

#663 Neuf Means Nine

April 13, 2022Scott Benner

Greg is the father of a type 1.

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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.

COMING SOON

#662 Control IQ Ninja

April 12, 2022Scott Benner

Jeremy is a Control IG Ninja.

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Scott Benner 0:00
Hello friends and welcome to episode 662 of the Juicebox Podcast.

Today we're going to speak with Jeremy who is a past guest on the show. Today's topic is much different than his first topic. We'll cover that later in the podcast. But today Jeremy's gonna tell you about how he manages his son's type one diabetes with tandems control IQ. And let me tell you something, Jeremy is a next level guy, he's a bit of a ninja. He took what he learned on this podcast, and just kept learning about control IQ, and today he's going to tell you all about how he does it. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. After the show today, if you'd head over to t one D exchange.org, forward slash juicebox and fill out the survey, I would appreciate it you need to be a US resident who has type one diabetes, or is the caregiver of someone with type one, it only takes a few minutes T one D exchange.org forward slash juicebox.

This episode of The Juicebox Podcast is sponsored by the Contour Next One blood glucose meter, head over to contour next one.com forward slash juicebox to see my favorite blood glucose meter. Today's show is also sponsored by us med A plus rating with the Better Business Bureau always provides 90 days worth of diabetes supplies, has fast free shipping and accepts over 800 private insurers. And on top of that they take pride in you receiving better service and better care than you're accustomed to getting with your current supplier. Go to us med.com forward slash juice box to get your free benefits check or call 888-721-1514 Make us med your diabetes supplier. What episode were you on the first time?

Jeremy 2:26
Um, it was the after dark divorce episode. Yeah, we

Scott Benner 2:30
didn't really talk about like, yeah, okay, so go ahead and reintroduce yourself.

Jeremy 2:35
Okay, I'm Jeremy Ross Meyer. I'm a single dad of a type one diabetic named Damon is 13 years old. And we have been diagnosed for four years and our agency has been between 5.3 and 5.8 for over three and a half years.

Scott Benner 2:59
Wow. And in these three and a half years, have you always been using control IQ or has it been different managed? No,

Jeremy 3:06
we we've done all three, we've done straight pumping with tandem. We've done Basal IQ, pumping, and control IQ pumping, all maintaining that same a one C spread very nice. Okay. I mean, sometimes I feel like I was blessed to be able to straight pump because you really really understand what adjustments do to blood sugar. But it you can start anywhere. Really?

Scott Benner 3:35
Yeah, you could figure it out with needles, you could figure it out with pens, you can figure it out with a pump like it's all just watching the insulin go in and seeing what it does. It's I mean, it's great obviously to be able to adjust your basil on the fly and not have to wait 24 hours to inject the gas to try to make an improvement or change. Just real quick for people. That episode that Jeremy was on before 508 After Dark adult child of divorce you actually came on that one because you started out. Let me see if I can remember this Jeremy, this will be interesting. You weren't Oh no, I

Jeremy 4:09
don't know if it is that when because you said adult. Oh,

Scott Benner 4:13
I said the wrong one. Excuse me. Cheese 372 After Dark divorce and co parenting.

Jeremy 4:19
There you go start one

Scott Benner 4:22
second a pot. Actually. There's a lot of them here. I have one too. I searched divorce in my episodes and came back with four. No, no kidding. All right, yours is 372 about co parenting because if I'm remembering correctly, you are divorced as your child is diagnosed. And and we all get along, right? And you guys actually get along, right? And that's what you're talking about. Right? I did get a lot of impact. Impactful letters back from people where they're like, can you just interview somebody who's not getting along and how they're doing it? Yeah. And I said good. Like getting somebody who's not getting along with their ex to come on a podcast and talk about it as like people are not generally excited to divulge that kind of stuff. But I have gotten a little closer in a recent episode 625 was about divorce and disagreement and that person. Yes.

Jeremy 5:15
And it was an excellent, excellent representation of the other side.

Scott Benner 5:19
Yeah, yeah. So I finally got there. It's not I'm just saying not easy to get somebody to come on and talk about their spouse or their ex spouse. Yeah. Especially if they're not getting along very well. All right. So Jeremy, you're back today? Because? Well, I know you, and I know you, especially through the Facebook page. But through our previous conversations, and we tech sometimes, and you are very good at using control IQ. And, you know, I've had somebody on recently to talk about it. And we I thought had a pretty surface conversation about it. And I didn't know enough about control IQ to push back in certain places. So you're sort of on here to help me dig deeper? Sure, yeah. So I mean, kind of take it away. Tell me what you what you would tell somebody else if I said, Hey, should I should I try control IQ, what would you say?

Jeremy 6:10
So just to kind of give you an idea here, I also am, this is not an invitation to contact me and ask, I also can follow three other children up here in Montana that are on control IQ, I also control their pumps, they're a onesies are all below seven, as well. So I've kind of done this long enough with enough samples to understand what needs to be done with control IQ to get it to work. Not just on my child, but on different age children on male females in puberty out of puberty. But what it really comes down to is that, before we even get into control IQ, there's a few things that, in my opinion, it doesn't matter what pump you're on, that needs to be better understood or mentioned, before we get into control IQ. Stuff like consistency, how you treat lows, what you treat lows with using protein at night, and just allowing basil to do its job. The way that we treat like, between my son and I is we either use mots apple juice, that's the all natural stuff. Or we use gummies. We know how much apple juice to drink to get to three carbs, we know how much to drink to eight carbs, and it's consistent. And it works the same way every single time. And you're going to hear the consistency through the control IQ point of view as well. We know that what a gummy will do to his blood sugar. We know that when he's dropping this hard he needs this many gummies the longer that you stick with the same sort of thing. The better results you're going to have instead of just throwing Oreos that your child

Scott Benner 8:17
then like let me let me make sure because I know what you're saying. But I want to make sure we're all clear. Sure there are impacts variables all over diabetes, including the things you don't think of as being impactful. And the idea of you're getting low Oh, what do I do doing something consistent breeds a consistent response and more and more importantly allows you to move forward without crazy highs or crazy lows or things that you don't expect to happen so if you're consistent with how you bump your your low blood sugars, then you'll be consistent with what happens afterwards not just like hey this time eat an Oreo next time have a piece of chocolate cake this time yeah cuz soda like that kind of thing. Treat the yes,

Jeremy 9:02
there's always times dt the whole fridge Yeah, right. You know, there's always those extremely high delta where they're about to pass out and you just grab anything and everything and throw it down their throat doesn't happen often. If it is happening often there's something wrong but moving moving on from that we have to kind of talk about what what I call garbage in garbage out. Which means that you know, you need to be checking your Dexcom ratings, not just doing nothing about them. That starts with a good glucometer and I this is not an ad for

Scott Benner 9:45
you want me to do the ad Jeremy. The Contour Next One blood glucose meter. Are you about to say that are you about this? It's a great meter.

Jeremy 9:51
I just couldn't remember what the hell it was called. But you use one thing. But anyways, in the thing that we've tried difference. There are tons of third party studies out there that shows that that Contour Next One is the most accurate meter on the market period. Now, I understand there are some people that, you know, can't afford, you know, something like that, because the strips are fairly expensive. But they're, there's so many times that that meter will exactly match Dexcom. It's not even funny. Yeah, I agree. And then there's certain things about Dexcom. Like you need I hear I hear a lot of people say, Oh, well, we never calibrate. We're a family that calibrates with my son. If you do not calibrate, the second it comes on, it will dump Low to low, and it will die. You have to calibrate my son immediately when it comes on. And then you're good for the first two days. You have to calibrate on the third, then we have to calibrate on the eighth every other fingerstick that we do every single morning this this consistency. And every single night before he goes to bed is normally within five points.

Scott Benner 11:11
But you still do it, you still do it every time.

Jeremy 11:15
You still do it every single time. Yeah, you you have to the center will die. We've we've heard you know, Kevin Sayer Come on, and say that it's just it doesn't work the same way for everybody. We just figured out what works for us. And with a very accurate Dexcom reading from a very, you know, accurate glucometer you can stop the garbage in garbage out. And what I mean by that is only testing the blood sugar in checking Dexcom whenever this site arrows sideways, and making sure you understand how the Dexcom works.

Scott Benner 11:59
So that the numbers you're working with are good or accurate. So they can end up making good decisions with Arden's interesting artists decks, either works, boom, or needs to be calibrated on the first day. Yeah, one of the other. I don't, I don't, I haven't seen a rhyme or reason to it, I would tell you the last six of them we've put on I haven't had to do that. And then before that a couple of them need lit people's body chemistry is different. There's all kinds of different things going on. But your your specific point is so incredibly important and valid, which is you are making decisions, measuring a medication based on a number and you might be getting that number with a meter that's not accurate, or to CGM, that's not accurate. And then you're making decisions and, and running forward. I love that you test twice a day.

Jeremy 12:48
But here's the bigger picture. Scott. Yeah, you keep saying that I'm making decisions. Now putting algorithms and control, right? You have bad Dexcom ratings. It's 100 points higher. And it's dumping more insulin than it should. Garbage in, garbage out, you have garbage information going into the algorithm, you're gonna get garbage out. So it is very vitally important to make sure that you have a Dexcom rating that is reliable. Yeah, this is this is this is all algorithms. This is Omnipod. Five, this is control IQ. This is going to be control IQ 2.0. Whatever else comes out from Medtronic, you know, everything is based off of that blood sugar reading. And if it's not accurate, how can you expect your results to be accurate?

Scott Benner 13:43
They can't. And you have to take some responsibility for that yourself.

Jeremy 13:47
Yes, yeah, absolutely. Yeah,

Scott Benner 13:49
there's, can I take a tiny like, brief little sidebar here on the Sure. I'm forever interested when longtime type ones come on. And they'll say things like, I didn't want to get a CGM until there was no calibration needed. Because it's always the inference is always that it's such an inconvenience, like, why would I take on this new thing, if it still needed my effort? And I think that's an old timey way of thinking about it. You know, I think that I mean, a CGM for my daughter is first, right? Like seriously, if the house was burning down and I could grab a pump or a CGM on the way out the door. It would be the CGM, right? Not to say that it's a one of the other decision. I'm also of course, a huge fan of the pump. But But my point is that is that the idea that if it's not completely nothing, I have to touch you ever or nothing? I have to think about that. I don't want to do it. I don't understand. You know, like, this is just this is where we're at with this technology and, you know, using Dexcom G sixes, as an example, you know, they tell you, you don't need to calibrate that means that Got it through the FDA, and you're gonna be okay. If you don't calibrate, but you that might be that one day the thing thinks you're 130. And you're, I don't know, 150 or you're exactly you're 80 and it says you're one I don't know, like it might not.

Jeremy 15:15
Here's the thing, though, Scott, is that if you want better than average control, right, you need to have better than average information going in effort. And in order to get that better than average information going in, you have to calibrate. You hear people all the time saying, oh, Dexcom is 15 minutes behind, not if your line is straight. Not it. That's only whenever it's falling or rising. If it's if you're primarily straight, and I know and I will get into this later, that I'm not saying my son is straight all day long. He is not he is just like garden, he has trips to 180 Maybe once a day, and he comes back down. I am not one of those people that that craves a absolutely straight line. I do not go nuts. I just don't allow it to get nutty. In the long run. Yeah.

Scott Benner 16:14
But your point is, is that when you're in the middle of stability, and you're the blood sugar is 96. And it's been 96 for the better part of three hours. If you're there's a way to be certain that that's true. And by checking out checking with a finger stick and then telling Yes. And then calibrating sometimes,

Jeremy 16:32
and that's first thing in the morning when they first wake up. Okay, that's how it's working last a water. Check your blood. He knows every morning glass of water, check your blood. Water gets blood moving, and he doesn't have anything impacting his blood sugar. Dexcom should be pretty straight on.

Scott Benner 16:49
Yeah. And it is normally. Oh, yeah, yeah. Okay. Yeah, it's

Jeremy 16:54
like within five point, if it's within five, we don't touch it. If it's within 10. Like if it's 10 or more, we're calibrating. And that's both. That's way sorry for the swearing. That's that's just it's not acceptable. And I know that may sound extreme, but it's not. It really isn't

Scott Benner 17:13
from your from your experience. What's my question here? This is just proving out to you over and over again. Yes, but it is not white guys calm would tell you to do is that correct? Absolutely not. Okay.

Jeremy 17:28
I'm just like, you know, dumping more insulin on your kids 30 minutes after he just ate is not what an endo would tell you to do. So I guess, moving on more to like the pump. The next thing that you kind of have to remember is that you have to understand the pump that you're on. Doesn't matter which pump it is you have to understand how it works. Especially if there's no algorithm involved. Control IQ is not a miracle machine, like a lot of people think adjustments still have to be close and made and sometimes made often. But you start looking at the tandem and I don't want to start sounding like a tandem shill, but I am. The big things with tandem is that you can adjust basil in point 001 increments after point one, like Omnipod, or Medtronic can do point 05. That's a 50 times increase in adjustability. And we all know how much Basil is how and based how important Basil is. Something a lot of people don't know is that the on a tandem. The carb ratio if it's under 10 you can adjust it by point one instead of one year if eight isn't working. And nine is too strong. You can do 8.1 8.2 8.3 8.4 A point but you can do by point one to dial in that carb ratio. Once again, this comes back to consistency. You need to use it you can't just flop on either or if nines too strong you can't say oh well I'll just you know turn their Basal down for a half an hour. No, get it right. I mean, let's be honest. Our kids normally eat the same thing every morning at breakfast. I tried to offer him a million different things but it's always pancakes with chocolate chips, strawberries, and milk. Wow. Every single morning a lot of cooking. Well, we always get those frozen. Okay, okay, so pancakes.

Scott Benner 19:51
Oh, I got your mind Jeremy. You're whipping up pancake batter and cutting up strawberries and so, so back to that other point. You're saying that, like, for instance, Arden's carb ratio is one to four and a half, but it could end up being one to 4.7. Instead, yes. Right. And you have and

Jeremy 20:10
it will, it will allow the tandem will allow you to make those 10th adjustments if the carb ratio is under 10. And you may think, Oh, well, you know, that's just being too picky. Well, no, like, whenever carb ratios get below 10, they get crazy. You know, my son is 13. He, according to his Endo, I don't really understand it. There's four stages of puberty. And he's in stage three, and He's peeking right now. And he doesn't understand how he's still less than 1%. Low. And it's, you know, he doesn't understand how he's 5.6. And he doesn't understand a lot. But, you know, the proper pump adjustment is one thing, you know,

Scott Benner 20:55
yeah. So, these, all these little things put together? Or the answer or the answer to stability, right? It's the Yes, making sure that the data you're working off of is sound. It's not just randomly picking an amount of insulin, but actually being able to dial it in very closely. Yes, and it's consistency with how you are addressing low blood sugars. It's consistency with drinking that glass of water in the morning, before you test your blood sugar, like all those little things, do you find them to be overwhelming? Or did they just happen? Pretty?

Jeremy 21:30
No, they they seem a little at first, and I've had a few parents tell me? Well, that seems like a lot. I'm like, No, it doesn't real after about, you know, a week, you'll be like, Oh, this makes sense. And the families that I do help, you know, and that they do get this way, you'll see like a huge improvement. They go, Oh, I get it now. Okay, because you'll start seeing those improvements. You know, it's not just in the pump, or the algorithm. It's how you're treating everything else.

