#703 Butthole Adjacent

Katie has type 1 diabetes and a rather unique diagnosis story.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to episode 703 of the Juicebox Podcast.

On today's show we're gonna be speaking with Katie. She's had type one diabetes for only about a year. But Katie is going to give a whole new meaning to the word open and honest on today's show. While you're listening, please do 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 looking for the diabetes Pro Tip series? It begins at episode 210 In your podcast player, or can be found at diabetes pro tip.com, and juicebox podcast.com. If you would like a list of the episodes available on the Pro Tip series, or really lists of all the different series in the podcast, you really should consider joining the private Facebook group Juicebox Podcast type one diabetes and then going up to the featured tab where they are all listed in a very neat and orderly fashion. The T one D exchange is looking for US citizens who have type one diabetes, or are the caregivers of someone with type one to take a brief survey AT 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 touched by type one, head over to touched by type one.org. To learn more about this great little organization, or to get tickets for their upcoming extravaganza, which yours truly will be speaking at. Lastly, but not leastly. The podcast is sponsored today by the Contour Next One blood glucose meter, you can get the Contour Next One at contour next one.com forward slash juicebox you will find links to all of the sponsors in the show notes of your podcast player and at juicebox podcast.com.

Katie 2:23
My name is Katie, I'm 28 years old and I was diagnosed with type one diabetes. Actually, I think it's going to be a year ago tomorrow.

Scott Benner 2:33
Really? Yeah. I just had the conversation with somebody recently where I said like so excited and like, like a child most like, you know, everybody comes on on their birthday or their diversity is or something like that. It's like it's such a coincidence that I realized that's not a coincidence. People look at the calendar and and pick when they come to their property one.

Katie 2:52
This one was semi coincidence. This was like the earliest, you know, date you had on and all that fun stuff. And then I just was like, Oh, well, that's the day before. That's kind of cool.

Scott Benner 3:02
Nice. Well, I'm happy you're here and, uh, years an interesting amount of time. So we'll say it again. You were how old? were you diagnosed?

Katie 3:09
I was 27.

Scott Benner 3:12
Do you have any expectation of this in the family or anything?

Katie 3:16
Oh, yeah. I think Oh, yeah. I think I mentioned in my email. I have my mom is a type one. Two of her sisters are type one. And then another one of her sisters daughters. So my first cousin is type one. So that's 1234 type ones kind of in my immediate family,

Scott Benner 3:37
your mom, two aunts. I say what am I from the south? A mom to ask. What do you prefer? Katie? Aunt or aunt?

Katie 3:48
I call aunts? I mean, I'm like semi from the south. But I say aunt.

Scott Benner 3:52
Okay. And then you makes five in the family. Yeah, yeah. I think there's gonna be more. Are there other people walking around looking real nervous?

Katie 4:02
I don't know. I besides myself, everybody else was diagnosed when they were like six or seven years old. And it's interesting. They've all been females. Like there's no Oh, okay. Oh, males. Yeah.

Scott Benner 4:14
What else I would this with a number like five? I feel like you're gonna tell me. Three of them have Hashimotos or hypothyroidism?

Katie 4:23
Actually, I don't 100% No, I know my mom doesn't have hypothyroid or Hashimotos. I know have a little cousin doesn't either. And I'm pretty sure the other two agents did not fit their celiac. No, not that I know. Okay, well, just I just diabetes. When

Scott Benner 4:46
you hit that number. I was like, oh, there's going to be a bevy of autoimmune diseases in that family and then nothing.

Katie 4:51
Yeah, you would think and then I mean, I have a really big family. So I guess I don't know everybody's intimate health history but that's Um, we talked about a whole lot, but even in the extended family, like, I don't think that there's any other real autoimmune stuff going on. Wow, that's

Scott Benner 5:06
fascinating. And all females, all females. Yeah, I think, um, I've said this before, I think it's my wife's side of the family seems to have some autoimmune. And it's all females. And then, and then suddenly my son got Hashimoto. So I guess that breaks that mold. But, but I don't know. Also, I'm adopted. So, you know, yeah. I could come from a week of people with autoimmune diseases have no idea. Okay, so this happened about a year ago, it wasn't a complete surprise. Was it one of those that you found out really, obviously early, because you're like, Oh, I recognize this, or?

Katie 5:45
I wish it was. Yeah. Okay. So I, I wanted to tell the story, it's hilarious, embarrassing, etc, etc. But I love it. And any of my friends who listen to the story are going to love it. So I actually, you know, I'm a nurse, and I work night shift. And this was last summer, I'd been like, I've been kind of dieting going back to the gym. I was losing weight. You know, I was like, Oh, great. Yeah, it's finally working. I feel like you hear that a lot. But uh, and I was like, really thirsty all the time. But I was like, it's summer I'm working night shift. I drink a lot of water on night shift, etc, etc. The the way that I found out actually, I started having some pain and an uncomfortable area. Vagina. No, no. Okay. Perry anal area.

Scott Benner 6:40
That's close to there though. Okay. Yes, yes. So for the layman. Katie, that's your tape.

Katie 6:47
It's right around the butthole. Gotcha.

Scott Benner 6:50
Boy, got Katie. In seven minutes. You might have named the episode right around the bottle.

Katie 6:57
I don't know how I would name my episode that fast. I was waiting for

Scott Benner 7:00
something. I'm not certain what you're gonna say next. But that's a strong contender. Go ahead. Third, so you're strong because you're drinking a lot of water go.

Katie 7:08
Yeah, yeah. So I'm at work and you know, it's getting painful to sit down. Like diabetes is not even on my radar. I haven't thought about diabetes since like, I was a kid when my mom would check my blood sugar all the time. So not even on my radar. I think that I have hemorrhoids like a hemorrhoid. Yeah, exactly. So I'm at work and I'm trying to just treat it at home because I'm a nurse and I hate to go to the doctor. So I like you know, bought all the creams, all that stuff trying to treat at home. Nothing's working. Finally, I'm like, You know what, I can't do this anymore. I get off work one morning and I go to an urgent care. And the doctor at urgent care. He looks at me and he's like, you know, have you had a hemorrhoid before? And I was like, No, I haven't. He was like, well, I could just prescribe you, you know, normal hemorrhoid stuff. But I'd kind of like to take a look at it. Sure. I don't think that was his cup of tea.

Scott Benner 8:07
I'm just imagining that you have to you think to yourself, I have to let somebody look at my butthole I'm not good at work where people can like where people I know I'm gonna go to an urgent care why don't know these people. But before you continue with your story, because I am enjoying it. If you wrestle that Khan's away from that dog and throw him out of the room. I'll give you $10 Okay,

Unknown Speaker 8:27
okay, hold on one second. Okay.

Scott Benner 8:36
I don't know if the rest of you could hear the licking and the, from the dog but it was trying to get into the story. And I was like, oh, dog. Can you hear me by the way while I'm talking? Okay, I'm back. Sorry,

Katie 8:46
guys. Are you talking about me when you're gone? Yeah, of

Scott Benner 8:48
course. Because Because your start I'm trying to get into the story and in the background while you're here like I'm gonna get I'm gonna lose my focus. I mean, you've already said taint. I said vagina. You've said butthole three times. You're about to show a stranger your ass and I'm like, I do not want that dog eating that Kong toy during this. So. Okay, go ahead. What kind of dog? Sorry.

Katie 9:10
He's like a 60 pound mine. Oh, lovely. From the streets. You know?

Scott Benner 9:14
It's nice that you took him up. Okay. Yeah.

Katie 9:17
Okay. Okay. So, um, go to urgent care. You know, the doctor wants to look at my butthole fine. He takes a look at it. He's like, I think you have cellulitis and I was like, Okay. Not what I was expecting. But he sent me home with an antibiotic. He was like, there may be an abscess there. If it opens you should go to the emergency room because we don't have good pain meds. And it's going to hurt.

Scott Benner 9:44
Yeah, so no, no. Yeah, he did happen. Oh, yeah. Oh, God. I know somebody that this happened to and just from their description of the pain. I'm already on the edge of my seat. Okay, go ahead. Katie. You went home. You must have been stunned first of all.

Katie 9:59
Yeah, I was like like, Well, I mean, I kind of was just like, Okay, I take these antibiotics for a few days, everything's good and well in the world and I'm back to my life

Scott Benner 10:07
probably thrilled you don't have a hemorrhoid. Yeah. Kind of.

Katie 10:12
I don't know much about hemorrhoids, to be honest. So that sounds like not a lot of fun. But I go home, you know, I'm like soaking in warm baths, trying to make myself comfortable. And at this point, just to set the story up also, my boyfriend and I had been together for February, March, April, May, June, four months at this point. Oh. Yeah. So he's, uh, at our apartment. I think we're living together then. I don't know. But anyways, he's at my apartment with me. And I'm in so much pain, like, just can't take it. And he's like, urging me this whole time. Just get an emergency room. And I'm like, no, no, like, you know, it's fine. Um, he was like, Well, what if it bursts open? And I was like, Oh, I've got some gauze and some cleaning solution. Like, I'll just keep it covered, and it'll be fine. And he's

Scott Benner 11:01
so funny. It's because you're a nurse. Right? That you had that? 100%? Yeah. Because if you told me what if my, I want to say at all so badly, but what if my butthole popped open? I'd be like, that's a valid concern. Let us go to the hospital right now. Okay. Yeah. But

Katie 11:18
meanwhile, me I'm like, you know, I can take care of that. Right. So it's hurting. It's getting worse, like throughout the day. So finally, he looks at me and he goes, Do you want me to look at

Scott Benner 11:30
it? Our month at the dog's back?

Katie 11:33
Yes, I he grabbed a squeaky toy. Oh my gosh, hold on. I'm gonna lock him in a room.

Scott Benner 11:38
There you go. The animal lovers alone like that? Are you guys like thrilled with this story? Like I am like she's about to make the decision. Am I going to show what might be a burst open? butthole to my four month boyfriend? I don't know. Would you do it? Think about it for a second. Would you just go to the hospital? i It's a big decision. Because this is probably I mean, you don't know if she's still with the guy or not right. This is probably a big moment. She's coming back. Okay. Katie, I did like a little build up while you were gone. Oh, gosh. Because the scene because Yeah. Because it's a big moment for you. Right? If you're with him for months, you clearly like him. It sounds like you're living together. And now you have to decide, am I going to look like a like a monster with like, a hole next to my other holes? Like cute. And by the way, do you bend over? Like a counter? Or do you go on your back? Right? It's a big question, don't you think? And you leave your underwear on and just kind of show him the one spot. All right, go ahead. Tell me what you got me.

Katie 12:49
Okay. I was like, Well, I don't really want you looking at it. But I kind of being you know, me. I was like, I kinda want to see a picture of it. So I can get it because I have no idea what this looks like at this point. I'm just taking that doctor's word for it. So I was like, yeah, if you don't mind, like, can you look at it? So I lay on the bed kind of on my side.

Unknown Speaker 13:13
Okay.

Katie 13:15
Yeah, you got to be comfortable. I'm gonna go through this intimate experience. You got to be really comfortable. So I have to

Scott Benner 13:21
ask you, Katie, when you laid down to do it, did you give any consideration to how you would look the least vile doing it?

Katie 13:29
I'm kind of I'm pretty sure like I kept the underwear like on you know, tried to cover myself up as much as possible by

Scott Benner 13:38
making take a picture. I did. No flash or flash. I don't remember because if you get a natural light, it looks a little nicer. And is this the first time you've ever taken a photo of your lady bits? Or was are you had you done this in the past? No, no, no. Oh, that was the first. I'm sorry. You're on your side. Go ahead. Do you? Do you expect him to do it?

Katie 14:02
Oh gosh, I'm trying to remember. I was so like, you know like traumatized at that moment. Yeah, it's hard to remember the details. I think that he did the cheeks.

Scott Benner 14:20
G voc hypo pan has no visible needle, and is a pre mixed auto injector of glucagon for treatment of very low blood sugar. In adults and kids with diabetes ages two and above. Find out more go to G vo glucagon.com forward slash juicebox G voc shouldn't be used in patients with insulinoma or pheochromocytoma. Visit G voc glucagon.com/risk. Are you in the Orlando area? Would you like to hear me speak live? Go to touched by type one.org. Click on the program's tab then annual conference. And you can register right Right now for touched by type ones Annual Conference, which aims to educate, encourage and empower people living with type one diabetes. Do you know what it costs register? That nothing. It's very pretty baby. Let's do it. Here, do it. Let's do it. Come on over on Saturday, August 27 and see me Scotty, where am I going to be the Loews Portofino Bay Hotel in Orlando, Florida. It seems like it's near universal studios. Registration again, is free and open to all with a connection to type one diabetes touched by type one.org. When you come over, bring your brand new meter with you, your Contour Next One blood glucose meter, the one you're going to get at contour next one.com forward slash juice box. I say it all the time. I'm not afraid to say it again. We just get the meter our doctor gives us most people don't get to choose if they did, they would choose accuracy, they would choose a bright light and easy to read screen something that is small enough that could be carried in a purse or a diabetes bag that has insanely accurate results. A bonus might be test strips that allow for Second Chance testing, and an optional app for your cell phone for your cell phone. What happened am I who also do we still call them cell phones, for your smartphone for your phone, let's just call your phone that keeps track of the data you get from your blood tests. That's the Contour Next One blood glucose meter. That's what you're looking for. Head to contour next one.com forward slash juice box right now you can learn more, or buy one today, you can actually get it online like through Amazon and places like that there's a link there for that. There's all this information about the accuracy the meter, the cost, you might that the costs that might be incurred with strips. And contour likes to remind me to remind you that it's possible that buying the Contour Next One blood glucose meter would be cheaper in cash than you're paying right now for your meter and supplies through your insurance, which would be bonkers. But as possible contour next.com forward slash juicebox. Get the blood glucose meter that I just use 20 minutes ago with Arden.

There are links in the show notes of your podcast player and links at juicebox podcast.com. To the sponsors. And all of the sponsors that Juicebox Podcast, when you click on the links, you're supporting the show. Very nice of them. Go ahead.

Katie 17:35
And as soon as he did that, it opened. Oh, oh. And he says, Oh, God bless him. He just looks up and he goes, I'm gonna go get some toilet paper. I was like, what? And he goes, we're going to the emergency room.

Scott Benner 17:53
Oh my god. Yeah. Did he? Did he redownload his Tinder app on the way to the hospital?

Katie 17:59
Sure he did. Man. It's a wonder we're still together. I don't know how that that's happened.

Scott Benner 18:04
Was there blood in pass? I'm so sorry. Oh, my God.

Katie 18:07
It's okay. Yeah. Like, like I said, I'm a nurse. Like,

Scott Benner 18:10
other people are listening to this.

Katie 18:12
They're gonna be mortified. I'm sorry, if you're you're you're listening your your views or whatever. I'm sorry if that drops.

Scott Benner 18:20
Oh, my gosh. Okay. All right. Blog and pass. We get it cleaned up a little bit. Yep.

Katie 18:27
Yeah. And he's like, we're going to emergency room and I'm like, no, no, it's fine. Like I can and he was like, No, we're, we're going. So we go to the emergency room. Mind you. I haven't eaten anything since like, midnight the night before? I was hadn't been feeling well.

Scott Benner 18:43
Yeah. Try not to go to the bathroom too. I'd imagine. Yes.

Katie 18:46
Yeah. That was excruciating. Go to the emergency room. I you know, we're out in the waiting room. I have to explain what happened to everybody again. And this is the waiting room. Also at the hospital I work at just

Unknown Speaker 18:59
FYI. Hey, Patti. What's up, Jim?

Katie 19:03
I definitely definitely saw people that I have worked with. And I don't work in the emergency room. But my nurse in the emergency room I went to nursing school with it was it was a fun time.

Scott Benner 19:14
I bet you they weren't thrilled either. Oh, I'm

Katie 19:17
sure. Were though,

Scott Benner 19:18
do you think later they run around? They're like I saw Katie's. But today

Katie 19:23
oh, gosh, probably that was probably a good dinner conversation,

Scott Benner 19:27
would it because if it happened in reverse, if the girl or guy that you went to nursing school with had to come show you they're asked for some reason, would you not? I mean, where's the line in medicine?

Katie 19:39
Well, I mean, I couldn't talk about who I could definitely say like, Hey, I had to look at a butthole today, but I definitely couldn't say whose butthole I don't know.

Scott Benner 19:50
I feel like in private moments, you guys just talk about each other incessantly. But whatever. Go ahead. Whatever you do on the podcast right now it's fine. Okay.

Katie 20:00
So we're in the waiting room. You know, when you go to the emergency room, they put in an IV and they just draw like basic lab work. They drew a BMP, which is just, you know, like a metabolic panel, and that has your blood glucose in it. And I get a notification on my phone, because I have like my chart system and all that fun stuff. And I get a notification on my phone that says, my glucose was high. So I pull it up, and I look at it, and my glucose was 312. And I was like, okay, um, well, surely somebody is going to talk to be about that. And maybe it's just the stress the infection, you know, that can raise blood sugar. So yeah, maybe that's it. So I go the entire emergency room visit, which was traumatizing in itself. And nobody says a word to me about the lab results. Yeah, like I have no other illnesses. I'm, you know, nothing wrong. And nobody says a word. So they end up lancing that abscess and send me home with more antibiotics. Which, for the record, the emergency room did not give me good pain medicine. I had they numbed it with lidocaine, which was terrible.

Scott Benner 21:16
Wait, somebody took a needle and put it in a butane shorted? Oh, my God. Yep. And at no point when this was happening, was it just so over was the rest of it so it was the fact that you're asked blew open? so overwhelming that you didn't go hey, my mom, my two aunts and my cousin have diabetes and my blood sugar's high.

Katie 21:38
I honestly, at Yeah, at that point, I was like, You know what, this is something I'll just deal with later. I just, I want my body to feel better.

Scott Benner 21:44
Okay. Oh, yeah. Well, I hear from like I said, I've had a person describe it to me, I think it's described as a horrible feeling. worse pain. Somebody told me once they had ever experienced in their life, but are we getting alright, I don't want to rush the story. This story could be about your this entire podcast could just be about your abscess. And then at the end, you'll be like, and I have diabetes. And I'll be like, No, we have to go. So. But go ahead. You're home now.

Katie 22:12
Yeah, yeah, I'm home. Long story short, I borrow my mom's old like meter and strips and all that stuff. Because I was like, I'll just test for a few days. See if it comes back down. You know, I test and I don't get a number below 300. I was like, alright, so I go to the My primary doctor. Does all the normal bloodwork. My agency, I think was 12.7. Was like had the antibodies and did the C peptide and all that fun stuff. And he was like, Yeah, you have type one diabetes.

Scott Benner 22:48
And do you think that that's where the abscess came from the extended high blood sugars?

Katie 22:53
Maybe that would be my guess, my endocrinologist I because I asked her. I was like, Do you think that I had this for like, a long time and just didn't know it? And she was like, No, I'm thinking it kind of started a couple weeks before you actually got diagnosed like it wasn't a whole whole long time. Okay.

Scott Benner 23:14
Wow. And this boy stayed with you.

Katie 23:18
Yep. We're still together.

Scott Benner 23:19
Wow. It's like one of those things where you went through a thing so horrifying. You're delayed fuse trauma bonding. Yeah. Is that what that's called? I think so. Oh, my God. When my wife and I were dating, something so horrendous happened. I would never tell you about it. And I do remember afterwards. Like thinking like, oh, I called her back.

Katie 23:45
I guess we still continued on,

Scott Benner 23:48
I guess we were like, Oh my gosh.

Katie 23:53
Well, everybody, I've told that story too, is like, you know, you have to marry him. Right?

Scott Benner 23:57
Well, that's at least buy him like a car or something. You know, like something significant that later? Yeah, he deserves something feel paid for like, like, in a significant way. Oh my gosh, okay. How long did it take for that to heal?

Katie 24:12
Um, once I started the antibiotics, it really wasn't bad. I mean, it was probably healed up in like a week or two.

Scott Benner 24:17
Okay. And how many days into your testing? Did you really like when did you start to think like, Oh, my God, I have diabetes. Like, was it the second day? Or did you hope

Katie 24:27
it was like, the morning after I tested like, first thing in the morning when I know, like, I hadn't had anything to eat like, and it was still, you know, like, 350. I was like, okay, yeah, that's, that's probably real. And I called my mom, you know, my mom. My boyfriend was with me the whole time in the emergency room. But I called my mom and asked for the testing supplies and kind of told her what was going on. And then I called her after I was diagnosed and she was like, Are they sure it's type one. Maybe it's type two. I think she just you know, was kind of in denial of it. Yeah.

Scott Benner 25:03
Well, and she tested you a lot as a kid. Yeah. Yeah. She was worried about her whole life probably.

Katie 25:08
Yeah. And then, you know, I know for her She probably thought like, after we grew up, like, Oh, my kids made it, you know, they don't have it. We're, we're good.

Scott Benner 25:16
Because the rest of the family was at a young age.

Katie 25:19
Yeah, yeah. And she in I mean, a lot of, you know, older diabetics, and even people in general, just, they didn't really know that you could be diagnosed older, you know, ya know, juvenile diabetes for so long for reason.

Scott Benner 25:32
Right? Oh, you got out of juvenile. You're all good now. Yeah, yeah, I understand. Okay. Do you? Do you think that you and baboy will ever make a baby together? Or is this a concern for you?

Katie 25:45
No, I mean, I think that's still on the horizon. I think that's it's kind of a concern for me. But I don't, I don't know. Gosh, I hadn't really thought about that.

Scott Benner 25:58
I'm sorry. No, like,

Katie 26:01
you know, we we just, we want kids so bad that, you know, I don't know, I think and, and like, diabetes, it's not like a death sentence. You know, so wouldn't be the worst thing in the world, I guess. And

Scott Benner 26:15
you have a different perspective. I mean, you obviously have a family with it. And you have it now yourself. Um,

Katie 26:22
yeah, I know, for a lot of people like it's, it's a really, a lot of people grieve and stuff, you know, when they get diagnosed, or their kid gets diagnosed, because it sounds like this horrifying thing that you're gonna have to deal with. And a lot of people have a hard time with that. But uh, I mean, for me, it was just like, oh, well, this is what I do now.

Scott Benner 26:41
Yeah. Do you ever talk to your mom about it like, or does she kind of held the way she feels privately?

Katie 26:47
No, I'm, we've we've talked about it a little bit. We're not very good about talking about our feelings. But I mean, we've talked about it a little bit.

Scott Benner 26:53
Yeah. Talking about your feelings. Now Catholic?

Katie 26:57
Did you just ask about Catholic? Yeah. How did you know that? I mean, I'm not but my family is.

Scott Benner 27:03
Okay. I know what's up door. Wow. Yeah. He talked to people long enough. You know, people call those What's that thing? They say you're not supposed to generalize? Yeah, you know, don't generalize about people. People are individuals blah, blah, blah. Yeah, sometimes.

Katie 27:20
Like, I just like, talk to a psychic or something. That's crazy.

Scott Benner 27:23
I just the guy who's recorded almost 1000 podcasts. That's all. That's fair. Yeah. Although, give yourself a gold star, because you're the first person who's asked exploded during their story. So

Katie 27:34
I was gonna I was gonna say at the beginning, I was like, I feel like I have a diagnosis story that I have not heard yet.

Scott Benner 27:40
I have to be honest. Like, I get so excited when somebody tells me something. I think no one's ever said this before. It really makes me feel like I'm digging deep no pun intended on the butt thing. Like I'm digging deep. And trying to like really, like, I'm like, wow, we're you're finding different angles to this. You know what I mean? Like, everyone doesn't come on and tell the same story over and over again, even though it's about being diagnosed. And I appreciate that by anyone listening who has any kind of stories like this, please get on the podcast. I love hearing about stuff like this. I really do. If you have no idea. It's early. I don't like I record at 9am Sometimes my time, but it's not that frequently. And when you started talking, like this morning, I was like, alright, Scott, you're making a podcast, like pull yourself together. You don't I mean, like, let's get going and I am jacked up now. Like, I swear to you, I have like, I'm so ready for this day. Just love hearing that story. I have the right job. I get to go

Katie 28:38
about your day. And you're like I heard about someone's butt hole this morning. Like everything is I'm just so jacked up.

Scott Benner 28:44
Katie, I can't tell you that. I'm gonna tell four people about your ass today.

Katie 28:50
I don't know if you realize but like, how many listeners do you have a few. They're all going to hear about

Scott Benner 28:55
it. I'm thinking in my personal life. I want to be like, Oh my God, how are you? Yeah, you want to hear a story about a girl you'll never meet and then and plus the and the best part of this is that before we began recording, I saw your boyfriend's name. And

Katie 29:11
right we started with the porn star. Oh god I wasn't that wasn't recording.

Scott Benner 29:14
No, we weren't recording during that. But your your boyfriend has a porn star name which is absolutely like, it's just I don't know, the whole thing is to like look at it unless you say something absolutely horrifying. Between now and the end. This is going to be the most fun I've had making the podcast this week. So

Katie 29:30
that makes me feel so special.

Scott Benner 29:33
It really should I have so I have so many inappropriate questions about it that I'm not going to ask because I'm polite even though people probably don't think that's true.

Katie 29:42
Thank you I'm probably gonna have my mom listen to this. Yeah.

Scott Benner 29:45
Oh no, I had all like you were you were like laying out the story and I was like, I wonder if she was shaved the way she wanted to be before this. Right like did you protect your lady parts from like the past and the like the bite like all that stuff? I was worried you had an infection when it was over. You have no idea what was running through my head that I didn't say. I'm really glad you didn't Oh, my God. Well, I said, I found a way to say it anyway without actually asking you like, right. And I don't actually have to answer. Exactly, because it was all in the like abstract. Yeah, yeah, there's a little trick case you ever want to use it? Okay, so you have diabetes. Now. Everybody's on board that this is happening, your infection is cleared up? And do you go back to the people you work with and go, Hey, you guys are terrible at your job?

Katie 30:32
Well, you know, like I said, I don't work in the emergency room. And I understand like, when you come into emergency room, a lot of people don't really realize that but like, they see your main complaint on the paper. And they're like, Okay, let's fix this main complaint. You know, yeah. Okay. They're their job isn't figure out whatever else is wrong with you. They shouldn't be off for that.

Scott Benner 30:51
Oh, you know, emergency emergent. I get it. Okay. Yeah, it

Katie 30:55
makes sense. But I did. You know, I told my co workers on the floor I worked on, you know, hey, you know, that hemorrhoid? I thought I had it's actually type one diabetes. And they all were like, what, you know, everybody was shocked. I had to go through the whole experience again, and yeah.

Scott Benner 31:14
Wow. Wow, that is a gift to go tell everybody because everyone knew you didn't feel well, right. You're probably telling coworkers like I can't sit down. This hurts. I probably have a hammer. Yeah.

Katie 31:24
I mean, we're nurses. We talk about you know, our health stuff. Like I know way more about a lot of my coworkers then I probably should, but yeah, yeah. And I mean, it was it was hilarious, too, and kind of embarrassing. Like, we would get new employees show up and my friends would be like, Hey, this is Katie, have her tell you about her type one diabetes story. And I'm like, Hey, quit.

