#1164 Cold Wind: Problems on Both Sides
"Aurora" is an E.R. nurse.
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Scott Benner 0:00
Hello friends, welcome to episode 1164 of the Juicebox Podcast
Welcome back to cold wind. Today we're going to be speaking with someone who we're calling Aurora. She has type one diabetes is a pediatric nurse in the ER we talk about all kinds of stuff about the hospital, including how parents bring their children in constantly for unnecessary reasons. What is this note here? Also, much to your surprise that a lot of children come into the ER with either fentanyl or marijuana overdoses. Oh, I remember her telling me this. Oh, you're gonna find this interesting. 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. How would you like to help type one diabetes research? Well, if you want to, it's easy. T one D exchange.org/juicebox. Finish the survey. It takes 10 minutes and you've helped. That's it. US residents only you have to have type one diabetes or be the caregiver of someone with type one. Bonus points. If you're male, or the parent of a boy. They're really looking for those people right now. But everybody is welcome. T one D exchange.org/juicebox. Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juicebox at checkout. This episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151 for us med is where my daughter gets her diabetes supplies from and you could to use the link or number to get your free benefit check and get started today with us met. Today's episode is sponsored by Medtronic diabetes, a company that's bringing together people who are redefining what it means to live with diabetes. Later in this episode, I'll be speaking with Mark, he was diagnosed with type one diabetes at 28. He's 47. Now he's going to tell you a little bit about his story. And then at the very end of the episode, you can hear my entire mini interview with Mark. To hear more stories from the Medtronic champion community or to share your own story. Visit Medtronic diabetes.com/juice box and check out the Medtronic champion hashtag on social media. This episode of The Juicebox Podcast is sponsored by the ever since CGM. Ever since it's gonna let you break away from some of the CGM norms you may be accustomed to no more weekly or bi weekly hassles of sensor changes. Never again, will you be able to accidentally bump your sensor off. You won't have to carry around CGM supplies and worrying about your adhesive lasting. Well that's the thing of the past. Ever since cgm.com/juicebox. You're leaving it to me to pick your name. Oh, yeah. You know, I can't I'm not good at this homozygous. I'm gonna say randomly female name Alright, 1234 you are. Alright, well, we don't want to make you overall I do we
Aurora 3:34
sure we're not. She's a princess.
Scott Benner 3:36
Okay. Aurora. Aurora, what do you do for a living?
Aurora 3:39
I am a pediatric. Emergency Department nurse.
Scott Benner 3:45
Pediatric peds? Er? Nurse? Correct. Okay. Size of the hospital. Big small medium.
Aurora 3:57
I mean, it feels big. I don't know what other pediatric hospitals are. Okay.
Scott Benner 4:01
There's a distinction for the ER right, like trauma levels which what is yours?
Aurora 4:07
I don't know that answer. We are not a truck. We are not a level one trunks and not a level one trauma center. Okay, we are nationally ranked in pediatrics that I know for sure. nationally. So the thing is, is our emergency department is too far from the operating rooms. So we therefore cannot have like a higher standing as an emergency or like,
Scott Benner 4:31
oh, that's how that that's how that gets measured. Like literally.
Aurora 4:35
That's one of the that's one of the measurements is how far the emergency department is from the operating room. Okay, as well as which overnight, providers you have on call in the hospital are within a certain knowledge. And so because we work with three other hospitals within my area,
Scott Benner 4:59
they just did take them there if they think they need that level. No, no,
Aurora 5:02
our providers can be anywhere, our endocrinologist or our endocrinologist, but like, say we need for something like say you come in and your kiddo who has type one has Therapeutics is perfect. Right? So
Scott Benner 5:16
did you just say the name of a hospital?
Aurora 5:18
I'm going to sorry.
Scott Benner 5:22
Oh, sorry. Well bleep that
Aurora 5:22
out. Yeah. So that could be at any of the other hospitals in the area that they could be servicing. So it's not, it may take a little bit of time, if they're not there. Or if there's a weird surgery situation,
Scott Benner 5:34
would they redirect an ambulance to where your thing is more easily helped whatever's wrong with you at the moment? For
Aurora 5:42
pediatrics? It depends. So we don't take traumas. traumas will go elsewhere.