Scott Benner 22:00
So when you hear when you hear me say that more effort upfront, saves you a ton on the back end, that's how you Yeah,

Jeremy 22:09
yes. And but the thing is, is it doesn't become a lot of front, other than the first couple of weeks, while you're getting used to once you get it, you're not being strict, you're not forcing, you know, I'm lucky as hell that my son loves apple juice, and he's never become bored of it. I asked him like every other month or so hey, do you want to try something else other than apple juice? And he goes, nope, I'm good. Yeah, but, you know, boys, etc, sometimes.

Scott Benner 22:43
Come tell me if this sounds familiar, you're all set up with a diabetes supplier. And they've told you don't worry, we're gonna send you your supplies on time, you're never gonna have to call us again, this is going to be easy. And then one day, your stuff doesn't show up. You run out of your Dexcom supplies, your libre supplies, your insulin pumps, and the new ones aren't there the way they're supposed to be? So you call them up on the phone? And what do you say? Well, I don't know what you say. But here's what I say when it happens to me. Say you guys told me this wasn't going to be a problem. They say is this always happens at the end of the year? Well, we needed a new prescription. And we reached out to your doctor, but they didn't get back to us. Then there's this long pause. Like it's not their fault. The people who told you they were going to take care of this are now foisting the blame onto someone else. What does that mean that they reached out to your doctor? I don't know. Does that mean they sent him a fax, they call them on the phone? They send up smoke signals? I couldn't begin to tell you what my old suppliers did. What I can tell you is what US med does. It's simple. They get it done. There's no none of bones. Not supposed to curse don't Yeah, it's but you hear what I'm saying? us mad tells you they're going to take care of it. They're going to get a script from your doctor than they get a script from your doctor. That's simple. US med takes over 800 private insurances. They accept Medicare nationwide. And they always provide 90 days worth of supplies with fast and free shipping. carry everything from insulin pumps to testing supplies CGM. They have what you need. All you have to do is go get your benefits checked at us. med.com forward slash juicebox. If you don't like the internet, you could also call 888-721-1514. Well, now we know where you're going to get your blood glucose meter at but now we need to decide which one are you going to buy? If you ask me, I'm gonna say the one that my daughter uses the Contour Next One blood glucose meter. I have no copy in front of me. I'm not looking at a website. Let me just tell you why I would pick that eater. First thing that pops in my mind, it's easy to hold, easy to carry, easy to put in a bag, or pair of pants, or wherever you carry your stuff. And I mean, like a pocket. It's small, but not too small. It's easy to read has a bright screen and a bright light for nighttime viewing. The test strips allow Second Chance testing, here's what that simply means. Should you touch the blood but not good enough, you can go back and get more without interfering with the quality of the test result. And that is not to say that it needs a lot of blood, it actually doesn't need very much at all. The sample size I find to be very small. This is in fact, the easiest to use, handiest and most importantly, most accurate blood glucose meter that my daughter has ever used, that I have ever used, that I have ever been in the same room with the Contour Next One blood glucose meter, go find out more about it. At contour next one.com forward slash juicebox. When you get there, you're going to see a very informative website, and easy ways to get yourself a great meter, it's actually possible that the meter and test strips could be cheaper in cash than you're paying right now through your insurance for your current meter. And there's very little chance that that meter is as accurate as the Contour Next One, there's only one thing left for you to do. Go to a browser type contour next one.com forward slash juicebox. You will also find links in the show notes of the podcast player you're using and at juicebox podcast.com. And by the way, if you're listening in an audio after this podcast, please hit subscribe or follow. Alright, that's it for the ads. Let's get back to Jeremy he has a lot more to share about how he uses control IQ.

Jeremy 26:50
The biggest thing is like we're talking and once again about pump adjustment is you'll hear often people will tell you to adjust Basal by 10%. That seems to be a pretty standard adjustment. But I always tell people not to and here's why. Let's say your kid is point seven five an hour, and you add 10% to that the math to that is it will end up equaling out point eight to five, I believe. And that will be a difference of point 075, you're adding point 075 When adding 10% 2.75. So then there are 825. Which tandem doesn't have a problem doing it can go out to that 1000s Remember, so eight point or sorry, point eight to five plus 10%, they need more, another Basal increase, you're now at point 907. And that's a difference of point 082. So you've went from an increase at seven five of point 075. And you've now increased Basal again by point eight, two or point zero a two. Then from 907, you add 10% You get point 997. Now you're adding point 09. It's not consistent. Every single time whenever I first started out, I the best thing like the CD could have told me is every single time or she kind of showed me on an AGP report. And I'll kind of talk about that a little bit later. But every time you see a change here, I want you to just change the pump by point zero to five. That was my quote, baby step. That's what she called the baby step to me, but it consists and then it's consistent point zero to five because you will know what point zero to five does. If it keeps increasing because you're going by 10% There's no consistency there, you're adding more and more and more or taking away less than less. Currently, point 025 is a huge jump for us. Once you get basil dialed in enough. I literally move my son's basil by five 1000s of a unit of basil per hour. I know exactly what that does. And it's normally nine out of 10 times enough to get him perfectly back in life. Wow. If you take our Dexcom 90 Day AGP report it is a straight line with very little variation. And it's all because of the consistency it's knowing what that point 005 Or a point 01 change in Basal will do and keeping it consistent.

Scott Benner 29:53
How often do you think you've changed his Basal rates?

Jeremy 29:57
So I changed them Two days ago, before that I had not touched them in a month and a half to two months, even in full bore puberty. And he's still his average blood sugar is still down there, very low one, hundreds and zesty is in the mid 20s. That's excellent. And I wasn't able to I once you get dialed in and you fully understand how to keep things consistent, things stay consistent. Now I understand there are people in honeymoon that does not apply to you. There are people that you know, have sports does not apply to you while my son is active. Um, that's it. A lot of it's about knowing how to treat before sports before jumping on the trampoline before doing all this other stuff. He knows like before PE because he's moved into independent at school. He knows before PE he goes and asks teacher, Hey, what are we doing today? And if it's something like we're playing dodgeball, or we're running the mile he knows to grab, you know, something out of his bag, and get some carbs move it. And that's just more consistency. But let's you want to get into control IQ. Yeah. And I totally know.

Scott Benner 31:16
I appreciate your overview of how you think about it, though. Yeah, I mean, really, that's very helpful to me. Because I mean, you'll admit, I would imagine, maybe you won't, but you listen to the podcast. So you're thinking at this. I think you're taking like, things that I talked about, and you're being more granular with them. Yeah, much more so than I ever AM. And, and you're fine tuning things down even farther, like you're, you keep tightening that that wrench until it's exactly where you want it to be. It's, it's amazing. I mean,

Jeremy 31:49
but the thing is, like I said, is that once you get there, you don't have to do much work once it's about learning the patterns and staying consistent, right? And looking at the AGP report at least once a week, and saying, Oh, look at that, I might want to scooch that up a little bit. Instead of just, oh my God, what's going on? It's like, one day, it's just random. If it happens two days for me, there needs to be a change. If the third day, it's still not right, you're gonna get changed again. You know, something's gonna change. You know

Scott Benner 32:25
what my bigger takeaway from this is? That wherever you are. You're not too far. Why do I how do I say this? Hold on. Let me Thanks, Jeremy. If your management style keeps you at a 200 blood sugar, and suddenly your blood sugar tries to jump to an average to 10 blood sugar, you don't have to manage much to get back to 200. If your average management keeps you at 150, or 120, or 110, or at whatever your management style is, once you're there, and you can accomplish it, even when other variables come in and try to move you off of your success. The adjustments to come back to where your norm is, or not these great, crazy things that need to be done. Is that the thing you're telling me? Yes. Okay. All right. I agree. Okay,

Jeremy 33:14
so yeah. Let's talk about algorithms and how, how at least control IQ works. Because I often see in post, people saying, way, way wrong things. And I often want to correct them, but I often come off as a jerk. And oftentimes Scott has to get on there and say, Oh, well, like Jeremy is a really good guy.

Scott Benner 33:40
Boys are not well, sometimes boys are not good at communicating and writing

Jeremy 33:44
No, no, no, absolutely not. So the first thing that you need to know about control IQ, is there's three different modes, there's normal mode, there's exercise mode, and then there's sleep mode. We do not we're not sleeping beauty, we do not use sleep mode, 24 hours a day, there's a lot of people that swear by it, but my endo would come unglued, and I'm just not going to deal with it. Our results are fine, we don't have to go there. So in normal mode, this is where control IQ is at 90% of the day if you're using control IQ as it should be. I'm not saying it's the right way because there's many ways to skin a cat. So in normal mode control IQ will target 112.5 I know that's a weird number, but it is a real number. However, we'll adjust the Basal based on predicted blood glucose levels 30 minutes out that six readings. Now if you're maintaining between 112.5 and 160 it will deliver the settings that you yourself or your end have put into your pump, nothing changes, it's not doing anything but running off the settings inside your pump. Now, control IQ will increase Basal insulin. If the sensor glucose value is predicted to be above 160. In the next 30 minutes, once again that six readings it looks at and says, okay, they're moving by plus five, the delta is moving by plus five, every five minutes. If I apply that six readings out, are they going to be above 160? Yes or No? If yes, it's going to start increasing the Basal. Now control IQ will decrease Basal insulin delivery, if the sensor glucose is predicted to be below 112.5. In the next 30 minutes. Once again, six rings out. If you're 180, and you start dumping by 20s, it's going to start you know cutting insulin control IQ will stop all Basal insulin delivery if the sensor glucose level is predicted to be below 70 In the next 30 minutes. So if you're dropping hard, and if it depending on how fast you're moving, if it thinks that you're going to be below 70, in the next 30 minutes, it will cut all insulin. Oftentimes, you have to you have to understand that when setting your Basal that while it's important with control IQ, insulin sensitivity factor is just as important as Basal if not more important than Basal with Ctrl IQ. Okay, because the pump uses the ISF or the insulin correction ratio or the correction factor. However you want to say it to determine how much insulin to increase or decrease when making its modulation to the Basal. So what I like to tell people is to think of it as an aggressiveness knob. If you're seeing big cycling, which means the start to go high, and then the you start to go low, and you're kind of riding a wave all night long. What that means is that you've actually got two wrongs, which looks like a right. While it's fairly steady, you're cycling. And what will happen. This happens I know with loop a little bit too. Not sure about Omnipod five yet. But what happens is if you get the Basal a little loose, you'll start drifting up, then control IQ will say oh, they're drifting up, we need to add more insulin, then ISF is a bit too stiff, and it will start sending you a low and you will cut insulin, and then you're stuck in and then you'll start going high because of the cost of insulin, then you'll go low, because you end up cycling,

Scott Benner 38:06
bouncing. Yeah,

Jeremy 38:07
so what looks normal, might be two wrongs look like a right. So and that's the biggest complaint is that Basal IQ cuts insulin, then they go high. And then they overcorrect and they go low. Right. So your pumps already trying to handle it. And you're not allowing it to because of your settings.

Scott Benner 38:28
Are you saying that this becomes obvious when you see basically the settings fighting with each other? There, there's

Jeremy 38:36
they're not fighting each other. They're just wrong. They're wrong, but they're not fighting each other. It's just the algorithm responding the way that it was designed to respond.

Scott Benner 38:47
And using those settings, it makes you it makes you a little too low, it cuts itself off, which makes you too high, it gets aggressive again, which makes you low. And you're saying that if these two settings were more in line with what you actually needed, there'd be this stability where there'd be some insulin, but you wouldn't be taking it away and then adding extra and taking away and adding extra time. Yes. Okay. And that process of take even though the algorithm can keep up with the problem, mostly taking away giving back taking away giving back that is not your goal.

Jeremy 39:19
No, absolutely not. Okay. So we kind of went over what normal mode looks like exercise mode, in my opinion, my opinion, is completely worthless unless you're thinking two hours ahead and what 13 year old looks two hours ahead. The way it works is instead of targeting that 112.5 It will target 150 instead, it will still deliver correction doses if you're predicted to be above 100 ad in the next 30 minutes. It will still increase Basal if predicts the blood glucose to be above 160 In the next 30 minutes. Um will decrease insulin, even if it predicts the BG lower than 160. In the next 30 minutes, it will suspend. If it predicts your blood glucose will be lower than 80 in the next 30 minutes instead of 70, like in normal mode. So, if you know that you're gonna go on a bike ride into hours, then yes, you can turn on exercise mode, and it will protect you. And it's great. If you're running a marathon, you know, an hour and a half, two hours away to turn it on, it works great. But for a lot of parents, they say, Oh, well, it doesn't work. And that's because they turn it on right before their kid gets on the trampoline, and then wonders why Johnny goes low on the trampoline. It's not great for those kids, you know, and those families that are a lot more spontaneous. And you know, I don't know about a lot of people, but like, my kid has a full size trampoline in the backyard, next to a huge 16 foot pool. And yes, he uses them together all summer long.

Scott Benner 41:04
Well, I think that it's funny, because while you're talking about this, I'm relating it to loop in my head. Yeah. And what I'm thinking is that when I see when I look at overnight, what I want to see is that Arden's Basal insulin is not being cut away constantly. And exactly, and that there's no correction, that correction, boluses aren't happening all the time. And I do want to say that things happen, and you want the algorithm to work. But generally speaking away from impacts, like you know, boluses food, you know, hormones, like in just a normal time, which God knows Jeremy, how often do the normal times happen? But in those normal times, you want your settings to just work there where they are, and the result is low and stable. Yes, yeah. And not low low, like normal and stable.

Jeremy 41:58
Yes. And then that moves us into that sleep mode that everybody raves about. So, really quick sleep mode will target a very tight range of 112 and a half to 120. While it's on but not deliver any correction doses whatsoever. It will however, be much more aggressive with increasing and decreasing the Basal. Once again, that's where the insulin sensitivity factor comes into great play. You have to have ISF dialed in immaculately overnight, along with basil. But, Damon normally, he gets down in that. Oh, 85 to 95 range all night long. From one week after starting control IQ I slept every single night. I maybe have one or two nights a month where he has a compression low and an alarm goes off. Other than that, if it wasn't for my sleep apnea, I would sleep all through the night

Scott Benner 43:09
85 to 95. Yeah, yeah. And you're doing that not in sleep mode?

Jeremy 43:15
No, we're doing that in sleep. Right? Excuse me, we're just not in sleep mode. 24/7 like a lot of people do. There's, there's a lot of people that that their life is very dense normally on older type ones, or type ones that have the very, very stringent, stringent routine every single day where everything's the same. We eat the same breakfast, lunch and dinner, we exercise at the same point in time, every single day, there's not a lot of variation, you're able to turn that 20 that sleep mode on 24/7. And if you're these people that have those settings set up just perfectly, there is no reason for control IQ to dump a 60% correction. Right? They do that themselves. They're already so in tune with themselves. Because they've been doing this for so long that they're making although they don't believe

Scott Benner 44:14
that they're making. They're making great Bolus is around food. They're not fast living a lot to begin with.

Jeremy 44:20
Exactly. And so they they benefit from Sleep mode being more aggressive and you know, when they're when they're awake, because they're they're not running away. You know, running 100 yard dash whenever like a 13 year old sees a girl from half a block away.