Scott Benner 31:45
The first day here break the ice. You remember the day your taint hurt Katie? Yeah, bring the new girl. Yeah, bring the new girl over and let her know.

Katie 31:54
Welcome to the new unit new employee,

Scott Benner 31:57
while the new employees thinking like so I've worked with a bunch of nurses who thought that diabetes was asked pain. I'm gonna know more than everybody in five minutes. Did you go to an? Did you go to an adult? No. Do

Katie 32:10
you go to your mom's Endo? Oh, no, no, I went to an adult Endo.

Scott Benner 32:13
Okay. Like found your own doctor started fresh? Yeah, it's

Katie 32:17
in the same. I mean, the area I'm in is kind of ruled by one health system. So it's the same kind of office but a different Endo. I kind of just took the because it took Gosh, at least a month or so to get in with the Endo. Yeah. And that was even just for like a virtual visit. I didn't, I still haven't got my endo in person. But yeah, I just kind of took the first one that was able to get me in.

Scott Benner 32:45
Okay, that's happened around where I live to, it almost feels like a mobster went to every doctor and said, You work for us now. Do it, you know, and suddenly, a doctor you've been using for years. It's like I'm now part of the blah, blah, blah health system. I was like, yeah, they got to Yeah, you know, it really feels like that somebody has you know, the doctors get sold on the like, we take care of the billing, we do this, all you have to do is be a doctor and they're like, oh, that sounds good. Well, honestly,

Katie 33:11
with like your own malpractice insurance and all that stuff. As a physician, it's hard to have an individual practice now. It kind of just makes more sense to be a part of a system on their end. Yeah,

Scott Benner 33:22
no, I can see how it's just funny how they fall like dominoes. Oh, yeah, right. Okay, so. So I'm super interested. Do you have me have four people you're closely related to that have diabetes, you know, have it? Do you go to them to commiserate? You go to them for advice? Or do you just pretend you're an island unto yourself and just start fresh on your own?

Katie 33:47
I'm probably a little mixture of both. I know my little cousin. She's, oh my goodness. I don't know how old she is. I think she just turned 13 So at this point, she was around like 12 or something. And I know that she had kind of mentioned to her mom, like, why am I the only kid in the family that has this you know, why am I the only of the cousins that has this kind of thing. So I pretty much immediately called her up and was like, Hey, you're not the only one now? Yeah. So I really kind of wanted to offer her some some camaraderie and support. It didn't really go so much for advice because I don't know. I don't I don't really know their management. You know, I don't know my cousin say once see or anything like that. But I did you know, my mom offered up a lot of advice. I don't know that I necessarily asked her advice, but

Scott Benner 34:44
I know she's gonna listen to this but like dang serious. I want to talk through this part. Right. So being serious. Did as you were and she were talking you and she is that right? Human she her her would have been wrong, wouldn't it?

Katie 35:00
I think it's she I think it's one of those things where she sounds weird, but that's correct.

Scott Benner 35:03
I made I got that right. Wow, I'm so impressed that That's right. Somebody, you know what I almost had somebody send me an email, nobody sent me an email, I'm, you're gonna get so many emails six months behind on my email, nobody email me. But when the two of you spoke about it did you find yourself thinking, Oh, that's not how you should be doing that mom or did you think okay, like, I don't know anything about this. So this is a good base of information.

Katie 35:29
Um, I'm not gonna lie to you, I kind of have always been that like, that kid that's like, Oh, I know better than my parents kind of thing. So I tried to be open minded and listen, and my mom did, you know, give me really good advice. But I mean, she definitely has a more traditional way of managing things. When I was diagnosed, she was on MBI. I think she's had a pump in the past before. And then shortly after I got diagnosed and got on a pump, she started talking to her Endo, again, about getting on a pump. So we've kind of helped each other in that way. But yeah, she definitely had like some more outdated advice at times. You know, I would tell her that like I would go to bed at you know, and my blood sugar would be at she like, aren't you afraid you're gonna drop overnight? And I'm like, No, it's It's fine. She's so it's you so used to go into bed at like, 121 3150 kind of thing.

Scott Benner 36:35
And how long has she had type one?

Katie 36:38
She was diagnosed when she was I think six. So that would have been 966 or 1964.

Scott Benner 36:48
Okay. All right. So she didn't have the same gear. She is she was she was live in a different situation now. Oh,

Katie 36:53
yes. Totally different. She told me all about I just listened to a podcast you recorded where? I think it was a lady around my mom's age. And she talked about like, the boiling the needles and all that stuff. Like, yeah, my mom's told me. She knew that. Yeah.

Scott Benner 37:08
Wow. Yeah, that's it. So when you hear her say that, and then you look at did you have new respect or understanding after she explained and you kind of held it up against what you do?

Katie 37:20
Yeah, yeah. And I mean, even like, it's interesting, because my endos advice sometimes is more similar to what my mom was telling me. So I'm like, you know, and my mom listens to her endocrinologist and makes adjustments based off what her endocrinologist says, you know, and like, I was like, she's still getting, you know, this semi outdated advice. So, you know, I can't sound like you can blame her for

Scott Benner 37:49
no, no, not

Katie 37:50
the way she thinks. You know? Of

Scott Benner 37:52
course not. I mean, honestly, taking diabetes out of it. It's sort of like, at all when I was growing up, my grandmother would be like your watches. This is amazing. It's Lawrence Welk. And I was like, What the hell are we doing here? Like, this is not entertaining. It's not amazing, but she thought it was like she came from a time where like, That guy was entertainment. I know. That's a reference. Katie. You have no context for what

Katie 38:12
I was just gonna tell you. I have no clue who Lawrence Welk is.

Scott Benner 38:15
Do you know the woman I spoke to yesterday didn't know who Perry Como was Do you know who Perry Como is?

Katie 38:21
No.

Scott Benner 38:21
Do you sing Christmas songs at Christmas time? Yeah, you definitely know who Perry called knows.

Katie 38:27
Okay. All right, then. Yes,

Scott Benner 38:28
I know who Perry I know. You're a liar. Maybe you're super open with your butt. But not with what your knowledge of party coma. That's fine. I watched that in there. Much like I appreciate that. Yeah, much like you had to watch that cost. And you're asked after that. Thank you. Alright, there's no reason to say but a bunch of times anymore. We're done. The story right? So okay, so your mom's stuff is a little antiquated? Is it fair to say that when it comes to diabetes on your mom, is that what we're talking about right now? Or you guys

Katie 39:00
who don't say that let her you know, she's helpful.

Scott Benner 39:05
Oh, where do you so how do you find me so quickly?

Katie 39:09
Um, the good old Google I think I don't know maybe it was on like a Facebook you know, I I go straight to type one diabetes Facebook groups. And you know, I dive right into it. I like to learn when I focus on something I like try to learn everything about it. So within like a week or two, I was on all these Facebook groups I found you know, all these books and all kinds of stuff. So yeah, I found you pretty quickly.

Scott Benner 39:36
Wow. Tell people you don't actually use the other groups anymore. Mine is the only one

Katie 39:40
right? That's the only group I'm in.

Scott Benner 39:44
Are you just being polite or is that?

Katie 39:46
Honestly, that's the only one that I actually am semi active and I guess I think I've posted in there a couple times. But the other ones I kind of look at sometimes and they're just sometimes they're just kind of sad.

Scott Benner 39:59
Yeah. I have a good feeling about mine actually. So yeah, yeah, yours is good. I like how it works. It's all attitude, right? You just pick an attitude and you decide this is how we're going to be. Yeah, I get I get notes like that, that I, you know, obviously, obviously Katie, I don't jump on this podcast and become a different person. So. But I get so many notes about like, you make diabetes easier because the way you talk about it or like that you interject humor into it. And I'm always like, confused by that. And like, I don't purposefully interject humor into diabetes. I just actually find some things funny that I think other people don't find amusing. That's all so. But I like also

Katie 40:38
to like, you know, if you're gonna live with a chronic illness, you got to you got to make some jokes about it time time.

Scott Benner 40:44
Yeah, you can't be so serious, right? It's exactly, yeah, it's a bummer. I mean, it's already a bummer. You have diabetes. So like, making it more of one is just, it's just piling on.

Katie 40:56
Yeah, that was one thing. You know, we talked about how great my boyfriend is, after the whole incident, we're not going to talk about anymore. But he, you know, soon after I kind of I got a little bit down, you know, I was like, Oh, God, like, I, I couldn't even take a pill every day consistently. Like, I don't know, I never had to deal with anything like that. So I was like, how am I going to do this, you know, blah, blah. And he kind of just looked at me and he was like, This is what you do now. There's no sense in being upset about it, or sad or worried about it. You just You just learn about it. And you just do it. So

Scott Benner 41:31
yeah, yeah. Well, that's, I mean, listen, great advice. That's boy perspective, right. There. It is. Yeah. What are we going to talk about this more? Just do it shut up?

Katie 41:43
Pretty much. That's his attitude on everything. Like, why are you worried about that? It's gonna work out. Like, how do you know?

Scott Benner 41:48
Yeah, because we're boys than we don't have the ability to wonder the other thing. Yeah. Like, can you imagine if we were all girls are all boys. Like, you know what I mean? Like, if everybody had like a like that men, classic boy mentality of like, it'd be fine, put your head down and walk forward. We'd all just be disconnected and running into walls. Yeah, we're all girls with the like, Oh, what if this happens, and we'd all nothing would ever get done? Right? We just sit in a circle worry the whole time. So exactly. It's interesting. It is really interesting how people can balance each other out. So have you did you find it difficult in the beginning? Or were you like to do everything you were supposed to do? Or did you pick it up pretty quickly and just do it?

Katie 42:31
Um, I feel like I picked it up pretty quickly. I don't know, I just, I, I kind of just like, did it. I don't know, there's not really a good. I wish I had better, you know, like, oh, I went through this, this and this. And, you know, I kind of just like, Okay, I want, I'm still young. I want kids someday I want to be around for grandkids like I also I should specify that I worked on at that point. I worked on a vascular and cardiac surgery floor. So I saw a lot of diabetics come in and get amputations and I saw all the bad side of you know, uncontrolled diabetes. And so I developed more, I think, a fear of highs than I did a flows. I hear a lot of people say like, they're so scared of going low. I was never scared of going low. Like I've always been, I get a little panicky when I start going high. Okay.

Scott Benner 43:29
Yeah, so what I was saying must have, like, you must have been like, Oh, I agree with this idea. Like when I say, like, I wake up every day thinking I'd rather stop a lower falling blood sugar than fight with a high one like that.

Katie 43:41
Oh, 100%, especially after I had my first like, real, real low. And I mean, I was I tested, I didn't have a CGM or anything at that point. And I tested and I was like, 23 I was home alone. And I was like, Okay, I'm just going to, you know, drink about a gallon of juice and we'll get it up and we'll be fine. And after I came out of that with like, no issues, I was like, Okay, I you know, I can handle it low.

Unknown Speaker 44:10
Okay, which is maybe a

Katie 44:12
little bit of a scary like, my endocrinologist is probably, you know, cringing hearing that but

Scott Benner 44:19
Well, I mean, listen, I think it's the only way to do it. Otherwise you get a blood sugar that's up and he spent the next three or four hours messing with it.

Katie 44:29
Exactly. It took me You know, I mean, that one probably took me a little longer to bring up it probably took me like a half an hour to bring up to you know, normal, but I hate hate hate fighting a high blood sugar.

Scott Benner 44:43
How make how low do you think you were in that moment?

Katie 44:47
My meter said 23 or 27? I think that's yeah, it is really low.

Scott Benner 44:54
You went back of like, did you think you're gonna have a seizure?

Katie 44:59
Ah, Uh, no, I, I didn't like I just I was pretty. It felt like being really drunk, honestly, you know, the seizure didn't even really crossed my mind. But I went back to work and I was talking to one of my co workers, and they were asking me about the diabetes and they're like, you know, what's, how's the lowest you've ever been? And I was like, yeah, one time I tested and I was 23. And one of my co workers popped up and he's like, Yeah, I had a patient one time his blood sugar was 23 he died. I was like, oh, yeah, I probably shouldn't let that happen again.

Scott Benner 45:33
Yeah, I was gonna tell you, Katie, that's really low. So I don't

Katie 45:37
want your listeners to think like I walked around at 23 that happened one time.

Scott Benner 45:40
When I say I'd rather stop a lower foreign budget. I mean, like 70 Diagonal down.

Katie 45:47
100% But like, honestly, I I think in my endocrinologist gets on me about the lows. Like I said, I don't have lows that bad anymore. But like, I I get so afraid of high sometimes that I end up going to blow. Okay. Kind of frequently.

Scott Benner 46:03
When that happened. Did you ever? Well, first of all, I don't know. Do you? Are you MDI, do you have a pump? I have a pump. And do you have CGM? Sometimes? Yes. But the way you answer it makes me think you have a Medtronic or a T Islam. No, no, I have an Omnipod Omnipod. Oh, usually when people are like, are gonna say things that are advertisers. They're so happy to say them. And I thought, Oh, you're trying to save my feelings, but you don't have to do. But like people can say what kind of pump they have. It's what about CGM? What are you using?

Katie 46:37
I use it Dexcom. Okay,

Scott Benner 46:38
so were you wearing it when you got that lowered? No,

Katie 46:41
that was like within. That was probably like within a few days of starting insulin. Oh, I forgot to tell you. So when I first got diagnosed, we were planning a trip to Nashville. And I was like trying to get my insulin sorted out before going to Nashville. And I wasn't able to get it. Because like, I didn't understand that the with my insurance I had to the hospital, I had to get the insulin at the hospitals pharmacy. I couldn't use like CVS or anything like that. So I like just went to Nashville for the weekend after being diagnosed with like, no insulin. Wow, zero out of 10 would not recommend. But Wow.

Scott Benner 47:27
She just like it's so new. You don't really know what you're doing. Right? Yeah. 100%, like, you probably you probably went this work, you know, you haven't this low. When you have this low blood sugar public, you know, it's fine. I'm going to eat, I'm going to take my insulin the way I'm supposed to. And then I'll run around and be a nurse for 12 hours without thinking things like, you know, running around might be exercise and exercise could drop your blood sugar and Bob like this, you don't know about any of it. And your mom doesn't even know to tell you about it. Because she would never do that. I would imagine I'm sure

Katie 47:57
right. It's so crazy that like, you know, I people hear that, you know, oh, I have family members that are type one. And I'm a nurse and like so I I feel like I was expected early on to just know everything about it. You know? And that definitely was not the case. Yeah, I feel like you don't really know. Yeah, you don't know anything until you kind of have to figure it out on your own no matter what experience you have with it already.

Scott Benner 48:22
Yeah, I always think it's interesting to when medical people come on and talk about it. Like there was an episode on this week. Guys, like an orthopedic surgeon, this kid gets diabetes. And you know, he didn't either, like nobody knows. Nobody knows. I make I used to make this point all the time. Like nobody knows anything about anything that doesn't impact them.

Katie 48:41
Oh, 100% Yeah. Yeah. And that's what you know, I, I would hear patients say sometimes like, oh, you know, I know my body. I know more about this. And I early on, I was kind of ignorant, maybe. And I was like, well, but you're not a medical professional. What do you know? But now that I've I'm living with something, I'm like, dang, they they were right. You know, you do know your body better than anybody else.

Scott Benner 49:04
Crazy. It really is crazy how quickly, it can become the truth that you have a better handle on something that you previously knew nothing about. That. Yeah. Then your doctor does. Yeah. And you tell people that and at some people I think are met with comfort on that one. And I think some people are met with that, like, well, that shouldn't be the case. It's almost anger. They're like that that couldn't that shouldn't be the doctor should know they need to tell me. And I guess you have to live with it for a little while until you kind of marinate and, and you realize what the situation actually is.

Katie 49:38
Yeah, yeah, exactly. Well,

Scott Benner 49:41
where are you at now? Where you share like where does your what do you call success? What do you shoot for day to day have you did you honeymoon?

Katie 49:49
I don't really think that I ever honeymoon Exactly. Like I've always required insulin. My insulin needs have definitely increased kind of over time, but so Yeah, I'm on the Omnipod index calm. My decks calm settings, like during the day I keep pretty tight. I think I have it set between like 70 and 120. Actually, I, my last day one C was 5.1, which I'm due to get that done here soon again. And I'm definitely not having the lows, like I used to, you know, my main focus now has been trying to keep that tight range with fewer lows.

Scott Benner 50:33
So and is it working? Are you starting to figure things out?

Katie 50:37
Kind of? Yeah. I've had to kind of rearrange my schedule a little bit. As my big thing was like, I would have Lowe's. In the afternoons when I'm off work, we take the dog for a walk at like three o'clock, and my natural instinct is to like eat lunch at like two o'clock. So I'm starting a walk with insulin on board and trying to sort that out. has been a little bit of a challenge, but

Scott Benner 51:04
well, you're so new at it, too. Yeah, you don't realize a year is like nothing.

Katie 51:11
Yeah, it doesn't feel like it doesn't feel like I'm new at it feels like I should have everything figured out by now.

Scott Benner 51:15
Doesn't work that way. I still cry. I was still crying after a year. Sometimes. Yeah. In the shower. Mainly. It's where I like to cry. Yeah. I would go shower. Hello. So you're giving away my personal secrets. I'm gonna tell you, I'm gonna tell your porn star boyfriends name in a second. So, but no, um, you know, back when Arden was little I would just like Kelly would come home at the end of the day. And I'd be like, Oh, I didn't get a chance to take a shower today. Let me just jump in the shower. I just get in the shower and like cry. And then I'd be like, Okay, I can do the rest of this day now.

Katie 51:49
Yep. You got to just let it out sometimes. Yeah.

Scott Benner 51:54
Yeah, it just it just is right. Okay. Well, I guess now that you brought it up, like, Hold on. Let me let me text my plumber. Now that you're

Katie 52:01
putting your business out there.

Scott Benner 52:03
Well, yeah, I mean, now that people know my shower doesn't work.

Katie 52:08
Hopefully people aren't going to assume that. You're only shower.

Scott Benner 52:18
Yeah, I have two showers. I'm very fancy. There's two showers. bougie. Oh, my goodness. You have no idea how fancy everything is. I have a shower and another show. to shower. Oh, yeah. It's crazy. It really is like there's just opulence everywhere. So we have carpeting and some of the rooms. Oh, wow.

Katie 52:41
Yeah, not all bad. Everybody. You're what does that cup of coffee thing you have? Yeah, by

Scott Benner 52:46
me. Your money paid for a rug with it. What do you think?

Katie 52:50
You let Scott afford to hold showers? Yeah,

Scott Benner 52:53
I'm dripping in gold to you should see me. I'm not even sure that my T shirt matches the sweat pants I'm wearing right now. But whatever. Does it it? Probably maybe it does.

Katie 53:03
I don't know what does matching. Anyways,

Scott Benner 53:04
Arden makes fun of me constantly about my clothing. So she's like that. She's that doesn't match. I'm like, How do you know? It feels like it does. She's like it doesn't. She just looked around. She's even rolled her eyes at me. She just looks at me with such disgust. And then it's over. She's like, how can you not know? I don't know. So of course. So this is kind of super interesting. Ready? Like, you have a year into it. You're a nurse, you've got all these people in your family. And you are still going through the same exact stuff that everyone else goes through? 100% Yes, no, you didn't get the past go kind of a situation. You know, people didn't come up to you and just like drip this great knowledge all over you. You're you're starting just like everyone else. You got your you know what I mean? Like, yeah, if

Katie 53:55
anything, I probably started out with like, less information. Because, because my doctor knew like, I'm a nurse. I told him I had, you know, type ones in the family. And so he was like, Okay, well, here's, here's some Lantis and human log, take it, you know, as directed, and I'll get you an appointment with an endocrinologist. And then then chronologist my first appointment. She was like, Okay, tell me about yourself. Do you want a pump and a CGM? Like in it? I didn't get like any education from anybody because everybody assumed, you know, oh, she knows what she's doing.

Scott Benner 54:30
So you know, it's funny. I realized now I've heard that so many times. I just had a different thought about everybody's like, Oh, the doctor just assumed I knew because I was a nurse. I wonder if the doctor didn't think Oh, good. Maybe she knows because I don't. That's possibility. Yeah. Like I do. Like, I wonder about that too. Like, it just hit me. I was like, Oh, I wonder if that's like a safety net for them. Not

Katie 54:51
another funny story too. I saw a diabetes educator with the endocrinologist office like once didn't you know they are very nice, but I didn't find it excruciating ly helpful. But I got a message from the educator I saw maybe like four or five months into my diagnosis. And she was like, Hey, we have an opening at the office as a diabetes educator, like if you are looking for a new job. I was like, I, I'm just trying to figure out my own stuff. Like I'm not really interested in that right now.

Scott Benner 55:24
That's also interesting, isn't it? Because yeah, the the insight there is, hey, you might not know much about this, but you probably know more about it than you know. Could you come on that? You know what I mean? Like, there's no there's no shining. There's no shining hill, where people like who know are like, Ah, come on over here. We've got it. Everybody's in the same boat. Really?

Katie 55:46
Yeah, yeah. We're all just like, you know. What's that Titanic reference, like Jack and Rose out in the ocean. Like, we're all fighting over the door. Trying to climb up on the doors.

Scott Benner 55:59
Not a bed. Like a, like a headboard? I don't

Katie 56:04
know. I don't know that I've ever seen the whole movie all the way through.

Scott Benner 56:07
Wait a minute. You've never seen Titanic all the way through?

Katie 56:12
No, I don't think so. I don't watch a lot of movies.

Scott Benner 56:15
Oh, okay. You're one of those. Yeah. Because that movie was so huge when it came out. People saw it three four times the movie theater.

Katie 56:26
You know, I might have been like a year old when it came out. So I understand wasn't me.

Scott Benner 56:30
I understand. You prefer Caitlin's? Like young or old?

Katie 56:37
What like, I'll be honest, I don't even know if I can tell you. That's rose in Titanic, right?

Scott Benner 56:43
Oh my god. Katie. Katie. Listen, this is gonna I've never I've never revealed this on the podcast before. But you know when you know when couples are like, You know what they call that? Like your? Like Kate Winslet your hall pass? He is. Okay, but I like her older.

Katie 57:01
Oh, gotcha. Yeah.

Scott Benner 57:03
I don't know what everyone says to me. Kate Winslet and I'm like, yeah, no, like, why am I I don't know Kate Winslet. She's not even my type.

Katie 57:12
I feel like she's very like, classy. She's like a classy. Kinda pretty.

Scott Benner 57:19
I'm just telling you. For me. It's Caitlin's.

Katie 57:23
Okay, I'm 100% googling Kate Winslet now.

Scott Benner 57:25
All right. Hold on. Are you doing it?

Katie 57:27
Literally now? Yeah, like literally right now. Alright, so

Scott Benner 57:30
I'm a Google images as well. Let me try to find one where I would tell you. This is the Kate Winslet for me. All right. She's in like a white long sleeve. Her hair is past her shoulder and there's It looks like she's standing in front of a piece of wood. It's like three rows down from vanity. fair.com.

Katie 57:56
Okay, I'm looking.

Scott Benner 58:00
Oh, yep. Okay, that yeah, that Caitlin's that I would buy a car for? Okay. Okay, that's fair. Thank you. I'm just saying this is my situation. Okay. Yeah. I again, actually not even my type. Now, any Kate Winslet pres pregnant picture that Caitlin's what I would buy a house for? I don't even know why. I'm just telling you.

Katie 58:23
Yeah. I don't know why you're telling me that. But now,

Scott Benner 58:24
you know, I want to, I want I want Caitlin's with that my baby I think is what I'm saying.

Katie 58:31
Right? This again, personal is it

Scott Benner 58:33
cuz she's really rich and famous, and I believe married? So. And by the way, that's fair. I'm actually married as well. So I don't I don't think any record coming to fruition anytime soon. I'm just telling you. And then there are pictures of Kate Winslet where I like I wouldn't like I wouldn't let that Kate Winslet clean my house. By the way, I don't have a house cleaner. But I was just I don't know why that. I do. Really wish I had somebody like, do people do that. Katie, do you ever do that? Like the the gifts and may come over and clean the house up ever? Oh, God, no, I can't afford that. I want that so badly. I can't even

Katie 59:08
I'll meet you. 100%. Actually, that's kind of a lie. So I'm travel nursing right now. I'm in a different state than I live in. And my sister in law offered to clean our apartment back home while I was gone, so I guess if that counts,

Scott Benner 59:25
well, I mean, are you paying her? Yeah, I

Katie 59:27
paid her. Well, that account. Okay, then. So yeah, yeah, I guess I can say I have a house cleaner

Scott Benner 59:32
now. Who's bougie? That's so bougie. Okay, send her to me. I need her to I just want you know what I dream of? Like someone just doing like a one deep clean, like twice a year.

Katie 59:43
Yes. Yeah. That's what she like, clean, like thoroughly cleaned the bathroom. The walls like all that stuff. It needed it.

Scott Benner 59:50
Yeah, I just wiped down a room. And as I was doing it, I thought, can I just get to the point where someone else does this for me.

Katie 59:57
That's how I know like, I've made it When someone's wiping your walls, yep, like cleaning out the vents and stuff. Uh huh.

Scott Benner 1:00:05
No, I really do have similar feelings. I was Oh god, I just had a question for you where to go? Dammit, dammit. This question was going to shape the entire direction of the end of the podcast. All right, hold on. Caitlin's lit. That had nothing to do with it. Oh, we did never settle but they were on a headboard and Titanic Matador I think, okay, good enough. So there was plenty of room on it. And there was no reason Jack could not have gotten up on that thing.

Katie 1:00:35
See, I've seen the argument that like the density of the board or whatever, like wouldn't have supported both

Scott Benner 1:00:40
of them. I didn't even try. That's true. They didn't even attempt it. They did and she's British. Those people are lighter. They have bones like a bird. That's fair. I read that on the internet. I don't think that's, that's true. Okay, so Caitlin's it house cleaning bougie. I'm trying to I'm trying to get my mind to get that my brain to say why I had such a good way to button this up. There's something about diabetes to people like, Oh, good. He was going to talk about diabetes and the diabetes.

Katie 1:01:12
I feel so bad. I feel like we haven't talked much about diabetes.

Scott Benner 1:01:15
I'll bleep this out later, Katie, you're at all exploded. So there was no way we were ever going to talk about diabetes? You should have known that. Yeah. I mean, honestly, oh, I found my thought. Okay. At the beginning of the podcast, you said, I'm going to tell a funny story. And that is usually not a good sign.

Katie 1:01:38
Right. That's usually not a super funny story.