Scott Benner 5:47
If I broke my leg, that's not really a trauma and I end up in a ambulance, would they take me to a certain hospital?
Aurora 5:53
They would take you to us? Okay. Okay. Otherwise broken. A broken leg could be a trauma. If it is, if your bone is coming through your leg, I think the skin is open. Right?
Scott Benner 6:05
Okay. All right, that makes sense. So how long, you know, roughly, have you had this position?
Aurora 6:12
I have been in this position for a little over a year and a half now, year and a half.
Scott Benner 6:18
And prior to that, what did you do?
Aurora 6:21
I was I worked in the same hospital and the medical portion patient side for several years. Okay, too long.
Scott Benner 6:32
So just tell me the progression of education. You leave high school? What do you do next? Yeah,
Aurora 6:39
I leave high school. I start taking prereqs for nursing school. And that takes me oh, gosh, seven years to finish prereqs because I was working full time. And going to school part time because I had to pay for my diabetes supplies. Okay. And so it took me a very long time I finished prereqs summer of 2019. And I was not able to get into nursing school ended up starting a different degree. While I was waiting because nursing school in my area can take several years to get into. And COVID hit. I got in to the program, August's 2020 and graduated nursing school in 2022. May 2022. Okay. started in September 2022. And then emergency department. Yeah.
Scott Benner 7:39
So you basically take six or seven years, you're almost you're probably 25 ish when you get done with your prerequisites. Yeah, yeah. Okay. Then hard to get in because there's only so many slots then COVID etc. But by 20 That's a lot of time to try to get to something. And then okay, so then by 2022, you're a nurse, and you're working right away in ER or No, not right away, right away. Okay. And why did you choose that? today's podcast is sponsored by the ever since CGM. Boasting a six month sensor. The Eversense CGM offers you these key advantages distinct on body vibe alerts when higher low, a consistent and exceptional accuracy over a six month period. And you only need two sensors per year. No longer will you have to carry your CGM supplies with you. You won't have to be concerned about your adhesive not lasting, accidentally knocking off a sensor or wasting a sensor when you have to replace your transmitter. That's right. There's no more weekly or bi weekly hassles of sensor changes. Not with the ever sent CGM. It's implantable and it's accurate ever since cgm.com/juicebox. The ever since CGM is the first and only long term CGM ever since sits comfortably right under the skin and your upper arm and it lasts way longer than any other CGM sensor. Never again will you have to worry about your sensor falling off before the end of its life. So if you want an incredibly accurate CGM that can't get knocked off and won't fall off. You're looking for the ever since CGM. Ever since cgm.com/juicebox.
Aurora 9:27
I come from were in the hospital I was working I would have up to 15 patients a day in the role that I was on and on an acute care floor so like med surg II floors, or cancer care or acute care, so I knew going in the nurses only had three to four patients. And to me, I was like, I'm gonna be so bored. So bored. Right Take these patients for 12 hours a day, three days a week, a lot of them can be chronic, you know, we would have patients on our units for two years at a time. And then they'd come back and forth, or whatever thing going on. And I was like, I don't want to do that. I don't the emotional, social, like, the relationships are great. And you can have really great relationships with that. But it can be, wants to be really taxing on the nurses,
Scott Benner 10:27
being too emotionally invested in people's health.
Aurora 10:31
Yeah, or, you know, and I mean, for most people is like a trigger thing. Like, we don't think in our culture about children dying, and children do die, children get really sick, and they die. And you know, we do everything we possibly can, but a lot of the time, that we really just prolong it. And it's painful for the patient. It's painful for our family. It's,
Scott Benner 10:54
I have a friend who's a NICU nurse. And they, when they first came out of school, and we're working, they'd find themselves being invited to funerals by families. Yeah,
Aurora 11:06
yeah. And, I mean, I'm not saying we shouldn't prolong the life that we shouldn't try to do everything that we can medically, to have let this child become an adult and have a faint, you know, like, and do all the normal people things that we do. I'm just saying that, that to me,
Scott Benner 11:22
it's a lot when you see people die.