Scott Benner 44:40
Yeah, right or going from the trampoline to the pool back of the trampoline or something like that. Yes,

Jeremy 44:45
exactly. I say. From there, it's it's a lot of it is understanding Dexcom reports and we're talking about clarity if you don't have clarity downloaded on your phone. Sign into it. There's tons of different reports. And yes, they look intimidating at first. Needless to say, the only thing that matters to me on on Dexcom clarity is that AGP report, it's the very last one, it shows you your average blood sugar at a given time throughout the whole day, then it has a blue bubble around it that shows basically, without getting horrifically nerdy shows you how variable you've been around that average blood sugar. And then from there, it's using those reports to make smart, educated, experienced decisions in a very consistent manner. To get better than average results, you look at the AGP report. And if you start seeing like on a seven day average, you keep raising every single day at 3:20pm. About an hour and a half before that will kick up. You should probably have a Basal segment there. It's about a lot of people will argue over two or three or one Basal segments in a pump. Yeah, my son has nine. Wow. And the reason that he has nine is because that's what he needs. And you look at a GDP report, like I said, I can pull up a 30 day graph and it's straight as can be. And the blue line is very, very close to that red, that red line in the middle. It's I don't want to say it's not rocket science. It's all with time and experience. And staying very consistent and understanding what each thing that you're adding is going to do.

Scott Benner 47:04
I'm pulling up Arden's AGP report right now. So they're gonna ask you a question about it. Because what you said was to make you know, you talked about making smart decisions about changes, but who tells you what those changes are? Like, what what about the report says something to you? And says, you know, go ahead, and, you know, this means do a thing. You know what I mean? Like, like, I have Arden's last. It's interesting, right? I just, it just popped up her last two days. And she's not, she doesn't have any hormonal impact in the last two days, or much less. Her standard deviation cuts in half, when that happens. Yeah, very, very interesting. It's it can go it can be as high as 40. At times, with still an average blood sugar of 110 to 114. Yep, yep. And then as soon as the birth control pill she's on goes to placebo, her deviation goes into the low 20s. Yeah, right away. And that's just,

Jeremy 48:06
and I've dealt with one other young, young, younger female, she was 13, that it was the same way. It just depending on what type of month it was, and we made those adjustments, and we made a different, you know, deal in the in the pump to deal with that time of the month. And we figured out, okay, every month, she needs this much more three days before she's really regular. Let's, you know, treat this the way it should be treated. We know that she's regular, let's be brave. And let's start increasing that insulin the day before, we know we need it. But go ahead and go back to the AGP reports. Let's

Scott Benner 48:49
talk about well, I got my glasses, but I'm, it's hard to count. So I just got old out of nowhere a couple years ago. So I went back and I went to 30 days now. So the last 30 days, the last three weeks, Arden has been trying. So I think everybody who listens knows like we're trying to regulate Ardens period with a birth control pill, it isn't going so great. But so I have her average glucose is 122 over the last 30 days, she has been very low 1.4% of the time, which means under 54, low 6.4% of the time, which means 70 under 70. I don't particularly consider that low, but that's okay. In target and the target of course is you know 70 to 180 for the report I have 80 Yes 83.4% of the time high over 180 10% of the time and very high point 3% of the time. Her coefficient of variation was 33 over the last month and like I said her standard deviation is 40. When you when you get all that involved now, in truth, I don't know I haven't looked back I don't look at CAP clarity as much as I should, to be perfectly honest. So so when I look at this line that I'm seeing, it appears to be incredibly stable. Right around 100 110. For this last 30 days, I see a little bit of an uptick around 2pm that lasts until about six or so. So if she does get higher, she can go 130 or so in that timeframe. And when I do see the 180s, it's in that exact timeframe, four o'clock, four o'clock to eight o'clock. Anyway, I don't know, what do I do with this?

Jeremy 50:36
So I focus on the red line in the middle, okay. And I kind of make sure that I understand that where males are and that there is going to be a spike. But in that 30 Day graphic lease, I normally make adjustments on the seventh day or the 14, but the 30 tells a lot. It tells how long have you had this problem. And if so, if you see on the 30 day graph, a slight uptick because I'm pretty I've seen AGP reports, and I'm like holy hell, and it takes a good month to straighten that red line out like rubber bands, that doesn't mean that they're like that every single day. That just means that your average, that's where your average is I don't care about day to day. Yeah, the median, I care about the average over time, because this is a marathon, not a race. And so if I saw on the 30 day graph, a slight increase at 2pm, I would look at my son's pump. And I would say okay, that basil at 1230, keeping in mind that his lunch is that 1130 At school, I know it's not lunch, that's the basil issue to me. And I would literally go to 1230 an hour and a half before two. And I found that all but one of the kids that I've helped, or one of the families that I've helped every single last one of them, it's been an hour and a half before the before the event on AGP. So I would go to 1230. And I would literally bump him if it's just a slight one, I would literally bumped him five 1000s on his Basal. Okay. And it will, at two o'clock it will hit and point 005 isn't enough to to drive them low. And then the next day, if you look at it, you're like, Okay, it's still there. But if I did another point 005 It would be done. You know, and that's where I go, I don't get so granular that I go by the 1000s. But I do go by the 5000s or the point one, because I can look at a line and be like, okay, that happened yesterday, too. And at that angle, or that delta the change in in blood sugar reading that that angle is going to need a point one instead of a point 005 It you know, you'll you'll get used to it, you'll you'll look at a line, you'll be like okay, that's happened three days now. That's that's going to be a point one instead of a point 005. That's because you're staying consistent. And you know what point 005 does, or you know what point one does?

Scott Benner 53:13
Well, so that's point

Jeremy 53:14

Sorry,

Scott Benner 53:16
now. So when I'm looking at this, looking at Ardens. Also, the other thing we're doing is it Arden is we're onboarding more and more responsibility to art. And as it gets closer to her leaving for college, a little bit of her practicing. And I think this is her doing a not great job of Pre-Bolus thing as much as she should for her launch.

Jeremy 53:36
So blow your mind. We don't Pre-Bolus at all ever

Scott Benner 53:42
anymore. Because everything's so tight for you. Yes, it doesn't matter.

Jeremy 53:48
It does not matter. Because the other thing that people don't think about it, lots of people do. I'm not saying everybody but a lot of the things that people don't understand is they'll show me a chart. And they'll say, Well, I dosed correctly for this meal. And look, they're still 250 At the end of the day. But if you look at the line when they dosed, they were already climbing. And the thing is, is whenever you Bolus with any pump on the market, any pump on the market whenever you Bolus for a meal, the pump assumes a straight line. If you hit Bolus, Ada carbs and hit enter. It's going to assume it tandem will automatically pull your Dexcom reading into that calculator. And let's say it was 150 it will assume that your blood sugar is 150 and completely steady. It does not take in in this this goes for Omnipod This goes for everything. It assumes a straight line so if you are 150 and you're an arrow up, it's going to a Under Bolus you, if you are 150 arrow down, you it's going to over Bolus you. So that comes back to like, if you look at the meal and you you're having ADA carbs, you're 150. And you're, let's say, arrow, Diag, diagonally up. And you're looking at the Delta and you're like, Okay, so the deltas moving about point six right now, you have to think 30 minutes ahead, so Okay, so 30 minutes ahead. At 630, that's six readings time, that's 30 points more. So you're gonna have to think okay, so I know my son's ISF is 55. So that looks like about an extra point seven units of insulin. So what I'll literally have him do is I'll say, hey, what does your pump say, to give you? And let's say it's, it says, to give him an even for four units just to, you know, throw an easy number out there? I'll tell him, Hey, can you change that to point or 4.7, please, because he's going up, the pump doesn't know he's going up, it assumes he's 150 in a straight line. So you add that extra insulin based on time, you're not going to have the time they won't even spike. It's understanding that that pump isn't going to deliver based on the change of Delta before a meal. And I hope that's not too. too nerdy.

Scott Benner 56:39
No. Are you kidding? That's why you're here. What are you talking about? That's exactly why you're actually I'm also, I didn't realize that in clarity that we had settings before the reports set where I don't care about them. Like, like, I want to me a high blood sugar's 140. That's yeah, that's what I bought them. And that's what I'm looking for.

Jeremy 57:07
Hi, so lots of people don't have that setup. correctly. Now, I understand your idea of a high is 140. And there's a lot of us that, you know, that is how it is. I prefer clarity to be set to 70 to 180. Okay. And I know that, you know, tell me why everybody here everybody hear me out here is Ada standard says 70% and time between 70 and 180. With a SD or a standard deviation of less than 1/3 of the average BG, that is your target. And here's why I use that in clarity to make people understand 72% Of all type ones do not meet that very, very loose standard. And I need people to understand that whenever it's said to somebody to 180, I can say, look, you're 83% in range right now, between 70 and 180. Remember, 73% of all type ones, don't even get that. However, you're doing so much better. Yeah. And if you set it to 140, that's great. If you can get it's like it's 80% in range between 70 and 140. That's more work than I care to do.

Scott Benner 58:30
So I just changed it. And I did it for the last 90 days. And in Target Range 83%. So, you know, so

Jeremy 58:41
right now like Thaman, let's do the 90 days, average glucose of 127. Very low point, one, low 1.3%. In target 91.3, highest 7.4 and very high at 0.6.

Scott Benner 59:02
That's interesting, our, our high and our very high are very similar. And our targets very similar. That's interesting, because

Jeremy 59:08
we don't put up with it. And we look at things before they happen and we take care of them before they happen. It's trusting what you know is going to happen is going to happen. And making sure you do something about it. You know, don't just I mean, control IQ. Like I said no algorithm is perfect. Yeah, if you just think that you're going to turn on control IQ or Omni pod five for that matter, or loop for that matter or any other algorithm and just be able to set it and forget it you're sorely mistaken is not going to work out what control IQ does for me is it provides sleep every night and a reduction in the time that I have to study things and the amount of changes I have to make by a better fold of 90% I still have to do a little bit of lifting care. But that's like I said before that comes with, with time and experience and understanding how insulin works in your or your child's body. And taking things in a very consistent manner. Once you understand how that point, you know, one change in Basil is going to hit and you're accurately able to change basil, or you correct a low blood sugar in a very consistent manner, things become so much easier because you understand what the impact of the insulin or the carbs are going to have. And your outcomes are going to be more precise and better done. Now, this, I know, it sounds like I'm being like, so strict, and everything else I'm not. It's just understanding it. And like, once I understood it, and I got everything dialed in, I do even less work. Because I've done figured it out for my son. And I've done figured it out for these other people that they can just go on cruise control. And we know that that whenever a change in basil needs to happen or a carb ratio change needs to happen. It's not a big deal. Make the small change to make the impact. And let it go. If it happens, again, make that small change again and let it go. It's not a big deal.

Scott Benner 1:01:24
Right. I think I think what you're saying has far reaching implications to not I mean, is the specific situation you are really motivated guy who's incredibly smart and tuned into this. Obviously, listen to a great podcast that got you going and you've just run with absolutely, yeah. I'm joking. But I'm not joking. I think the podcast is terrific. But you know what I'm saying? So, but what I'm going that is that everyone doesn't need to do it at the level that Jeremy's talking about to get the benefit of the of the big picture of what he's talking about. Because I feel like you're I almost feel like I'm hearing my voice come back through you on a lot of a lot of points about you know, stay involved. You know, pay attention. Don't settle for high blood sugars don't over treat low blood sugars like this. Some of those things are just universally true. Yeah, for people.

Jeremy 1:02:21
But when those things happen, whenever you do give too much insulin or you're too bold. Don't let that be afraid. Just that is something that happens. And as long as you say, okay, that happened. Let's move past it and keep going and don't get scared with it. If you over treat a low and he goes in your child goes high. That's okay. That's one high in the time of their life is a marathon not a race. Don't beat yourself up. I see all these parents beating themselves up that. Oh, well, we overcorrected. And now they're high for the next three hours, and I corrected three hours ago. And it's like, Stop, just stop beating yourself up, take care of it, drop it, learn from the situation and move on. Right, your mental health as a caretaker, is just as important as your child's health. Yeah. Do not allow your child's diabetes to take control of your mental status. I mean, I ended up having to go on to Paxil, just to deal with the anxiety. I ended up in the hospital with heart attack like symptoms and ended up being stressed and anxiety. Learn what you can, so you understand what's going on. keep things consistent. So you have consistent outcomes, make small, impactful decisions and drop things that don't work. If it happens one day, it's random. If it happens more than once, change something, don't wait. And then because you get just the third day, it happens, you get frustrated. The fourth day, you start feeling down that you can't take care of your child make the change. And if it's something small, just just try one small thing, and then go okay, that kind of worked. Let's do it a little bit more, and work your way up to being able to do things by yourself, but don't allow this disease to overcome yet.

Scott Benner 1:04:23
Let me let me get some clarity on something you just said. So are you saying that prior to you understanding all of this, the stress was a lot is the stress still there now? No, no,

Jeremy 1:04:33
we live life man. Yeah. So they know everybody. There's some people that say, Oh, your son may not must not be doing anything they do. This kid is more active than most. He's not in any sports. He is. He's a nerd like me. He's in all honors classes. He has straight A's. He's in the National Honor Society. The kid I can't even help him. him with his math homework anymore. The kids smart is the web, but he's still active. He goes for bike rides, he goes, jumps on the trampoline, he wins. He runs around with his brother and sister. He does all types of very active things. He goes to the jump Park. And we do this spontaneously. We don't do it in fear go, oh, well, we're gonna go swimming tomorrow. Oh, God, can't wonder wonder what's going to happen with his blood sugar? No, take extra carbs go in there. Give him some extra cardio before he jumps in the pool. Let them have fun. Let's go. Let's live life. I know it's terrifying. But the thing is that you got to try. And if it doesn't work the first time try again. I think a lot of eventually something's gonna work. Right.

Scott Benner 1:05:44
And I think a lot of the mental comfort that comes eventually is from seeing things happen that you expect. And yeah, yeah, and paying attention to the beginning to these things. Your Basal if you're on it, you know, if you're on an algorithm, even more so for insulin sensitivity, but still on just a regular pump, insulin sensitivity, carb ratios, correction factors, you get those things close even, and things get better. And then once they're close, then you can kind of see them a little better, that it's not so wildly out of tune that you have to guess. I know that all sounds like Yeah, sure. That sounds easy. How do I do that? I mean, you know, I mean, I've talked about it a million times in the podcast, I think the way you do it is by getting your basil right? First, then start worrying about your meals, your ratios, and then start thinking more about different impacts and different foods correction factors from there, etc. Like, you do have to it takes time to get it straight, you're not going to just your doctor is not going to magically set your settings in the right spot. And even if they do, even if they get like a slot machine lucky, you know, the kid's gonna still grow or you're even as an adult or going to gain 10 pounds or lose 10 pounds or start walking more sitting more. And then suddenly those settings aren't right anymore. It takes it takes paying attention. I think one of the most important things you said here's, you know, you got to take a little responsibility and, and put a little effort into it, you know, and not the kind of effort where you're just like I'm trying, I'm trying but like focused effort, that that may lead to

Jeremy 1:07:18
a lot of educating yourself properly. Then understanding what is actually going on inside of your child's body. And understanding what your body, their body, how their body is different than yours. And understand how food digests differently in your body compared to theirs. Do you have a chance to wear a Dexcom? Do it. Scott's done it. I've done it. Lots of parents have done it. Once you understand what it's supposed to look like. It becomes so much easier to do it yourself.