Scott Benner 1:01:41
Yeah. The layman don't really know what's funny, you understand? Right? Well, I get it. I'm a professional. I know what's funny. And so usually, when people say that, I think, oh, hell, how am I going to dig out of this hole after they tell this horrible story that nobody thinks is funny. But then because, you know, it's like, it's like, he used to work for my uncle when I was a kid. And there were these short, like, 15, I worked in a sheetmetal shop, it was not a pleasant job, Kitty. And, by the way, I have another question for you. This time I wrote it down. Because I'm not an idiot. I'm not getting fooled by my brain twice today. So you'd get these 15 minute breaks from this horror of a life you were living, you'd have some bad food, people would drink coffee for 15 minutes, you'd kind of relax and get up enough energy to make it to lunch, you know, and my uncle would sit down, he's dead down so I can tell the story. And he would start to spin these yarns that were mind numbingly boring. And he would get stuck on details that had no relevance to what you were talking about. And my best example is that one time, he was telling a story about something and in the story, there was a car truck, and he got stuck on what year like make model year the truck was. And he went to such lengths to come up with the answer to this. That you just thought, well, the whole story hinges on this being a 58 Chevy pickup truck or whatever the hell he was saying, right? Yeah, that after he found the year making model the truck, the truck never came up again in the story.

Katie 1:03:17
Of course not. I thought you're gonna tell me it was like a basic, you know, 1990 Ford Ranger or something? No, Katie, it

Scott Benner 1:03:24
had nothing.

Katie 1:03:25
It didn't even come up. Oh, my God.

Scott Benner 1:03:27
It just nothing. And I sat there even as a young man. so angry that he told that story so poorly. Like I, I hated how badly he told the story. It just made me I was like, you have all of our attention. I could be cracking these people right up now. And instead, you're telling us a bad story and spending five minutes in the middle trying to decide if Chevy made a pickup truck and whatever year you were like, yammering on about Ah. So anyway, when you told your story, I was like, Katie was right. This is good.

Katie 1:04:01
Yeah, like, thanks. So it's, it's been a hinge of my like, story. So everybody I tell it to you is highly entertained, either highly disgusted or highly entertained, maybe a little bit about oh,

Scott Benner 1:04:14
no, no, no, that's just a good trust me. You trust me? Trust God. That's a good story. What I was gonna ask you about is travel nursing. Yeah. So a lot more money?

Katie 1:04:27
Yes, yeah, I should. I could probably say that.

Scott Benner 1:04:30
Yeah. So I'm hearing nurses talking about a lot. And I have a friend whose daughter is a travel nurse. And I've seen some people complain about it. The hospital won't pay the employees. They have a lot of money, but they'll pay a travel nurse to come in and they'll pay them more money.

Katie 1:04:45
Yeah, well, here's the thing that's starting to happen now is that like, and this is why I'm actually probably on my last contract, at least for a little while. But the hospitals now are dropping the rates to where your actual pay He is not much more than their own nurses. But you're going to be making money in like housing and food stipends and stuff like that.

Scott Benner 1:05:12
Oh, so they pay for your apartment.

Katie 1:05:14
So kind of like your agency pays for the apartment, sort of they, you know, they use like government standards for tax free stipends and all that fun stuff. So

Scott Benner 1:05:28
are the agencies actually maintaining residences and then moving people in and out of them?

Katie 1:05:34
Some of them do, but honestly, you know, usually just find like your own Airbnb or, you know, short term leases, and you kind of find it on your own, but you get this stipend every week to pay for it. The person

Scott Benner 1:05:46
I know is using the travel nurse program to like, expand their medical knowledge and to travel. Yeah, right. So like, she went to Baltimore. And she said that in six months, she has now all of the skills she needs about gunshots, for example. And then once she felt she felt like that hospital had everything she could, you know, she stayed a little longer. And then boom, she went out to Arizona, I think, and I think now she's in Hawaii. it for her. Yeah, she's just like, kind of, like, gaining knowledge and having a an adventure, you know, in her in her mid 20s. So, the vertical Yeah,

Katie 1:06:25
that that's kind of our, our process. You know, we haven't traveled super far just because we're both really close to our families. So we've definitely stayed in a couple new places. One that's been enjoyable. But now

Scott Benner 1:06:36
I'm worried Katie that you're that you're supporting this boy.

Katie 1:06:40
No, no, no. He works. He works remotely, actually. And he's in school. Yeah.

Scott Benner 1:06:45
Boy, so it was a wonderful time. So he can just move around because he works remotely.

Katie 1:06:50
100% Yeah.

Scott Benner 1:06:51
I'm a sucker. Katie.

Katie 1:06:54
You're doing it all wrong.

Scott Benner 1:06:54
I am. I mean, I'm sitting in front of almost no equipment. This stuff could travel. What am I doing?

Katie 1:07:01
Yeah, he has like all of his, you know, company supplied computers and stuff and just packs it up wherever we go.

Scott Benner 1:07:08
Let me let me be honest, we let's talk like turkey for a second. Katie. Boy making enough money to support you. Like is he okay? Are we gonna have to look for someone else?

Katie 1:07:17
No, no, he's he's totally fine. And like I said, he's in school. He's getting his doctorate degree. So really gonna

Scott Benner 1:07:22
be good. Yeah, we will what smarty pants getting a doctorate and

Katie 1:07:25
he's getting a doctor education. And he's gonna kill me if I get this wrong, because we only talked about all the time.

Scott Benner 1:07:32
Like you don't love him? If you don't know. So go ahead. Oh, I

Katie 1:07:35
love him. I do not enough

Scott Benner 1:07:36
to know about his interest, but go ahead.

Katie 1:07:39
to higher education, leadership. That's what it is.

Scott Benner 1:07:42
Higher Education Leadership.

Katie 1:07:44
Yeah, I think his ultimate goal, I think he wants to be like, he wants to teach college or be in like administration. At a college university type thing.

Scott Benner 1:07:55
Yeah. Do that remotely. No, no. That's

Katie 1:07:58
why this is a short term thing. Gotcha. Okay. And, you know, we want the kids in the house and all that stuff. So yeah, this was just something we saw the opportunity and

Scott Benner 1:08:08
took it. No, I think it's terrific. Is he an intellectual? Yes. Oh, yes. No, some people think that's not a great thing. Really, you don't you don't hear that?

Katie 1:08:17
No, I've never heard that. Okay. I love an intellectual.

Scott Benner 1:08:21
I don't dislike him. I'm I'm saying that. There are people who would say, Look at me. This has got nothing to do with your boyfriend, by the way. But I think there are people that hear that word. And there's there's, I think pretty two different reactions. Like I hear, Oh, smart, educated person. And some people hear there's a person who has no real world knowledge who will then go shape young people's minds. Oh, see what I'm saying?

Katie 1:08:45
Yeah, I get what you're saying. He definitely has the real world knowledge. You know, he you talked about working for your uncle or with your uncle. He like worked, you know, blue collar jobs for his dad and uncle like, he's he's been out in the world a little bit.

Scott Benner 1:09:02
Oh, well, let's be honest. Katie, he saw your buttocks blood. So I think really, he's got a different level of understanding of the world than most people do. Seriously, if you have children one day when they come out, he'll just be like, yes, it's no big deal. Probably I could totally look at this with no trouble.

Katie 1:09:22
Let me so funny too, because he is like 100% You know, doesn't do well with blood and guts and you know, that kind of stuff. But he sucks it up for the people he cares about, ya know? Or like, you know, our dog too. He you know, he'll clean up after the dog and stuff and you can tell he dies a little bit inside but he doesn't

Scott Benner 1:09:41
kill you. I didn't like that you held yourself up level with dog poop at the end there. But that was that was like the only other example I had necessary drove up parallel. You know whether it's helping me with my butthole Scott or cleaning up after the dogs, they can't make it outside. My guy's a good guy.

Katie 1:10:02
That's all. That's all boils down to. He's a good guy. Yeah.

Scott Benner 1:10:05
boils. By the way. There's something Oh my god. Yeah. By the way, please, please respect the fact that you said piles earlier. And that that's a old euphemism for hemorrhoids. And I did not mention it. I did not know that. No, no, you didn't. But you knew Boyle's? Yes. Yeah, we could do this all day. I mean, I could you probably would get bored by it. It's the people listening, I imagine would be like, Oh, God, let it go. And I'm like, No,

Katie 1:10:32
yeah, just just end it. We can. Alright.

Scott Benner 1:10:37
Well, let's just ended then, Katie, unless we there's something that we didn't talk about that you would like to

Katie 1:10:41
the only thing that I kind of, I read back over my email that I sent you because it's been forever. The other thing I kind of wanted to talk about a little bit was like, I see you have a lot of like, parents of kids with type ones. I don't really see a whole lot of like, kids with parents that have type one. And I know like, parenthood and stuff like that is something people who have type one kind of worry about. But you know, my experience growing up, my mom and her sister, her one sister babysat me all the time. And I definitely saw some scary lows and stuff with my aunt. I think I mentioned in my email, like I remember, you know, pouring orange juice down her throat or rubbing icing on her gums. And like, even after all that, like I still felt like I didn't know much about diabetes. You know? So who

Scott Benner 1:11:36
was babysitting? Who?

Katie 1:11:38
Yeah, fair.

Scott Benner 1:11:39
Yeah. Did they pay you when that happened?

Katie 1:11:42
No, I was young, you know,

Scott Benner 1:11:44
but I'm gonna need that 10 back.

Katie 1:11:48
I don't even think they paid my aunt for babysitting. We both you know, she was she was like a second mom to me. So we both were just so well,

Scott Benner 1:11:54
you get what you get. But, but also your aunt At what age was having like, significant low blood sugar?

Katie 1:12:03
She probably would have been in her 30s or 40s. At the time, maybe?

Scott Benner 1:12:08
And this is maybe how long ago? Do you think 15?

Katie 1:12:12
This is like late 90s. Maybe because I was born in 93. So I remember doing this as like a toddler. So

Scott Benner 1:12:19
alright, so almost maybe 20 years ago? Yeah, that's probably fair. All right, or more. And so her. So part of your aunt management was periodically I'm gonna pass out and you're gonna need to get me orange juice.

Katie 1:12:33
Yeah, she just, she was very like, up and down, up and down, you know,

Scott Benner 1:12:40
traumatic as a kid, when an adult is being put in your scenario. And you're being told this is the person taking care of you. And you know, I might be taking care of them.

Katie 1:12:49
I never really thought about it like that. It was just so because my mom had lows too. So it was just so normal. That it it didn't really like bother me. I was just like, oh, and Terry's low better give her some orange juice. Like, I don't know, it never really like crossed my mind is something abnormal or weird?

Scott Benner 1:13:10
I wish. I wish I don't wish I wonder if Arden was your mom's age. And I was your mom's dad's age. If I would have figured something out differently back then. Or if it would have just felt like a thing that happens to you that you can't impact? Because I imagine that's how they felt right? Like this is just part of it.

Katie 1:13:33
Yeah, 100% like you don't have the resources. You know, you don't have the whole world at your fingertips. Fingertips back then. So it's just kind of like, this is what it is. This is what we do when it's low. And hopefully we can fix it.

Scott Benner 1:13:49
Well, my point. Yeah, but my point was that most of the stuff that you hear about now on the podcast, that seems so obvious, because people have CGM 's, and pumps and stuff like that, I came up with this stuff before that stuff existed for us. Like I was like, like figuring it out the whole time. Like, there's no doubt that the Dexcom like it, it propelled me for my ability to understand what I was seeing. But I was like, studiously every day trying to figure out what was happening to art, and so we could do a better job with it. And I'm sure

Katie 1:14:23
you would have figured out I mean, with the tools you had, I'm sure you would have figured out something like you. I referenced that one lady you had on that was about my mom's age. And I think she mentioned that her dad came up with some kind of formula with like fat and protein, you know, even when she was young. Yeah. So and working with beef or pork insulin or NPH, or whatever she had at the time. Like, that was a recent episode. Yeah, I feel like you would have you would have done something like that. Maybe not math so much, but you would have figured something out, you know,

Scott Benner 1:14:56
like, that's what I'm sitting here wondering. I was like, I'm like, Could I Have? Could I have found a way to make the leap? Or? Or would it have just overwhelmed me? And I would have just said, Okay, well, you know, we'll keep orange juice and icing in the house, because this is what happens. I just, I mean, we'll never know, but,

Katie 1:15:14
but I feel like with your personality, like you wouldn't have I mean, personalities don't. Just because you're in this time, you know, your personality would have been your personality then. So I feel like your personality wouldn't let you just settle for, oh, this is what we do. Keep orange juice on hand kind of thing.

Scott Benner 1:15:31
See, that makes me sad. Katie, like, because I picture when you say that I picture your mom, right? And she's in this situation or someone like her? And for whatever reason, they don't come to the bigger answer or see the bigger picture or something like that. And then that makes all that time seem wasted to me. And then I have such a hard time with wasted time.

Katie 1:15:54
Yeah, that's why like, I've tried to, you know, with my mom now. So that Aunt, by the way, has since passed away, she passed away a few years ago. But I've really tried with my mom, to kind of instill the knowledge I've learned, while also taking the knowledge she's learned and kind of combining them. And maybe we can both come out a little bit better. Yeah, with both our knowledge combined.

Scott Benner 1:16:20
I was gonna ask you about that. But first of all, ask you did your did your aunt die from something diabetes related?

Katie 1:16:26
You know, I'm not 100% Sure. I don't think that there was she passed away in our sleep. So I don't think that there was ever I don't think anybody was interested in autopsy or anything like that. I believe she had some kind of heart trouble, too. So it was probably one of those two things. Yeah.

Scott Benner 1:16:45
The heart from the diabetes, though. If if your blood sugar Yeah. How old was she?

Unknown Speaker 1:16:51
She was yes, D 50. Some? Wow.

Scott Benner 1:16:58
I'm sorry.

Katie 1:16:59

50. So my thank you. Yeah. Thanks. I mean, we were extremely close not to get to, you know, not sad and stuff. But yeah, we were really close. Yeah.

Scott Benner 1:17:08
Well, you know, it only makes sense to bookend an episode that started the way it did with the passing of Your Beloved. And so, you know, because these things do not appear to mesh together well, at all. So it has been a roller coaster. Yeah, we're really getting to it here. I want to know, if you're where I get our 15 minutes into it. My childish brain is finally let me go back to other things. I'm so sorry. Don't be listen. The way this unfolded is the way it unfolded. I think it was terrific. So we're not gonna we're not going to go backwards here. But I'm wondering if you are having you that I did not say you correctly there. But I'm wondering if you were having any luck imparting modern management onto your mom, or if she's even interested in it?

Katie 1:17:55
I think so. Um, like I said, I, she, so she was MDI, and then she had a pump when I was young, I want to say maybe early 2000s ish, she had a pump for a while. And then she was kind of just having issues with that. So she went back to MBI for a long time. After I was diagnosed, I got I got the Dexcom and Omni pod pretty quick. Like, I'm pretty sure I got both of those within a month or two of being diagnosed. And I kind of told her how much easier things felt with those. And she was like, Yeah, I've been thinking about going back on a pump. I was like, I really think that you should give it another try. And she's, she's happy with it now. And I've kind of she's kind of started to accept that, you know, writing in the 70s. And 80s isn't a bad thing.

Scott Benner 1:18:53
Did that feel low to her at first? Yes. Yeah. Good. Has her agency improved since you've been diagnosed?

Katie 1:19:02
It has actually. I think she was I don't think she would mind me sharing. But I think she was like in the eights maybe. And I think she's down into the sevens. Now, what she's trying to get her bees replaced. So she's also been working on getting her agency down for that.

Scott Benner 1:19:19
I see. Well, she listened to the podcast, or is this too,

Katie 1:19:23
I'm gonna try really hard to get her to listen to it. She's not very tech savvy. So it's probably going to have to wait, you know, till I can get over there and whenever it comes out and actually set it up for but I would like for her to listen,

Scott Benner 1:19:35
would you would she listen to like the pro tips or the defining stuff. Do you think

Katie 1:19:41
if I can set it up for her? She might. Interesting. She's retired now. So she should

Scott Benner 1:19:45
what does that mean? What's your mom's name? Her name is Pam. Pam, what are you doing? Just I could use the downloads and it sounds like you could use the help. So like let's just help each other. I think you're a one see, Katie's probably in the 60s Right.

Katie 1:19:59
Um, My last one was 5.10.

Scott Benner 1:20:01
My goodness, nevermind it. Is that from Lowe's a little bit or, you

Katie 1:20:06
know, I'm like that one I think was less than I think it was like less than 2%. Low.

Scott Benner 1:20:11
Wow, how are you eating your best style?

Katie 1:20:16
During? No, not really no, I kind of just eat what I want. I tried to just I figured out what is easy to dose for. And I eat those things. With the exception of like, I go out to eat and stuff. And that's usually the times when blood sugars get a little crazy, but I think overall, I eat what I want. I almost

Scott Benner 1:20:38
jokingly called you a cheater when you said I found out what I'm good at bully stick for getting the fight, Katie tried to figure out french fries.

Katie 1:20:47
I've tried. I've tried. It's tough. I know it is.

Scott Benner 1:20:51
No, I completely know. I keep wondering when Arden leaves her school, how soon it's going to be before she's like, Alright, I'm not gonna beat that anymore. Like, you know, like, she'll just be like, I don't have the time to figure out how to Bolus for that. Like when she's in college, or that's my

Katie 1:21:05
thing like I does, I'll eat during the day, I'll pretty much eat anything, because I have time to figure it out. Like, when I work, I have to get up at like, 530 in the morning for work. So when we're planning dinner, and I don't get off until about 730 at night, so when I'm eating dinner, it's like 830 I don't want to eat something that I'm gonna have to be up late trying to figure out Yeah, so especially for dinners, I try to keep it pretty simple.

Scott Benner 1:21:29
Hey, you wanna you want to sleep? Yeah, exactly. I need sleep. all make sense to me. Okay. Yeah. So I feel like we're done. But I want to make sure you feel good. No, I

Katie 1:21:42
yeah, I feel good now.

Scott Benner 1:21:43
Good. Because you gave and you deserve to get back. Get what I'm saying? Yeah, story anyone's ever told. I mean, I don't remember most of the podcasts. But I hear from other people. It's good. So I assume there have been other good stories. I'm Do you understand that concept, Katie, that I'm the worst person to ask about the podcast.

Katie 1:22:01
I 100%. Understand, okay. Like, I don't even really know we talked about so I'm sure and you record so many of these. Like, I'm sure it's all just flirty. Okay?

Scott Benner 1:22:09
You started explaining something that you were just like, Oh, and this woman came on and blah, blah, blah. And I'm thinking, Oh, that sounds so familiar. Like, I'm sure that did actually happen. It went up two days ago, which means I've no, yes, it did. I forgot about that. So that means I've edited that episode in the last 10 days. And I'm just like, oh, that sounds so familiar.

Katie 1:22:29
Yeah, I totally get it.

Scott Benner 1:22:31
Oh, my God. Like, I don't know if you've ever like seen Isabel helping on the Facebook page? Yes, yeah. She'll jump in. And she'll be like, there's this one, this one and this one? And I'm like, How does she know that? That's that's like, I tell her sometimes privately. I'm like, I feel like you know my life better than I do.

Katie 1:22:49
It's probably does, because I mean, I feel like you probably go on like, autopilot. Sometimes.

Scott Benner 1:22:55
I'm just talking, like, when I talk to people, I just say whatever occurs to me. Yeah, there are times when I think like, you know, Katie, I don't know if you realize it or not, what we really talked about today was, you know, nurses, and medical people, they don't even know about diabetes. So you probably shouldn't feel too bad. If you're not a nurse or a medical person, you probably know as much as they do. Coming in from, you know, from starting at zero, we talked about. I mean, just kind of, I know in ways that that's not what we talked about. But I feel like it's what it's about right like that there used to be ways to manage diabetes, there have not been as valuable for some people in your family, and you're now you're now kind of blossoming with this new technology and new ideas, things like that. To me that says the people keep up with technology. Pay attention. You said Jerry, once he's in the fives, and you're, you know, only in a year makes it feel very possible even though you didn't know what you were doing. You were

Katie 1:23:56
so glad you're wrapping this up, because I was so worried that like, my episode would be one that like people don't get anything from you know what I mean?

Scott Benner 1:24:04
No, I don't know not. Not at all right. Like, listen, you had an abscess in your me it was in your butt. So it's funnier. But you had an abscess from high blood sugars. I hope that sticks with people, right? Yeah, high blood sugars can make your body it makes it difficult for your body to heal from other things. Your mom is in a situation with just an eight a one C which a lot of people would be happy with where she can't get a knee surgery. Yeah, right. So we talked about a lot of stuff like don't let the fact that I copped to liking Kate Winslet in this episode, and that your butthole exploded. Don't let that Mar what we've done here today. Katie, this has been a really informative thing. And the best part is, and this is the trick of the podcast, Katie, is that at the end? That's what people will remember. But they won't know that they learned it. It's learning without knowing. Ah, yeah, fix it. That's what makes it accessible.

Katie 1:25:02
I like it. And that's probably I mean, yeah, that makes sense. That's what keeps people engaged and listening. If you sat here and just talked about, I mean, your Pro Tip series is amazing. But if this whole podcast was all like, that kind of setup, I feel like, you know, yeah,

Scott Benner 1:25:18
it's just too much. It. Can you imagine, like, if I sat down? What if we sat down today? We're like, Hey, this is Katie. Katie's 27. She's had diabetes for a year for people in her family have had it her aunt has already passed away probably from heart failure from diabetes. Her mom's a one season the AIDS and she can't get a knee surgery because of it. By that point, you'd be like, I am out. I want to hear this. Get me out of this. And you lead with the butthole story. So everybody's like, trust me. No one shut this off. Because they're right now like, I wonder what else this girl is gonna say. If she led storytelling

Katie 1:25:52
right there. You got to get them engaged. Yeah.

Scott Benner 1:25:55
And we did a thing where we talked about all your lady bits and it wasn't even sexual was so

Katie 1:26:00
fun. Something my mom can still listen to. Oh, good.

Scott Benner 1:26:02
Yeah. And trust me. There have been times where people are like, Well, great. Now my mom can't listen to this.

Katie 1:26:08
Well, my mom's My mom was a nurse too. So either way, she was gonna listen to it.

Scott Benner 1:26:11
But yeah, I figured she might have been when I stalked you on Facebook. During the conference. You stalk me on Facebook, you do that? Well, and when we're talking, I need contact. Now that I saw the dog. I saw the boy. I saw you.

Katie 1:26:25
I saw you, right.

Scott Benner 1:26:26
I mean, I I can't say what I was just because. Well, I don't know. Just say it and I'll go ahead. Don't say it. No, I'm gonna say it. I'm gonna bleep it out. Okay. Okay, so this thing popped into my head. It is completely for comedy, right? I promise you. I was gonna say, I'd let him give me a hand. Wish I wouldn't really do. But I was trying the most, like, farcical compliment. The most farcical thing that I thought was also funny popped into my head. And that's what I was gonna say, but this podcast, people don't listen to for that part of my personality. So I didn't say it. Fair enough. Yeah. And it's going to be hilarious later bleeped out. So that's why I'm sure yeah. Oh, my God, just think about it now.

Katie 1:27:17
You know, I'm saying, Oh, my God, I'm gonna I'm gonna cringe. I'm gonna do all the things listening

Scott Benner 1:27:21
to this again. I saw the dog. I saw everything. Also, I saw two dogs, which confused me.

Katie 1:27:29
Yeah, that's my parents dog. I take

Scott Benner 1:27:31
other people's dogs getting your photographs.

Katie 1:27:34
Well, I used to live with them. Also,

Scott Benner 1:27:37
during this episode, a spammer tried to put something up on the Facebook page, which I took care of. Look at you. I googled, I texted with a plumber. In times when you didn't know I did. Are you impressed at all? Haiti by my skills?

Katie 1:27:52
I definitely am impressed.

Scott Benner 1:27:54
Shut up, stop it. You're, you're, you're terrific, by the way. And one of the things you're the kind of person and at the age where I, it gives me a lot of hope that the podcast is actually valuable for people because I really should be you. There's just no world where 27 year old person should be listened to a podcast made by a 50 year old guy. You know what I mean? And that and that you like the podcast, but you never actually said, but I'm assuming you do.

Katie 1:28:22
I mean, I've listened to a lot of them. So I should say that, but no, like, honestly, when I first started listening, I was kind of hesitant, because I think I've heard people say this before, like, well, it feels like it's really geared towards parents with kids with type one and like, so when I first started listening, I was like, I don't know, maybe I'll pick up a couple of things. But I mean, then I just really got engaged. And I feel like I do pick up tidbits from everybody's stories, you know, whether it's a kid or an older adult who has type one or whatever, like, it's definitely you can pick up something that's useful for you, no matter who's talking.

Scott Benner 1:28:57
It's such a simplistic. Listen, I get like, we're all simple people, like people are simple, right? But people do that thing. Like, what's that guy, he doesn't have diabetes, and his diabetes knowledge comes from him taking care of his daughter. So this must be about taking care of kids with type one, like, I get right, I get how that would happen. But, you know, there's a problem when people think there are different kinds of diabetes. You know, there's not the way my daughter's diabetes works is about the way everybody else has diabetes, right? You know, I mean, there's variables and there's personal impacts and stuff like that. But for the most part, insulin makes your blood sugar go down carbs, makes your blood sugar go up, etc, etc. Like there's the you know, it's not it's not 30 years ago, where people I bet your aunt probably told you she was Burdell

Katie 1:29:45
I don't think I've ever heard that term before. But really, they didn't use this Oh, yeah. Before like this podcast and the group and stuff like that. Yeah, I don't. I don't think I ever heard anybody really say that term.

Scott Benner 1:29:55
Aside of the word though. Do you think that was the feeling like oh my boy, yes. out all over the place. There's nothing I can do about it. That kind of stuff.

Unknown Speaker 1:30:03
Yes, yeah.

Scott Benner 1:30:04
Right. Like she they acted like they had a, like a seizure disorder, like you could live for three months and everything would be fine. And then one day just out of nowhere, oh, I'm having a seizure. And in instead of understanding, like the impacts of the insulin was just again, no way they could know back then. I don't think without decent technology that to track it with but anyway.

Katie 1:30:28
Well, I think that's why people get so frustrated too. I know, I have like, when my blood sugar, like last night started going up in the middle of the night. And there's like, I couldn't figure out any reason why it was, you know, and that was like the frustrating part. I eventually figured it out. But like, I think that's when people get really frustrated and upset, and they kind of throw their hands up in the air. And they're like, Oh, this is just diabetes. And, you know, this is how it goes. And I can't do anything about it. But there's always a reason. Sometimes it's hard to figure out. And it takes some time. But I mean, your blood sugar doesn't just go up or down. It's either too much or too little insulin, basically. Yeah,

Scott Benner 1:31:06
I completely agree. Yeah, I just do I know I can. I've had it be that frustrating for me. And I can imagine, especially if you're an adult, right? Or a young adult with type one, you're more on your own. And you just you go to bed with a blood sugar of 110. And you wake up and it's 300. Like I was just sleeping.

Katie 1:31:27
Like Yeah, and like this worked perfectly fine the last 89 Nights, right?

Scott Benner 1:31:31
And how am I going to be aggressive with this, if suddenly, I'm not going to need it again, I'm gonna make I'm gonna make myself low, I'm gonna be asleep. But I get it like it's, it's, it feels unknowable. And there are still times when it's unknowable. But for the most part, you know, with good technology now and some and some decent understanding of terms and tools and stuff you should be able to. Anyway, you should be able to get your knees replaced Katie one day without having to get your agency down.