Aurora 11:26
It is. And I mean, it was just, I didn't think I would be happy. I didn't think I would find like but growth. And also at my hospital. So nurses have a variability of autonomy based on state based on institution and the policies and autonomy, and then kind of like the breadth of their scope of practice, right? In patient, they do not have a good breath for autonomy for a scope of practice. And I've watched several, you know, so many doctors just snap at nurses for no reason, like an just, I don't do well with that. So the emergency department I did my senior practicum in, I really liked it. And I said, Okay, it's either going to be it's going to be critical care all the way. Because I love to use my brain. I love looking at labs and looking at the patient, how they look and their vital signs and putting it all together and being like, Oh, wow, this is what's going on. And I know what I need to do. Now I know what I need to ask for. Whereas cute care, you don't really have that.
Scott Benner 12:27
Yeah. So you like the speed of it? You like the challenge of it, you like that there's more patients in a shift so you don't get too attached to people? Yeah, if
Aurora 12:40
a patient is in my emergency department room, and I've had them for four hours, I walked into the room and I'm like, I'm sorry, you're seeing my face again. We're trying to figure it out. Like I want them gone by like four hours, because nobody wants to be in an emergency department for that long. Yeah. So
Scott Benner 12:55
what made you want to come on and do this recording?
Aurora 13:00
I don't have a good answer. Let's go with that. But it's perplexing. The things that I hear people say, or the inequalities that I have seen in patients with diabetes who are coming in, and it's not just patients with diabetes, it's all but I mean, this is diabetes podcast. So that's what we're talking about.
Scott Benner 13:25
I'm happy to listen to, to whatever you want to say. It doesn't have to be about diabetes, specifically, what do you mean your it's confusing what people say?
Aurora 13:34
Not it's not confusing. Like it's surprising the crap that comes out of my coworkers mouths, like,
Scott Benner 13:40
Okay, you want to give me some examples? Um,
Aurora 13:44
okay, so yesterday, I was hanging blood. And this is a scary thing, right? But a couple of weeks ago, I had a nurse who was about to give a, a pen injection for insulin, right? And she's like, I'm always so terrified to get insulin. I'm like, why are you terrified? She goes, because it's such a high risk medication. I was like, your body makes insulin. So it's not scary.
Scott Benner 14:10
How long do you think that person had been? A nurse has been here a year? Are there a lot of new nurses right now? Because of the shift after COVID? I'm
Aurora 14:21
gonna say yes, but I know that. This emergency department would always take new grads. Okay, so I don't know the comparison. Okay.
Scott Benner 14:31
So there's there's always new nurses coming.
Aurora 14:35
Oh, always. And if they're not new nurses, they might be new to the IDI or their travel nurses. You know, there's always a variability of like, but I mean, we have staff members who have been on staff for 20 years and in the emergency department for 20 years nursing. So the
Scott Benner 14:49
combat side is their turnover, but not with everybody. Like some people come and go and some people stay long term. I guess once you get there if it's really right for you, then you might settle into it. Yeah. Okay, so something as simple is like, I'm scared to give insulin because it's a dangerous medication. Yeah.
Aurora 15:07
Which is understandable. But I was like, Hey, your body makes insulin, it's, it's totally fine. I was like, if they go low, they go low, which is not at the Met error, right? If they do, but if they go low, you get more juice, I'm not fine. And we do not give enough insulin whatsoever in any form of this hospital to actually make a patient low unless you are way overdosing and not properly getting my insulin. Or there
Scott Benner 15:33
are other things that co workers say that would be off putting, but you're not personally attached to it. Like it sounds like it sounds like a little bit of your response to that was as a nurse, and a little bit of your response to that was as a type one. Like, like you and me, like it almost feels like a little bit. You're like, oh my god, like you don't understand diabetes at all. That vibe, like how did it make you feel when when they said that? You weren't pissed? You were just No, no, just like this another person who thinks that
Aurora 16:04
we give insulin a week of insulin we have. We don't have a day where we don't have a diabetic in the emergency department, whether it's a new diagnosis, or somebody's in sick day or somebody's in decay
Scott Benner 16:14
every day. Every day type twos type ones every day. We don't really have type twos. Type twos don't come to emergency. Not not pediatric. Okay. Oh, I'm
Aurora 16:25
sorry. Usually, like, yeah, they don't usually have type two. Yeah,
Scott Benner 16:29
it's interesting. So you're a pediatric er, nurse. The place isn't just for endocrinology. But there is a good endocrinology department there. So you see a lot of these people is that about how that works. Right now we're going to hear from a member of the Medtronic champion community. This episode of The Juicebox Podcast is sponsored by Medtronic diabetes. And this is Mark.