Scott Benner 1:07:54
And it's a little more relaxing to Yes, we see 140 blood sugar for two hours doesn't feel like you've you know, made some pain and full failure. You just realize that that happens to a lot of people. You know, everyday people would fully functioning pancreas is that are working perfectly. Still see elevated blood sugar sometimes. I mean, I had to eat pretty hard to get my blood sugar to 160. But I still was able to do it with a nerf pizza. You know,

Jeremy 1:08:21
I eat like crap. And that was not an issue with me.

Scott Benner 1:08:25
That's interesting. Yeah, I had to eat so much just to hit 161 time. Other than that, I was eating cereal like, like, I don't know if you remember at one point, I took two different kinds of sugared cereal, mix them together in the same bowl and eat them. Yeah, my blood sugar did

Jeremy 1:08:40
I think it was what sugar smacks in Fruity Pebbles,

Scott Benner 1:08:43
hops or something like that. And my blood sugar never even went up. I was almost disappointed by it. I was almost like, oh, you know? But anyway. Geez, Jeremy, this is great. Like, how long do you think it took you to figure all this out put into practice.

Jeremy 1:09:00
Um, slowly over the course of about two years, I was about 80% there over three years. I was like, completely relaxed and like it is what it is. Let's fix it move on. And was able to just look at things a lot smoother. Now there are those families out there though, that have those Alpha moms that I love to death, because whenever they get a hold of me, and I'm like, what do you do for a living and they're like, I'm an accountant. I'm a numbers person. Those people and literally it takes me two weeks to figure them out. Explain what's going on. And they move right on their way and they still have you know, under seven agencies to this day. I was that person. I am a type of person that while I was the kid that took the VCR apart and put it back together and it still worked missing three parts I need to understand what's going on. And I'm just one of those people. And I really dove into it. Especially the biology part of, you know, what happens in what what why is his body so much different than mine? And why is it doing this? And understanding what? The tug of war as you describe it? What can I do on each end of the rope to pull harder, pull less or get it right, you know, that's making small, concise adjustments?

Scott Benner 1:10:38
Well, I'll tell you why we were talking IHS did origins basil. So I look, I looked at that clarity report. And I thought this, like this a one see that I've been okay with, which is her right around a six because she's making more decisions and, and choosing Bolus isn't things like that on her own. Without too much input right now, I thought, Oh, this is a reflection of that she's, I don't know that she's, you know, just kind of finding her stride with it. But then when I looked at that report, I thought, That's not fair. Because I have a lot of stability, away from food, that's still a little higher than I want it to be. So I just changed her basil from 1.1 to 1.2, just to see what would happen. And I'm gonna, I'm gonna watch it over the next day or so and see if I, if I can find some consistency. I mean, we have incredible consistency. But to find it a little lower, would be interesting. And then I think that'll probably help with the food too. That's happening. The food impacts that are happening, like I said, between probably around 132 o'clock, and six, seven o'clock in the afternoon. So I appreciate you making me think about it. So I get busy sometimes to get an amen.

Jeremy 1:11:47
Yeah, and I mean, there are and that's that's just the basis of it. There are other things that I do that are more on the ninja level than then just the standard stuff. I don't expect people do that like stuff like understanding like, my son eats the same food at the same time every morning during the weird weekday. So what I literally do is I will just like, you know, you would I purposely make his basil, a little stronger, about an hour and a half before he eats on a weekday. That's my Pre-Bolus. That is not normal. I don't teach people that. But the thing is, is like I know that at school, his lunches at the same time, every single day, right? And you can't get this kid off of peanut butter and jelly sandwiches with a bag of chips, a Diet Coke, and some strawberries. You just can't get that kid off of that meal. I offer him all different types of things grandma puts in different types of things. It all comes back to peanut butter and jelly sandwich. This is what I want. Maybe he'll have some pistachios one day.

Scott Benner 1:13:02
So you're upping basil as a Pre-Bolus. Knowing that these meals, these exact meals are going to happen over and over again at the same exact Yes. Okay.

Jeremy 1:13:10
Because it's it's it's literally, you know, knowing or expecting, you know, the day I'm saying I'm getting frustrated. Expect what you know is going to happen is going to happen. Oh, okay.

Scott Benner 1:13:24
Yeah, I probably should have come up with a saying that was easier to say there. But well, yeah.

Jeremy 1:13:29
And then, like the only variable I have is after lunch and seeing immediately going to go outside and start chasing girls around, or is he gonna stand and do nothing? Yeah, because Jesus, like, you like the end? I'm like, Dude, why are you dumping? And he's like, Oh, I ran around and chase girls at lunch. I'm like, Dude, if you're gonna do that, cut some carbs out of lunch. If it's 80 carbs covered 50 carbs. I don't think you can chase the girls all day long.

Scott Benner 1:14:03
Jeremy. I don't think he knows till he sees them.

Jeremy 1:14:05
Yeah, exactly. I know.

Scott Benner 1:14:09
That's amazing. I appreciate you doing this very much. Is there anything else that we should be adding to this thing? Because I'm gonna ask you a question. At the end. I just want to make sure you've got out what you want to say.

Jeremy 1:14:22
No, I don't I mean that that's a pretty good understanding of control IQ and how I do and how I teach people to do it. And how we how we adjust things to live a more, I guess, productive life while having great blood sugars, and not having to worry all day about diabetes anymore.

Scott Benner 1:14:50
Okay. So okay, so if I were to come to you, and I'd said Hey, Jeremy, I use control like you by the way you do. Just out of the goodness of your heart you help people.

Jeremy 1:15:02
Yeah. And once again, not an invitation to start messaging me Do not I got four families on my plate right now.

Scott Benner 1:15:11
It's about enough. Jeremy's got a job, you know. So, alright, so Well, that's very kind of you to help people. So if I come to you right now, and I'm like, Hey, Jeremy, listen, I'm on control IQ. But I'm seeing, you know, spikes at mealtimes that aren't correcting for hours at a time. And I'm getting some lows overnight. What do you look at first, you just pull all

Jeremy 1:15:33
I need from them is the seven day AGP report and they're pumped settings. No kidding. And then I maybe ask 20 questions about how what do you normally eat? When do you normally eat? What insulin do you use? Is bedtime consistent on a nightly basis? What kind of activity does your child choose to have? Or that type of thing? Or do they are they on their period yet? If so, is it regular? Just the normal questions that, you know, either your CDE or your Endo? Or

Scott Benner 1:16:14
should probably should be asking.

Jeremy 1:16:16
And if they ask those questions for a very specific reason, because it paints a picture, at least in my head of when I look at that AGP report. What am I actually seen? Am I seeing basil that's way off from a kid that has no activity and eats five or six times a day nonregulated in time and whatnot? Do I have a very protein based diet to have a low carb diet? Personally Thaman he eats whatever the hell he wants whenever he wants. Most I've ever Bolus for in a single meal was 543.

Scott Benner 1:17:03
Wow, 543 carbs.

Jeremy 1:17:05
Yes, you go and look at these dams, and milkshakes at this. This burger shop that's up here. And they're just gigantic. And they're like $17. And they have waffles sticking out of them and everything else and you look at it, you start thinking and you you're like, yep. And then we came to 547 after staring at it for about 15 minutes. And that's what we did. And how

Scott Benner 1:17:29
much insulin was that for him? No. Sorry, about what

Jeremy 1:17:36
it was. His carb ratio was six or 6.5 at the time. Um, let's see here. I can divide by 690 some odd units.

Scott Benner 1:17:51
Wow. Did a 90 unit Bolus? Yeah. And he wasn't low. Nope.

Jeremy 1:17:59
You know, did I have to hit it again about an hour and a half later when I knew the fat was going to kick in? Because I trusted that I knew what was going to happen is going to happen. Yes, I did. Do you think control IQ is going to be able to do that? Or Omnipod? Five or loop or anything? No, it can't you have to be proactive. Do it. override the pump. All pumps can be overrated, whether it has an algorithm or not.

Scott Benner 1:18:23
Yeah. Jeremy, I gotta tell you, if I had if I had a diploma for this podcast, you'd be the first one to get it. That's amazing. I would not have the nerve to give that much. I don't think and I'm pretty ballsy about it. Wow. That's, I'm assuming most of his bosses are not nearly that large. But yeah, but that's a great

Jeremy 1:18:48
example of he sees like 100 car Bolus maybe once every other week. Dinner averages are about 80 to 90 carbs. Lunch is at 90 carbs. Breakfast is 65 Every single day.

Scott Benner 1:19:04
Hey Arlindo had Arden just had a lunch. That was a salad. And then she asked for a bowl of vegetables. She had rice basmati rice, corn, steamed corn and steamed carrots. And it's a pretty big bowl of you know, of vegetables. And I think we bolused I know it was and then we picked 45 for the vegetables which was the carriage the rice and the corn. And then I think the salad was even 20 So she got like 65 carbs for salad and vegetables this afternoon. And her blood sugar still sticking at like 120 so we missed a little bit on

Jeremy 1:19:50
that. That's fine though that that's low glycemic food. Do you understand that? But I mean, you didn't to me you didn't miss? No, it's like it might ramble too. I like the 140 is okay. But I'm sure once you saw that you're like, sticking a little bit. You either let Luke get a little aggressive on the on everything or you told her to take a half a unit.

Scott Benner 1:20:15
Yeah, I told her to add, I told her to have three carbs to our last Bolus, which is something you do in loops that you can't do in, in some of the proprietary algorithms, which I think is if

Jeremy 1:20:27
you can do it in control IQ, you can add carbs to an old but I prefer not to do it, I prefer a straight overwrite, okay, because once again, I know what half of a unit is. Now, if I put three carbs in. If it's been more than one hour, since the last correction, it's also going to correct his blood sugar, it's going to add extra, or it's going to take away extra depending on delta. So I would rather say okay, I'm looking at his line. It's fairly straight. I know I OB says he has two units on board, but it's not real. So I'm going to hit him with point five. Because I know what point five does, right? If I was to put three extra carbs in, it may give him point two, it may give him point seven, it may give him point six depending on which way the arrow is going, which how his blood sugar is going. If he's had a correction in the last hour, not if there's been an auto Bolus in the last hour. Not. There's so much very variability there. I'm not going to deal with that. I know what a half a unit will do. Hit him with a half a unit let him go. I love it. Do we override the pump all day long? Every day? No, no, I don't either. It is so dialed in that you don't have to. But when you do, we do.

Scott Benner 1:21:56
Yeah. Hey, Jeremy, I have to tell you, I I know that after you talk to somebody the first time you probably Converse back and forth with them and text and things like that and takes some days and weeks probably to adjust it right down. I found myself wishing we could record every interaction you had with somebody just to see how it happens. I know we can't but yeah, it. That's the piece that's missing is that somebody like you remind people you work in a motorcycle shop. Is that right?

Jeremy 1:22:25
Yes. I'm the marketing manager of a Harley Davidson dealership. That's I actually well, I'm actually from two dealerships here. In town, we own a sister store. I ride Harley's I own Harley's, I have a beard. I'm you're a typical biker, with the weird ass hair cut. And I swear a lot, I drink Mountain Dew a lot. And I talk about how fat I am all the time,

Scott Benner 1:22:54
and turns yourself into a pretty damn good endocrinologist. So

Jeremy 1:22:58
yeah, I'm not gonna go into our Endo, not gonna say that you're not going to work me into that. But I mean, the other awesome thing is like, I may be all those things, I may be a pancreas to my son and a few other kids and whatnot. But to me, giving back to the community is what really matters. And like, I am also a voting board member and a marketing director for the Montana youth diabetes Association, which is after the ADA camp, left Montana and left all the type ones high and dry. All the volunteers that had been going to that camp for since they were kids said, let's get a camp going and get these kids back to camp in Montana. Very nice. And so we I'm giving back that way I have to, because the community has given so much to me and my son's health, you know, mostly, you know, the podcast and you and everybody in the group that I have to give back some way that I can.

Scott Benner 1:24:09
Yeah, no, I understand feeling like that. I think you're doing amazing stuff to on top of everything else. And I appreciate you coming on here and sharing this with people because there's just no, nobody really tells you what to do. They just give you the thing and then it works out as well as it does and then they call that good and and that's where it stays forever. So

Jeremy 1:24:30
just understanding how the algorithm works and and how it doesn't work and when to step in and when not to step in and it's time and experience and not just sitting on things and doing things and trying things and failing and succeeding and you do something enough eventually it's going to work out. Yeah.

Scott Benner 1:24:54
I agree. All right, Jeremy, I can't thank you enough for doing this man. I really do wish you would have named Good fellows, because when you say his name, that's what I hear anyway. But that's not that's not your problem. It's mine. I'm glad he's doing so well and that you're doing so well. It really is. It's a testament to what I mean what you can accomplish if you get good information and you want to put some effort into it. It really is. Astonishing. You know, I hope you're proud of yourself. Seriously. I try Yeah, no, really, man. It's a it's really something that you've accomplished. So that boy might never know but I know and the people listening now so like I said, I would I would send my first my first ever degree off from the podcast will go to you if I ever make one. Sounds good. Don't look for me to do that. That sounds like a lot of work. But I really I really can't thank you enough for taking the time to do this. Thank you very much.

Jeremy 1:25:51
Not a problem Scott.

Scott Benner 1:26:01
Well, first we want to thank Jeremy for coming back on the show and sharing what he's learned about control IQ. And then we want to thank you s med. And remind you to go to us med.com forward slash juice box or call 888-721-1514 To get your free benefits check. Thanks also goes out to the Contour Next One blood glucose meter. You can find out more and get started right now. You can actually buy one right there at this I know you can buy one at my like contour next one.com forward slash juice box

alright everybody, thank you so much for listening. What else should I tell you? Oh, there are many other episodes about algorithm based pumping. I have a list of them. In fact, let me tell you what they are. Now what the hell we're all here together right? What are you in a big hurry to get back to your job? Let's just listen for another second. Okay, here they are. The first episode I ever done I ever done boy. The first episode the episode. This is going well. The first the first start over. The first episode I ever did about an algorithm was looping it was episode 227 called diabetes concierge. Did one then called a loopy few months episode 252 Then episode three or four loop de loop. Episode Three Tov Fox in the loop house part one episode 313 Fox in the loop house part two, Episode 326. We talked about the mini med 670 G and an episode 420. Fox in the loop house part three. Those are with Kenny Fox, you'll love those. In episode 537. Haley came on she's a tandem pump trainer. In Episode 601, we told the story of how I started looping. In an episode called Gina made me loop. Episode 620 was an exclusive interview with on the pod CEO called exclusive on the pod five interview. And of course today, in Episode 662. Jeremy breaks down how he uses control IQ. We're going to be talking a lot more about these algorithms in the future. So if you're enjoying these, go check out the old ones. And if you just got done with this and thought I'm not get that algorithm to check out the Pro Tip series, and they will definitely help you pump without the algorithm. As a matter of fact, they'll help you pump with the algorithm too. But I'm just trying to find a way to mention some more stuff in the podcast. I think you see what's going on. Alright, thanks again for listening. Your support means everything wonderful ratings and reviews pouring in for the podcast. Downloads and streams are at an all time high. And all of that means that you are sharing the podcast with someone else and for that I cannot thank you enough. It is the most important piece about how the podcast grows.