Katie 1:32:00
Well, I'm hoping to not have to get my knees replaced. But yeah, definitely.

Scott Benner 1:32:04
You know, the man told me the other day, I might need one. Oh, really? I got my knee cleaned out. Right? It was all like painful. And I guess my meniscus was torn up. And so he went in there and cleaned it out. And then he told me afterwards, hey, there's a lot of arthritis on the inside part of your knee. Was that the interior? Is that how the body works in theory and anterior? Is that right? Your nurse gave you

Katie 1:32:26
into an anterior there's like ligaments and stuff that are injured. What do you talk about?

Scott Benner 1:32:29
I'm like, Isn't that how you measure your knee? Like the inside of your knee? Is the interior part in the Oh, yeah, that's right. He says, Katie, come on. I didn't even go to the gym. I go to nursing on this podcast longtime. Listen, it's an hour and a half. You're fine. What do you get tired? Yeah, I'm

Katie 1:32:43
tired. All right.

Scott Benner 1:32:44
You have the whole day off. He told me. Yeah, true. I do have to go do things after this. Oh, that sounds too good to flit around or whatever you do. I don't know what you do. And so anyway, he comes out afterwards. And he's like, you might need a replacement, like 10 years. So I was like, Oh, great.

Katie 1:32:59
That's terrible. I mean, it's it's not it's not as bad as kind of it sounds my dad has had to replace recently, too. He's doing all right.

Scott Benner 1:33:07
He's doing all right. That's not a shining endorsement.

Katie 1:33:11
Oh, I mean, I could tell you like it's been terrible, but it hasn't. He's done. Good.

Scott Benner 1:33:14
Good. All right, Katie, I appreciate you doing this very much. If you'd hold on for a second, I'd like to thank you in private.

Katie 1:33:21
Okay. Yeah, sounds good. Thanks.

Scott Benner 1:33:33
A huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com Ford slash juicebox. You spell that g VOKEGLUC. Ag o n.com. Forward slash juicebox. Also want to thank the Contour Next One blood glucose meter and touched by type one. Come see me at that conference touched by type one.org and get yourself a Contour Next One blood glucose meter at contour next one.com forward slash Juicebox. Podcast. If you're enjoying the Juicebox Podcast, please subscribe in a podcast app. If you're already subscribed. Telling someone else about the show is another great way to support the podcast. And if you need something, or are interested in learning more about one of the sponsors, clicking on my links directly is a huge help. Those links are in the show notes of your podcast player and at juicebox podcast.com. I want to thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. And don't forget if you're a US resident who has type one diabetes or is the caregiver of someone with type one, you can take the T one D exchange survey in fewer than 10 Min. That's this survey is HIPAA compliant absolutely anonymous helps people living with type one diabetes and supports the Juicebox Podcast T one D exchange.org forward slash juicebox

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#701 Child of the 60s

Monica has type 1 diabetes and was diagnosed at age three.

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

+ Click for EPISODE TRANSCRIPT

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to episode 701 of the Juicebox Podcast.

Today we're going to talk with Monica who was diagnosed at three years old. But today, she's 61. Monica has a rich life full of interesting experiences. And she's here today to tell us about them. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. Or becoming bold with insulin. You do not have to ask a doctor to go to T one D exchange.org. Forward slash juicebox. Join the registry and fill out the survey that you can do have your own a CT T one D exchange, Ford slash juice box when you take the survey, you're supporting people with type one diabetes, and the Juicebox Podcast. Are you looking for the diabetes Pro Tip series? It begins at episode 210. You can also find it at diabetes pro tip.com and juicebox podcast.com. Or in the private Facebook group Juicebox Podcast type one diabetes, there's a list of the diabetes Pro Tip series, and all of the series within the podcast. This episode of The Juicebox Podcast is sponsored by Ian pen from Medtronic diabetes in pen is an insulin pen that talks to an application on your smartphone and gives you much of the functionality that you will get from an insulin pump. In Penn today.com The podcast is also sponsored today by us med. Don't just get your diabetes supplies from anywhere. Get them from us med Call today for your free benefits check 888-721-1514 Or you could just go to us med.com forward slash juicebox. Us men always provides 90 days worth of supplies. And they give you fast and free shipping. Us med.com forward slash juicebox are you wearing a headset?

Monica 2:25
I'm wearing yes like your pod thing. earbud whatever you call it. It's working on the computer I have doesn't have like a plugin for the other kind. And I was like oh, crap. I have to this was before I have to buy some Bluetooth ones.

Scott Benner 2:44
I think you could have gotten a adapter. You were looking for an excuse to buy yourself some nice bluetooth headphones marching?

Monica 2:50
Yeah, yes. It gave me a great excuse. And I'm always looking for those.

Scott Benner 2:56
It's okay to say that to me, by the way you are being recorded. So whoever whoever you were hiding the purchase from right here this one day.

Monica 3:03
I don't really hide them.

Scott Benner 3:06
The other day my wife says to me, I bought a sofa. I like wet wipe. Hello. What's happening? So she's completely overtaken our dining room COVID You know, and I think she's learned that she likes working from home. And she thinks she's going to be doing it at least a number of days a week. Forever, probably. And she says to me, I'm I'm gonna get rid of the dining room table, take this light off the ceiling, get a desk and put a sofa in here. And she was just saying it. You know what I mean? Like, I was like, oh, yeah, whatever you want to do. And meanwhile, I was like, Where are we going to eat? But it's fine. You know, I guess we didn't really use the dining room that much anyway. And then one day, she's like, I ordered a sofa. It's pink. I've always wanted a pink sofa. I said okay. Okay, I didn't even know what to say. I just not a big deal. Well, Ben, I didn't. I didn't care. You just she just bought a sofa. Now I feel like if I would have bought a sofa it might not have gone the same way.

Monica 4:12
May have been questions.

Scott Benner 4:13
Somebody would have been like, let me see this sofa. Why do you think this is necessary? Where's it going to go? Please explain your actions. I just stood there. I was like, Okay, so anyway, Monica, you seem pretty relaxed.

Monica 4:27
So I wrote this little note down that I'm nervous. But it was funny to me because a number of years ago I had media training because I would go on TV, radio, etc. For the state Dietetic Association and I also spoke to a lot of groups, nutrition, just kind of, you know, basic things, but um, and I'd always have the little trickle of sweat down my back and then I was good. And then I thought Why am I nervous? I'm, you know, I'm talking to one individual You know, it was just a funny thought.

Scott Benner 5:02
Yeah, no one's ever gonna write. You know, the funny thing is, is that if that was local television, you were doing. Yeah, you might be talking to more people doing this than you have in the past, but it's still just you and I speaking at the moment, so it's no big deal. Yes. Yeah. Well, that's great. What

Monica 5:19
I did learn when that the radio shows that I did, often I did them around the holidays, and you know, talk about tips. And people might call in or might not, I learned that years later, they were still replaying them. And some of them went all the way across the state of Arkansas. And I was like, wow, I didn't know that. But I mean, I didn't care. It was just kind of a funny thing. When someone said, they heard me again on the radio, and I thought, that was like two years ago.

Scott Benner 5:46
So I've done the I forget what they call them, but they put me in a room. And it was you're on a set, right? And you're you're dressed nicely and miked up, and it would go back and forth. Like you'd be on like morning television. And then you'd be on morning radio, then morning, radio the morning, and it would just and I did it for like, I think four or five hours straight. And I was dizzy. By the time it was over. I did it with a I think with a nurse practitioner. I don't remember her name. And we only talked about sending your kids on sleepovers when they had diabetes. Oh, wow. It was just it was exhausting. I couldn't believe how difficult it was by the time it was over.

Monica 6:29
Yeah. Well, great that you did it. I'm sure it was appreciated by a lot of people.

Scott Benner 6:34
Oh, your eye? Let me be clear. I was paid to do it. That's okay. Okay. It's all good. It was it was interesting. I you know, it's funny, it was back around. Do you remember Lilly diabetes? Had those little Disney books? Yes, they actually stopped. I think Lilly and Disney stopped their. Their partnership recently. I don't know if they've announced it yet. But I think it's done. And, um, and it was around that first book. It was like Coco's first sleepover or something like if I'm remembering it, right. And we just like, I'll never forget getting that call. And Lily was like, Would you do this? And I guess so. So I went to New York City, I spent the night got up early in the morning, went to a studio and just talked about sleepovers for five hours. We're not going to do that. Now. Tell me. Tell me how old you are. And when you were diagnosed?

Monica 7:26
Sure, I am 61 years old. And I was diagnosed when I was three, which would be 1963 1963 61 years

Scott Benner 7:37
old. I have to admit, I thought you had diabetes for a long time. And then when you came on, your voice sounded so young that I thought maybe I read the wrong description for a person when I sat down.

Monica 7:48
So I'm so lucky that, you know, the two gene pools mom and dad, on my mom's side, there was always this youthful appearance and energy and all that and my dad's side, they just seem to look older. And my they were my parents were only nine months apart. But people used to mess with him. Like who's that young girl you married, you know, and they thought there was about a 10 year age difference. And so I'm fortunate I followed mom's side. Great as my dad was I've just for the for the other part.

Scott Benner 8:22
Yeah. You just have a great voice. And I wouldn't Oh, thank you, I would not have been able to guess your age from your voice, which is neither here nor there. But that's how it struck me when you jumped on. Okay, so you were diagnosed in the early 60s? How old? Were you again? Yes, three, three.

Monica 8:39
So I my mom kept so many things. But what she told me my mom and dad are both now deceased. My mom died a little over a year ago in 2020. And she was 90 So longevity there. But she said over the years that I started asking for sweet drinks, I don't know if that was soda or what or juice and I began wetting the bed and that that was very unusual one they didn't they didn't give us a lot of sweet drinks there might have been some fruit capital juice, orange juice, milk, you know those kinds of things water and so those were unusual and so she took me to the doctor so I never was like deathly ill. And the cute story and that I also remember like these you know you have flashes of the kids stuff. I never felt bad so she took me to my the family doctor Doctor fulsome isn't that funny? I remember his name. Um, and then I don't know what I think they did a blood test and then they sent me over at Children's Hospital of Los Angeles because we lived in Los Angeles then. And I I'm guessing that the care there was really really good but I I never felt bad. And during the hospital stay of a couple of weeks they wish they would be looking for me. Because I there was a chair by, they put me in like a crib, and there was a chair by the crib. And I figured out how to climb out and I go visit what I called the sick kids. And so my mom said, there'd be these paging overhead, you know, looking for me when they came, you know, because they'd have to go home at night to sleep. But anyway, it's just funny. Just, you know, I was never I never felt sick.

Scott Benner 10:34
You couldn't think you didn't think yourself that way. Was that even at a young age? You didn't think of yourself that way that that carry through your life? Yes,

Monica 10:43
absolutely. Um, I mean, I've never felt funny about talking about being diabetic. But I also never, that wasn't my first thought. You know, I, I was a tomboy, I was active. I going through these records that my sister in law sent when they packed up my mom and dad's house. I was in every imaginable play, tumbling. Everything from, you know, as young as you were able to my mom signed us up at the different, you know, little theaters and Parks and Rec and whatever kinds of things were available to us. Yeah.

Scott Benner 11:24
And I'm assuming that your management allows you not to really think about diabetes too much, right? Because you were probably just getting, I mean, was that even I wasn't even regular an MPH at that point, right. That was, was that beef and pork.

Monica 11:38
It was beef and pork. And I don't know which one I was on. I was on one shot a day. And it was, it was not I remember your other person you interviewed not too long ago was talking about lenti and semi linty. I was never on that. And they, they use these glass syringes that they stored in a metal pan that had a lid on it, and there was alcohol in it. And I heard another one of your interviews with somebody, somebody they boiled there's I'm sure they did that too. But between boy liens, it was in this metal pan. And that stayed in the master bathroom or the bathroom attached the master bedroom. And I also found, again, my mom, I guess semi hoarder, the dietitians notes of how to feed me, in essence, and they followed the tag total available glucose method, which accounts for the Calculate glucose effect from carbohydrate, protein and fat. And that was in 1963. Yes, and my mom had the records from 1963 in 1977, that the dietitian had given her and there was a couple of questions. My mom was a health nut. So asking about tofu at some point. Grilled liver was on my food list. Somewhere in there, I must have had that.

Scott Benner 13:05
I'm gonna say that doesn't sound good. Did your mom keep the syringes? Or the vials or anything?

Monica 13:11
I don't I don't have any of those. Because so we've, we lived in Southern California for a long time, but then there have been several moves, following that. So I think in the course of some of those moves, those things didn't follow. So and I, I don't know, I can't remember at what point I went from one shot to more, but have you know, you have these little flashes of things. So I remember we were struggling with blood sugar, I must have been preteen ish teen, and nobody could explain why. And finally, we ended up with a female physician. And she said, Well, it's probably her hormones. And you know, it's just weird how information comes in, in those old days and quotes, you know, and so I just, I just know, I was always able to be super active. I was, I did everything

Scott Benner 14:13
you have. I have a couple of questions. So first, let me say this before because it stuck in my head. Now. I don't know what episode it was. But I remember someone talking about having broken their glass syringe and that and it being a like a significant financial strain on the family. And they didn't know what to do. So they actually went to the pharmacist who gave them another and then put them on a payment plan. And then their parent had to show up at the pharmacy weekly and put a little money on it. Like it was almost like layaway that you got to take home with you. Oh my Monica, you're banging something on the desk. No, not fidgeting or touching things. Oh, I

Monica 14:53
did take one sip of a drink. Oh, no, you're allowed to. And I guess when I set it down musta come through very

Scott Benner 15:00
low. Yes, yes. That don't worry about that. So, but I'm always really interested about your remembrance of how you tracked your health back then. Were you peeing on sticks or what were you doing?

Monica 15:15
It is, I mean, you think about so the dark age thing. It's comical, but my dad had some mathematical formula and lucky for us, he got his bachelor's degree in mathematics, and he'd always been doing that or engineering type things. But he was given some formula and I just remember him taking the dipstick results. Okay, the dipstick, so you're you're either showing ketones or you're not, I mean, the dipstick. And so the urine dipstick, he plugged some number in somewhere, they came up with how many of these total available glucose glucose grams I was going to eat, and the resultant amount of insulin. And I just remember him standing in, in the bathroom, he had some little logbook notebook something there, and he would run his formula. I don't have any record of that. I just, you know, again, young kid watching your dad while you wait on your shot.

Scott Benner 16:18
Your father figured something out on his own to help you.

Monica 16:23
The I think the hospital taught them something. Okay.

Scott Benner 16:27
But it was a lot of fun.

Monica 16:30
Yes. No technology and periodic go to the family doctor and get your blood drawn. Where you don't have. Yeah,

Scott Benner 16:38
where are you getting? So there was no blood draws to track your health. Was there be were you peeing on sticks to get color? Yes. Okay. Yes. And what did they What did those colors I see I'm always amazed by this because the color would tell you you were too high or too low, but then there was no next step to take right? Correct. Yeah. That's why people's

Monica 16:59
blood draws were at the family doctor. I don't know the frequency. But I go in there and they find out my blood sugar. periodically.

Scott Benner 17:09
Yeah. And that was it. Was that an A onesie even back then? No, it wasn't no, no, no

Monica 17:15
a one sees we're not like tilba atds That's what I keep. My brother was diagnosed with type one and not teen 75 So they live dark ages for probably seven eight years. Also

Scott Benner 17:27
Wait a second. So your your brother older or younger brother.

Monica 17:31
Younger, I've got an autoimmune family. I've got psoriatic rheumatoid arthritis with my older sister and I've got type one diabetes with my brother. Younger.

Scott Benner 17:41
How bad is that arthritis.

Monica 17:44
With Tullis is in rough shape. Unfortunately, she carries some extra weight. She also has hypothyroid she has all matters of stuff and I'm not sure she's had all the right testing done. I was texting with her the other day because I was listening to your your doctor. That's the specialist in thyroids. And I figure I got to keep learning on that side to try to I didn't even realize all these other autoimmune stuff. were tied back to the T one D people. I had no idea until I started listening and seeing I guess I just lived in this pretty good world. It didn't happen to me, you know?

Scott Benner 18:24
Yeah, I'll say this that. I don't know a ton about the arthritis. But I can tell you that if her thyroid isn't well managed, then she could be having pain, joint pain, stuff like that. They might not be helping the arthritis. Yeah, you know, could be making things worse, at the very least.

Monica 18:45
Yep. I plan to kind of talk further with her. And we'll try to figure out next steps, but because I think that somewhere there's missing puzzles. She has really severe asthma. She has a number of things.

Scott Benner 18:59
Asthma, too. Hmm, Hmm. Interesting. How old is she now?

Monica 19:04
She's two years older than me. So she'd be 63. And my brother is five years younger than me.

Scott Benner 19:11
Okay. Did you and your brother have any kind of kinship around diabetes? Or were you? I mean, he would have still been in the house when he was diagnosed. Right?

Monica 19:22
So sort of, so what happened? I was 15. So I was I was talking to him last month or so. And I was just asking him questions, too, because there's stuff that I don't remember. And I said, so keep in mind when I ask you these things, one, I'll we I got moved with my dad temporarily to Virginia, not because of a separation and my parents had two jobs. But my brother was diagnosed right before that. And I'm 15 I'm a rotten teenage brat. You know, I'm a girl going through hormones. I'm in high school living my life. And so I'm not he's my little brother. You know what I mean? Not that I didn't care about him. But it's just kind of, it's just kind of how it is with siblings. And I remember they, he had a one year honeymoon period. And all the only thing that I can clearly remember that is they told my mom, just don't give him ice cream at night. And if you do give it to him during the day, so and let him play it off, run it off. And so he got to go along for a year without insulin. And somewhere in there, my family, my mom and my brother moved to join my dad and I in Virginia, and he ended up with a really good endocrinologist at Georgetown, because they were so near DC. And he's always done really, really well too.

Scott Benner 20:48
Interesting. So you guys, so your parents had some background a number of years in fact, and then they got another child diagnosed and then they got a different kind of medical backup. Did you see his care being much different than yours?

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Monica 25:14
Yes. When he went to so first of all, he was on to two types of insulin, but they were still, he said, purified pork was his initial long acting. And he, he went to this doctor at Georgetown, and the doctor told him, here's my plan. And it was kind of rigid carbohydrates distributed through meals and snacks, the rest of his food intake, because he was growing. So 11, almost at that point, is whatever you want protein or vegetables or you know, other things can fill in the gaps. But he basically told my brother and my mom, but my brother because he wanted to influence him. If you don't do what I tell you, you won't be able to be my patient anymore. And something to the effect of and I'm really good. You know, and I believe because of how well my brother did, he was probably kind of accurate in that.

Scott Benner 26:18
Okay, so he just sort of gave him the high school football coach version of like, you're gonna do it my way or you don't get you don't get to be on the team. And did he have better outcomes than you? Are we still not measuring outcomes at that point? We're not right. 75 we're not measuring

Monica 26:35
anything. I think that. I mean, he probably had some more hypoglycemia, but it's hard to know. But like me, I mean, he played sports, he played soccer that traveled up to Canada and all over he, he just did well. I was in a Girl Scout troop that backpacked all over Southern California, we would be in the mountains, the desert, the beach, you name it. We were camping out. And I did that. And, and I don't remember episodes of hypoglycemia through that. I tried to ask my sister because she was older than me. Do you remember me having any struggles like that? She's like, No. And she didn't remember what I carried to help me. She remembers my mom giving me juice, you know, here and there. But well, I only have one. I'm sorry. No,

Scott Benner 27:32
no, we're just gonna say when you're doing those one shots. If you're eating, there's probably not a ton of opportunity to be low. And you're I mean, because what do you think your agency probably was?

Monica 27:45
I don't know. Because the first one I got? Well, I don't know what it was. But I know when I wanted to get pregnant with my daughter, which was she was born in 88. I knew I had to have to under seven a onesies. And I worked out continuously and I achieved that. And I plan my pregnancy carefully. Luckily for me, things worked that way. And I was able to have her at the right time. She was only born four days early. She was seven pounds normal size, you know, all the things went right. So

Scott Benner 28:26
let me take a tiny bit of a detour here for a second. I just had you ever have those shocking moments when you realize you're older than you think you are? Yes happened to me a moment ago when you were 61 years old told me that your daughter was born the year before I graduated from high school. But in my mind, you're 61 I know this is stupid. I'm 50. And you're much older than I am. Except you're not. Like it didn't stop my heart. But it froze me for half a second. You were like she was on an ad. I was like, oh god, why am I so old?

Monica 29:02
I think about all the time because my daughter is 33 years old. And I'm like, No way How

Scott Benner 29:11
when I hear that. I'm like, Oh, she her daughter's kind of getting older. younger than me. But that really took me for a loop. So, Mike, what really stuck to me was is that you had an 81 C in the eights I'm guessing and you exercised your way into the sevens

Monica 29:30
I don't really know what it was for all I know is I I've always exercise so that makes it sound like I I overdid it. I just made sure that I didn't miss any consistency. And I I always ate pretty well. But all of us have our little things now and then. But I did. I did have a turning point with when I was a dietitian in Washington DC that made me really focus on my eating. But I'll tell you that in a second. And so I just made sure that I wasn't over seven by being a little extra careful. And then the next time I have record of an A one see is when I went on my first pump in 1992. And it was my baseline before the pump was 7.8. So not terrible.

Scott Benner 30:18
Yeah, it's really interesting. Any of your How many children do you have in total?

Monica 30:23
I just have her because in spite of the fact I did maintain really good blood sugar's and agencies and all those Now granted, because we don't know what things like timing range where then I was pretty clear of any problems, side effects anything. And then I was in my somewhere in my pregnancy with her and I was working at Johns Hopkins Oncology Center. And I needed I went to see the eye center there, which is world renowned. And they decided I needed a little lasering to to keep my eyes good. There was some beginnings of retinopathy. So I did that. I had her. I start jogging to get back, you know, the pregnancy weight off. And I had a little little retinal bleed. And I went in and I'm like, What the Hey, and I said, I thought I was so good. And they just said that. The way my little capillaries grew Rama, I it made them more fragile to the jarring movement. I don't know. But I was jogging. And so they they treated me again. And then I was stable. Pretty much forever retinopathy has been my only side effect. But I have full sight. I just, you know, have had to keep on it and keep treating it.

Scott Benner 31:47
It's interesting to listen to somebody talk about that many years ago, because, you know, when you're you're saying, but you know, I got it to the sevens. It was good. You know, that whole thing? I think now pregnancy, they want you in the loaf, like in the fives, or to be pregnant.

Monica 32:02
Right? Those are those days,

Scott Benner 32:04
of course. But I'm saying I'm not judging it. I just think it's interesting to hear it. And it's it's good of you to talk about the retinopathy issue too. Because even though that was the standard, everyone, I'm guessing based on technology, this was kind of the best anybody could do. But you still ended up having an issue with it. And because there are people nowadays who hear well, like I have a seven, I'm okay. And I'm like, Well, for now, maybe, you know, like and there's all this stuff that you could be doing or ways to understand your insulin better. That could put you in a situation where maybe you're not getting your eyes lasered one day, you know now yeah, what was that experience? Like?

Monica 32:49
Um, it was, I mean, it wasn't terrible. It's just depending on how much they did at a time. I might have a nagging headache afterwards, but I normally drove myself to and from I didn't you know, it wasn't something that took away my day.

Scott Benner 33:03
And we've helped stop the progression

Monica 33:07
for the most part and then so fast forward, I'm living in where I live now in Arkansas, and I had just been to the to see the ophthalmologist, my eyes were good, my Awan see, because once I got on the pump, my onesies stayed like 5355 up to low sixes. I think I might have hit a 6768. Occasionally. This is without CGM. But so I had like a massive bleed in my left eye. And I just like the day after, I'd been to the eye doctor, and I just I got on their emergency line, like what in the world. So they, they told me you know, raise your head up, do this, do that. And all the blood cleared and ever since I think there's probably been somewhere in there that was probably a little more laser treatment is kind of hard to remember before after that. But every time I go now and only go once a year to the specialist, the retinal specialist. He's like you have a perfect macula. Everything looks so stable. They're always pretty amazed. But again, that's because I kept my control. Good.

Scott Benner 34:28
Yeah, you did get it lower too. And as the technology I mean, you did what I think is the greatest thing. You know, as the technology became available, you didn't shy away from it. And that's really important, honestly, Hey, you. What did you What did you do for a living as an adult?

Monica 34:46
So I have I graduated from the University of Connecticut with my Bachelor of Science in Clinical dietetics I became a dietitian and I did clinic work for a while. And then I ended up getting with, I always liked the idea of being with corporations because you had job advancement opportunities. So I ended up with a nursing home Corporation. And I kind of covered like a lot of the East Coast, Virginia, Maryland, DC, I went to their nursing homes and did sort of quality assurance and some charting and just made sure they were feeding people appropriately. And somewhere in there, the people that were in charge of writing the menus, and this was a large company that were like 1200 nursing homes, wanted to move the position out of a dieticians basement in Pittsburgh, into the corporate office that had opened in Arkansas. And so they start talking to me about it, because I, I've always, this is gonna sound very braggy. But I'm pretty smart, you know, I do pretty well, I can stay organized. So those things were recognized by other people. And so I applied, and they moved me into here in their headquarters, which it doesn't the company doesn't exist anymore, eventually went away, got bought and this and that. But they had me run their menu program, which I had to supervise like dieticians in certain regions to make sure the food match the food preferences of the people that live there.

Scott Benner 36:32
Monica, are you are you telling me that you followed your husband to Virginia, so he had to follow you to Arkansas?

Monica 36:39
i Okay, so I am on my third marriage, which I've been in 20 years. So I, I left a husband back in Maryland, and brought my daughter she was three and a half to Arkansas. And the job opportunity was great, because then it could, you know, help that happen. And got here and you know, because in your in your different segments, you do things with mental health, I did two bad choices. Who knows why? Because I'm assertive on the job, but apparently not so in my personal life or wasn't. And so after some therapy, I became the same person across the board, you know, assertive able to speak for myself? Well, and I always tease my current husband, you're probably Sorry, I got all that therapy.

Scott Benner 37:31
Of the three of them, you're having the least good time, just so you know.

Monica 37:37
Although he's hung with me 20 years, so it's all good.

Scott Benner 37:41
When you got married the first time.

Monica 37:43
So I was 26, I believe, and then my daughter two years later. And then she was three and a half when I decided he unfortunately had some problems and drinking and some things that just we needed to go to for the best of both of us. And yeah,

Scott Benner 38:05
talk about for a second, though, what you mean, what you meant by not being as assertive. You like just letting things happen that you knew weren't right. Or you didn't? Yes, yeah, the Speak Up that kind of stuff.