Speaker 1 16:51
I use injections for about six months. And then my endocrinologist at a navy recommended a
Scott Benner 16:57
pump. How long had you been in the Navy? Eight years up to that point? I've interviewed a number of people who have been diagnosed during service and most of the time they're discharged. What happened to you?
Speaker 1 17:07
I was medically discharged. Yeah, six months after my diagnosis.
Scott Benner 17:11
Was it your goal to stay in the Navy for your whole life? Your career was? Yeah,
Speaker 1 17:15
yeah. In fact, I think a few months before my diagnosis, my wife and I had that discussion about, you know, staying in for the long term. And, you know, we've made the decision despite all the hardships and time away from home, that was what we loved the most.
Scott Benner 17:28
Was the Navy, like a lifetime goal of yours? lifetime goal.
Speaker 1 17:33
I mean, as my earliest childhood memories were flying, being a fighter pilot,
Scott Benner 17:37
how did your diagnosis impact your lifelong dream?
Speaker 1 17:40
It was devastating. Everything I had done in life, everything I'd worked up to up to that point was just taken away in an instant. I was not prepared for that at all. What does your support system look like? friends, your family caregivers, you know, for me to Medtronic, champions, community, you know, all those resources that are out there to help guide the way but then help keep abreast on you know, the new things that are coming down the pipe and to give you hope for eventually that we can find a cure. Stick
Scott Benner 18:06
around at the end of this episode to hear my entire conversation with Mark. And you can hear more stories from Medtronic champions and share your own story at Medtronic diabetes.com/juicebox. diabetes comes with a lot of things to remember. So it's nice when someone takes something off of your plate. US med has done that for us. When it's time for art and supplies to be refreshed. We get an email rolls up in your inbox says hi Arden. This is your friendly reorder email from us mid you open up the email to big button that says click here to reorder and you're done. Finally, somebody taking away a responsibility instead of adding one. US med has done that for us. An email arrives we click on a link and the next thing you know your products are at the front door. That simple. Us med.com/juice box or call 888-721-1514 I never have to wonder if Arden has enough supplies. I click on one link. I open up a box. I put the stuff in the drawer. And we're done. US med carries everything from insulin pumps, and diabetes testing supplies to the latest CGM like the libre three and the Dexcom G seven. They accept Medicare nationwide, over 800 private insurers and all you have to do to get started is called 888-721-1514 or go to my link us med.com/juicebox using that number or my link helps to support the production of the Juicebox Podcast. Yeah, okay.
Aurora 19:44
So a lot of pediatric emergency departments are split with main emergency departments, adult emergency departments. We are not we are a self standing pediatric emergency department. We get an adult there's something wrong with them. We ship them out as soon as possible. Okay,
Scott Benner 20:01
what do you see people most for DKA? Yeah,
Aurora 20:04
I want to say DKA new diagnosis, and we service for different states. So if there is a severe enough new diagnosis, they come to us, as well as the hospitals in the area, even as far as you know, 200 miles across the state well, either lifeflight or to you to
Scott Benner 20:29
a place where there's a nurse who's afraid of insulin, because you guys are the specialists,
Aurora 20:33
as the artists. Okay, we are the pediatric specialists. Yes. And I mean, it's, it's not something to not be afraid of it is a rite of it. They should be well, but yeah,
Scott Benner 20:43
I mean, Aurora, I'm not going to argue with that. But if I mean, that would be like a mechanic being afraid of a lug wrench, wouldn't it? I don't know. I mean, you use it all day long. Every day, it's in your hand constantly. How can you be can be used by it? Well, there is
Aurora 20:57
a portion of it to is like, huge. So you have to take a glucose, right? You put the glucose, there's a freaking calculator. You also have to make sure that the residents because we have med students, we have residents, and they have what three years of residency, then we have a fellow who is above them, and then we have an attending, okay, but the low man on the totem pole is the one putting in the order. So the ones calling into crime. So you have to trust that your resident is putting in the correct order, then you have to double check out their orders are correct. Doing that you're putting in everything correctly, you also have to check the ketones, which we call a bomb because it's a finger poke. So you have to check the ketones and whether or not the ketones are medium, small or large. You have to put in and we have a thing for that. And then it'll calculate, let's say if we're on sick day, what if it's one and a half or double the dose? Right? So you have to make sure that that is all correct. And so that could happen. What she was saying, being scared of getting it. Yeah.