#661 Tell Me Something Good

April 11, 2022Scott Benner

Lori has had type 1 diabetes for over four decades.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, welcome to episode 661 of the Juicebox Podcast.

On today's episode of The Juicebox Podcast, we'll be speaking with Laurie, a type one for over four decades. She is when I'm just speaking in sentence fragments aren't I? Laurie has had type one diabetes for over 40 years. And she's here to share her story with us today. 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. Are you thinking to yourself, I'd like to do something nice today for people living with type one diabetes, but I also want to support the Juicebox Podcast, and I only have time to do one thing. Oh, if that's something you're thinking, you're in luck, because if you go to T one D exchange.org, forward slash juicebox. Join the registry, fill out the survey. This will take fewer than 10 minutes, and you will be done. And then you will have accomplished both of your goals. You will have helped people with type one diabetes and supported the Juicebox Podcast, you need to be a US resident who has type one or is the caregiver of someone with type one. Those are pretty much the rules T one D exchange.org. Forward slash juicebox. 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. today's podcast is also sponsored by us med. If you're looking for a supplier for your diabetes supplies, US med is probably the way to go. Head over right now for your free benefits check us med.com forward slash juice box or Juicebox Podcast listeners can call 888-721-1514 get white glove treatment from a company who always provides 90 days worth of supplies, and fast free shipping us med

Lori 2:15
Morning everybody. I'm Laurie. And I've been a type one diabetic for 42 years. So I've written the path of the evolving diabetic world with technology from I feel like I was a dinosaur in the dinosaur age with diabetes. When I got diagnosed and it has progressed, it progressed kind of slowly for a while. And then all of a sudden, it's just I feel like the technology has just taken off and light speeds. So for all of us that suffer with a disease, that's a very good thing for all of us to take better charge and better control of it. And I'm really, really grateful, grateful that I've been diabetic for 42 years, and I have no side effects as of yet. And I don't see that I will ever have any because I'm pretty diligent about how I take care. And I thank you, Scott for doing what you do, because you're just a wealth of information for all of us. Thank you so. So that's when I found out about you, when we we've moved four times in three years. And so juggling around the United States, and my husband's been transferred, his company got bought out, and then he was trapped. They kept them but they moved them. So being juggling around the United States, that's been challenging because you, you know, you got to I feel like I'm my own doctor. And I don't necessarily always need a doctor to help me but trying to find somebody that can help you with just navigate. And when I ended up on the second move, I ended up with a doctor and the PA there. She was like you have incredible control. She said and you need to listen to this guy, because his daughter is a type one. And he goes about treating his diabetes with his daughter the way that you do. And I go really? And she goes yeah, she goes listen to him and check out these episodes and I was like, if I hadn't moved I probably would have never found out about you. That's amazing. I shouldn't say never, you know maybe somewhere down the line I would have found out about you but she that office that girl is just super intelligent and I like her actually better than the doctor and she's the PA.

Scott Benner 5:01
I thank you very much.

Lori 5:04
Yeah. So and they were the ones that got me on Dexcom. And so I didn't, I didn't understand why my doctor where we lived forever. Why she never recommended it. I had heard of you know those tools, but I was in good control, I thought you know that I've always been a decent control. So I just kind of, you know, how you just go along, you just go along and you go along, you go along, and then you get introduced to that, and you're like, your world changes. You know,

Scott Benner 5:39
Laurie, can I ask you a couple questions? Sure. First of all, do you have the kind of job where you're in meetings with other people and you lead the meetings?

Lori 5:50
Um, no, you're not. Okay.

Scott Benner 5:52
Did you really prepare for this today?

Lori 5:58
Yeah, I prepared.

Scott Benner 6:00
I'm gonna tell you why. Because, um, because I know, I've got you off balance here. And I don't mean to, I think right now, if I said, Everyone, this is Laurie. She's had diabetes for a while, I could take my headphones off and leave the room. And I'd have a good podcast when I came back. Because you're so you're, you have you really know your life with it. So I'm excited to pick through it. I really, I really am. I just, I, as you were talking, we're getting further away from some of the things I wanted to ask you. So I wanted to slow you down so that I could, so I can pick back through it. When you

Lori 6:32
start. I mean, I've been an I was a educator for a color company for 20 years. And so I was on stage and spoke in front of people for 20 years.

Scott Benner 6:43
Yeah, that's exactly how you feel while you're talking. You. I feel like honestly, like, you could hold my attention. And I could just probably kick back and, and close my eyes and listen. So so let me but let's not let's not we want to make sure that people who complain about me talking too much have something to complain about. Okay, so my first question was, when you began to introduce yourself, you You went directly to the advent of technology, and what a big deal it is to you. Can you give people some perspective? About what you've lived through? And why? Why you feel that way?

Lori 7:21
Oh, sure. Yeah. What do you want?

Scott Benner 7:25
Yeah. What is it about now? I've got you off balance. I'm sorry. Did you go ahead and talk? I just want to, you know, I want to know what you live through and why that experience made you pick that as the first thing to say when you started talking?

Lori 7:38
Oh, okay. Yeah, I will absolutely tell you, I'll tell you one. horrific story that happened to me. And it. I was really fortunate that it came out the way it came out. But when I was, you know, diagnosed and doing injections, it was that was a tough road. For me. It was easy, but it was unpredictable. And this story, I mean, that's why the Dexcom has changed in the insulin pump. The insulin pump changed my life first. And then the Dexcom changed my life second, so it was a game changer for me.

Scott Benner 8:20
So the unpredictability of not being able to see your blood sugars. And just I mean, you were doing regular and mph, or were you doing

Lori 8:28
Yes. Regular an MPH? Yes. And the mph? Do you want me to just talk?

Scott Benner 8:34
No, yeah, no, I don't let me stop you up yourself. I was just kind of teasing you a little bit that I felt like I felt like if I was like, and Laurie diabetes, right? I could just leave and come back in an hour. I put my headphones back on and you'd be finishing your story. That's not no, don't don't. I'm sorry. Don't inhibit yourself. But yeah, just go ahead, please.

Lori 8:53
Okay, so when I was diagnosed, basically, it was, I was losing tons of weight, and I'm a hairdresser. And so I work behind the chair. And when you work behind the chair, you know, you don't always eat when you eat you, you throw it down in about two minutes whenever you can throw a bike down. And so I just worked and I've always been really skinny and very athletic. And so I told my husband, I go, there's something wrong, I'm losing all this weight. I'm super tired. And we went he was in a bowling league. So we went to a Bowling Tournament with all of our friends, you know, to a different city and we went to dinner that night. And it was a Saturday evening and it was like you could put a hose of an outside hose like you would water your flowers with and just let it run constantly in down my throat because that's how much water I want it. Yeah. And our friend. I had never heard of diabetes. I didn't even know what the word was. And our friend, she worked in a doctor's office that she was at the Bowling Tournament with us, her and her husband. And she told my husband, she said, You need to get Laurie to the doctor as soon as possible because I think she's got diabetes. Wow. So I called her doctor's office because she worked in a primary care doctor office on Monday morning. And they got me in that day. And I went there, and I went straight to the hospital. And so, I thought I had, like a brain tumor or something. Because I was cutting hair, my vision was blurry, and I was losing all this weight. And I was like, I probably got cancer, you know, I mean, what is happening to me? And so I went into the hospital, and, you know, they gave me told me what I had to do. And I never looked at it. Like it was a terrible thing, because I didn't even really know what it was. I didn't even understand

Scott Benner 11:07
it. 19 and 1979. Laurie, is that about

Lori 11:10
119? A March of 1988. Yeah, okay. So I got married in October of 79. And in March, I was diagnosed I told my husband I go, you know, we never should have gotten married. We should have just together did you try to get I got married and I became a diabetic,

Scott Benner 11:27
get marrying him gave you diabetes.

Lori 11:30
I would always call them be like he was an insurance agent at the time at the Sears store. And I would call him and I'd be like, can you bring me home some of those chocolate covered peanuts at the candy counter. I would always bring those home for me and I would just like scarf them down. Well, that all came to a halt. You know,

Scott Benner 11:50
I'm loving this. I love that you went to a Bowling Tournament. I imagine most people listening don't know that. Bowling used to be such a big deal. That every Saturday on ABC there were bowling tournaments on Oh, I

Lori 12:04
know we used to watch them. My husband was an avid bowler he golfed in a bowling league with his guys on Friday nights every week. And so here we are. We're at this Bowling Tournament. And they're really those guys are all suit. We're just with them this last weekend. They were all they're all super funny.

Scott Benner 12:21
That's a major. So fun. Yeah, it was a big it was it was ours and people would sit and watch like it was nothing. Oh my gosh. Okay, I'm gonna have a good time here. Okay, so you are diagnosed because your friend kind of sees it. But you realize something's really wrong. I'm assuming, you know, thinking, Oh, I have cancer or tumor or something like that. And then they say diabetes to you. But at a time when like there's not a lot of real understanding about I mean, it's not understand I guess the the insulin lacked and the technology lack so much that you were just shooting insulin in the morning and then in the evening, is that pretty much it? Yeah, I

Lori 12:57
did mph in the morning with regular. And then I would I took regular at dinnertime. And then I took NPH at bedtime. Okay. And it was I mean, I was so diligent about everything. But you know, we didn't even have I don't even know that we had a computer back that I don't think we I don't think we even had a computer because I think when my son was born, that's when we he was like few years old. That's when we bought our first computer. So we didn't even have computer life to research anything or do anything but I'm a foodie. And food has never been important to me. I don't care about food. I could if I eat because I got to eat really to be honest with you. Do I enjoy a good meal? Yeah, I do. But I'm not one of these. I weigh the same as I did in high school. I mean, I've been the same weight forever. And so that was never like a concern for me. It was just like, Okay, how do I make this work where I can keep my blood sugar's steady. And then I have no glucose monitor and all even to prick your finger to test your blood sugar. And I finally got years later I got I think it was called Life scam. It was like a notebook. It was so ginormous. And I hauled that thing around in my purse to check my blood sugar all the time. So and I would check my blood sugar like eight to 10 times a day because I was so anal about where am I at what's happening, you know? But I opened a hair salon in 1983. What was actually November of 82 and an 83. You know, it was really the first full year and I was diabetic at that time. And I worked I worked Like a dog, you know, but I loved my job. I never felt like I was working ever, even with running a staff and doing all this stuff with your own business. I just loved, loved my work. And so with doing that, my husband, this is the story that I would like to share, because this is how technology has truly changed my life. And I've got a few stories like this because the mph, I was a ritual, I did the same thing. Every day. Same thing, every day, I would eat the same breakfast, I would pack the same lunch I never ate out. I always pack my food and pack my own food. I would work 12 hour days at the salon. So I would have to pack you know, my snack, my lunch, my dinner. And my husband came in and I cut his hair one night. And then he said okay, I'll see you at home. And now I had taken my regular eat my dinner and I always had like a granola bar or you know, something we had a white hand right next door. So if I ever ran out of food at least I had a white hand next door to our my hair salon. So I would send one of the assistants i Can you go over there and grab me this because I got to have some food and I would be cutting hair. And I could feel myself dipping down and I'm like, I need some food. And that's what I did not that was a hard thing is that okay? I'm taking this much insulin, I'm eating this kind of food. And you could you just a day is a day, you know, sometimes you got stressed sometimes you don't some so your body is always juggling around and you can't see what's going on. And on your insides. You know how much sugar is actually in that blood? I wish I could see all those little sugar things jumping around in there swiping. But anyway, so he came in, and I cut his hair. And he said, Okay, I'll see you at home. And it was like the end of the day. And so I packed everything up, I had to pack up from the salon and got my car. And we lived about 20 minutes from where my salon was. And I was about halfway home and I could feel myself dipping down and I thought I just gotta get home, I don't have that much further to go. And I was out of food. I didn't have sugar tablets, I didn't have nothing in my car. And that's like a rarity. But you know, I didn't expect anything to happen in the next 20 minutes. And

so I got literally I was maybe like, a block from our house. And we lived the road in the back of our house backyard. It was all fields behind there. But it the I had to make like a left turn on this road before I got to my street which was you know, the main the main back road. So I'm just gonna give it a name because it was 95th street. That was the main back road. And I was on the street over from our street on book road. And I had to make a left hand turn and I was at a stop sign. And I was all confused. And I could not figure out where I was. And this man at the stop sign. I turned and I was driving and this man was just laying on his horn. And he he saw I was like frayed you know, because I did not now I'm like almost I'm nearing my house. But I did not know I was nearing my house. That's how my brain was not functioning because I had such a low blood sugar. And he goes, You're drunk. I'm calling the police. And I was like, I go buddy, I am not drunk. I mean, I noticed say that much right? And I just kept driving because I was scared. And I wanted to get away from him. So I kept driving. And I went past my house, the backyard of my house. I drove right past it because I did not really know where I was. And I just kept driving and I thought okay, now I kind of know where I am. And I just kept driving and I drove into you I don't know if you remember but we had handy Andes back then. Hardware stores or big like Menards or Home Depot now or whatever. They were Handy Andy so I drove into the parking lot there and the police, the police were there.

Scott Benner 19:55
Oh, waiting for you. Waiting. Yeah, I had I had to look Whitehead, I didn't know what that was. I think these are more local things. So that's the convenience store. Right? Yeah.

Lori 20:05
It's like a 711. You know? Yeah. And so I pull into the parking lot. And there's this elderly couple coming out. And I rolled my window down. And I said, You know what, please, can you go get me some sugar. I'm a type one diabetic, I'm having a really low blood sugar. And I have to get some sugar in my body. And they were so nice. They turned around and went in. And I guess handy, Andy might say, had a candy bar. And so they went and got me a candy bar and brought it out. And the police came up to me, because they're thinking I'm drunk, because this guy said I was drunk. And they came up to me. And I said, You know what, I'm having a low blood sugar. I said, I was confused. I could not, I did not know where I was. And so I sat there and ate this chocolate bar, which is going to send my blood sugar high. And I didn't have a blood sugar testing machine. But I knew that's what it was going to do. And I just sat there, and my husband now we didn't have cell phones, either. My husband was wondering, like, where is she? Like, what happened to her. She was supposed to leave after me. And she's not home. And so I sat there until my blood sugar, I felt like normal, the police said, We're gonna sit here with you until you get where you feel like you're normal. And those elderly people wouldn't even let me pay him for the chocolate bar. They were so nice. And so anyway, the police followed me home and tell I got into my driveway, and I was able to walk into the house. And that was, that's what having not having a, you know, Dexcom or a contour next meter or, you know, one touch Ultra meter or whatever meter you want to call it. That's what not having that stuff did. And I mean, it's happened to me more than once there. It happened to me at night when I was driving home from work. And it was winter, because we lived in the Midwest at that time. And it was winter. And I was all confused in my neighborhood just driving around, and I didn't have a cell phone. And I'm like, Oh my God, where am I? The bees? I gotta get home

Scott Benner 22:20
to these episodes. Come on quickly, or? Yes. They Yeah, I don't know where?