Monica 38:17
So, my, my parents, so this is what led me to this place that my parents always tried to help in the communities and things. My dad was active with fair housing, in our Southern California town, so that, you know, whatever you look like you could move into that neighborhood. And it was a super wonderful mix of ethnicities and races and things like that over time. And so, in that mindset of helping people, I think I took on the wrong belief that you could not just help them but fix them. So I apparently started to attract to myself fixers, you know, people that needed fixing Yeah, and instead of just people that could be your partner, and I had that happen twice. The first one, you know, you had somebody on the first one, because of his alcoholism ended up being somewhat abusive, more verbal than physical, but a little physical. And so when I left that situation, I didn't get help right away to get me past that. And it's easy then to fold yourself in with someone else. Not exactly the same, but just not right. And so those those things happened, but fortunate for me, my best friend is like a psychological examiner. So she's got her master's in psychology, and she was able to get me to somebody that was really competent, and very, very helpful.

Scott Benner 39:59
Thank you. Free of the idea that, that you were going to be able to help people who maybe didn't want the help, or were beyond the help, or maybe it just wasn't your job to begin with to help them.

Monica 40:11
Correct. Correct.

Scott Benner 40:13
Okay. Well, that's, that's amazing that you did that. In, you know, I see takes

Monica 40:20
work and stress and things

Scott Benner 40:22
like that. Yeah, that's really cool. And it benefited your daughter, I imagine.

Monica 40:26
Yes. Yep. And my, my husband now, he's, he's just, she's a part of the family, you know, because it's been so long when we got together his son, he has four children, but his youngest was nine. And my daughter was 13. So kind of, you know, they, they learn to go together? Let's do things. Yeah.

Scott Benner 40:49
Does your daughter have any autoimmune issues?

Monica 40:52
Not that we know of at this point. And, you know, I, I was taught that, you know, if you want to birth them, and you breastfeed them, you have the potential to protect them. That may not be true, but I breastfed her for several months, like her attached to me. And then when I went back to work, I did pumping, so I could keep her on breast milk for almost a year, just frozen, you know, we thought out and give it to her. So I always felt like that was healthy.

Scott Benner 41:25
Yeah. Did you do that? Because somebody told you to, or you just had a feeling like this could maybe help and I have diabetes. So let's give her the best chance was that the vibe

Monica 41:35
somewhere in there? I was told that I cannot remember the exact source. You know, again, things were evolving in knowledge and all that. Yeah.

Scott Benner 41:46
Can we take a detour for half a second? Please? You said your mom lived to 90. And you worked in the, in the in the system where people are, you know, helping older people live at the end of their life? Did your mom have to live in a facility ever?

Monica 42:03
Yes. Let me think about it. My dad lived to be 87. So my mom had a stroke when she was 78. And she, she was super healthy. I mean, this woman worked out did yoga did all kinds of things. But they said, Just genetically and it was blood pressure related. Probably what happened sooner she hadn't eaten the way she did and exercise and maintain being quite thin. So she has a stroke. My dad's trying to help take care of her and my, my sister because I don't they were in Northern Virginia and I'm now in Arkansas, my sister was kind of keeping an eye on what was going on in my dad's start to be a little different. So ultimately, we figured out he had Alzheimer's, and it just needed, they needed to be somewhere safe for them. So they moved him into an assisted living place, initially, and then, over time more to a memory care unit in the same facility.

Scott Benner 43:02
Talk about for a second, what people should be looking for. We're like, well, what are some red flags when you're looking at places like that?

Monica 43:11
My sister did more of the research, but we looked at the ratings that the state gives them. We looked at, you know, their staffing ratios, what kind of programs they offer, you know, that's social programs. And when they're in assisted living, they can often go on trips, you know, they carry them in a van or a bus to activities. So they did theater, they did different things. And my parents because we grew up in California, they always enjoyed wine. And so they do even like little cocktail hour at the assisted living and people had a glass of wine, you know, and some appetizers, so they did a lot of things that fit the lifestyle for them. By the way, I didn't stay with long term care. I ended up in pharmaceutical sales. So doing that, well. That's where I spent 22 years also well,

Scott Benner 44:05
I you know I just something wrong in my head a minute ago, and I kind of was googling while you were answering that question. This is interesting. Some people are starting to call Alzheimer's type three diabetes. Really? Yeah, so I'll read you something from Healthline. Some research studies have proposed that Alzheimer's disease should be also classified as the type of diabetes called type three diabetes. A term has been proposed to describe the hypothesis that Alzheimer's which is a major cause of dementia is triggered by a type of insulin resistance and insulin like growth factor dysfunction that occurs specifically in the brain. And if we if we google Alzheimer's, autoimmune new research published in the Journal of Applied laboratory medicine identified specific auto antibodies that mistakenly target the body's own tissues in the surgery Well, in the cerebral spinal fluid of Alzheimer's patients, I guess this is a doctor's name says adds to the evidence that this might be an autoimmune disorder.

Monica 45:20
super weird. What is your my brother and your mom has always been biological research. So tying back to this just quickly, he, at one of the companies he worked at, they had developed some kind of a evaluation to see if you might be at risk. There's certain things in your in your bloodstream, and he tested himself and my sister, and they didn't match up. And I was like, Oh, great. I'm the only one you haven't tested. If one out of five or something can match, I might be in that mix. So

Scott Benner 45:57
I meant I'm sorry, I started to step on you. But I'm glad you finished your thought first. But Did your mom have any autoimmune stuff?

Monica 46:04
Um, no, um, she had some asthma. And then somewhere along lines, even though she was never a smoker, she ended up with a lung cancer tumor that they luckily were able to radiate and stabilize, and it never progressed. But that was kind of that's kind of all for her.

Scott Benner 46:27
I don't think that it's categorized yet, excuse me this way. But asthma is caused by an overreaction from the immune system to certain triggers. So you might not ever have had a chance you and your you and your brother and your sister, you guys were you guys were you might have been destined for this, you know?

Monica 46:47
Yes. And you know, there's in the town that I live in, there's a an osteopathic medical school. And when they first opened up, I think it's been three years ago, now, I met the team that was going to be instructing the students there. And one of them was, or maybe more than one was an adult onset type one. And he got approval initially, to do research with the people that are adult onset type ones. And I don't know what happened, because I don't think they're still at the school. And I was super curious about that. Because I've known some people that, you know, had that. But I always thought, man, they need to just study broadly, these crazy auto immune families, you know, and fit that in the mix. today.

Scott Benner 47:39
I have talked to enough people at this point where I just think it's, I mean, it's, I don't I can't say I'm not a doctor, I haven't done a study, but it's fairly obvious, you know, that autoimmune can travel in bloodlines. And that's really something but can I ask you, overall, looking back? I mean, you had diet, you've had diabetes for the 58 years. Geez. And do you see it as a major impact on your life aside of health? Or do you not feel that way about it?

Monica 48:15
I never have. Like, I mean, I just do everything. And, you know, in the last few years, but these are the things that nobody, people make assumptions about longtime diabetics, especially those that have some science backgrounds, that we know everything we need to know. But I didn't know, all the things were at risk of like, and some of your other people have talked about this carpal tunnel, trigger finger, frozen shoulder, all those things. I didn't know there was higher risk, because I was diabetic. I just, you know, I had I've had those things that they're not still present in my life like that, you know, they've been fixed, or, you know, I do the work to help them go away. But I just I think, well, people need to know at least what to look for. And the more the reasons why to take better care of themselves. And I know you think that some of the people that were without technology always believed hyperglycemia was better than hypoglycemia. But in my family that wasn't it because we always felt like you can fix hypoglycemia, you know, you can drink some juice, you can eat something. But you can't fix that chronic needling away in your bloodstream and your nerves and your because

Scott Benner 49:39
you didn't have an insulin that you could just try to correct with. You were stuck. We know the next time to inject and that was that.

Monica 49:47
But we also I just I can't remember a time I wasn't on my bike at the playground, playing basketball or football with the boys. I just can't remember not doing that stuff. And I think it, it my my current nurse practitioner says, I think that's why you're as good as you are now.

Scott Benner 50:11
So active. Yeah. Well, I mean, you grew up in a warm place to in the 60s. Yes. So, you know, I'm assuming there was a lot of like, Bye, mom, and then you come back eight hours later, stuff like that going on, right? I mean, that's what we used to do. Just we run out the door in the morning and never come home. So absolutely, yeah. Yeah, it all makes sense. I mean, activity is incredibly important. It is. It definitely helps insulin work better, it helps you that, you know, helps your digestion and you know, digesting your food through you shortens the amount of time that it's in there impacting your blood sugar. There's all kinds of great reasons to be active for certain for everybody, not just for people with type one. Yes. Now, so you didn't really feel a big impact on your life. But I do. I do want to ask you, maybe I don't care what the answer is. I'm just interested when technology became a part of your life, and I haven't asked you like you pump or no.

Monica 51:07
Oh, yes. So um, two years ago, 2019 late, to be honest, this time I got on. So I've been doing technology, but not so much with CGM. I got on a tandem with a Dexcom G six. Love, love, love it. And before that, I've worn a pump since 1992. The model of pump I had before the tandem was one of the Medtronic models that did have a CGM associated with it. So if somebody out there gets mad for me saying this, I was on a model like a paradigm five, it's an older model. And the then, CGM I felt was terrible. So what I didn't wear it for the longest time, and then I began to wear it. You'll love that every other week. And I don't know why I picked that random thing. But I just thought at least now and then I can be checking, you know what it looks like. So I did that for a few years, or a couple years anyway, but I just, I didn't like how it had to be applied that it only lasted six days. Just things so the decks calm. And I started researching these different CGM that I also looked at before I changed to the Tannum. I did get an omni pod sent to me the little trial thing, I did several things. I think I wanted the technology of 10 I'm only had the Basal IQ at the time. And then I knew in six months, the CIQ was coming. And I wanted that, and I didn't like the Medtronic system, deciding your Basal for you and doing all those kinds of that auto mode. Okay? Even though I know you can do adjustments with that. And I, no one, no one really taught me and this so I don't mean to be blaming someone else. You're I'm responsible for me. But the Pre-Bolus ing thing was only ever brought up to me on pomp therapy once or twice, but in my sales job and some of my other things I did. I tried that. And I had so many word follow up the bottom events because of you'd be out eating food never came different things that I stopped doing that and I would just dosed when I saw the food. And so I probably had the bouncy effects, you know, you go up and then you normalize you go up, and then you normalize. So the tandem with the Dexcom has given me a lot of information. And I really, really value it. And it's the tandem community on Facebook, the private group that led me to you to your podcast.

Scott Benner 54:00
Oh, good. That's lovely. I have a question. Do you think that when you switched from your older pump, and I Oh, by the way, I think this is the part where I say I'm sorry, Medtronic, I don't control what people think about your stuff. And then we move on to where I did not know any of this about Monica, please.

Monica 54:18
I actually really respect them and their research and their it's just personal preference. I understand that's their science is good. So I don't have a judgment on that.

Scott Benner 54:28
It's just become a running joke in the podcast. That's all so I just have to keep it going. But my question is, is it possible that prior to Dex calm and control IQ, where is it possible you were running heavier basil than you should have been? Do you remember your basil going down when you got to a CGM?

Monica 54:51
Um well so because of my age in my life have changed some. The answer is actually no but um But I know like,

Scott Benner 55:03
because why asking Monique? why I'm asking is I'm picking through the idea of is it possible to before you could see your, you know, you could see your blood sugar in real time where you were maybe doing that MDI thing of like, heavier Basal, to keep your agency lower, and then kind of feeding the insulin before you got low situation and then Pre-Bolus and wouldn't have worked for you. Do you know what I'm saying? Does that make sense?

Monica 55:27
Yeah. So I think that so the old rule that the the, the people like the nurse practitioners, they would talk to me about is Oh, you don't want your Basal to be greater than 50%? I think that rule has changed a little bit. But so mine was sometimes 5557, something went in there. So you're probably right, in terms of their thinking at the time, too. But yes, and yes, yeah.

Scott Benner 55:57
Interesting. Yeah. I mean, it's just, it's just being able to see your blood sugar is obviously just as such a game changer, you know, at about making decisions, and then the algorithm on top of it is probably magical to you after living with diabetes for this much time.

Monica 56:13
Yes. And my since I've been on this system, my agency has been essentially five to 5.3, so since two years ago. And so that's great. And it's consistent that way, and my time in ranges 93 to 95%. With a standard deviation, it depends, but sometimes it's 27. Think it's gone up as much as 33% 33 standard deviation, but it's really terrific. Oh, yeah, always within the acceptable range. And you know, it's interesting, my brother uses a Dexcom. But he does MDI, and we were talking about that, and they'd always just looked at is a one C, and he said, he's changed endos. And the one he has now was talking about time and range. And they ran his and his, like, either 95 or 97%. I don't know, his standard deviation, but he's, he's done really well.

Scott Benner 57:12
So that's really cool. It's amazing, actually, I mean, that you guys have been persevering like this, and doing such great jobs for yourselves. And it's even nice that you're still considering looking out for your sister. Really, really wonderful. Because people need help, you know, that you can't, you can't know everything about this stuff. You know, and you find information and, and it's, it's great to pass. I mean, you said that somebody from a tandem group told you about the podcast.

Monica 57:45
Yes. So, um, I don't know. Okay, I wasn't a Facebook person. And then when. So in, in 2020, I began my dietitians private practice, I left the pharma and I opened up my own, it's just part time but business. So I got on Facebook to do some of the intandem said something about to look at something of theirs. You should go on Facebook. I don't know as a video or a Facebook Live or something. So I thought, Okay, I'm gonna get on Facebook. And part of that was a time factor in my old job. I just had too many things to do on a computer and I didn't want one more thing. But um, so I so I got on there for dieticians, Facebook Lives, tandems Facebook Lives, and then I saw this tandem group. And in there, people will ask questions a little bit like the Facebook group for juice box. And people would offer their advice of either the sugar surfing book, and or your podcast, and they might even cite an episode. And I was like, I guess I need to go over and get on that podcast. And so I've been just picking and choosing some of the episodes initially, and then I'm ultimately I'll get through all of them, but I chose the ones that would help me best with the CIQ because I was still struggling with the Roly Poly thing. You know, I was like, come on. Yeah, you guys see me is the answer that I want. And I'm only seeing it sometimes

Scott Benner 59:22
way episodes helped you with the loop episodes about the algorithms. or

Monica 59:28
so Pre-Bolus seen the things like feed on the floor, because I would always say to my, the nurse practitioner, I see. I get up in the morning, I'm at seven, I walk around for a few minutes. I I didn't always drink water first thing in the morning, which is something I know as a dietitian anyway, but I didn't know how to do it initially. And I'm like, up to 130 What is going on, you know and so, so just things like that. And just again, though being able to see it, you know, and I also started looking at my night times, which are not bad. But I was like, Why do I have these little, these little rises and you know, peaks and valleys. They're narrow, but they're in there. So I, I adjusted my Basal, and it's pretty much straight across now. So yeah,

Scott Benner 1:00:21
that's so cool. I'm glad it was helpful I really am. If it was helpful at all, it's amazing.

Monica 1:00:25
Really, it's been really, really good. And you and Jenny are amazing in the tips and things. And so I went, I mostly referred to things that were related to me and pomp therapy. So if there was a pro tip on MDI or something, uh, bypass some of that. And, you know, certain things I go past, just because I needed specific things.

Scott Benner 1:00:51
No, I understand. I really do. I think that, um, you know, just the, the, the act of listening to the show, I think is helpful. And I would, I could, you know, I can make a reasonable argument that even if you listen to the stuff you're not interested in, that there'll be something in it that could help you, you know, meaning like MDI when you're pumping, or vice versa. But I take your point, and I mean, it's not like you have I mean, there are 500. And I don't know how many episodes, honestly, I don't know how many episodes are anymore, there's a lot of them. So you can't just listen to everything if you don't have the time. But well, I

Monica 1:01:26
just prioritize them. It's not really that I don't plan to listen to them. I sort of made it, you know, listen to the ones that were going to have more what I felt like immediate

Scott Benner 1:01:36
effect. Oh, you liked the podcast, don't you? I do. Excellent. Yes. Well, I want to come on.

Monica 1:01:44
Um, well, just thinking about, I think, and I said in the, the email that just, I feel lucky, but lucky with the fact that I also have, you know, invested in doing things for myself, just because I came into the timezone that, you know, people didn't do well, in terms of 1963, you know, and matter of fact, I went nine years to a diabetic camp for kids. And sorry, I'm adjusting my, your thing was crawling out of my ears. Could I do something? Can you hear me? Okay, good. Yes. Okay, um, where there are, there are people from that camp that I went for years with that are blind, dead, et cetera, and, you know, amputations and things like that. I have a friend in St. Louis, from there that just got out of the hospital, because she was, you know, having terrible blood sugars. And so though, the people that I was around, and, you know, we came through a good camp that was based out of Loma Linda University and taught a lot of good things, but there just weren't, there weren't the technology and things to help make that journey? Better? Like it is now?

Scott Benner 1:03:03
Yeah. Do you think candy now? Do you think that the information? I mean, there's an obvious question, but the information from back then versus now is just, it's night and day, right? It's like there's, I mean, was there anything that you were taught back then that has real value in today's world?

Monica 1:03:20
Right, well, that staying active, yes. And I probably do some of the things you guys talk about with, you know, kind of think about the too much insulin thing, but I think back to what I'm eating, and so I'm like, do I need to have that much of that food, because it's gonna lead me to take a big old giant dose of insulin, I probably do. That's, that's old world thinking. And I probably have a little bit that hangs around. But if I really want something, I'm going to try to figure out how to do this for it. And forget the amount of insulin.

Scott Benner 1:03:59
So a good balance of common sense and technology. Yeah, that's excellent. That's great. Do you have a particular eating style or not really,

Monica 1:04:08
I'm not really but what I what I've done because again, my my life is a little different. So days that I have clients in the office and I'm going to be in there and sitting for a good portion of the day. I mean, I get up and walk around the block and near my office because you know, it's a decent downtown area. I will tend to eat a low carb lunch so I go get a grilled chicken salad, something like that, where I've always been so active that for fitness reasons I ate high carb, more than 55% of my diet was carbs. Because of how much i did i i bicycle that I ran I strength train. I did all of it. So now because I'm a little little less active age, we move just a number different things. I don't have that level of, you know, I don't go on a Saturday go ride 30 miles on my bike anymore. Yeah, so that doesn't mean I don't do things I'm you know, I do things but different. So I so I can give myself the freedom to not think I need to have my glycogen all built up for that long run or ride. I'm okay to eat a low carb lunch and think different about it. But I've been playing around with some vegetarianism and like we had something last night I tortured my husband with trying my new ideas. But, you know, I don't have any style.

Scott Benner 1:05:39
I'm sure he was thrilled. I'm sure he was absolutely thrilled. Like it whenever you made did it end up being good? Or were you in the state actually

Monica 1:05:47
was good we just had it was red lentil and sweet potato soup. And so vegan, and it was spicy, but I was like, it's spicy without flavor. What's the deal here? And he's like, it just needs salt. So, you know, I've been trying to cut back on sodium for both of our good health. And so it's finally like, Okay, put some salt in it.

Scott Benner 1:06:13
And some cute dup sirloin steak. And

Monica 1:06:17
so that's the funny thing about him. So I'll think, Oh, I'm gonna make a pot of beans. And I'm thinking, you know, onion, celery, jalapeno, something. And he's like, where's the meat? And he literally said, Just get me a can have spam and I about gag when he talks about spam. But you could eat spam.

Scott Benner 1:06:36
Oh my god, I think I've had that as a child. I think we fried it. Yeah, that's what he said he did too terrible that I'm thinking back on it. That's really terrible. Oh, my gosh, Monica, is there anything that we haven't talked about that you hope to?

Monica 1:06:52
I was going to say that people on both Facebook sites yours in the the one to 10 him talk about endocrinologist. And oh, you need to get with your Endo. So even though I live in what's considered the second or third biggest city in the state? We have for more than a decade. been lucky if we have one endocrinologist? Lucky, which is the situation now. So when there were none. And I needed to find somebody. Because I was in my pharmaceutical job. I, you know, just asked a doctor to the side, it was like internal medicine, you know, would I need to find a doctor? I have type one diabetes, would you be willing to care for me? And almost universally, it was like, huh, I'd really prefer not to. And I'm saying well, do you know that I'm also a whole person, and I'm over the age of 50. And I need other care, not just the diabetes? And unstable. You know, and it was really bizarre. Yes. So finding good care is a luxury.

Scott Benner 1:08:13
It certainly is. Yeah, it certainly is. Yeah, it's not that easy. And that's why diabetes, and to be perfectly honest, most health, most health issues that run long term, you need to understand them for yourself, like you can't just go to a doctor and then shut yourself off, and then wait to go back to the doctor again. And then if you have problems, just go I mean, I did what the doctor told me. You can't you have to take real agency over yourself. And you just need to, you just need to there's no, there's no way around it, you're not going to do as well, if you wait for someone else to help you. It's it's just it's it's just, I mean, I've just seen it be true over and over again. And I don't think it has, like I said, I'm beginning to see that I don't think it has as much to do with diabetes. It's just in general how healthcare works. And not to even say that it's bad. You know, it's it's cutting edge. It's probably as good as it's ever been on the planet. But it's still people aren't with you every day. They don't have the same concern about you as as you have about yourself. And yes, and they see you as a management thing, which is reasonable. And you're you're trying to live a life. So taking good care of yourself is the best thing you can do. I think that's why the podcast does as well as it as it does. Yes, you know what I mean? And I'm happy that it was valuable for you or anybody who listens honestly.

Monica 1:09:41
And I think that that people saying oh you're in you're doing good or whatever is usually relative to their uncontrolled folks be a type one or type two. So they're and I would have this fighting with the endocrinologist when we had like four of them in town. A Um, you're saying I'm doing good, but my agency went up. And it's still inside the mid sixes. But it used to be closer to five, seven or something. And I was like, you know, we need to adjust something. Because this this level of good is not my good.

Scott Benner 1:10:20
Yeah, good is an interesting word. I've noticed when talking to people, it's always relative, it's always compared to just something that's worse. And no matter what it is, you know, like how you don't say, Oh, I'm good. You know, your leg got chopped off and an accident, but you just saw a guy who lost both of his arms strike while I'm doing better than the guy with no arms. And it just it really, it really is. It needs to be and that's why I always push people on it. When they say something like, How's you're able to say it's good? What does that mean? You know what I mean? Even like you, you know, back in the day, they told you, you're seven, you're good. And well, you know, could have been better. They didn't know it back then. And you could be in that situation, modern day where you're at a practice where everybody's got an A one, C, you're sevens, or eights, and your six nine looks genius to people. And they're like, Oh, don't do anything? No, not that I'm telling you. Your six nine is bad. It's just there's room, you know, you can you can do something about it or your variability, you know, I think is probably as important. You know, I mean, I can't make the distinction for you. But it's as important to share a once a, you know, it's, you know, you don't want your blood sugar to be bouncing around.

Monica 1:11:33
And the other thing that I believe now, so as more and more people are on the technology. So I said, I'm fortunate the nurse practitioner I see worked in the endocrinology department for years and years and years, and she's a CDE. So she's really on top of things. But I said to her, and she was training another nurse practitioner. I don't know why the postprandial glucose is at two hours. For people like me, you and I wasn't criticizing you and people like you should be asking us to be under 140. I mean, preferably lower, but I'm just saying that's a normal person's to our postprandial glucose can go up to 140. And why we're still using that 180 number as good in quotes. Doesn't make sense in a sign of kind of like a hybrid closed loop. You know, we're almost like, pancreas is over here. You know, and, and so. So I'm going to try to talk to you about being under that. 140. And actually, obviously, strive for better than that, but just as putting a lower cap

Scott Benner 1:12:44
on things. I and yeah, I think I say it here pretty often. But to me, you know, if you get the 140 after a meal, like Okay, I think of 160 as a miss and 180 as a spike. Well, yeah, like, that's how I think of it. Yeah, you know, like, I'm not saying your blood sugar is always going to be like super 83 You know, 8590 201 You know what I mean? Like, it's gonna go up, sometimes you're gonna miss on your, on your Bolus at times, or miscalculate carbs, or whatever is gonna happen. You have a site that's going bad, there's a million things that could happen. But it's about to me, it's about stopping it, and not letting it get out of hand. And then that's where you run into problems where, you know, people who are, haven't been around type one as long or haven't heard about, you know, ideas are going to start telling you well, you can't stack your insulin, you're gonna get low. And you know, I don't think you should stack insulin either. I'm not saying that. But if you Bolus for 45, carbs reach 130 and your blood sugar shooting up. And it turns out the meal was 55 carbs, well, then putting in the extra insulin is not stalking it's covering the carbs. Yeah, but it's a it's a distinction that gets lost on people sometimes. And then they watch their 140 turn into one ad, and they're one ad to turn into 250. And they're 250 turned into 300. And then they get caught in that, you know, that that like void of like, oh, well, it's going to come back down. I don't want to put in insulin and make myself low and they just start staring at the high blood sugar and waiting and waiting and waiting. And before you know it. They're They're super high. They don't have any idea how to bring it down. And eventually they are going to cause a low because it's going to take so much insulin to break it free. So yeah, I like using insulin sooner to avoid highs. I also like it because it it often means you're using less insulin, which should result in fewer lows later.

Monica 1:14:43
Precisely. Yeah.

Scott Benner 1:14:44
That's just how I think about

Monica 1:14:45
it. Yeah, so I have two meals that I haven't figured out and it's I like cottage cheese and a lot of people don't and up in the morning sometimes I'll have some cottage cheese on the side of a piece of toast and I'm like, I don't care what I do. At this point, I haven't figured that one out, it's going to shoot up to 180. And I'm like, I keep bringing that Pre-Bolus earlier. And oatmeal. Oatmeal is like the greatest food but I have not gotten that one quite worked out, right. So I'm like, we're gonna keep playing. I'm not gonna let it win.

Scott Benner 1:15:19
Keep keep fighting and trying one day, you'll find it to one day, you'll find the measure and mix of, you know, Pre-Bolus and amount and you'll just be like, Oh my God, it worked. And that's it, then you know, you'll be like, sick. It'll be sick of oatmeal because you tried it so many times.

Monica 1:15:35
Exactly. Anyway, but those like, I've figured out most of the foods, but those two are still a little uphill climb, but I'll figure it out. Good

Scott Benner 1:15:43
for you. Well, Monica, this has been terrific. I really appreciate you coming on the show and talking to me like this. I had a really good time. And you have a lot of wealth of knowledge and, and perspective, and I appreciate you sharing it with everybody.

Monica 1:15:56
Well, thank you for letting me it's been really enjoyable. And I enjoy listening to all of your interviews.

Scott Benner 1:16:02
Thank you. Well, I think people will enjoy this one as well. Thank you so much to Ian pen from Medtronic diabetes, for sponsoring this episode of The Juicebox Podcast, please remember to head over to in Penn today.com. If you'd like to learn more about that insulin pan that talks to that app through Bluetooth. I also want to thank you s Med and remind you that you can get a free benefits check right now at us med.com forward slash juice box or by dialing 888-721-1514. I'd also like to thank Monica for coming on the show and sharing her story. And thanks to you as well for listening, downloading, subscribing, and sharing the Juicebox Podcast. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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#700 Bone Daddy

Chad is the father of a type 1 and an orthopedic surgeon.

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

+ Click for EPISODE TRANSCRIPT

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello Friends, I want to welcome you to Episode 700 of the Juicebox Podcast that is more talking than even I thought I could do.