Scott Benner 21:55
So that's why I was getting that like so it's possible that she's not weary. She's worried that the person telling her what to do is messing it up. Oh,
Aurora 22:03
oh, yeah. All the time. Every order that comes in whether it's anything it doesn't, it's not just diabetes orders.
Scott Benner 22:09
Yes. Why am I worried that the orders coming in? might be wrong?
Aurora 22:12
Human error?
Scott Benner 22:14
How often does it happen, though? Oh, all the time. Like, per patient? Or how do we want to break it down? Is it like, every person that walks in there, somebody's going to make a mistake about them? Or in every shift? I'm gonna see a mistake.
Aurora 22:30
No, I'm not saying like a mistake I'm saying, within orders that come in, as a nurse every order that comes in for me to do something I take a look at. And I'm gonna say at least twice with every patient that I have. I have questions on orders, and one or two of them is incorrect. And they have to put it back incorrectly. We
Scott Benner 22:53
can't call that a mistake, a bad order from a doctor or residents not
Aurora 22:57
a mistake, because we're catching a learning process.
Scott Benner 23:01
Yeah, there baby. Sorry, sorry. Yeah, there's a legal distinction. But okay, so you stop it from actually being a problem, but a mistake was made. That gets caught down the line. I say nurses,
Aurora 23:12
the last hand is the last the last person to do anything to touch that patient. So therefore, the nurse is the last stopping point. Okay.
Scott Benner 23:22
Yeah. All right. So I understand. So the resident who's maybe the least qualified is making the decision. And then the nurse is double checking those decisions to make sure they're not messing up. But in your words, twice with each patient, you might find something that needs to be readjusted. No, if I'm being generous. Oh my god. Okay, that's fine. So if I get a nurse that doesn't know, and a resident that doesn't know, that's when I'm in trouble. Yeah. Do they try to pair them in a way that that doesn't happen? Like more,
Aurora 23:55
but the hospital is really good at our my charge nurses are really good at managing patient load. And if you don't, we do have a culture of like, everybody's learning. And there's never there's never a stupid question. There is never, you know, don't not ask the questions, ask the questions, you know, ask for help. And it's there. Yeah. So, you know, giving us insulin. Insulin is always a double check. We go through, she's like, I've already gone through it can go through it again. Let's draw it up. Let's give that insulin right. Okay. Yeah, no problem. And, you know, usually it's totally fine. Getting all of those steps in to be able to do that
Scott Benner 24:30
because it goes through like channels like the residents send something down. It's not right, you catch it? Is it a thing that you put back into the computer? Or do you like grab them on the side and go, Hey, this isn't right.
Aurora 24:42
Yeah. Yeah, or call them or I call their attending? I mean, the good so the residents do talk to the fellow and to the attending as well as the nurses as well. So we all we all sit within, you know, we're in the emergency department. Our providers are not in a room half across the hospital. They're there. bear with us, right? So we can easily say, hey, this order is wrong, please fix it. Right? This is why it's wrong. And they all do talk together. It's not just their residents making the decision, but like the residents, the one putting in orders.
Scott Benner 25:12
What would you be most comfortable coming into your ER with a child with? Like, what do you think? What do you guys do great. Like, you know, you go to five guys that make a great burger. When I come to your ER department. If I brought my kid in there, what would I be best bringing a kid in there with? What do you guys do? Well, I think we do a lot of it well, okay. So is this just a fact of the situation that things get dropped? And other people catch them? Yes. You're not saying this is bad. You're saying this is how it works? Yes. Okay. Are you comfortable? Would you be comfortable taking your child to that? Er, yeah.