Lori 22:25
Yep, they would come on very quickly, out of nowhere. And so. And another time my husband traveled, and my son and I were home alone, and he was in grade school. He was little but my husband always taught him if something happens with your mom at night, you call 911. And so my son, you know, he was little so he was sleeping in bed with me, right? And I, I woke up and I could feel my blood sugar going and I didn't have anything by my bed, which is unusual, because but I wasn't I was not smart enough that about at all. You know, I just I'm trying to figure it out really kind of on my own. Yeah. And so he was in bed with me. And I told him I said, Go get your Go get me a juice downstairs, orange juice or, and Steve out my husband. He always kept Coca Cola because you know, that brings your sugar up really quick. And so my son rent went down and brought me up Coca Cola, but he called 911. When he went downstairs in the kitchen, he called 911. And so the paramedics came and he went and answered the door, and he's in his pajamas. He's so cute. He was this little kid, you know, and they came in, and by then I was getting back to normal because the Coca Cola had taken effect. But I would have episodes, like at two three in the morning. This was before I was on an insulin pump to three in the morning, I would do the same thing I'd take my MPH at night, I'd have a bowl of Cheerios, and I would sit up and do my paperwork for the salon go to bed like around midnight, and I would think I would be fine because I took my MPH usually around 930 or 10 o'clock and eat my bowl of cereal and because I worked evenings so I didn't get home from work a lot of times till 930 And so then by the time I got situated at my house and did my insulin and ate my bowl cereal and did my paperwork, you know, it'd be midnight I go to bed. And my husband would be like I would he would have my head and he would be trying to get me to drink a juice. And when you're that because he I would do things in my sleep I guess where he knew and I woke him up. And so and that would happen probably a couple times. The year and so that's why he taught her son, that that's what he had to do because he traveled. And so it was my son and I at home alone, you know,

Scott Benner 25:09
were you ever were you ever able to make adjustments to the insulin to stop it from happening? Or how did they How did you address it just with the food and hoping

Lori 25:17
Yeah, just the food and hoping because my doctors you know, I would tell them and they, they, they didn't tell me to lower the dose you know, and looking back like I should have lowered the dose myself, you know, but I was just a good student. I did what everybody told me and I just bite it by the rules and thought well this is the way life is with diabetes and injections

Scott Benner 25:45
how? Tell me how old you are in 1980 2222 Wow, you're 62 now

Lori 25:53
yeah 6420 42 years Wow, that's crazy.

Scott Benner 25:58
Yeah, I I mean, listen, it's the it's the theme right? Nobody feels confident making adjustments on their own they just take for granted that this is what it is and then you know they have some burden they have to live with now and and that's it and if a doctor doesn't help them with it, they never change it. How what was the next most meaningful shift? You're gonna say getting an insulin pump probably when did that happen?

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Lori 29:01
while just not even getting an insulin pump by getting a glucose monitor where you could test your blood sugar's Okay, that was a game changer because then I I checked my blood sugars like you know, every while I was working. So I would always check my blood sugars like in the morning when I got up and then I would eat breakfast and if I wasn't going into work until a little bit later that day. Then I would check it again you know before I left for work because then it was like lunchtime, you know? So then I was going to eat lunch so I would have to know what it is but that and then I started then I started altering my insulin myself. Good when I could test my blood sugar's did that help it help out? It helped and my doctor told me he goes you know what you are in such great control but when they're working on an insulin Pump. And when it comes out, you need to get it. And he was talking to me about an insulin pump pry for two years before they even came out with that he goes, this is what's happening. And this is what you need to do when they come out with it. That's crazy. And I was like rally and he goes, Yes, I go. I think I do a pretty good job this way. He goes, nope, you'll do a better job this way.

Scott Benner 30:18
How old do you think you were when you got the pump?

Lori 30:20
I was it was back. My son was in college. So I think he graduated in 2003. So I would probably guess I think it was around 2005. Maybe

Scott Benner 30:32
yes. You 25 years without it.

Lori 30:36
Yeah, yeah. Yeah. At what

Scott Benner 30:38
point did you switch over to a faster acting insulin? Do you remember? Like, I mean, like Humalog went on to next

Lori 30:45
human log came along. I think that came along when I went on the insulin pump. Really? Okay. I think that's when I went to unhuman log, if I recall,

Scott Benner 30:57
what you're saying you did regular an MPH for 25 years.

Lori 31:01
I did regular an MPH for like a long, long time. Okay, maybe he changed me. Before that because I was on human log. Then I had to go on Nova log. And now I'm back on human log again, in my insulin pump, but I'm, you know, researching these other insolence now, too, because I'm like, I'm going to, I'm going to talk to you that I have back in the city with the PA that told me about you. So I'm really happy because I'm gonna have a conversation. Well, listen,

Scott Benner 31:33
I just did a little googling Eli Lilly began producing began production of the insulin product human blog at its new bulk manufacturing facility in Carolina, Puerto Rico in mid 2005. Your memory is pretty good on that. So Oh, yeah. Exists prior to that.

Lori 31:52
Yeah. So then I was on regular until the insulin pump. So yeah. And that, and then the insulin pump. You know, that was another big learning curve for me, because you still had to test your blood sugar. But then, and I was on med tronics insulin pump. And so I was, I mean, I got that thing working like a smoothie operating machine. And I got rid of my lows in the middle of the night never happened. Well, they were they were gone. And my husband, you know, he was so relieved, because he didn't have to worry about me when he wasn't home. You know, he always worried about me driving.

Scott Benner 32:41
How did it affect your son? Did he? Is he kind of like a caregiver person now? Is he is he paranoid? How does it affect them grown up? Or do you think?

Lori 32:50
No, I don't think he's paranoid because he knows how disciplined I am. You know, and I would always just tell him, I said, You know what, this is the way this disease is. And when you do injections, you can't control what the insulin is going to do in your body all the time. You just can't control it. And so I said, That's my mom has to, you know, I always have to travel with food. And we would, I mean, when we, him and I, I'm a big rollerblader I've rollerbladed for over 40 years. So, I mean, I'm a hockey person. So like, I was a hockey cheerleader. So I've always been that person on to things on your feet that move and work athletically. And so my son when he was two, I took them to the ice rink, because I'm like, You're gonna play hockey. And so once he got, you know, decent on ice skates, then I'm like, Okay, we're going to rollerblades and our buddy. So we went to rollerblades and we would rollerblade together and I would always have to have a backpack because I didn't have a fanny pack them. You mean I didn't even know about a fanny pack them but I always had to carry a juice box because I would wrote we'd rollerblade long and hard and, you know, at this point, I wasn't on an insulin pump. I was still on injections, you know. So it, it was like you couldn't suspend or lower or Temp Basal or whatever, you couldn't do any of that. And so I always have to carry a juice box or you no sugar with me all the time, because of that exercise level. So he was always aware, you know what I mean? So because I would have to pack that backpack and he was never really afraid, but he could tell. He always knew when I was dipping down Have you always tell

Scott Benner 34:50
Have you spoken to him as an adult about growing up like that?

Lori 34:54
No, I never really I never really have spoken to him about that. Okay, My husband tells stories, you know, because to all of his guy friends, you know, when we get together, you know, is he's, he's, they're like, Yeah, we heard the stories about you driving the car and they thought you were drunk. And so my husband has told his friends about what he's gone through with those kinds of stories, you know, cuz it was always a worry for him. But hey, man,

Scott Benner 35:23
did you have any issues growing up that way? Like through your 20s 30s? Like, did it have any impacts on you, socially, or psychologically, or anything like that? You feel pretty good, right?

Lori 35:33
I just I just took the bull by the horn and did it and never looked back. I never worried about it. I never. I just, I'm a disciplined personality. And so when I know I gotta do something. I do it. I don't, you know, I don't look at it. Like, oh, I'm just gonna fly by the seat of my pants. Even though I was flying by the seat of my pants. I didn't know I was flying by the seat of my pants. I was just doing what I thought I was supposed to do. But it it wasn't always a perfect world. You know? And whilst I still isn't always a perfect world, as you know,

Scott Benner 36:15
no, of course, I don't even know what I'm getting at. I just, you seem I mean, it's obvious you're from a different generation is how it feels to me. Like, you know, like you grew up in a time of you're born in the 50s. I imagine, right? Yeah, yeah. And 57. Yeah, you grew up in a you grew up at a time where there was no real expectation for like, constant happiness or contentment, or something like that, like you were just you were living and staying alive and doing the things you were supposed to do.

Lori 36:41
Yeah, I mean, that's I was I, while my father passed away, have a massive heart attack when I was 11. Oh, my God. He was 46 years old. And I saw my mom. She was just devastated. We had just moved to a new house on the lake and lived in Lake and, you know, the Midwest and my dad, that's always what he wanted. We moved there in October, and he passed away the night before Christmas. That year. And after that, I always I always knew that I had to be able to just take care of myself because I saw my mom have to just, I mean, she did. She wasn't working. My dad worked, because that's what happened back then. Right? Your dad worked and you're supported the family. You had one car, you lived in a simple little house and you live life and you went to church every Sunday. And you know, that's what you did. So after that experience, I mean, that was, that was a game changer for me. I was in sixth grade. And after that, you know what I was always a go. I was always independent. My mom said she goes, You're stubborn and independent, always. But I was like a go getter. And I always did what I was supposed to do, because I was like, I am not going to tip over have a massive heart attack. I'm gonna be athletic, I'm gonna eat good. I'm gonna do all this, you know. So, I think that, you know, being raised with my mom and that situation. I got a job as soon as I could work, because, you know, we didn't have money because we lost my dad. My mom never worked. And then she went to work like in a dime store in the town, you know, because she didn't have education. Yeah, other than high school. And so when you grow up in those kind of times, it shapes what you become in the future, right? 100%

Scott Benner 38:50
Yeah, I can't imagine not. Wow, that's a that's a probably a pretty common story for then. Did your dad smoke?

Lori 38:59
He was a smoker. Everybody was a smoker. That's why Yeah, every my mom's smoke, my dad's smoke, my smoke. My uncle smoked. Everybody smoked back then. Right. And that was just the way

Scott Benner 39:11
have you identified any type one or other autoimmune issues in your family line?

Lori 39:16
Now, nobody, that's what's bizarre. My mom, it was hypoglycemic for a number of years, and then it just all of a sudden went away. But she followed her diet. And I followed her diet that she's supposed to follow, being, you know, she's and so that's the only link that we can find. There's, there's nobody else

Scott Benner 39:40
nobody that anybody knows about, I guess. Also that my

Lori 39:44
cousin, his daughter, she was 22 and in college, and she found out she's a twin, and she became type one diabetic.

Scott Benner 39:51
How long ago was that?

Lori 39:54
Oh boy, she's in her. She's got to be in her early You 30s Now probably interesting. So but they but my cousin called me and he goes, Oh my god, Emily was just diagnosed we she came home for Christmas break and she was not feeling good. And we took her to the doctor and they checked her and she's type one. Now Claire, her twin nothing. Yeah.

Scott Benner 40:20
Well, I mean, that's not I mean, it's not surprising, I guess I just I don't know I got all wrapped up in your in your life and growing up in that time. That's really just a simple, a simpler way to live. You know.

Lori 40:34
I mean, literally, that's the way everybody should be living nowadays. I mean, I grew up I worked at the NW i Water skied every day, we were at the beach all the time. And, you know, my friends, like they would have a lake house, you know, up in the woods somewhere and we get in a car when we were 16. And we could drive and we go up to that lake house and hang out there and go to the outhouse. I mean, they didn't even have a running bath toilet, we go the outhouse. And you know, and so it was, I mean it, big bonfires in the fields and high schools. And you know, when you're in high school with all your friends, and you know, you're outdoors, we snowmobile, we've snowmobile, to the hockey rink, and then cheer for the game that was going to be there, you know, beyond that night, because we were cheerleaders, me and my friends. And it's, it's just, you know, it was just different.

Scott Benner 41:29
I didn't know there were cheerleaders on skates, you've taught me that. I do have a question. I if this seems inappropriate to you, don't answer me. Just tell me to move on. Okay. But 16 years old bonfire kids? What was the level of Hanky Panky where you kissing? Drinking? Smoking? What what did you do in that time?

Lori 41:48
Well, there was always a keg. Okay. There was always a keg in the field. So we call them keggers. And so you know, but you'd have all the athletes there. You know, I mean, we're I was a cheerleader. You're not supposed to do that, or you can get kicked off the team, but everybody did it. So we always, you know, we go out in the drive for miles out in the country because my friends, their parents had farms and fields and we get a CAGR gone. Okay, everybody after the game, We're Gone To The Gager. You know,

Scott Benner 42:21
there's no kid like your parents didn't know where you were. They didn't know. I mean, they

Lori 42:25
knew that I'm going over to so and so's and they just okay, you know, okay. And

Scott Benner 42:33
smoke cigarettes. Good. Oh, my God. Yeah.

Lori 42:36
So this one, this is a funny story. But my girlfriend, they had a lake house up in the woods. That's when I was telling you about what the outhouse and. And it was the waters just, I mean, all the water where I lived was pristine and crystal clear. And we would go up there and hang out. But our other high school friend, his parents had a resort that wasn't far from there. And so there were two guys and high school brothers that their parents are on this resort and every spring, they would have a weekend long cager at the resort. And so we would go up and stay at my girlfriend's cabin, and then we drive over to the CAGR because it was like started, people would start arriving Friday night, and they go home on Sunday. And everybody would just take a bath and brush their teeth in the lake because it was clean and nobody cared. And you know, you'd go the bathroom in the woods and nobody cared. And it was sounds, it was like caveman style of partying fun. But you know, those are all just great memories that we you know, there it it was just a great time and place to grow up and live and experience life and I'm a water person. We've, my husband and I have lived on the water. While we got after I opened my salon. I did very well and we bought a lake house. And so we traveled to the lake house every weekend. Because I had my own business, I could do that. And so we had that for 15 years. And then we sold our house that was in town. And we moved up north and bought a house on the water where we lived full time and then we got transferred three you know we got transferred all these times. So it's just you know, yeah, it's it's just kind of weird how life changes do you need to look so anyway, now I'm by the ocean but so it's still water.

Scott Benner 44:46
Do you need to you need to look at your blood sugar. Are you okay? Yeah, I'm

Lori 44:49
fine. If you know your Dexcom goes off at 80 So

Scott Benner 44:53
yours is the Navy. Okay, yeah, gotcha. And now you're on one of the shores you're on. You're on a.

Lori 44:58
Yeah, Lana? Sure. Yeah, so that's that's good. Yeah. Went from the lake to the shore to the desert to the shore. Like, gosh, you've

Scott Benner 45:07
been? You've been all over the place, though. Yeah. You held on to your Midwestern accent, so you're good. Oh,

Lori 45:15
yeah. So anyway, that technology has the insulin pump changed my life in a huge, huge way. And then, two years ago, is when I found out about Dexcom. And that is changed my life in a big way. And then I found you. So and I just, it just confirmed with me that, you know, I've been pretty doing pretty damn good. Raising myself kind of in the dark on my own with my diabetes, because I've been bold with insulin, my diabetic life. And, and I didn't, you know, I would just do it. I just do it. And, you know,

Scott Benner 45:56
no, I think it's amazing that you were able to to do that. I mean, like you said, just, and looking back, just just getting the meter and just being able to get enough data to start making reasonable decisions about things. It's yeah, now now look at it like, right. Oops, sorry. I'm saying sorry. Now, you've got this, how did you sort of the Dexcom was given was told to you by a doctor's office?