On today's show, I'll be speaking with Chad, he is the father of a child with type one diabetes. He's also an orthopedic surgeon. It's completely possible that this is the longest episode that I've ever published. I'm not sure I probably should have looked into it before I recorded this. But anyway, it feels like it's the longest one. I'm getting into that into that territory. And like you think we could do a three hour podcast maybe one day, we'll see. While you're listening, don't forget to take breaks so you can rest. I'm just kidding. Don't forget while you're listening, that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. You know, if you're a US resident who has type one diabetes, or is the caregiver of someone with type one in just a few minutes, you can help people with type one by taking a short survey AT T one D exchange.org. Forward slash juice box. You can do it right there from your sofa. It will not take long. 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 juice box. Today's extravaganza is also brought to you by Omni pod makers of the Omni pod dash and the Omni pod five, you may be eligible for a free 30 day trial, the dash and so much more that I have yet to tell you about. You'll find out of course at Omni pod.com forward slash juicebox or by listening to the ACT later in the episode.

Chad Zooker, M.D. 2:14
My name is Chad Zooker. I am a board certified orthopedic surgeon in Baltimore. And I specialize in sports medicine. And for surgical purposes, that means I do a lot of knee and shoulder arthroscopy. So think of ACL reconstructions, meniscus surgery, rotator cuff surgery. And in my non surgical, professional world, I see a lot of everything. So treating all manner of orthopedic injuries from broken bones to strains and sprains of joints and muscles. knees, shoulders, some backs, ankles, elbows, hands and fingers. Pretty much. If you can jam it, sprain it, tear it, break it, I can at least get you started. And if it's a little bit out of my typical expertise for treatment, I work in a larger practice that has several specialists that love the non knees and non shoulders that I like to treat.

Scott Benner 3:15
Right? Well, here's the real secret. I have a question about origins arrest. That's the only reason I let you on the show. Sure.

Chad Zooker, M.D. 3:23
You just treat me like everybody else. I know Scott, don't worry.

Scott Benner 3:26
Oh, Chad, hey, it's good to see you at the grocery store. How are you? The kids are good they are my knee is how often how many times a week.

Chad Zooker, M.D. 3:35
It's it's funny that so it's three, four times a week easy. And I'll usually on the weekend, you'll collect a few texts, a few messages. And Monday morning, I email my secretary I say hey, you know, here's so and so friend, can we get them in to see me today? Such insights needs an x ray. And if Monday morning comes and I'm not sending that email, I start to wonder like, Am I losing my touch here? Like nobody reached out to me in the last few days?

Scott Benner 3:59
I don't have my friend. So it's interesting, you bring this up, because I don't know if you've ever heard Adam on the show. He's a pediatrician, but he's also a very good friend of mine. And when I have questions about my kids, I shudder to say i i text them. And as I'm doing it, I'm horrified with myself. You don't I mean, like because I know he's a person. He has a life. You know, and you're like, hey, just real quick, is there a stomach bug going around right now? You know,

Chad Zooker, M.D. 4:29
it's uh, you gotta if you especially in a town like we call it small tomorrow, because a lot of us are born here raised here and never leave. And if you are not comfortable with that idea that you're just going to be intermingled with one degree of separation for the rest of your professional career then you can't you gotta leave you can't practice you have to be there. And honestly, I really don't mind I think very few people are have a problem with kind of boundaries or when they should text or call and instead of like You know, if you had sent me that message two hours ago, during the office day, I could have taken care of this easy. But now you're turning to me at nine o'clock at night when I'll help you with it. But I really there's not much I can do, you know, remotely right

Scott Benner 5:12
now. Yeah, I have to tell you, I love there's is there's nothing not to love about the office calling you to schedule an appointment, instead of you having to call the office scheduling, Dr. Needleman said that I should call you and get your son in like, and it feels like, ah, whatever leaf, you know,

Chad Zooker, M.D. 5:30
it's, you know, for me, I get a text, I'd say no problem, you know, let me have someone call you, I cut and paste it to the email. And it's 10 seconds of my effort, and then they get a call directly. And then they feel like they're getting the VIP treatment. So you know, why not? It's good for business, it's good for patient care, it helps direct where people need to get to quicker. So it's really, it's not as much a bother as you think. And usually, if it's somebody I'm close to, there's a handful of friends that I consider really good friends. They never take advantage of it. And they know that it doesn't matter. They could text me too in the morning, I'm never gonna get upset, but there's, you know, not the 98% that could probably use a little bit of thought before they, you know, send a non urgent text at like 10 o'clock at night when there's not much we can do about it. And I'm an orthopod, you know, we're not dealing with life and death. So

Scott Benner 6:21
Chad, do you know that happens to me in a different way,

Chad Zooker, M.D. 6:25
I believe in knowing what you do. And I just gotta, I gotta say, it's amazing what you've created here. Oh, thank you. And I can tell you as a, you know, I look at your podcast and the Facebook group. And just the way that you are willing to give up your time and look at people's curves and say, talk to me about your bagels, and it still feels like it's not a medical professional, it's not a somebody running a business, it still feels like you're a dad who you know, happens to know a little bit more about this than the newbie in the cloud. And you just want to help and I just, you know, as a doctor, I appreciate it. As a dad, I appreciate it. And I can't get through an interview with you and not give you some major credit for what you've created here. And I imagine the trade off is you get these, you know, urgent, quote unquote, messages about a blood sugar about a Dexcom curve, like what do I do with this?

Scott Benner 7:23
I don't mind the messages when they come at 230 in the morning, and I sent in that style of like, one line, one question, new text, next question. And it's, you know, it comes to the messenger, and it's like, boom, boom, my wife's like, what is that? I'm like, a lady in the Philippines does not understand her blood sugar. And like, I guess she didn't understand the timezones, either. And you know, but that's pretty much it. Although, while we were getting ready this morning, and you were getting your microphone together, I was talking to a woman named Julia and Canada about her kids blood sugar through a text at the same time. But yeah, I don't mind. It's funny, I don't mind. But there's a moment where it gets overwhelming and I just can't answer and then that actually feels that that gives me a guilty feeling. Like if like to leave something on answer, it makes me feel it's not a good feeling. Let's just say, I relate to that very well. Yeah. Well, at the end of this episode, I'm gonna ask you a question about each of my children, and I'm gonna get some, I'm gonna get some free advice from you, what do you think

Chad Zooker, M.D. 8:27
I am, you are on the spot, you get bumped right up to the VIP list. And you can always whether it's for you, your kids, any orthopedic questions, you get the special VIP treatment?

Scott Benner 8:38
Well, we'll save that for the end. What made you want to come on the show?

Chad Zooker, M.D. 8:42
So I was flooding through the Facebook group one night, and you put a post, I think I just good timing. And you had put up this post saying, I'm looking for some medical folks in different specialties and trying to put together a series of episodes that tie in where type one, you know, spills into things that aren't just directly endocrine related. And I as a, as a super fan of the show, my wife and I are just, you know, huge fans of what you're doing. And I was like, oh my god, this is like, I've been trying to find an angle where I could be useful and helpful to get on juicebox. Here it is. And, and I think I soon as you posted that message, I had put together an email within 510 minutes, threw my CV in there and fired it off. And I was surprised at how quickly you responded that you know, the sound great. Yeah. I'll send you a link and we'll schedule is like wow, that was that was too easy. Yeah.

Scott Benner 9:38
Well, Chad, it's because you send an email that was like you were trying to get a job with me. So I this guy really wants to be on the podcast. See I whether it's wanting to be on the podcast or wanting to take care of diabetes, I find desire to be really important. Yeah, you know, so Yeah, I ended up telling people when I talked to them a lot, you can tell that they're going to be okay one day with diabetes, because they want to be. And I know that's like a, it's a weird thing to parse out. Because you could just sit there and think, you know, I really want this to go well, but there's a difference between just wanting it to go well, and being willing to put in effort in places where you have no comfort, and to hear information that you have no relation to, and to force yourself like you're in school to sit down and make sense of it and to give it time. You know, maybe not completely connected to that idea. But one of the one of the things I hear back from people so much that breaks my heart, and kind of two different ways, is I know the answers are in the podcast, I don't have time to listen to the podcast. And it makes me feel like, well, you don't have time not to listen to the podcast, because the reason you feel like you don't have time right now, is because you're overwhelmed. Partially, partially because you're overwhelmed by diabetes. Like, what if we just carved out time ignored some other things, learned more about how insulin works made your life easier and see if that wouldn't free up some of your your headspace, you know, but it's a weird leap for people to make when they're like, I got three kids like, When am I gonna listen to a podcast? I was like, Well,

Chad Zooker, M.D. 11:21
I don't know, when you figure it out. Yeah. It's funny that you mentioned that because so my wife and I were, you know, we're coming up to the morning of the interview. And I said, you know, let's just get our like, I want to get all the facts straight. I'm thinking like, how did we hear about the podcast? And we're talking about and I think, literally, so when, when our son was diagnosed, we were in the hospital, in that initial admission, and, you know, she was sifting through everything she could find online. And I think she came across the maybe some old posts from Arden's day. And she connected that to the podcast. And she's not a podcast person, but she knows I am. And so like, probably within two days of diagnosis, she's telling me about this Juicebox Podcast, and me being a big dummy and not listening, because I'm so sort of focused in on trying to figure out diabetes. Because as a doctor, we're not really trained to treat diabetes, believe it or not, that I'm saying, Yeah, it sounds interesting, I don't know, like, great, and just kept putting it in the back of my head until maybe, you know, three, four, or five months later, I listen to some episodes, I'm like, wow, this is perfect. This is like exactly what anybody needs explained in very direct and easy to understand terms. And if you pay attention to the pro tips, and if you start digging in on some of the episodes that are more technical, you'll get it and you got to practice and it takes time. But you know, she was listening from probably the first night of diagnosis, figuring out how to use you even how to use a podcast app. And she's already got it figured out within 24 hours. And, and I'm just sort of, like, I got this, I got this, and I don't got this until I started to listen and really, you know, put the effort in to learn it. Because it's like any other skill, you can, you know, can't really perfect diabetes, but you can get better at it. If you practice.

Scott Benner 13:11
Well, there's also a there's quite a leap to make in your head too. I mean, all this has just happened to your child, it's happening to you in a different way. And I mean, what you're supposed to expect that podcast is gonna help you like, I mean, really, when you think about a cast, you think a True Crime, Comedy, you know, actors talking to their friends. It's not like you're like, oh, yeah, that must be where the secret to my problem is.

Chad Zooker, M.D. 13:35
Right? Yeah. But you know, sometimes if you pay attention, and if you have say, wow, look at how many people are getting really good results. It's not just they love it, because it's relatable. They're, they're actually changing their outcomes. There's a value here. And that's why, you know, this, your podcasts in particular is one that stands out as being entertaining, and it's pointing at times, and sometimes you just want to listen to someone's story, because then you don't feel like you're the only one. And then you tune into you and Jenny, and you're like, oh, so fat and protein do have an effect. And I actually could maybe try to quantify that if I start looking at the data right in front of my face, from the Dexcom. And from what I know, in terms of the nutritional content of whatever they're eating, and, you know, playing around with some of these things like the Warsaw method and some of the other trips, tricks, tips and techniques that that we can do.

Scott Benner 14:31
So no, I agree. It's, I mean, I'm, I'm incredibly proud of the podcast and I think it's a great blend of a lot of different things. And I'm happy when anybody finds something in it, that it's valuable to them. I think the whole thing is valuable. Like I genuinely believe if you just listen to this show, like just either started now and you know, listened forward or went back and dug through the pro tips and that kind of stuff and then continue to listen or some people Well, bless them go back to the beginning and just listen straight through. I think it's an A once in the fives.

Chad Zooker, M.D. 15:06
I think it's Yeah, everything you need is there. The toolbox is right there. You just got to get familiar with all the tools in it and start using them.

Scott Benner 15:13
Yeah, no kidding. All right. Well, how about I'm sorry, are we saying was your son or daughter,

Chad Zooker, M.D. 15:18
so as my son, so you know, the origin story of so our son and so Zach is he just turned 12. He's literally, you know, even a week at the age of 12. Right now, seven years old, and first grade, oddly enough, is,

Scott Benner 15:35
was he on a school trip to a science lab, and he was bitten by a radioactive packet of sugar is that when

Chad Zooker, M.D. 15:40
he wishes he wishes, I wish those origin stories are more fun. So so but there's, you know, everybody has their little quirks to their story. So we were in first grade, and we had moved schools completely no reason related to type one, to start first grade, his, within a week or two, he made a good new friend who turns out that his friend has type one, the teacher has type one. And we put together an assembly and they're teaching the whole school about type one diabetes and how it's not contagious and what the Dexcom does. And two weeks after the assembly, we're at the movies. And for anyone who doesn't know our son, he is like, he's the he's the kid that won't share anything, because he doesn't want to, like, you know, your mouth to touch his water. You know, we're not sharing snacks or barely sharing popcorn, so we smuggle in our water bottles. And he finishes his water, he finishes my water, he finishes my wastewater, he actually started drinking his sister's water. And he said to us, I think I have type one, you know, just matter of factly just because it was fresh in his mind, and I'm completely blowing this off, like, you just had this assembly like, you know, I don't think so. And my wife was like, you know, had much better intuition and said, Well, you know, this was Sunday night. So Monday morning, we call the pediatrician, she makes an appointment. It's just mostly we love our pediatrician. He's, he's great. Why not go see the doc and see. And so Tuesday morning, they're at the pediatrician, I'm at work and I get a call from him from the from the pediatrician saying, Zachary has diabetes. Three words. And, like in that moment, it's, it's like the time standstill and stops for a second. And you, you get that gut punch where you've like, you know, no clue what's up and down. And I think within it seemed like 10 minutes, but it was probably three seconds, I replied back. Okay, what do we do next? And flipping like, you know, into my surgeon mode, here's a problem, how do we fix it? What's torn? How do we fix it? What's broken? How do we fix it? And, and so he said, you know, you know, I'm gonna send you, I'm gonna send him to the hospital to this hospital. And, and then, you know, my wife called me and it's all a blur. And we go to the hospital, and his, his diet, buddy from his class, with the family, whole family shows up at the end of the school day. So this was, maybe mid morning, we're in the hospital. And I'm over there by three, four o'clock, and his buddy walks in with their family, we call them our died, our diabetes Sherpas. And you know, so they're, they've already become pretty close friends, but they're best friends at this point now. And we're, that's it, you know, he's his little buddy is up in the hospital bed with him. And they're showing each other how to check finger six. And I think because of the fact that we actually here, we got to give him the credit to be kind of proactive and say, I think I have this, we diagnosed pretty early, we were out of the hospital and 24 hours, I think, and he was back in school by the end of the week, where we have a very supportive nursing staff and he was the seventh type one in the school between the upper middle and lower school at that time.

Scott Benner 19:05
Well, I've it's a really touching and lovely story. And what I took from it is that your wife trust the kids more than you. But

Chad Zooker, M.D. 19:12
I think I think that goes without saying that in all things. And it's funny that, you know, my medical degree, stops at the door in our house. Even for orthopedic issues, nobody's listening to me and any good sound medical advice once I'm in the house, but, but she knew and she, she's amazing. And she's gonna hear this episode, and she knows how amazing she is. But she pretty much runs the daytime affairs, and she's managing all of the decision making remotely with the, you know, between texts. And we love our school system or our school and our school nurse, but COVID gave us an opportunity to go completely solo on this and we we haven't been in the nurse's suite for two years, two and a half years now. And she manages most of it data That

Scott Benner 20:00
feedback at school now.

Chad Zooker, M.D. 20:02
Yeah, so we're very lucky that the school we're at here has been in person almost entirely since the beginning of the pandemic, and they've made some, their testing once a week, everybody in the school, they've been very, it's just a good sense of community. So there was no question that everybody's going to wear a mask in school. And they had very little remote only time during the initial pandemic. And then for the last two school years, they've been in person the whole time, and my wife that happens to be a physician assistant, which you'd also think might prepare us for handling, you know, managing a medical diagnosis. But you know, she has been amazing and taking the reins of doing most of the day to day management and working with me, but spending more time working with with our son now instead of in the office, but I'm looking forward to having her back in the office more frequently and in the operating room. Because I'm always looking for more help.

Scott Benner 21:02
Can I Can I ask you to expand on that a little bit? Like, what's it like? So I would imagine being a doctor and your wife, your wife, being a physician's assistant, you have that? I'm kind of going through this right now. My mom is ill, she's older and she's ill, and somebody gave me some great advice to not look too far ahead. Just kind of tackle the problem in front of you keep going. And I was surprised in the first weeks of in the first weeks of my mom's illness, she's I guess I'm going to talk about this here chat. Okay, hold on a second. That's, that's okay. Let me set her

Chad Zooker, M.D. 21:39
but I'm sorry. I'm sorry to hear that. She's not doing well. Yeah,

Scott Benner 21:42
she's she's doing actually oddly, well, hold on a sec. Okay, the whole thing. So, going back about six months, my mom is fine. I'm, she's 79 years old. She lives by herself. She uses a walker to help her get around. But, you know, two or three days a week gets on a community bus goes to the gym, you know what I mean? Like, you know, this whole thing. I go and drive her to a cardiac appointment one day, it's just a regular appointment, where they look at her pacemaker, which he's had for, you know, 20 years maybe. And I didn't notice anything different about her. You don't I mean, I picked her up, I took her down, she got out of the car, she walked into the building the whole day, when as I expected it to 12 hours later, my brother calls me in the middle of the night and says, I'm taking mom to the emergency room. Alright, and I was like, why? What's wrong because she's has incredible stomach pain. And she can't go to the bathroom and something's wrong. So it's COVID. And my brother has to sit in the parking lot for seven hours while my mom sits in pain in her nightgown, in the emergency room by herself. And my brother, finally, I wake up in the morning, and I say to him, how's it going? He goes, she's not in yet. And I said, You got to get her somewhere else, man. So he scooped her up, took her to a different hospital. There. She waited a couple more hours but got in. And they quickly diagnosed my mom with a UTI kept her for a couple of days gave her some antibiotics sent her home. Well, she continued to struggle. And a week or so later, we had our back at the emergency room, where this time they did some imaging again, as they did the first time. And you know said oh, well, this is just you know, the, the residual the, the UTI will drain her bladder and send her home, she'll be fine. They do that. And a week later, my mom is still in trouble. But now she's declining. And I'm going to tell you that I've never really experienced anything like this. But it was like watching someone turn a light dimmer down kind of quickly. Like my mom went from that lady who I described at the beginning to sitting in a chair and not being able to stand up being weak, having a hard time keeping your eyes open like this whole thing. So I get her back to another er, and this time in the ER, I pressed them. I was like, Look, if you're gonna make her wait, you have to give her a Foley catheter and drain her bladder. They drained her bladder and took out 2000 cc's of urine. Wow, even I know that's a lot. It's a soda bottle full of liquid. Yeah. And luckily, I got them to drain her first because this time they scanned her when her bladder wasn't full so they could see the cancer. All right. And so my mom had a large mass the size of a large grapefruit near her ovary. She was you know, still with that news took two days to get her out of the ER into the hospital. And they started you know, working on ROP for a plan. And I felt like the oncology OB that she was you know that she But was assigned. I felt like he wasn't really interested in doing surgery on my mom. He said he was. But then everything he did kind of indicated that he wasn't like he. I can't say for sure. But I feel like he was going to slow walk her into the ground, if that makes sense. Yeah, I understand. Okay. And so we're watching it happen over weeks. And one day, I'm just in my car driving back and forth from the hospital to sere. And I had this realization.

It's not NGOs that don't understand diabetes. I've gone on this thought for so many years that how could it be possible that we create all these endocrinologist that don't understand how to help people with type one diabetes? How do they not understand this thing? How do they not know how to talk to people how to and then I went, Oh, God, it might just be doctors. Like, and I was. And then I thought, How is it possible I get on this podcast and tell people all the time, take control of your health. Don't listen to that's good enough, or you're in range or whatever. Like, I literally fell into the same trap that I watched people do because it was now suddenly cancer and not diabetes. Like I felt like all the things I knew I didn't know. And then when I just took the things that I know about type one and how to how to go through the healthcare system and manage things and understand things and just apply them to my mom. Boom. Since then, my mom has had surgery. They cleared away all the cancer. They gave her a full hysterectomy. They found a little more cancer that was kind of intertwined in a hernia that she had they fixed her hernia. She's in rehab now. And getting ready to see the doctor two weeks post post op, but not the doctor that saw her at the hospital. Right? My neighbor's son grew up to be this is crazy. I guess this is why I'm telling you this. My neighbor son grew up to be an orthopedic surgeon. And I know he's a good one because at a pretty prestigious hospital on the East Coast. When there was one opening, he got it. Right. And I texted him. And he said, Oh, when I was in medical school, I had a friend who became a an oncology OB, he texted her, she texted her as her mentor. And three days later, my mom was being seen by the mentor who said, I take this right out, you don't worry about it. There you go, just like that. And it wasn't until I started treating my mom's illness, the way I treat Ardens diabetes, that anything happened. I genuinely think my mom's dead today, if I didn't think why am I listening to them?

Chad Zooker, M.D. 27:47
All the things you say advocate for yourself. You got the toolbox. It's your toolbox. You built it and you just had to tweak the tools for a different, you know, a different project.

Scott Benner 27:57
Yeah, I felt stupid at first Chad, I felt like I was walking around with the toolbox in my hand going. I don't understand why I can't work this out. You know, that's

Chad Zooker, M.D. 28:05
deep. But yeah, but first of all, you shouldn't because, you know, you've said this many times. You're not a medical expert. And even if you were you could, I am I'm a doctor I got it, I got a diploma somewhere buried in my basement. That proves it. But I wasn't prepared to treat the type one diabetes, either as a doctor, let alone as a parent. So you're different when you're the family when you're the patient. It's it's it's different. It's okay to that's not have clear thought and mind when you tackle, you know, in that first few hours of learning a diagnosis.

Scott Benner 28:42
Yeah. Well, Chad, you're very good at this because I told that story just to get you to this spot. So

Chad Zooker, M.D. 28:48
you're good at something in medical school, when you know so you go through two years of learning everything in the books and you're you just buried in exams. And then after two years, alright, let's go see some patients. Let's go to the wards. And one of our doctors, one of the mentors came in and he, you know, he basically had this. He came in dressed as an old man, he was a makeup, he really looked like we couldn't tell who he was. And the whole, some of his little spiel that day was talk to patients like they're regular people who have no understanding of anything medical. Even if that patient is a doctor, always talk in the most simplest basic terms, not because people are stupid and don't understand you. But at that moment, they can't process everything. And if you don't keep it simple, and explain it in a concise and clear way that that you know, they understand. There's no chance that any of that information is going to get through and even if you are very simple and concise and explaining things when someone's been hit with a ton of bricks over their head like your mom diagnosis like a cancer diagnosis like a type one diagnosis, maybe 10% 24 St gets through, you know, it's like the goalie is pretty good that first day and not letting much through into your brain to process so, it I've always taken that to heart and you know, I, I never speak in and I can you know act like I'm a dumb bone doctor that's our little joke we like to say that we're strong as an ox and half as smart in orthopedics, but I always try and explain things on a very basic level to patients to make sure they get it because you know, even though I'm not dealing in life and death in my practice, it's still a big deal to talk about surgery to somebody and recommend something like that or trying to encourage of physical therapy program or something that may take six months to recover and you need a patient on board to believe you. Will they got to put the work in to actually get there.

Scott Benner 30:50
Yeah, it doesn't matter what the ailment is, and you shouldn't you know, I know you're joking, but you know your art your art is as valuable as anyone else's.

G vo Capo pen has no visible needle, and it's a premixed autoinjector of glucagon for treatment of very low blood sugar. In adults and kids with diabetes ages two and above. Find out more go to Jeeva glucagon.com forward slash juicebox G voc shouldn't be used in patients with insulinoma or pheochromocytoma. Visit G voc glucagon.com/risk. If you've heard about the diabetes pro tips, and you'd like to find them here in the podcast, they begin at Episode 210, where they're available at juicebox podcast.com. And at diabetes pro tip.com. I'd also like to remind you to take the survey AT T one D exchange.org. Forward slash juicebox. Before we get back Chad, I'd like to tell you about the Omni pod. Here's what it is. It's a tubeless insulin pump. Actually, my daughter has been wearing it on the pod every day since she was four years old, and she's about to turn 18 I think you might enjoy it as well. Here are your options, you go to Omni pod.com forward slash juicebox. When you get there, you can see if you're eligible for a free 30 day trial of the Omni pod dash. You can also find out more about on the pods algorithm based offering the Omni pod five. If you have a Dexcom G six, and the Omni pod five, they talk to each other and make insulin decisions. Let's say you're interested in the Omni pod five, but it's not covered by your insurance yet. And you think well I'll just wait then you don't have to, you could actually get started with the Omni pod Dash. And then when it's covered by your insurance switch effortlessly to the on the pod five. That's something that on the pod calls the Omni pod promise, they promise that you can I forget how they say it. Maybe I should know this while making me. Don't you think? I have it right here. Let me just read it. I'll pretend like I'm, I'm just gonna read it ready. There's no need to wait for the next big thing. Because with the Omni pod promise, you can upgrade to Omni pods latest technologies for no additional cost as soon as they're available to you and covered by insurance terms and conditions apply of course, and you can find out more details@omnipod.com forward slash juicebox which just means if you're not eligible for the five yet, but you want it you can get the dash now and just switch when your eligibility happens. The Omni pod is a terrific device it is to Bliss and you can wear it to bathe or shower or swim. You don't have to take it off for sports or other activities. If you know what I mean adults, you'll always be getting your insulin just the way you're supposed to on the pod.com forward slash juice box for full safety risk and information and Omni pod promises terms and conditions. You can also visit omnipod.com forward slash juice box. Now let's get back to Chad. We have a lot more to talk about.

I want you to talk a little bit about to medical professionals or parents and the diagnosis comes. I mean everybody feels completely unprepared but I would think most lay people would assume you'd be alright. But it's no different for you is it?

Chad Zooker, M.D. 34:46
No, it's I mean it's it's so easy to answer that question. There's not even a qualifier or we were halfway ready. Now. It's you're not ready in medical school. I didn't learn much more helix there either, you know, so this is a lot on the job training for how we manage his type one and just trying to understand the nuances of his body. The changes with now that he's 12 And he's, you know, he is taller than me now, I'm not a small person. He's almost six feet tall at age 12. And he's playing lacrosse at the club level, and he's playing basketball. And it's awesome to watch him because he is intense when he plays. He's the kid who wants to run sprints at the end. And he wants to beat everybody at the sprints and the coaches yelling at the team saying how is this defenseman beating you guys at sprints? So, trying to manage, you know, shifts in blood sugar when he's going 110% in a practice, let alone a game. And trying to figure out, you know, where we're going to put the Dexcom where we're gonna put, you know, we had a tournament this weekend, I took a kitchen Tupperware and I hid his phone in the back of the goal. So I could pick up a reading while he's on the field. You know, so yeah, so you're just not prepared for any of

Scott Benner 36:05
it? Well, what would you say? I'm sorry to cut you off. I mean,

Chad Zooker, M.D. 36:09
now, just so you just yeah, it, you know, I, my last treatment of diabetes as a doctor was as a resident writing a sliding scale for inpatients with NPH insulin on a sliding scale that none of us would use today.