Aurora 25:52
Children, I don't have children and I can't have children. But yeah, you'd be comfortable going there. I'm also a nurse myself. So that's a hard question to answer. Like, I wouldn't take my child until they were absolutely dying. You know, why? Why? Because a lot of things don't need to go to the doctor For not
Scott Benner 26:11
because they would do a bad job once you got there. All right. So is a lot of the backup in the yard. Just people go into the yard when they don't need to. Correct. What are things that people go to the ER for that they should have stayed home for?
Aurora 26:25
Your kid has a fever, they have had a cough for two days. They're not eating?
Scott Benner 26:31
Do people ever come in with those concerns that it turns out to be something
Aurora 26:35
very rarely, I feel like in an emergency department, we have levels for care and what you're going to need. So when you get triage, your nurse assigned you it's called an ESI level. That's fine. Do an ESI level. So one is you are back in our recess room and you have you know, four nurses on you all the doctors available a respiratory therapist, and we are putting in lines, we are drawing labs, we are getting scans doing all of the things at once, right? This is the like, Grey's Anatomy, you're crashing? Okay? That's an ESI level one and that can be a breather that can be like a medically complex child who is just like looking like absolute crap. Diabetic who is having cerebral edema. We've had that a couple of times. You know, kids who are coming in seizing and the seizing is not stopping fentanyl overdoses, those sorts of
Scott Benner 27:30
things. But fentanyl overdoses with little kids? Oh,
Aurora 27:34
yeah. Cardiac arrest. That's another one respiratory arise.
Scott Benner 27:40
In the course of a shift. How long is a shift 12 hours? Well, how many heart attacks do you see in 12 hours in children.
Aurora 27:48
It's very rare to have a heart attack and a child they would usually have some form of like birth defect or something maybe react problem or it's a middle of the night they went into cardiac arrest or while they were sleeping. Like I said situation and so we're really reassessing them to get LifeLock. So they come and go, there's not a specific amount in a shift
Scott Benner 28:11
in a month. How many fentanyl overdoses 232 or three in a month. And how many shifts you work a week. Three 312 shifts two or three overdoses.
Aurora 28:26
Yeah, or marijuana overdoses. Which parents please. I know the like marijuana comes in great packages and gummies and stuff, please put them up in your cupboards Far, far away. Put them in a lockbox. Kids get into them. They don't realize your kid comes in and we think it's meningitis. And we find out it's marijuana.
Scott Benner 28:43
Oh my god. So more frequently than I would imagine. Kids get into gummies of their parents. Yes. As kids your eyes, they bring them to the emergency room.
Aurora 28:54
And they look like they're dead. Yeah. Oh, cuz they're like overdose on marijuana.
Scott Benner 28:59
No kidding.
Aurora 29:00
Yeah, we've had three in the last week get really bad.
Scott Benner 29:04
Seriously? How come? All right, hold on, we're not gonna go down the wrong path. But how do people not know not to leave that where their kids can find it? I guess they're high too. Maybe they don't know.
Aurora 29:14
I don't know. I'm just it's a PSA, please.
Scott Benner 29:17
What else should people hit? Maybe this is the road to go with you. Or what? What else do people do where they they shouldn't be doing? Like what else is very preventable that you say? We
Aurora 29:27
get a lot of nausea, vomiting, abdominal pain, or teach teaching kids how to pull their nose, please. I know we went through COVID I get we're not supposed to cough. You can cough into your shoulder. You can blow your nose where people aren't going anywhere and people aren't blowing their nose, children. I have an eight year old who didn't know how to blow his nose and I taught him how to blow his nose. He kept vomiting. We call it post vomiting. If you're coughing, and then all of a sudden you vomit right? Because you get all that mucus that's going into your stomach, the mucus that's going into your stomach from your lungs. problems when you cough it up is an irritant to your stomach and it causes you to vomit. You're
Scott Benner 30:04
saying if your child is vomiting because they can't blow their nose, and everything's backing up down their throat, maybe you should reevaluate your parenting skills. Yeah,
Aurora 30:15
you should teach your child how to blow their nose. Do you put the tissue on their nose? And you block one nasal passage, and you say, now try to close your mouth, but act like you're blowing out a candle? And oh, my gosh, they can blow their nose. Do you think people don't know that? Absolutely. Oh,
Scott Benner 30:34
my God, that's upsetting. Okay, Jesus. All right. So they don't know not to leave weed near their kids. The edibles? Kids aren't eating the actual flower. Are they to the what? The flower the bud? Like? Do they actually know? It's the gum? gummies? The gummies? Right. Okay. And worse, the kids get the harder drugs sometimes.