Lori 46:23
Correct? Yeah. Because I'm in you know, I'm in the city where they make it. So um, so the, the doctors here are all about it, because it's local. So, anyway, they, the doctor mentioned it to me, and then I went in with the PA, so she could train me on it. And so when I went in with PA, she trained and they got me, they told me I needed to go on a tandem pump, My God, why? And they go, because they will communicate with each other. And you like to have such tight control that I think this pump can give you tighter control. And so I switched. I went on the Dexcom first, and then I went on the tandem pump. And so with doing that, it it literally like learning tandem was a whole nother way of life on that insulin pump compared to Medtronic. And I actually liked Medtronic better, he did like the Medtronic better, I did like it better. So I went off of the tandem and went back to the Medtronic because I could not get my sugars to buttoned down on the tandem correctly to do it. And so, so my doctor, she said, Okay, so now I'm in a new state, right, I was leaving this state. And she said, I think you should give tandem another try down the road. And so I went to the other state. And I ended up through Facebook group, because I talked about the tandem and the issues I was having with it. And that I was just gonna go back on a Medtronic, I didn't know what to do in a diabetic group. And there was a tandem representative somehow found out and he called me. And I explained to him what I was how I had it. I will say I'm, I don't try to criticize people. But I've been a trainer, you know, for years, because I had a staff and worked for a color company and daughter, but she came to educate me on the tandem pump. And she said, Well, we're gonna learn and do this together. And I was like, we're gonna learn and do this to get her a

Scott Benner 48:56
little worried. She didn't understand that already. While she didn't,

Lori 48:59
it was obvious. And so when I went on it, I was struggling and struggling and struggling. And I just said, Forget it. I'm going back until I can get somebody that knows how to train you on this machine. And I called tandem on a regular basis trying to make it happen. So when I got to the other state, I decided that I was going to try it again. And so I gave it a try, and I've been on it ever since. And I had a really, really the guy that I talked to he hooked me up with one of the top trainers and we did it all over the phone.

Scott Benner 49:36
Good. So are you using it more like you know,

Lori 49:41
I do use Control IQ the one thing that I that is, you know, because I don't eat white food. I just I don't care about it. It doesn't matter to me. Wow. Are

Scott Benner 49:57
you saying stuff like that? Yeah, I

Lori 49:59
don't need I haven't had a piece of pizza in I don't even know how many years. And so it's like, I just don't eat that stuff. But I used to. And I used to do it on the Medtronic, you know, with, you could do the Temp Basal settings, and I would do it for like, hours, you know, because pizza breaks down in hours, right? So you got to change your gotta change your insulin ratio, you know, to accommodate it. And, and this one, you got to turn the control IQ off to make that happen. So, you know, even with protein sometimes, so it's got the two hour window where you can do the extended Bolus, then I, you know, I go back in maybe sometimes, like, after an hour and a half, and I set another one. Okay, to extend out again. Yeah. So that's kind of the, I think that there's, if they had a diabetic talking to them, when they design an insulin pump, I think they would get a lot more information, how to design it to make it work the way diabetics want it to work.

Scott Benner 51:07
Well, what do you what do you wish the control IQ would do that it doesn't do?

Lori 51:11
Well, I wish that you could just automatically have an extended, you could have that extended time where you wouldn't have to turn it off. You could just go in and do what if you needed four hours or six hours or eight hours, what if you get sick? You know,

Scott Benner 51:29
so you can't explain to it that the food you've just eaten has a longer impact than the algorithms ready for you can't Yeah, you can't tell it. This is listen, this is pizza, we're going to be doing this for the next five hours. Right?

Lori 51:42
I got you, right, you got to turn the control IQ on go back to regular pumping, go back to just doing like what my Medtronic pump did, you know, and my doctor told me, she goes, Well then do that. If that's what you need to do, then just do that. But I make it all work. You know how it works now, and I just don't want to be pushing all these buttons all the time and fussing around with it all the time. And you know what I mean?

Scott Benner 52:05
Yeah, you would like it to work without you having to be involved so much. Yeah, I understand. Yeah, I have a question that I can uniquely ask you, because of your age, do you have concerns about as you age, the management of diabetes? Do you ever think about that? Yes. What what's, what's the thing that sticks in your heads most?

Lori 52:29
Well, I mean, you know, as I age in the management, you know, I've had it for 42 years, and it really doesn't matter how you I mean, it does matter, I shouldn't say it doesn't matter, because it totally does matter. But if you're so diligent about your care for all these years, you know, when you hit have, let's say, I make it another 20 years, that puts me at 84. You know, what? It? What are the insides of my body going to be like, you know, what, are my eyes gonna be like, what are my kidneys gonna be like, you know, I'm not going to be running a marathon at 84 I doubt you know, or rollerblading, like, you know, around the country. So, you know, so I just, you know, that's what always concerns me, because I don't ever, I hope I go like my father before that, before I ever have any side effect from diabetes. I would rather just go ding, and tip me over. And don't let me have any side effects. You know. So the side effects there. I mean, I did hair for a living trust me you talk to you get clients that are diabetic. And I was like a nutritionist for all my clients. They loved coming to me because I always talked about food and how I cook and recipes and what I do, and they're like, Oh my God, I've never met anybody that takes such good care of themselves. And it shows. And you are you do so great. And I go I love. I'm diligent, you know, and I love food. And I love good food. I love healthy food. I love fresh fruit. I don't like processed foods. So. So that's just the way I've operated. Forever. Yeah, you know,

Scott Benner 54:17
I always think about like dexterity and cognitive stuff. Like what happens when you Oh, slow down a little better. You can't use your fingers as finely those sorts of things.

Lori 54:27
Yeah. Yeah. I mean, the whole you know, cuz dementia is way more prevalent diabetics, you know, so I'm always like, Oh, God, don't put me there. I don't want that. That's for sure. My husband always goes Oh, it's Laurie in the kitchen, because there's always something that happens in the kitchen cooking. You know, it's just stupid stuff. And he always makes jokes you know about me, because I'm blind and he's like Laurie the blonde. She's in the kitchen again. You know?

Scott Benner 54:58
I just I just I I don't know, I know it's a long way off, and I'll be a long way dead. But I don't like thinking of art. And, you know, as an older person now not sure about how much insulin to give herself or to make a mistake, because she thinks she's already or didn't do it already. Yeah, you know that that bothers me.

Lori 55:17
Yeah, but you know, by the time Arden is older, it's going to be a way different playing field for diabetic. Yeah, I hope so. That's gonna be Oh, my God. I mean, when you look at 42 years, and you look at just since 2005, when I got on the insulin pump. And you look at from 2005 to now. Yeah, I mean, that is 16 years. And look at what spend

Scott Benner 55:42
on. It's amazing. The LEAP is really amazing. It's

Lori 55:47
I mean, so you put Arden What is she 15 or 1617. Now? Oh, 17. So, you put 15 years on that? You know, she's going to be what? 32? Yeah, yeah, no kidding. And so you look at at 32 how it could be different for?

Scott Benner 56:05
I hope, so I hope I get to see it. I really do want to see what happens next.

Lori 56:10
Yeah, I mean, I'm just, I spoke to diabetics, my doctors in the state where we live forever on the water. She was just like, you know, what, I, I want you to talk to the diabetic support groups, because you are your, I would bring her like my loaves of bread that I would make, you know, with almond flour. And you know, I'd make a cinnamon bread and, and a white bread and an Italian bread. And I would bring them to my doctor and I go, you should try these because they're really, really good. And they're really healthy for you. And she's like, Oh my God, you make the best food. And so I would go speak at these diabetic groups. And I would bring like my food, like my bread so that because it was in the morning, and they could have like coffee and bread in the morning. And it's all blood sugar controlled bread, you know, so they just loved me, they loved me speaking to them about how I take care of myself, because I could only talk from my standpoint. And they were like, God, I wish I could just be more like you and I go Why can't you? Yeah, so they go, you don't need to wish about it. You just need to do it.

Scott Benner 57:21
Yeah, I try that all the time. Like, I'm not doing anything particularly special. I don't have any great, you know, abilities that you don't have. I'm just making some pretty specific decisions at the right time. You know, so,

Lori 57:35
I mean, that's all it's a balancing act. Yeah, you know, that's all it is, you're balancing every minute of the day. It it. I don't care what it is, you know, you got when I would stand behind the chair and work and I would be like, Okay, I gotta have a juice box, I'd be like, Excuse me, I go on the back room, I'd grab a juice box, I'd come out, I would drink it down in front of my client, they go yo, can I go, you should know me by now. I'm fine. And so you know, it was just always balancing, you know, it was always balancing. But I taught you know, for a hair color company also for 20 years. And I would I traveled all over I lived in a really big city in the Midwest and big city. And so, I mean, you could travel two hours and still be in a suburb, that city. So I traveled all over and then I had to fly and travel the United States. So, you know, until I was on an insulin pump, you know, you if I traveled around the United States, and I would you know fly in the night before teach the class the next day and fly out that night. So it was like an overnight but you would I always would go through the airport and I would bring my juice boxes with me and I would be like, you know, you gotta let me through with this because they were always laying now you can't take that or whatever. And I was like, No, I'm a diabetic do Okay, so I'm gonna get on the plane and if I have a low blood sugar, then you guys are gonna have to take care of me instead of me taking care of myself. So they would always let me through with it all but I had to travel with all that gear, you know, and manage it all and then you're teaching a class and when you're teaching a class if I felt myself dipping down and this was before insulin pump time, right? So you feel yourself dipping down I always had a juice box and all my you know, color containers that I have to bring into the salons and to train their staff and you know, so I would always just pull it out and I would say you know let's take a break for a couple minutes pull it out drink it down and everybody come back reconvene and away we go again, you know, so simple is is just you just have to balance it and navigate it however you have to navigate it because no diabetic is like no two are alike. I mean it's different bodies different key insights. So it's just a way of how you manage and get along and navigate. But I drove from one state back here to the state that I'm in when we got transferred. A year ago, we got transferred, you know, every year. So in June of 2020, I was in a different state than I am now. But I would drive back to this state that I'm in because our son lives, like two hours from here. And so I would stop and stay up my friends here, but it's a 10 hour drive. So I would get in the car, and I would listen to you for the whole 10 hours. And I was like, That is like the best thing. The Time just flies.

Scott Benner 1:00:44
So good. I had been dying to ask you about that. How do you 60 years old? Like, I know, somebody, you know, tells you about the podcast, but I mean, had you ever used your podcast player before that?

Lori 1:00:57
Oh, yeah, I listened to podcast before them. But I never. I didn't even think about searching for a diabetic podcast. I mean, it just never came to I mean, I knew about Facebook groups, but I didn't know about podcasts. Right, that there was stuff out there for podcasts, you know, so yeah, so once I found that I just found, you know, like, I would I play in the kitchen when I'm cooking I listened to you.

Scott Benner 1:01:28
Is is it helping? Is it like, I mean, cuz you're

Lori 1:01:31
well, it just what it what you've done a lot for me is it's confirmed a lot of things that I do. Okay. It's been confirmation of a lot of things that I do, and, and just getting better at dialing it in even more, you know,

Scott Benner 1:01:52
so even though you're, even though you're doing those things, do you have a did you have a level of uneasiness that you were breaking a rule or something like that,

Lori 1:02:00
or no, no, just not? Not at all? No, I've never been I've never had an uneasiness about breaking rules, if it's gonna help me, yeah, never. That's a good, that's a good way to break the rules all the time. If like, my husband goes, God, you he was always even with the injections. He's like, you know, you gotta watch it. Because we'd have my whole family up at our lake house, the 25 of us and the way it works, so you got to feed 25 people, right. And so a couple was assigned kitchen duty every day. So my cousins, my aunts and uncles, my mom, you know, my sister, my brother were I mean, my mom had 11 siblings. So we all grew up going to the lake together, all my cousins and all the her siblings and spouses, and we'd all have cottages. And so I wanted to do that when I got married. I wanted to lake house, so I could continue that whole, you know, tradition. And so anyway, we would have my cousins and everybody up there. And so everybody would cook and we had a menu. We did a menu every year, a menu. And so it wasn't always like the food that I could really eat because it's just it's carbohydrates. Let's face it, right? carbohydrates. But I would just eat my cereal in the morning because they always have cereal, because of kids, all the little kids that we had, you know, love cereal and have my cereal and at lunchtime, you know, because back then, it's like, I really didn't. I didn't know because I was just doing this injection that injection. But when I was at the lake, and I got my blood sugar machine and I could check my blood sugar's then it was way better because then I could eat the stuff. Then I was eating carbohydrates. I was still skinny. But I was eating carbohydrates. And but you know, I was waterskiing. I was swimming we were to being I was always cleaning in my house because you got 25 people there, but we would assign cleaning duties, you'll laugh. So we had food duty. So you were in the kitchen one day, that week. And that was it, you're done cooking. And then all the guys always got it. They go golfing in the morning, they get ice for all the coolers, they come back and take care of everybody had their own cooler. So you came back to carry your own cooler. We had a treat table. So there was a treat table that was like a big coffee table that we had sitting with all the treats because everybody would bake and bring treats and then we'd bake during the week. And all the little kids you should have watched um, they were so funny. They go over to the treat table and they try and sneak a treat without asking the parent and the grandmas would catch them and they'd be like, you know, Darren, did you? Did you ask your mom, you gotta go ask your mom. And he be like, okay, you know, little kids. So we had all that kind of fun. Would up there and I would eat it. But I would I did pretty darn good. But there were times at night because we'd stay up until late all of us cousins, and we, you know, have a few beverages and we'd go to bed and get up the next morning. But there were a few times where in the middle of the night I went low. Probably because I ate, you know, my regular had worn off by them, you know, from dinner. But I don't know, my husband goes, it always happens when we have this vacation. Because your schedule is different, you're up late, you're you sleep in a little bit later in the morning activity with the different you take extra insulin because you're eating different and you do that. And so he always he had a couple of times, while a couple of times throughout, we did it for 15 years. So before we sold it, but we had a couple of times, where in the middle of the night he was or like in the morning when I would sleep in even he would come up and check on me. And he found me where I dipped down even in the morning. So he just come up there and give me juice and you know, then my mom comes up and my sister comes up and they all there you wake up and they're all staring at you. And you're like geez, what did you have to call the troops and forgot? Leave me alone. Ya know? So anyway, that's that's the way life was, you know, before anything came around like a mortar now.

Scott Benner 1:06:34
That's excellent. Did we talk about everything that you were hoping to talk about? Or do I leave something out?

Lori 1:06:40
Um, the one thing that I will say is that that I'm hoping you get your person on your podcast and that I know when it's gonna happen is that three years ago, yeah, three years ago before we got transferred the first time I was seeing like a naturopathic doctor and she I did blood you know, I do my diabetic bloodwork. And she goes Laurie your thyroids, like Lo, she goes, I think you should be on thyroid medicine. And I go, what? She goes, Do you feel oh, can I go? You know what, I've always felt fine. I've always had tons of energy. And she goes, Well, I'm going to call your primary care because I think you should be on thyroid medication. And I'm like, Really, my endocrinologist I always did bloodwork and every year you know they check all that stuff, and I never knew nothing. So I was like borderline low. Well then I went on the thyroid medicine and then I went to my endo and talk to her about it. And she goes you know what, if you feel fine, don't take it. So I didn't take quick taken and I go you know what? I don't.