Scott Benner 36:23
Well, as you say, that the woman I was talking to when we started this episode is in Canada, and she showed me some stuff. And like I said, I answered, I said, You comma, Canada, question mark. And she goes, Yes, I'm in Canada. So she's not using, you know, regular and mph, but they still have her on us using a sliding scale. She's like, I can't figure out what's going on. I'm like, Well, you're not using enough insulin for the meals. And I mean, I think your basil is too weak, but I can't tell because of what's happening. Like you have to you have to get a carb ratio, you know, to try to get this closer. But nobody's even talking to her about it. So it still does happen in place. It's not I mean, it's not maybe the whole of Canada. But there's there's some provinces that that are just like, there's some states, I'm talking to a woman, man, a young mom in Arizona right now, too. And they got her kid on a sliding scale to right, just jumps up and down all day long, but was so what did you What was the first thing? I mean, what were the first couple of things like how did the building blocks go together? So it started to make sense.

Chad Zooker, M.D. 37:28
So I mean, I'm, I'm a, I'm a surgeon, I think concretely, I'm a fixer. I also like to think of the give me a problem, don't tell me how to fix it, give me a problem. And let me figure it out. So we start figuring out, you know, cart counts and start realizing quickly, hey, it's a lot easier to weigh stuff than to try and count anything. So we get in that mindset of, we're going to use a kitchen scale for everything. And starting to figure out how we respond to certain foods and listening to the podcast was super helpful, talking to our, our Sherpa, or diabetes Sherpas that from his diabetes family that were helping us. Really, my wife was amazing. Like, you know, from day one, we knew we wanted x calm, and we wanted a pump. And it wasn't like, you know, maybe in a little bit. She had the rep was in the hospital, meeting us from Dexcom. And we had a Dexcom on him in less than a month. And we had a pump by three months. And that was mostly her pushing, because she knew that those tools, were going to make it easier for us to manage. And we're going to give us more peace of mind to not keep doing the 2am finger sticks, sending him to school and not having to worry that he's going to drop low during a gym class because we could watch it remotely. So understanding and getting those tools to work for us. And then you know, when I see people complaining about Dexcom and I can tell you 80% of our sensors fail early. We bought stock index com simply on the fact that we kept replacing 80% of our sensors and they were still making such such margins and revenues. I said if they're making a profit replacing so much of their stock, you know so much of their product. I got to own that company before before they you know they get any more expensive. So that's

Scott Benner 39:15
that's funny, but let me tell you that might have been flawed thinking because I don't think Well, I don't know the last time art and sensor didn't last 10 days. I can't think of whatever happening once like hers goes right up till it shuts off works perfectly.

Chad Zooker, M.D. 39:29
It's we get seven to eight. I think what I mean, I mean our son is really lean. He's he's stretched out lean. So I think a lot of it has to do with that. But understanding hydration that is like the Top 10 Top 10 troubleshooting steps you take before anything else makes a huge difference. Just understanding how it works. So when people are so befuddled by the difference between their finger stick and their Dexcom and sometimes if I have the time I'll maybe type out a nice explanation to try and help out but you know Understanding how the technology the trends learning that you follow the trends, not the absolute number. So piece by piece. That's that's how you put it together. And then it's the way I looked at it is every opportunity to Bolus basil change its data, it's an experiment. He eats a pizza, and you know, his sugars go too high, we go too low, you learn from the data. And you adapt. So, you know, it's, we're changing Bezos, probably every two to three days, just because he goes through a growth spurt. And just when you get it locked in, it changes on you. And rather than getting frustrated and saying, Well, maybe it's pumps not working, maybe you know, the insulin went bad. We say, well, probably all those things that are pretty consistently reliable, they're fine. And it's the fact that he's going through a growth spurt again, that we need to make some adjustments and not be afraid to not just change his basil by a little bit. But by, I'd like to go by a percentage. So we'll dial it in by 10% or 20% shift at a time, rather than just going up point oh, five or point one, like we used to do in the early days of being really, really slow and careful about it.

Scott Benner 41:09
I have to tell you, like hearing you say all that, it just warms my whole chest up. I'm so happy. It should

Chad Zooker, M.D. 41:15
Yeah, well, it's your fault. It's your fault completely in a good way.

Scott Benner 41:19
I just and it makes me Well, it used to make me sad. I used to think, Oh, well, some people are gonna get it and some people aren't. Right. And even when you're listening, you might think well, okay, great. Chad understands Chad went to medical school, he's obviously has an ability to understand this. I don't have that ability. But I don't think that's the case. I don't think that I've put it, it's in this podcast, in terms that I feel like are accessible to everybody. And yes, and your desire to do it. I really don't want that to come off as like insulting, but you have to want to do it, you have to like it's it's like anything else. It's like, it's how my son learned how to like deadlift, 525 pounds, he didn't just start at 525. You know, he, he started at a lower number. He dedicated himself to it. And he kept going until he accomplished step by step by step, diabetes, the same thing. It's, it's no different than any other thing. That's, that's difficult. You start you take small bites, you figure it out, you keep you keep goals, attainable, you don't look too far down the road, like I was talking about with my with my mom, like, you know, like you just do what needs to be done today. And you don't worry too much about tomorrow. Sometimes you don't worry too much about this afternoon, you know, you just you do what needs to be done right now. And eventually, through experience, both good and bad, positive and negative, you just sort of come out the other end. It's just like your rebirth and you're like, Oh, I understand diabetes. Now. Like I know how to use this sense on I know not to stare at this blood sugar all day and go this is the pumps fault. Like I have a note waiting for me right now that says I switched to an insulin pump. And this was a huge mistake. And and I was like, alright, Mike, you know, and it's my my, my kids a one C rolling daily a one C was like seven now it's seven and a half. And so I see that. And I realized what the person saying is, look, I moved to a pump and my kids average a one C daily is gone up what I what I saw was your average a one C was already too high by point and a half in my estimation. And so which indicates to me that your your settings were already not close enough. They were just you were okay with them. For some reason, maybe the doctor told you who cares why, like you were okay with a 781 C. And which means you're not using enough basil, in my estimation just blindly. And you know, you probably don't understand how to bolster your meals correctly. And now suddenly you move to a pump where they were probably the doctor probably gave you even even weaker Basal rates because they were like, We don't want you to get low with I mean, I don't know how low you're getting if you're a one C seven, right? Like so. I mean, unless you're bouncing around like crazy. And I am going to answer that person at some point. And I'm going to tell them look, your basil is probably wrong. Show me your graph, they're going to show me a graph where I'm going to imagine I'm gonna see stability around the 150 160 range. And we're going to talk about getting their basil right, making sure they're, you know, don't check your Bolus. It's the same thing over and over again. And I used to get frustrated by it, because I would think it's in the podcast. And then I realized that it's, there's going to need to be a community aspect to this too. I can't just expect everybody to do what you and your wife did pick up the stupid podcast and listen through it like it was the tour of looking for answers, you know, so So

Chad Zooker, M.D. 44:51
I was terrified about the pump. You know, my wife was pushing like, we got approval and I'm thinking like, it's only two three months and I got this I know how to use a pen. I know I need as a dose shots, why do we need a pump? And I couldn't imagine going back, we had to go back on MDI for a couple of days, because we had a failed PDM. And we're waiting for the new one to be shipped out. And we were fine. We calculated we reverse calculated what the long acting was going to be. And we were we were great for a day. But there's no way I'd want to go back to MDI after living in the pump world and being able to change basals, you know, every couple of hours, if I feel like it, it's just having that control over the, you know, the outcomes. But I absolutely understand that hesitancy and it absolutely took us time to figure out how to make those settings work for us. And not just blindly trust the our endo who be loved, but, you know, they're doing their best in the moment. But that moment in a child is going to change in two days. So having the tools to make those adjustments is critical. Rather than railing on the endo for not, you know, making adjustments for you every two or three days. Just do it yourself. Yeah,

Scott Benner 46:07
no, I I. So I'm, Jenny and I are getting ready to in to two out 2022 Actually, I've dated this episode so much. You're you're not gonna have to wait for yours. So you're just gonna have to go up soon. I'm talking about my mom and all kinds of like time related stuff. I don't want to mess people up on too much. Perfect. Yeah, you tricked me into getting your your episode off center. But, but right now Jenny and I are, it's the end of the year 2021. Yep. And in 2021, we did variables, like we leaned pretty heavily into into talking about variables with Jenny this year. And next year, we're going to readdress the Pro Tip series, like we're going to do a deeper dive on the Pro Tip series itself. And that started out by me going online and asking people like, here's an episode, what questions do you have now still, after listening to this episode, like, let's make this episode better? You know, I love it. I love that idea of basically building a, you know, a compendium to it. And and so I'm looking, I'm watching people answer. And there's part of me that's like, Oh, God, like, there are more, there's more to say, which I knew, but it still broke my heart a little bit. Like I didn't get it all completely right the first time, but it is all off the top of my head. I know, do you find that hard to believe that the protests are off the top of my head and the top of hers?

Chad Zooker, M.D. 47:25
You know, understanding? I think if I didn't have some sense of how long you've been doing this, and Jenny has been doing this and the fact that you know that, that it is what Jenny lives and you live, you know, I can I could get that. But and I will say when I listened to the pro tips, I often get to the end of the episode, and I'm like, that was really good. But I wanted more. I wanted, you know, a little deeper dive because I feel like, as you start to understand it better, like as a newbie, I would, I would have to listen to the pro tip, you know, episode five times to get it. But now I'm like, I understood everything they just said. Give me chapter two of that same topic. Now I'm ready for, you know, protein 201. And for you know, basil, 305. Class,

Scott Benner 48:10
we're gonna try. So yeah, but my point was, is that as people are answering back, it helped me realize like, it's not that I didn't know. But I was like, well, there's so much more to talk about, for some people, for the people who want it. You know what I mean? Like, it's not going to be for everybody. I think there are some people who are happy with a seven, which I don't. I mean, listen, it's, it's not for me to judge, you know, I don't I don't care what you do. And, and maybe they're in a different situation. I even understand when people say I'm too busy to listen to it, like I get it, you know, but I was a little like, like, because I think those pro tip episodes are maybe, in my estimation, the most helpful thing that I've seen, it's available freely online for people about diabetes, right? And it's the

Chad Zooker, M.D. 48:57
best advice I could give any when people ask me when sometimes, you know, a new family is diagnosed and somebody connects us with them. It's not even like the first thing out of our mouth is do you know about the Juicebox Podcast now? Go, go sign up for it. Go find the episodes, start listening to the protests. It's not even the dump, don't pass, go don't collect $200 Start that first. And we could figure out the Dexcom and everything else later,

Scott Benner 49:20
you're gonna hear something crazy. I don't normally I listened. I'm not going to now or in the future to tell you guys how much the podcast is downloaded. But you know, I'm not gonna put a real number on it because it's kind of I know, that's weird. But that in the podcast world that's pretty proprietary information that I need for sure advertising and stuff like that. But the first episode of the Pro Tip series, that to 10 its newly diagnosed or starting over has been downloaded about 50,000 times. Wow. So

Chad Zooker, M.D. 49:53
that's, I mean, it's huge. But look, we got close to 5 million type one diabetics in the US and a lot more 10 times that type two, we need to get that downloaded, you know? Oh, no, no 50 million times.

Scott Benner 50:06
First of all, I agree. Yeah. And at the same time, I can tell you that I saw a, there's another diabetes podcast that last year celebrated. And I felt really good for the person, please don't get me wrong. Like, I'm not, I'm not holding one up against the other. But for the purposes of perspective, this person said, I had a really great first year with my diabetes podcast, I had over 4000 downloads, right in the year. And, I mean, it's like 1030 in the morning, and I haven't looked at my downloads. But if I don't have 4000 downloads today, something's going really wrong chat. I gotta get on it. You know what I mean? Like, it's, it's a, it's a scope thing. And I agree with you like, once you, once you have something that's going to help people your next job is to, is to scale it, you know, and yeah, and try to reach more people. But absolutely, and hopefully a percentage of them come away with something valuable. But you really did like, what's your kids? I want to say, can you say,

Chad Zooker, M.D. 51:01
We don't like to talk numbers. But I will, I will say that our best improvement came after, you know, as we were listening to everything we're learning in the podcast. And then the other thing is, is it really we're hitting a moving target with this kid and his growth, it's I don't know where he gets it from, because he's outpaced anyone in the family. And he's, and he's got more room to go from what I can tell. But, but we're happy with where he's at. And you know, and we try to focus in, I'd like to see time and range kind of become more of a standard, but even I use a onesie, when I screen my patients, and we're talking about how diabetes may or may not affect issues with their cup regarding surgery and bone healing and everything else. My first question is, you know, what was your last day one? See? Yeah. And type ones are spot on. They know the number, you know, they're, they're not my worry, my problem children, it's my type two patients who say, what's an A one C or, you know, they're coming back with some double digit number. And having, you know, far less of an insight into why that matters, or how that matters. My type one patients are on point almost universally with, with their management with their agency and understanding how it affects them. And, and it really doesn't get in the way of our treatment. Usually.

Scott Benner 52:27
Yeah, I agree with you about time and range for certain and I didn't mean to make you upset, or uncomfortable. But you did. You started to allude to a leap, but you didn't tell me what it was.

Chad Zooker, M.D. 52:37
To sorry, to you a leap,

Scott Benner 52:39
there was some leap where you moved up a percentage or a number just you just didn't say the number, that's all?

Chad Zooker, M.D. 52:45
Well, yeah, so without saying the number, I will say, but it was when we we started doing our own adjustments. It wasn't. I know when you saw it every three months. Yeah, that was the difference when we were making adjustments every week. Not every three months. Gotcha.

Scott Benner 52:59
Excellent. No, that's a I mean, to be honest, like most of this game is being comfortable enough with the insulin to make decisions on your own. It's pretty big.

Chad Zooker, M.D. 53:09
It's huge. And I always say and I met probably stole it from you, but I don't know. Insulin works low sugar works fast. So you know, what, what are you worried about? You can you can always you can always add a little more sugar to the to the recipe if you overdo it. But it's forever trying to drag down a stubborn high. Yeah, if you're not being aggressive.

Scott Benner 53:29
It's interesting, isn't it in so many aspects where people take the physical body out of the equation for some reason, they look at the, the insulin, but they don't think about the body. Like like you said earlier, like, you know, your son's needs, you know, they they greatly change fairly consistently and, and instead of saying, oh, you know, what was the thing somebody I saw somebody say the other day, it was something about like, Oh, what happened to my blood sugar? Is it because I put a red shirt on today. And I'm like, I mean, I get that's funny. And it is fun to be light hearted about it. But you also run the risk of telling new people that this thing is unknowable. And it's, it's not an unknowable, you know, you just have to know what to look for and, and staying flexible. Like that is such a big deal. Like it just is. I mean, listen, if you have a daughter, especially one who's of menstruating age, and you don't understand the be flexible part of diabetes, you're gonna have weeks that they go poorly.

Chad Zooker, M.D. 54:27
Yeah, I read what you know what you've done in how you've finally tried to figure out the changes with menstrual cycles and other people in the in the podcast group. And on the one hand, where, you know, we don't love being in this club that we're all in for type one, but we do sometimes say wow, managing his changes with growth and puberty are one thing but at least we're not trying to manage, you know, a monthly change and doubling a Basal with a menstrual cycle, which seems so hard to keep in range and to stay consistent and And hats off to the to the parents of women type one women and type one women out there who are, you know, at that, that extra burden of trying to keep that with a week to week, you know little doubling of Basal needs is just hard to fathom.

Scott Benner 55:21
It's like you're going for a walk and someone's like you should take a bag with 50 pounds or oxen it right? Wait, I wasn't walking up the mountain enough, you should definitely carry a bag or 50 pounds or oxidant that'll that'll really, you know, let's test you a little bit. You know, chat chat, I'm having a wonderful time talking to you. I've realized now I've taken you over the time. And I haven't asked you if you're okay with that. And

Chad Zooker, M.D. 55:43
I am and I blocked off. This is a rare treat for me because my Wednesdays are usually a really hectic office day. And I actually blocked off the whole morning, I don't have patients till the afternoon. So I'm happy to stay on longer. Or if you want to dig in on some orthopedic specific stuff, I'm more than happy to stay on.

Scott Benner 56:01
I'm completely touched. And what I was gonna say is, we have not yet covered any of the reasons why you asked to be on the podcast, and I'm looking at, I'm looking at my counter up here and we're like cresting an hour. And I was like when I've done it again, I just so specifically to your to your practice. I did find myself wondering when you're talking about type twos? I mean, is it just general health, that keeps people from healing or from not being injured? Or, you know, can you point specifically to diabetes impacts on joints and muscles and ligaments.

Chad Zooker, M.D. 56:38
So, you know, as I was doing a little prep work last night, I was looking at some research just to kind of freshen up things and numbers. There's some studies out there, they actually show a one C doesn't have an effect, if you just look at that single number as a risk factor for an infection after a knee replacement or a wound infection after a surgery. If I look as a whole, if I just take my gestalt of taking care of people now that I've been in practice 10 years. Type Two diabetics are a wide wide range of patients, because you have some that are barely type two that are have an elevated agency and are diet controlled, and you have some that are just poorly managed. They're on insulin already. And it's a slippery slope. In my mind, when you have type two diabetes and insulin, I feel like sometimes you're almost feeding the the resistance, because you're just pumping, your body's already pumped more insulin into the system. And that wasn't enough. So now we're adding extra outside insulin. And there's a lot of lifestyle issues related to activity, how much exercise we're getting, how active people's lifestyles are from work and nonwork. Diets are huge. I think as doctors, we are awful. Just god awful at understanding nutrition. And we don't teach we meaning we are not teaching any doctors, but nobody really gave me a great instruction on nutrition. And I've had an interest in it for my own personal health reasons and absolutely double down on it now that I'm trying to understand nutrition better for our son. So there's a whole host of things that I think make treating a type one and type two diabetic, really a different patient when you stratify risk, and you talk about you know, how was my diabetes going to affect my outcome, whether it's a fracture, a surgery, a sprain. And just to circle back because we've talked about spraying tear when we talk about the grade of tear so so when you sprain something, you stretch and or tear it. So a grade one sprain is a little stretch. But as we start to tear that structure that ligament, then you get into higher grade grade two, grade three. So also, you know, discussing terminology with patients and but yeah, so So diabetes affects things, but it doesn't have to, and I think it's greater than just your a one C or greater than just your, your, you know, fasting blood sugar. It's what are the factors in your life that have led to that point in time? And how are you managing your overall general health in terms of diet and exercise? That absolutely has got to be part of our discussion. When we talk about orthopedic injuries, it's not enough for me to fix you, and put the broken thing back together when you gotta get the function back into the system somehow, and that's going to take effort from you know, from the patient and from physical therapy and attitude and effort are the two things I can't give you. But I can actually put, you know, emphasize they're important. I have to

Scott Benner 59:46
say that I've been surprised through COVID that in a in a worldwide scenario where it became pretty obvious that your general health had a lot to do with you being able to fight COVID that, yeah, we didn't talk about it at all, like as a country or through medicine or social media, it just in general did not get spoken about very much. And to go back to what you said a minute ago, about you were specifically talking about type twos. And you said, you feel like sometimes it's a slippery slope using insulin, I felt like what you were saying was that sometimes people skip over the lifestyle factors that they have, that they could try to change and jump right to the insulin is and right. So you're skipping problem A and just addressing what problem a is a is, is adding to is that? Am I understanding? Yeah, yeah,

Chad Zooker, M.D. 1:00:41
it's, you know, insulin resistance your body, your body doesn't respond to insulin anymore. And we deal with this with type one. Also, sometimes when you've had sometimes long standing type one or maybe other lifestyle issues that are giving you some resistance, in addition to the fact that you don't make any to begin with. But yeah, the how do we improve our insulin resistance, and once again, I'm not a medical doctor, I'd say all the time to my patients, I'm a, I'm a glorified mechanic. But if I had a minor in any part of medicine, now it's diabetes. And now I understand type one and type 220 times better than I ever did. So insulin resistance, we can change that. So when somebody has type two, and we say, you know, you can, you can get rid of your type two, there's truth to that if we make modifications to our diet, and have less of a need for insulin in the foods we eat. And we also need to increase the sensitivity of our tissue, and what's one of the biggest tissue that's going to drive glucose out of your blood, it's our muscle. So if we make more and bigger muscles, now all of a sudden, our body is helping us to need that glucose to get out of the blood. And the if you look now, and you get a little nerdy on the science, there are regulated, there are receptors on our muscles for glucose, and insulin, helps to unlock that receptor key and the lock opens up glucose goes on the muscle. How do we get that? How do we get that door to open up more frequently and more doors to open? Well, you're gonna have to use that muscle and going for a walk is good. That's a good start. But what if we added some weightlifting to it also, then we start to really make some shifts here in the metabolism side of things. And if we also change, and I always talk to patients about weight loss, because it affects knee pain and arthritis, and, and I always say, we're going to work on our weight loss in the kitchen that's not in the gym, we're not going to chase a bad diet. So what are the dietary changes we're going to make that are going to help us and it's not a one size fits all. I mean, I mean, there's so many diets out there, and there's probably a diet that's perfect for every person on the planet, but it's not the same one. And I encourage a lot of trial and error. And we talk about low carb diets, and I've talked about Paleo diets with patients, and they get all hyped about keto and SR, let's talk about keto. And let's understand what that really means in terms of what your intake is going to be and how sustainable is that going to be for more than a few weeks or a month. And I spend a lot more time than I thought I ever would as a orthopod, who just likes to do surgery, talking about diet modifications, lifestyle changes, getting a proper exercise, I get patients that say, show me your squat, and let's squat down here and start making some form corrections. When people say it hurts when I squat, and I don't accept that if it hurts when you squat, you shouldn't squat. I say well, let's let's see why it hurts. And that's actually teach you how to do that better and get some physical therapy involved or a trainer involved. Yeah, it's huge. The lifestyle piece is is far better than I can do surgery wise for a lot of my patients.

Scott Benner 1:03:47
Well, I appreciate you bringing it up, because a lot of people don't want to talk about it, it's it now. Well, and you you you run the risk of offending people too. I think that I think it's important to say that, that you know, when you specifically talking about type twos, and insulin resistance, I'm not even talking about your your body makeup, you know, you could look thin, you could look heavy, and have type two diabetes, it, it doesn't matter, it's how your body's dealing with it. I think that what you said about just lifting heavier things. I mean, I'm I'm as far from a doctor as there could possibly be but it seems to me that we are basically like organisms that are machines, right? Like your your lifecycle is you you're born you grow to a to a size where you can be valuable to the clan, right. And that and that used to mean walking around lifting things carrying things and now it means making a podcast and sitting in this chair. And so your body very well may see your lifestyle as Oh, you know, I guess it's okay if we start aging out now because he's not helping the clan. You know, and so you have to go We'll make that somewhere else. Yeah,

Chad Zooker, M.D. 1:05:02
I mean, all the time, we talked about that the evolution of the human form the human body, we're living in a body that evolved 1000s of years ago to hunter gatherer. And there's really nothing, you know, our, our lifestyles changed. And now you don't have to go out and hunt, you know, a buffalo to survive off the meat, you can go to the corner of convenience store and Hunter bag of chips. So it's a problem with that we have this, you know, this calories all around us, and a lot less effort required to achieve them. And we earn our key by sitting in front of computer screens now. So, which I think is great. I mean, I am not lifting heavy boxes in a warehouse, I'd sit in on a stool and I stand up and walk around, and I stand still for hours, at a time doing surgery. But I have to fill my other time with lifting heavy things. And, you know, doing extra exercise and activity that takes advantage of the fact that my joints do move, and the muscles do move. And that's absolutely, it's a hard sell a little bit, even though it makes perfect sense if you explain it the right way. But it's hard, you got to do the work,

Scott Benner 1:06:13
he used the example of a person working in a warehouse person working in a warehouse that they're living, you know, working day is that they have to supplement it in their personal time with rest, you know, because they can't just go and they're normally you see, those people are in incredible shape, you know, because they're, they're basically exercising all day as part of their job. You just flip that around, if you're a person like me who sits around all day working, then when in your personal time, I need to move. But it's I mean, it's not rocket science, right? Like, we not really need a certain amount of, of movement, we need a certain amount of, of heavy weightlifting, whatever heavy is to you. Like you don't need to, you need to yank up 525 pounds, my kids trying to throw a baseball through a brick wall, you mean like you're just trying for your muscles to stay taut, active, little larger, so that you burn off your insulin, you're well and you manage your insulin well through your gen, he talks about all the time how people with good muscular skeletons, you know, man that they have lower insulin needs, usually, you know, and

Chad Zooker, M.D. 1:07:21
if you it makes sense if you understand the physiology involved, if you. So always, I always like to use these kind of make it simple analogies. But when we talk about I talked to people about exercise, and all they're doing is maybe running on a treadmill, or they're riding a bike, but they're not doing any weight training or stretching or yoga. So if you get on the bike today, and you ride the bike for 30 minutes, you burn calories for 30 minutes, your muscles work for 30 minutes, and that's good work. But as soon as you stop that ride, the factory is closed, the lights go off, the workers go home, and there's no more work being done. If I go lift weights for 30 minutes, I'm actually creating not in a bad way. But I'm creating some little micro tears, a little bit of damage going on. To use resistance, if I'm using, you know, a heavyweight and the muscle responds, by getting stronger by getting larger in terms of the muscle units by recruiting more muscle units to do work, that magic happens after I put the weight down and I walk away, and I go to sleep that night. And that, that that factory is still burning that third shift overnight when I lifted weights, so they're both important, but but they do different things. And you can keep your metabolism running, you know paths passively when you're not doing anything if you've done some resistance exercise as part of your overall you know, weekly repertoire of activity.

Scott Benner 1:08:46
Your your I just did a variable on I think exercise. Got I think I did I gotta be honest with you, Chad, this podcast is a blur to me sometimes, but where I remember Jenny talking about those exact things about the difference between resistance. And you know, and anaerobic. My son was just telling me about a teammate of his who's doing this thing now where he just puts his feet he stands up with his feet apart. And then he basically tries to rip the ground open with his legs, like interested in you know, he's pushing out with his feet. And my son's like, I watch him and he he's working harder than people who are throwing around 400 pounds. And yeah, and he's like, it's just he and the kid thinks he's getting stronger from it. You know, like, it's just,

Chad Zooker, M.D. 1:09:32
he's doing an isometric exercise. He's he's firing his, you know, his glutes, the muscles on the side of our hips, which don't get nearly enough love as they should. He's got to fire those muscles to spread the earth apart between between his feet, right? So there's something happening there even though if you're watching him, you know, you're like, wow, I was just filming like a weird tick tock or what's happening.