Aurora 30:55
Oh, yeah. I mean, like, they're people who have drugs and, you know, obviously code on cocaine in their homes and their children. Get around it, you know, and it's really sad.
Scott Benner 31:06
No kidding. You ever seen a baby? Like, really injured from that? What do you qualify as injured? I mean, you know, they just stare at a wall for the rest of their life, or they're dead, something in between those things?
Aurora 31:17
I don't know. Because we don't. I mean, I them after, that's when I was upstairs, we would have like, abuse from those that were afflicted with addiction, we would hurt their child. I don't know about the children are seeing now because I don't tell social situations. Gotcha.
Scott Benner 31:38
But a number of the things you see in the ER are would be preventable. But somebody with an IQ over 80
Aurora 31:45
is somebody who didn't have social determinants of health that were ruling our life. Yes. You're very polite. Okay. I mean, I truly believe this is what that's what it boils down to is social determinants of health like it. And I know other people who have our health care workers that have come on for this, I've talked about it. But it surely is, if you don't have access to your phone to be able to go to my chart and message your provider or can't get into the provider, because they can't see you like, just a PCP visit in my area right now is for monthly time, I have been needing to see a specialist for a new autoimmune disease for five months now. And I'm still one more month away from this new appointment. It's ruining my life, like it's making absolutely terrible, and you can't get on.
Scott Benner 32:33
Yeah, no, I want to talk about that. But that's not what I was kind of what I was getting. And I'm saying like, we don't need to be any special kind of intelligent to keep weed away from babies or make sure they don't get an oxy or something like that.
Aurora 32:45
No, yeah. I mean, like, how do you how do you stop addiction? How do you stop that social determinant of health? What what started that addiction? What NSSM is causing this to be an in product, what percentage
Scott Benner 32:59
of your day is wrapped around stuff that if those problems didn't exist for people, you wouldn't see these people? Like how many people out of every 10? Is it avoidable and not a health like not just a flat out thing that went wrong with their health that they couldn't stop? Does that make sense? My question, yeah,
Aurora 33:17
I'm trying to think, to three to
Scott Benner 33:21
two or three out of every 10 people if they just had better skills, or opportunity. They would not be in the ER. Oh, no, Simon, then. Oh, okay. I wasn't sure how clear I asked at first. That's why I kind of restated it. So three of 10 are like my appendix pop. That was nothing I could do about that. Yeah, I fell over. I broke my leg. There's nothing I could do about that. But the but seven out of 10 are things that if you put a person with common sense, and a reasonable start to life, this probably doesn't end up happening to them. Yeah. Is that frustrating as a nurse,
Aurora 33:58
it can be okay, not all the time. Sometimes it's, you know, new parents coming in. This is their first baby. They've never been around a child and the child was sick for the first time. Okay, sure. Got this not aspect. Patients not breathing very while they're not wanting to eat, they're a little sleepy. You know, we unwrap them. We suction them really nice and well with our vacuum suction. And, you know, we let them eat. We give parents education reassurance, hey, you're gonna suction every three hours, you're gonna section before they eat. And if the warming breathing gets worse, we give them a pamphlet, like this is what we want you to this is where it's looking worse, because you're getting a lot of information out at once. Put it on your fridge, right? So when you have that question when it comes back up, it's right there. You know where it is. And then you can either come back in or you can be reassured by your baby's looking fine, right. So like, that is absolute really needed. That is probably one of my funnest things that I do is like giving those parents that education because it can prolong them not coming into the emergency that they can prolong them not being worried. So
Scott Benner 35:15
what I'm calling common sense, you're calling determinism. I guess this is just me judging things from my perspective. But you've described a number of things so far, that I think with like three seconds, a clear thought I could figure out, but people are ending up in the ER over it. Yeah, yeah. Like, I've had children. And sometimes you're right, like, they get sick, and they get all snotty, and they gets blocked up, and then you like, clear it for them? Yeah, that's it. It's not that hard. But I guess it is, if it is, right.