Scott Benner 1:07:50
Okay, hypothyroidism or hyperthyroidism.

Lori 1:07:53
I don't even know what it was at the time. But I found out now those hypo hypo okay, I was. So for I moved. And then when I went and saw the Endo, and I went and saw a hormone doctor because people told me go see a hormone doctor, they know how to regulate thyroid. So I went saw him and he started me on can I say the? Okay, Armour Thyroid and like a high dose of it. He goes, your thyroid is really low. And I don't really. And so he's the one who started me back on the medicine again. Okay. And so then I talked to my endo about it. And she goes, Well, just, you know, keep going to see him and do it. So then when I moved again, and got to the next endocrinologist, she's like, boy, you're on a lot. And I quote, I know, I don't understand it. And so every two months since I started seeing her last November she's done bloodwork for my thyroid, and my dose has changed every two months. And I still I don't even know

Scott Benner 1:09:06
what's the number What's your TSH at you know?

Lori 1:09:10
I would have to dig out my test results. Yeah, but so anyway, now I'm going to see a deal here because they do thyroid and I'm going to go bring my I'm gonna bring all my labs with from the previous state and these last laps that I had done. Yeah, and because my doctor back there in the other state, I was supposed to do a video visit with her but I had to cancel because we were flying out to back home and I couldn't do it. I told the nurse you know that I needed her to look at it and all she's got to do is just put a message in my chart right? And so she they just called me like yesterday, I think it was and said the doctor said to keep your dose this I'm okay. And I'm like, Okay,

Scott Benner 1:10:02
well, I think Dr. BENITO would say that she, she would treat people over a two TSH, and I think you're the goal was to get it as low as you possibly can with stability without causing hyper symptoms. So,

Lori 1:10:16
yeah, because I, I don't mean to interrupt you, but I saw a primary care doctor here trying to get hoping to get this bloodwork stuff figured out. And he said, Well, this is weird, because your last blood work. Looks like you're on the edge of hyper. And this is hypo he goes, it's like you're sitting in between.

Scott Benner 1:10:41
Yeah, I mean, if you're hyper than the medications too much, and you'd have Oh, have you checked? Have you felt any different taking it?

Lori 1:10:52
Um, no, I have to say that I really don't feel any different. Right? I have, I'll tell you what's happening. That has not happened. You know, like I, I got, when I first started taking it, I was having such like hot flashes. And I went through, you know, the change at age 50. And it was a piece of cake. I never had an issue. And I feel like I'm hot. I'm living in a state where the climate is beautiful all the time. And in a city and I, I should not be sweating the previous state. I should have been sweating. And I don't sweat where I get dripping sweat. But I get like this heatwave in my body. And that goes away. And it's not hot

Scott Benner 1:11:40
right now. Right? It could well, your thyroid controls your body temperature. I know. How about your maps? Is your hair growing better? How about your nails? Anything? Any? Yeah,

Lori 1:11:51
I mean, my nails are kind of the same. I will say that, you know, I noticed like my eyebrows got different, thicker, thinner, thinner. But now they're now they're kind of like they're back to normal and just a little thinner on the ends of them. I had thick eyebrows.

Scott Benner 1:12:10
Laurie Can I tell you one thing? I got my eyebrows threaded recently. I went with our don't laugh at me. I went with Arden. She gets her hers threaded. And my family makes fun of my eyebrows all the time because they curl down on the outside. And they always tell me it looks like my eyebrows are frowning. So I looked at the lady and I was like, Can you fix these? And my daughter's like, what are you doing? I was like, I'm gonna try this. So it hurt.

Lori 1:12:37
Oh, yeah, it does. I've had mine threaded before. And I said I would never do it again. Because she totally botched my eyebrows. And I was like, and I'm in the hair world. Yeah. And I was like, No, you didn't, I'm gonna be in charge of my brows.

Scott Benner 1:12:52
Nice job. So we went that I somehow I go with Arden for her threading. And so the next time she went, I didn't think anything of it. And then she went back at another time. And I was like, I looked at the woman. I was like, Does this need to touch up? And she's like, Yeah, sit down. Okay,

Lori 1:13:07
well, it's easier as you do it, you know, because then you don't have the bulk of the brows you get where it's just maintaining the brows.

Scott Benner 1:13:14
She's unrelenting. She pulls them out. And it's like, it feels like it's like you're pulling out piano wires, you know? Gosh,

Lori 1:13:22
oh, my God is so funny. I mean, we did waxing at my salon, you know, forever. And so people would get their eyebrows waxed. And I was like, Oh, God, that would hurt when you rip that hair out. Like

Scott Benner 1:13:37
I said, I think I'm gonna keep doing it. So. But anyway,

Lori 1:13:44
threading is probably better than waxing.

Scott Benner 1:13:46
Well, I'm not getting my eyebrows waxed, I have to draw a line somewhere. Anyway,

Lori 1:13:52
well that you could do at home yourself. You just put the wax on, put the strip on and you just press it down and you tear it off and you're done.

Scott Benner 1:14:00
I would I would question myself if I was doing but you know, you started talking about your thyroid by saying something about the doctor but you never asked me the question. It was a great story. But you know,

Lori 1:14:10
yeah, but I know you have talked about art and having a thyroid issue and your wife having a thyroid issue. And you're and you finally got this doctor that has helped them and I thought I need I need somebody that kind of know cuz I've been bouncing around for like three years with this stupid thyroid thing and it's like, do I even really need to do anything or do I not need it? Do I need to do any I think I don't

Scott Benner 1:14:34
think you should. I don't think it's not a big deal. I mean to get that hormone like level right? It's the problem is finding a doctor who's really thoughtful and good at it. And I I agree. Yeah, I got lucky find and Addy. I took advice from a friend of mine who's been a guest on the podcast Vicki and she said you can't trust the end. Oh, to do this. You have to find somebody who really do This is great at this. And I asked another I asked a bunch of doctors about it and I got a bunch of recommendations and I found the one and it and thank God because she's really been terrific. She's actually just helped my son and my daughter with they're checking their guts for to make sure like the like the the bacteria in their gut is, is healthy. Yeah. And they both need some help. So we just got the results back last night. We have an appointment next week with Addy and she's gonna go through the protocol for the next couple of months to help them get balanced. And she thinks that Arden's acne and joint pain might go away after we do this.

Lori 1:15:43
I think it will, I'll just tell you that I, well, the diet, the fight the person, I'm gonna see about the thyroid, they do the God they it's a naturopathic like she's a deal, but they got naturopathic doctors that work there. So they do all this natural, you know, stuff to try and help your gut get regular and all this. I, when we lived in the same state two years ago, I Mike, I was I've been a rollerblader for years, you know, on my hip is kind of bothered me for 10 years. And I was like, I have this pain down the side of my leg. And I went and joined a walking group and I was power walking. And then I was having a hard time and I had this my gut hurt. I was like, my groin hurt. And I was like, What is going on. And so I quit the walking group, and it all kind of went away. But I changed. I never have been a big fan of gluten anyway. But I went on, I went and saw this, that hormone doctor that I saw, there was a nutritionist in there and she's a natural like nutritionist person. And she told me, she goes your gut, you gotta get your gut, healthy. She didn't do tests. But she said this, I told her the way I ate, and she goes, You got to get some good bacteria in there. She said you could get Kim Chi or something like that. So I started making my own homemade kimchi. Because that's the way I am. You know, I'd rather make it myself. I know what's in it. And I can, you know, eat it. And so I did that for months, like months, and my whole I like, everything, everything just kind of subsided and went away. And then we were still living in the same state. And in April. Now, I had gone rollerblading again. And in April, I got up and I could not walk, okay, my leg what I needed crutches. And I was like, Oh, God, this is not good. My hip was dying. And we moved. That's April. And we moved in June, the beginning of June. And I was getting trigger point injections in my muscles. And that was helping me and it helped me make the move. And then after we moved, I we had stairs in this house. We were in a ranch in the other state. And we had stairs in this house. And I could I got where I could hardly walk the stairs. And I ended up having a torn took them from April to December to find out I had a labrum tear in my hip. And they think that's so anyway, this was interesting is that I thought I was going to come back to San Diego. I said where I'm at, I could take California to get it fixed. Because they told me in the other state that there weren't doctors there that did that. I was like, what? How can you live in a city? It's a big city where you don't have a doctor that does labrum tears. And so anyway, I converse with the doctor back where I'm living now. And

that doctor said, Well, you got to go to you got to talk to this doctor because I just do hips. And I'm like God, does anybody do like more than one thing anymore? And so I talked to that gal and she told me she said we don't even do them, repair them on women your age because there's only a 50% success rate. Okay, and I was like, why? And she goes, yeah, she said, I You just got to go to a Hip, hip guy and get a hip replacement. That's what we do. I won't even do it. She said And so then I went back to the other state and talk to the other doctor there. And he did do labrum tear repairs, but he told me the same thing. So I got kind of two of the same opinions. And he said, the labrum tear. I just did two labrum tear repairs eight months ago. And they're both back here getting a hip replacement because it didn't work. So he said, I can do it on you save your hip joint, but you got arthritis in your hip. I go, it's 40 years, rollerblading, probably. And so I just did the full out hip replacement, June 10. And we moved July 2. And I stayed back in that state because I couldn't leave and with three weeks into the surgery, and go to a house where I mean, we weren't even going to have our stuff. So I wasn't even going to have a bed. My husband slept on a blow up bed in the house that we got. And so anyway, now I'm in hip replacement recovery, but the doctor told me my first question was, will I be able to rollerblade again? And he said, Absolutely not. And I go, what? He goes, No, you can't do it. You need to sell them. And I was like, Are you kidding me? That sucks. I was so I was like picturing myself rollerblading the boardwalk, you know? Yeah. Oh, wow. That's life, you know, so I'll find another athletic activity to

Scott Benner 1:21:37
do. Yeah. Well, Laurie, I've had a really wonderful time talking to you. I have to go spend the rest of my day cooking. It's not my day at the beach house. But my son's college, because of COVID is having a terrible time staffing. And because of that, there are long waits for food, and my wife and I are going to cook up a bunch of different things and take them to him so that he can eat in his room a little better. Oh, that's nice. Yeah, so this is the rest of my day. Now. We're gonna be down there. Like, it's gonna look like we're preparing because we're gonna have to bring enough errors, roommates and everything else. So it's, yeah, I'm gonna be making some Yeah, you're

Lori 1:22:15
gonna be a cafeteria and your kitchen. That seems like but anyway, if you can get that thyroid person on, that would be awesome. Because I would totally love to hear.

Scott Benner 1:22:25
Oh, well, she's been one. Was that okay? Yeah, hold on a second. Let me get you the episode number. Is that all you wondered? Hold on a second. I like talking to you. Because you asked the question that never asked it. Hold on a second. I'll find it. She is. Episode 413. thyroid disease explained. Okay, there you go. She's really good till you'll love it.

Lori 1:22:53
Yeah, I'll listen to her. So I'm going next week to see my new my new person now in the

Scott Benner 1:23:01
Yeah, fourth move. Listen to her before you go to the appointment.

Lori 1:23:06
Yeah, well, I listen to her today. Great.

Scott Benner 1:23:09
All right. Well, thank you so much. I really appreciate you doing this. Well, I

Lori 1:23:12
appreciate what you do. I mean, you do a lot for everybody. And I commend you for the care you give your daughter because your daughter is really, really lucky to have you. You know, that's very sweet. I mean, she's really, really lucky. Most of us got to figure it out on our own, you know, and it's great to have a community.

Scott Benner 1:23:33
Yeah, no, I'm glad. I'm glad that what we're doing here at home that's helping other people to

Lori 1:23:38
Yeah, makes a difference. You know, a big, big difference. If I would have had something like this when I was diagnosed, I would be like, geez, you know, way better.

Scott Benner 1:23:47
I really do see that. My mom is sick right now. And I we particularly kind of rough day yesterday. And at the end of the day, I realized I hadn't been interacting much with the people on Facebook. And I went in there and I was kind of melancholy. I was like, you know, just like I said, Tell me something good. And the hundreds of replies that came back. Were people just sharing good things in their life. I thought, wow, look at this amazing community that, that this whole thing together, you know, people were there. Some of them didn't realize that I was upset. They were just like, here's something great that happened to me today. And they've told me something about their kids or their life or got a new job or something just never stopped. And you know, when you translate that over to talking about diabetes, it's amazing. Someone can go on there and ask a question about, you know, a Pre-Bolus or something like that. And then right. Oh,

Lori 1:24:39
yeah. I mean, it's, it's, it's just awesome. Yeah. Well, I'll tell you something good. That happened yesterday. It wasn't my anniversary of 42 years to my husband. Oh,

Scott Benner 1:24:49
happy anniversary. Yeah. And you just you just saved yourself. Because now now I can call this episode tell me something good. Because I was gonna call it Handy Andy.

You just got you just saved yourself at the very end.

Lori 1:25:12
Yeah, he's a great guy to ask for anybody better.

Scott Benner 1:25:15
So wonderful. My best to both of you. That's really wonderful.

Lori 1:25:19
Yep. All right. Thanks a lot, Scott. It's been great. And I wish you and Arden and your family and your son well at college, and, you know,

Scott Benner 1:25:28
I really have a lot to me.

Lori 1:25:30
Hope he always has a full belly.

Scott Benner 1:25:34
He's at least going through this week.

Lori 1:25:36
They're eating machines of that age. Oh my god, you

Scott Benner 1:25:39
can tell how angry they are. You get like these angry texts with pictures of lions in the cafeteria. Like, I can't even get in here. And he's like, even if I got in, it would take 45 minutes to get to the food. I gotta get to my next class. And he's getting irritated. So we're gonna we're gonna help him out a little bit.

Lori 1:25:53
Yeah. My son Rodney. Just a quick little note, my son when he was in college, he had a credit card for emergencies. And I would always pay the bill, right? And I would be like, What is this like? $300 on here for food. He played roller hockey. Because he played hockey all his years growing up, and he still plays hockey. He actually plays three nights a week in a men's league, but and I'd be what? And he goes, Mom, do you have any idea how hungry? I am? Like, I'm hungry. And I go, but are you buying for the whole floor? Or the house? Or what? Cuz it's like $300 He goes, No, he goes, You know, we play hockey. We go out, we eat and I go, Yeah, you must be buying for everybody at the table. But they're hungry boys. They eat lots and lots of food and you gotta supply for the friends. Like, oh my God,

Scott Benner 1:26:54
that's gonna be it. I'm gonna go get a couple of pounds of chicken breasts and smoke them all. And we're gonna make a bunch of rice and a bunch of other stuff and just take them so Alright, well, thank you. Okay, well once I

Lori 1:27:05
have fun on the kitchen, thank you

Scott Benner 1:27:16
a huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juice box. you spell that GVOKEGL You see ag o n.com. Forward slash juice box. And I'd also like to thank us Med and remind you to go to us med.com Ford slash juice box or call 887211514 To get your free benefits check. It should not be difficult to get your diabetes supplies. It also shouldn't be a headache. Check out us med. Hey, do me a favor. If you're listening in Apple podcasts, Spotify, Amazon music or anywhere like that, hit subscribe or follow in the app that you're currently listening in will take you just two seconds, but it will help the show immensely. Subscribe and follow in a podcast or audio apps. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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