Scott Benner 1:09:55
My kids my kids like my God, he's like, he's sweating and like it's hard. You Am I making this up? And maybe you don't know isometric exercise developed by a man who got caught in a cabin in a, you know, lands like snow? What is it called when snow goes over a mountain? Avalanche, avalanche, and he stuck in there for like months, and he kept himself in amazing shape pushing on doorframes and things like that. Am I making that up?

Chad Zooker, M.D. 1:10:21
I don't know. But I like I mean, it sounds plausible. So

Scott Benner 1:10:25
like, let's pretend it's fact. And yeah,

Chad Zooker, M.D. 1:10:27
it's a that's exactly what I learned in an isometric muscle school. That sounds right. Yeah, that's crazy.

Scott Benner 1:10:31
Yeah, you can Google it on your own time, if you want. It's just how I heard it. That's really something I appreciate you talking about all this? Is there more? Is there anything else you want to talk about?

Chad Zooker, M.D. 1:10:42
Well, I mean, so I mean, I could talk about this topic for for days, because that's just I'm, I'm a geek when it comes to movement and the importance of it. And that's what I spend most of my day talking to patients about, you got to move more, you know, whether we're talking about your rotator cuff tendinitis that's shorter is achy from sitting in front of the computer too much, or we're trying to understand why sitting is bad for us and how we have to counterbalance it. But I think as a surgeon, one thing I also want to bring up because I see it come up not infrequently now is with surgery, and having surgery and our devices and our pumps and our index coms. And libre, and what have you, I think I'm always an advocate for that being part of your you know, that all stays on. And my or I almost, I don't usually lose my cool, but I got hot last week when I got an email about a type one patient coming up for a shoulder scope. And it was even like brought up like, are they going to be allowed to have their devices and it wasn't coming from. I'm not sure kind of who had put that idea in the patient's head, it might have been like a pre op exam. But I think that is such an easy tool for it to help us. So I was I always want patients to know, your doctor number one should be on your team. If you're certainly not advocating for you to keep all that stuff on and the O R, then you got to you got to be a little pushy. The anesthesia doctors I work with absolutely loved the technology because it makes their job way easier to have the ability to watch your blood sugar and not have to worry about it during surgery. And I think that that's something that, you know, I see a lot of people when they're having a procedure or surgery, they're always worried about that, but it seems like they're afraid to ask and that should absolutely be something you asked your your physician, your your surgeon, your anesthesia doctor, if you're in a hospital, if you're admitted to the hospital for whatever reason. Don't ever let anyone tell you you can't have your devices. And make us think and ask for a charge nurse and ask for a patient advocate. And if your doctor isn't, you know, writing an order to say patient may use their own pump or may use their own CGM, you know, then then be a little bit more pushy about it or wanting to say get another doctor. But

Scott Benner 1:13:06
yeah, what happens when the doctors keep pushing back like this is not apples to apples, but I'm speaking with three different people right now who have a TSH level. That indicates to me and anybody who really understands thyroid that they need a thyroid replacement hormone, right? But their doctors subscribe to the idea that if your TSH isn't over 10 then you don't get a thyroid replacement hormone. This one one is a kid who's falling asleep basically hair's falling out. We can't, like you know, doctors like oh no, TSH isn't high. It's not that another one's a woman I just started talking to this morning in Australia who's like, and she and she brought up this great point like the doctor shopping is expensive. Like, like, how many doctors do I need to go to before I hit one of those? Yeah, here it takes some Synthroid. You know what I mean? And what happens when you're advocating for yourself, but in the midst of advocating someone standing in front of you, who's holding the key going now, you can't come in? Like, like, what do you do?

Chad Zooker, M.D. 1:14:08
Yeah. Well, this is tough because you know, it's not fair or right, that you have sort of that mentality and you see this with what you mentioned with the TSH and treating thyroid, you see it with the loopers. When we get into those folks who have chosen to do a DIY DIY looping and their endos aren't supportive or sometimes when you know you're stuck maybe between geographically between a rough location or long distance between any providers and a direction and you're just trying to get supplies. So the number one you got to advocate for yourself and if you feel strongly enough that maybe your doctor is not pursuing the right avenues, it's always okay to go to another doctor. And I never discourage second opinions. I offer patients I say Let me you know, you won't offend me. Have you seen one of my partners in my group, I'll send you to someone else in town I trust at least let me help you find someone I know is, understands this problem well, so that you're not getting the opinion of someone that's not qualified. Any doctor who's afraid of a second opinion or fights back on it, that's, to me, that's a red flag. And it's sticky. When we deal with something like diabetes management where you know, you may not be able to just, you know, disconnect your doctor, and then worry about who's going to write your prescriptions when you need insulin, but it's okay to shop around or, or not so much going to 10 Different doctors, but, you know, you've put up the section of the website where you track kind of that kind of the good doctors, people like, the Facebook groups are great, you know, find the group in your area geographically, and who do you like and who's sympathetic to this problem, or, you know, who's got thyroid issues that's got an endo, that's really proactive. So you got to do a little bit of work here and be willing to maybe leave a doctor you really like for 99% of it, but the 1% is driving you crazy that they won't get behind.

Scott Benner 1:16:09
I worry, I worry about the problem associated with well thyroid and diabetes, where if your health is so far out of whack, that you can you can be there just a fraction of who you are physically and mentally. You know what I mean? And you're in you're like, you're like, Well, you got to fight you got to ask you how to go on, you're like, I can't lift my head up I, when my when my iron got really low. There was a moment where I was just there going, like, Look, if someone doesn't help me, I'm going to die. Like I can't get up and help myself now. And I think when your blood sugars are super low or super high or bouncing around, where you're, you know where your thyroid so whacked out of your skull that you can barely breathe walking upstairs or keep your eyes open. Like how do you fight in that situation? Like at what point do we expect somebody to know their job and not just look at the finger? Oh, it's in range. It's I know,

Chad Zooker, M.D. 1:16:59
it's it's tough. And I'm, you know, I am, I love my specialty. And I'm blessed to deal with. I love the musculoskeletal system and I can I'm comfortable fixing things. If something's broke, I fix it. It's torn, I reconstructed. You tear your ACL, I'll make you a new one. And that's such an easier kind of treatment tree to go through. And that's why I chose orthopedics because I didn't like medicine where all right, you got something wrong. Let's give you a pill. And let's wait a month and see if it works. And then it worked a little bit. Let's give you a double the dose. Well, let's try another pill. So I don't I like that concreteness of something's broke, I fix it.

Scott Benner 1:17:36
Don't get me wrong. I know there was there was no answer your question, but it I know, it needs to be asked. So the people listening can hear that? There's no answer to the question. Yeah,

Chad Zooker, M.D. 1:17:45
I think just just like this podcast emboldened you to take care of your diabetes and your day to day management. Use that set that same mindset of okay, so I think I'm doing okay, on the insulin and the diabetes in the blood sugar, the thyroid is where I'm not. So what am I going to have to do? I can't prescribe myself Synthroid. But I know that whomever is is taking care of this problem now is not the right guy for the job of the right guy for the job. So you're gonna have to do a little legwork, maybe, and maybe not physical, like get up and go to places but start asking people talk to your primary care physician and say, you know, who do you like not for diabetes? Just say, say, what do you do with your patients with hyperthyroid? Where are you sending them? Are you treating them yourself? A lot of primary care doctors take care of thyroid dysfunction, because it's so common. We talk about it in the context of diabetes all the time, because of the autoimmune issue, but there's a lot more people with thyroid issues that are not diabetic than our Yeah. So it doesn't just fall into the to the endos bucket, it falls into most primary care doctors and you know, and so being willing to just expand your thought process a little bit and maybe not, you know, filter everything through your Endo, because you trust them so much for type one, but maybe you need your endo for type one, and maybe you trust your PCP to manage your thyroid,

Scott Benner 1:19:14
I'm gonna tell you something. And then I'm gonna ask your questions I'm gonna let you out of here. So I just had this private conversation with somebody the other day, it's not important who it was or why it came up. And this is what I said, after watching diabetes for so long with my my daughter, after watching thyroid for so long with my wife, then with my daughter, and now my son who has Hashimotos and then watching my mom, go through her diagnosis and figure out that she has cancer and needs to have it removed and everything that comes along with it. What I've come to the conclusion is, yes, the system doesn't work properly. A lot of the times for people in these situations, but if you think the answer It is we'll fix the system, you're out of your mind. And you're about to waste your like, I'm not saying you shouldn't try to fix the system, go ahead, if you've got free time, go ahead and rail against the wind and try to make the world work a different way and etc. But just remember that people are the failing of the system, and the system is built on people. And so you can't fundamentally, like just look at how we're talking about diabetes, you can't, that's just one little idea. You can't fundamentally fix the world, you have to get in there and fight for yourself, there's no, you, you're still going to have your health problems. If the system's broke, you understanding the system's broke, isn't going to make your health problems go away. It's just an excuse. It's, it's well, I can't do this the system I live in Canada, they give us a sliding scale. My doctor, my doctor doesn't understand that my TSH might be four and I have symptoms. And if they gave me Synthroid, the symptoms would go away, my life would be better. It doesn't matter. Like I mean, it does. And in a perfect world, if I had a magic wand, I'd fix it for you. But that's not going to happen. And that's where you got to set your mind right and get to work. You either want to have success in your health, and you're willing to work on it by yourself, or you're going to have what I consider to be at this point. Now now that I've gone through it a bit of a childish attitude that there are magic people in the world who fix problems. It's just it's not how it goes, Man, there are there are regular people, and there are some people who help you with your health. But some of them are great. And some of them don't have all the information they need. And some of them were just really good at the book learning and wanted to make a bunch of money. Like you don't I mean, like you're gonna get a mixture of all these people, you spending time banging your head against the wall going, This isn't fair, or this isn't right, or it shouldn't be better. It that isn't going to help anything.

Chad Zooker, M.D. 1:21:57
I early in practice, I came to the realization, and I'm a doctor, I took an oath to do no harm. I am in this for helping people primarily and I'm blessed, I can make a nice living because I'm in a specialty that does well. But I'm not I'm not here, you know, just to cash out. And if you are medicines, the wrong the wrong place to be anyway. But you learn early on, you can't help everybody. But you can help those people who want to help themselves. And you start to really see the difference between somebody who really needs help wants help. And someone that is not going to do anything to help themselves. And it doesn't matter what you tell them what you prescribe them. And what you need to focus 80% of your effort is into that, you know, into those patients that you can help and not into the 20% that are never going to help themselves. Don't put 80% of your effort into the 20% that can't do anything for themselves or won't. And that's I'm not I don't want to sound harsh or callous, because I'm the doctor and I can just you know, either take my advice or leave it but I don't give people advice and spend my schedule is a wreck, I never stay on time. And it's because I spend time with each patient for what they need. And when I start to realize that someone isn't going to help themselves, I don't say Well, look, this isn't working, you can't come back, I'm not going to see anymore. I'll keep giving them the same set of recommendations, we'll have that talk again and again. But I'm going to bend over backwards for that patient that I really think needs, needs the extra help, and we'll take it and we'll run with it. You know, and you see it on the podcast, we still in the Facebook, when somebody puts a post up as a piece of cake blood sugar is 400 Ugh, diabetes sucks, help versus, you know, ate a piece of cake. Here's what I bolused. Here's my curve, you know, and gives you all this information is like you could tell they really want to understand where they could have been better, way more easier way more helpful for that person. And also for anyone else who comes after and sees that post. Wow, I have a similar situation. I can understand all the variables in this equation, versus I just want to complain about it but not do anything about it and said

Scott Benner 1:24:09
you don't need me to but I'll stand with your statement. Because very recently someone asked me, What are some of the leaps that I've made doing this thing that I do? Like where are some of my my learnings and you know, how did I kind of Vault forward and I said, I said one of them was the day that I recognized that I can't help everybody. You know that that was a big deal for me. Because you you get chained to I don't even know how to put it like, there. It's um, I think I've learned to talk about it like this, like in a class of 20 people. You might have four brilliant kids, you know, the kids in the middle might be pretty average there might be three or four at the end who are really struggling. And we seem to teach to the three struggling kids and It feels kind. But we don't talk about how that eliminates real success for the other 17, who could take more and jump forward with it. And I think it's the same thing as what you just said. And I just, I recognize that at some point like I can, I can put this information out there. Hopefully people can take it up on their own and use it if they can't, I'm willing to try everything. I mean, I've built a fairly fantastic Facebook group for you to go talk to each other. And it is unlike most Facebook groups, and that there's really very little bickering people aren't mean to each other. You know, like, it's, it's, it's, it's not censored. You know what I mean? Like people's posts don't get deleted, because you say something I don't like I don't give a crap. If you know, I don't agree with you, if it's your truth, it's good with me. But that I can't stand back with those three people, and die with them and not help the other 17. And that's what I figured out I was doing at one point as I was going down with the ship, instead of taking the life raft that was offered. And you know, there were other people who could have gotten the boat. And they chose not to. And there are times, and I know this doesn't sound great, but there are times that some of those people can't get into the boat, and I can't physically get them in either. And that's when you have to say, This is sad, but I don't think I can help that person. Like the thing I have to offer is not valuable to them at all. I've done my best to boil down and simplify everything I'm saying I think it is accessible to most people. You know, intellectually assessable is what I mean. And, and if it's not, this is the best I can do. Like I've offered you the best options that that are running out of my head and keeping in mind that I am not a structured person. Like if you've if you've ever listened to those protests, like just keep in mind, I get Jenny when I can get Jenny. She pops on in front of me. And I said to her, Hey, can we talk about insulin today? Hey, can we talk about MDI today? Let's talk about CGM. Today, I want to make it a prototype. Let's drill down on it. She's not prepared when I start talking. And I'm not either and you might think, well, you should be except I'm a guy. Like I'm one literally one person. I was looking at the charts yesterday for Apple podcasts in medicine. And I consistently chart at the top of medicine in the top 20 to 30. With podcasts that are actual businesses that have like, you know, business partners and marketing departments and producers and audio technicians and you know, money coming in like, right, I'm hanging with them. It's me, man. Like, like, it's the editing the setting up of the the interviews, how the interviews go, like, it's, it's, it's all on me, and I don't have like, I mean, listen, if you're listening, and you'd like to infuse a million dollars into the podcast, I'll hire people right away, trust me, and I think I could grow it and probably get your money back. But I otherwise I don't have that. You know. So

Chad Zooker, M.D. 1:28:03
that's why we that's why we like it, it is Jen, it's still genuinely, it's a dad talking about, you know, his experience. And I think that comes that comes across your intention is still pretty, pretty honest. And I don't think any of us begrudge you in this community. Any, you know, sponsorship, and any financial gains that may come as you grow this out, but it's still it's still, it's not coming from that place. It's coming from, I've learned some stuff, I think it'll help you, hey, if you want to dial in, it can help you to if you don't want it to now. That's okay. There's you know, 10s of 1000s of other people that are really digging this right now,

Scott Benner 1:28:43
I appreciate that. I don't feel badly about the about having advertisers. I mean, genuinely, I have, I have bills and children, and also my wife, I don't think, like try to imagine if my wife was married to a guy sitting in a room talking to a microphone and it didn't earn any money, don't you think she'd be like, oh, and but but the other side of it is I just couldn't do it. Like, I know, it's not for you guys to worry about. But I mean, I, I sat up here yesterday for the better part of 13 hours working on this podcast, you know, like I didn't like their leaves on my yard that need to be picked up. Other such things that I ignored to make sure that next week those episodes come out for you and that they're entertaining and provide quality for you. In different aspects of your life. It's a full time job. It really is. If I had help, it would still be a full time job. But anyway, the point is, is you don't leave people behind on purpose. It becomes circumstantial at some point. It's just there's nothing left for you to do. And hopefully and by the way, I it's not a hopeless situation. Because I have you know for the better for lack of a better term left people behind who six months later, come back and say, I wasn't in the right frame of mind back then. But I am now and I'm getting it. And so maybe just exposing them to it is a is a kindness, you know, in itself. So it's all you can cross my fingers.

Chad Zooker, M.D. 1:30:14
You help the ones you can help. And it's not. There's good doctors, as bad doctors as better doctors. Most of us get into this path with the willingness to want the burn to help people on on whatever level we can. And it's hard, the system is broken. It's frustrating, it's dealing with insurance companies, there's so many distractions in my day that have very little to do with helping patients that keep trying to edge in and you keep pushing out. But if I can get that spark, that patient clicks in the room, our eyes meet, I said something that made sense. And they actually come back a few months later, and they did it. And they're feeling better. They've lost weight, whatever it was, you know, that's it. That's That's what keeps you going. Because you realize that you're reaching somebody. So you're reaching lots of lots of somebody's but you get that feedback. And that just wants you to help another one help another one it you know, somebody's listening out there. Even if it's sifting through, you know, lots of people who aren't ready to help themselves to find the one that is, yeah,

Scott Benner 1:31:24
I listen, I wish there are times I wish I had a call yesterday for an hour with a new, an old sponsor that's coming back, right. And I'll be able to explain it better later. But I said to them in the meeting, like you have to understand the podcast exists because I want to help people. I'm taking your ad because I need your money to help those people. And I think that you have a genuinely valuable quality product here. Like I said, there are other people I could have taken this ad from and there are plenty of people have asked, but yours is I'm specifically comfortable taking your money. I said, but just keep in mind, like I will do my best to let people know about your product. And I hope they click to learn more. And if they want it, that's terrific. But don't make any mistake, I just need your money. So I can talk to these people and pay my bills. Like you'd never had a more honest business meeting than you'll have with me. And so and I said, you know, if you were just some like low carb, like, Bs, like thing of the month or something, and I get those emails all day long, I don't even answer them. I just delete them. Like I'm not gonna get involved in your, you know, your fly by night thing where you're trying to get rich real quick off of people like I don't, you should see the people that I that I gate from getting to you. It's trust me it's a it's a thing. But um, that's it to me, like I'm trying to help people and if I can I can I need money to do it. I mean, again, my my daughter said to me other day, she's like, don't you think one rich person listens? I was like, What do you think? You think someone's just gonna send a couple mil over here, so I don't have to take ads anymore. And she goes, maybe and I was like, Oh, all right. Well, I guess I would be okay.

Chad Zooker, M.D. 1:33:10
It just takes one. Yeah.

Scott Benner 1:33:12
She and I were laughing about it. But I was like, I don't think that's how it's gonna work. Sweetie. I was like, and I don't mind the ads. I'm an American, um, I'm down with, you know, consumerism and, and how this place works like I'm okay with with how this goes. I don't have any bad feelings about at all. So here's my next question. Arden we'll talk about my ankles hurt when she you know, my knees hurt my wrists hurt. You know, we've we've optimized Arden's health in every way that we can think of her her thyroid is amazingly maintained her blood sugar's are very well maintained. She takes you know, we even did a poop sample God she is going to one day listen to this and just be like you. My both of my kids did it to measure their gut biome, the other taking, you know, some pretty like strong probiotic stuff to like, balance their gut biome, like I've done everything I can do. Okay, right. And, and she'll still come up and be like, my wrist hurts. And she wants me to put my thumb in the top of her wrist like what feels like the joint between your hand and your your arm and my finger on the other side squeeze so that it's hard so that it almost creates a separation in the joint and then wiggle her hand back and forth. And when I do that, to me, my hand goes back and forth. When you do it to her, it clicks and pops and snaps in her wrist.

Chad Zooker, M.D. 1:34:35
Okay? But it hurts or it doesn't hurt. She

Scott Benner 1:34:39
She does not like it. And she's been by the way to a rheumatory specialist and she doesn't have arthritis.

Chad Zooker, M.D. 1:34:47
And she's had X rays of arrest at some point.

Scott Benner 1:34:49
I mean, I've chatted too long life. I don't I don't think of a risk no like I don't think he's ever had X rays like Could it just be like a, like a physical

Chad Zooker, M.D. 1:35:00
It can be has you ever heard of a wrist and she'd do any gymnastics or anything really wrist heavy in her past sports lives? No,

Scott Benner 1:35:07
but I can tell you as weird as that sounds, my wife has a similar thing in her wrist. It's not nearly as bad though.

Chad Zooker, M.D. 1:35:13
Okay. I mean, there's some there are some less common things congenital differences and how we're built and things will definitely get passed on from parent to child. The wrist is complicated I, I treat wrist basic stuff, I have two hands specialists in my group, anything weird that goes right to either of those two, because they are so honed in on all the little joints. And there's there's a joint between your two forearm bones right at the wrist, there's eight little bones in there, we call the carpals. And then you get into the base of the hand and every place two bones meet as a joint and an opportunity for something weird and unique to happen. So I generally tell patients to ignore clicking, I say we're mechanical animals, we move to like our car engine, so we should make noise. But when it's painful, and it's reproducible, so you can you can make that happen the same way every time. And if it's not happening on the other side, it's probably worth seeing, at least you know, somebody that's a hand and wrist specialist in your area, minimum gets some X rays, let them do some of the other special little exams that we do around the hand and wrist and dig in there. And if you know, if you're like us that deductible is met, you know, within two months into the new year. So getting an MRI or if there's any process to this club we're in getting an MRI is not can be a great way to look at some of those tiny little joints. And there are some there's a little thing called the TFCC. That's a like a little meniscus and part of your wrist. The diu J is the distal radioulnar joint, it's where those two forearm bones meet. There's some weird and unique things. And it's probably worth looking at if for no other reason than just to cross off a mechanical problem.

Scott Benner 1:36:56
She told me the other day they were playing volleyball in school and she bumped the ball with that, like that top of her forearm and she said a pain shot from her wrist right upper arm indoor, indoor neck.

Chad Zooker, M.D. 1:37:09
So it's Yes, I believe the pain went that far that way. But we don't have like a nerve that goes up uphill. Yeah, you could get a pinched nerve in your neck coming all the way down to that part of the risk for sure. But it sounds like whatever's going on here is right in that joint. So I don't think it's necessarily dangerous to keep playing, I think she can put weight on her hand and do push ups, planks and other things. Sometimes that's helpful. If she's not doing some forearm and wrist stretches or not doing any yoga, we could maybe use that as a way to pull her in to do some plank positions down dog some of those things that forced the wrist into a couple of different stretches than we get from regular activity. But it would probably be I would recommend seeing, you know, a hand doc in your area. And if we want to talk offline or email me, you know, location wise, I can see who I might know or what places I might like in a given region of the country where there's good hand,

Scott Benner 1:38:12
a FedEx box and senator to Baltimore. So it doesn't matter. We got

Chad Zooker, M.D. 1:38:15
to we got to, I've got two great partners in my group that are awesome. And we also have the Curtis National Hand Center in Baltimore. So we've got great hand hand care in Baltimore.

Scott Benner 1:38:24
My muscles like I'm not flexible, Arden's not like she's, you know, Arden likes incredibly hard rubs, like incredibly hard massage, like to the point where if you did to somebody else, they'd be like, my god, that's insane. You know, like, she's, she and I are both the kind of people who will lay on the floor and be like, can someone just walk on my back for a while, you know, please. But it's hard. That kind of stuff is difficult to pick through. So I appreciate your input on it. I really do. Anytime, anytime. Is there anything we didn't talk about yet? I can't believe there is. But

Chad Zooker, M.D. 1:38:55
I don't think because I did and I didn't work her in earlier, but I got to give a little shout out to to my daughter, who is she's 15. So we have two children. Our type one is 12. His sister is just absolutely amazing. And is a super advocate for all things type one and all things related to her brother, and they are incessantly teasing one another out of good natured ribbing that we all do in this house, but luckily, not any fist fighting. So I gotta I gotta throw a little little shout out to her because I didn't get a chance to work her in. Excellent.

Scott Benner 1:39:30
Well, I think everybody appreciates getting support. So that's really cool over to do. My kids are very similar with each other. So my wife's like, what are they doing? I'm like, they're just being brother and sister leave them alone.

Chad Zooker, M.D. 1:39:43
I told her early on, you know, because because we saw that our son was on a trajectory to be larger than average. I said, Be nice to him now, because I have a feeling he's going to be the biggest person in this house by the time he's done growing. And so now he's the tallest I still have at least 50 Plus pounds on him. But I think, you know, once I get him in the weight room, when he's a little older, he'll he'll easily surpass that me too.

Scott Benner 1:40:06
My son sent me a video of him doing a deadlift that was like five, like over 525. And I sent it to my friend. And he goes, Well, I guess you've told him the last thing you're ever gonna tell him? And I was like, yeah, so I think I think my kid could just grab me by the shoulders and toss me aside if he wanted to. So

Chad Zooker, M.D. 1:40:23
that's a little that's a legitimate, we talked about how much someone should lift if we're talking about a division one college level athlete, a multiplier of body weight is how we talk about those things. So he's deadlifting, more than twice his body weight. So, you know, that's, that's a very good you know, threshold that we want to be at or above when you when you talk about what it takes to be at a certain level of play.

Scott Benner 1:40:48
Yeah, he actually said to me that he's really thoughtful. Personally, he called me the other day he FaceTime that, by the way, kids don't call they always FaceTime doesn't matter if they're driving or walking. I'm like, you know, that other button if you just touched the picture, the anyway. So he's like, I don't need to lift more weight than I'm lifting. And I'm like, why he goes, it's stupid. He goes, what he's like, where's this going to end? And I was like, right? He goes, I'm gonna work more on flexibility to I mean, he's like, I'm gonna keep lifting where I'm lifting, but I want to work more on flexibility. I'm gonna look at that ISO stuff that my friends doing. And I was like, okay, he goes, I mean, he's, like, what's the point? If I deadlift 600 pounds, he's like, you know, at some point, that's not going to help he gets

Chad Zooker, M.D. 1:41:27
it gets into goal setting. So I also talk to patients, what do you like, why are you doing this, when we talk about what you're doing for exercise, his goal is to be a better baseball player to be better at his position at hitting and running. So he's not trying to deadlift, you know, in powerlifting competition, so he's kind of right. And he should work on his flexibility, because that's, that's the third piece of the puzzle, its movement, its strength and flexibility is that third leg that needs to be there, but um, so, so not not only, you know, reframing that discussion and say, Alright, so what are the what are the goals, we're going to set and then lifting accordingly with proper schemes and maybe resetting some of his rep schemes to be, you know, maintained, but also not reaching for higher and higher and risking injury or just deadlifting? You know, 600 to deadlift. 600. Yeah,

Scott Benner 1:42:18
that's it. He came to it on his own. I was like, I think you're right. And he's like, Alright, I gotta go. Okay.

Chad Zooker, M.D. 1:42:24
It almost sounds like he's becoming a mature young man. Yeah,

Scott Benner 1:42:26
he's just, he's just running it past me real quick. And I was happy. He had a good idea. He was looking for a little backup. And, and that was it. I will. I'm gonna let you get an idea. Yeah, give me one second. Hold on. I really appreciate you doing this. Thank you. You're welcome. A huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Capo pen at G voc glucagon.com. Ford slash juice box. You spell that? G v o KEGLUC. Ag o n.com. Forward slash juicebox. I'd also like to thank Omni pod makers of the Omni pod dash, the Omni pod promise and the Omni pod five. Learn more at Omni pod.com forward slash juice box. Don't forget to take that survey AT T one D exchange.org. Forward slash juice box.

Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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