Aurora 35:46
I don't know what it is. I don't know if it's because we have such a good pediatric hospital in the area. And so everybody's just like, go my hospital. Right. But isn't it expensive to go to the hospital? Well, our our hospital has, everybody can apply for assistance, and then it's based on income. So whatever level and whatever's leftover from the hospital visit, what uh, how did they determine it? I don't know. Okay, but a lot of it's uncompensated incompetence care. I don't know one
Scott Benner 36:18
time when Arden was little, she'll be very embarrassed. I said this, but that's her problem, not mine. She's very little. And she was in the bathroom. And she didn't like the way it smelled. So she rolled up toilet paper and stuck it up her nose. Solid. Yeah, I issues like, I don't know, she was not that old, like two or three years old, right? But this one little wad of toilet paper got stuck so far up her nose. We couldn't get it out. Yeah. And so I sat her down. And I looked at her and I thought with my thinker, and I thought we tried one thing that I'm embarrassed to say that didn't work. We tried, like putting like a funnel on the end of the vacuum cleaner hose to see if we could like grab it that way. Like so there was like a little funnel tip that was being sucked on by the vacuum that didn't grab it. And then it hit me what to do. And I blocked up one of her nostrils kept my mouth over her mouth blew and filled her filter up with air. And the thing shout out and hit me in the face. You can also do that with mucus. Yeah, I'm sure it can. Now, point is, is that at no point during this like, show, which it was? Did I think I'm gonna go to the hospital. But you're saying people would come to the hospital that? Yeah. Oh, I say. All right. I don't know what to do. So you're not here to tell me that the people at the hospital don't know what they're doing. You're here to tell me that the people coming to the hospital don't know what they're doing. Yeah, well. So let's be honest. Let's be honest. So, again, the limiting factor here is people. Yeah, somewhere along the line, someone I don't know, is overmatched. I guess that's the simplest way to say it for whatever reason. And they end up needing help from someone else who eventually sees this so many times over and over again, that they become a little numb to it. And then another person comes in with an honest to god problem. And you don't see people like that anymore. You see, like, you see the confusion and the repetition. So when like the only me like because that's my always one of my, my bigger questions is like, what happens when someone's actually in there with an actual problem?
Aurora 38:35
Oh, I mean, all the resources go towards them, and everybody else waits. That's how it works.
Scott Benner 38:41
But how do they miss things that are actual problems? In the beginning, they miss them because most of the time seven out of 10 times it's nothing? Is that it?
Aurora 38:49
Okay, so can it express? Yeah, so pediatrics, like kids are really good at compensating their body is really good at compensating. And like so there'll be like mail coming a little crummy, little crummy, little crummy, right? And then they just we call it a nosedive. They're on the edge of the cliff and something that just pushes them down. And they're crummy looking. Right? And so parents know. And sometimes those like spidey senses are going off at a time that possibly is not that. And then sometimes they go off a little too late, you know. And so it's just like, there's no balance to it. But of course, if your kid is sick in the event, second week, and let's say they've had the flu, and we know the flu is going around, even though they've been sick all week. And you notice the flu parents don't bring them in and say fix my child. I'm sorry, it's a virus. We can't fix your child.
Scott Benner 39:44
Do you think people get panicked when the illnesses start going on for many days and they think oh, God, something worse is coming instead of realizing that you had to write this virus out. Yeah. And that sometimes people actually do have honest to god problems and everybody thinks that's happening to them. Um, yeah,
Aurora 40:00
let's say that they had a virus and now all of a sudden they're coming in and they have diabetes, then that's an emergency, right?
Scott Benner 40:06
Where you end up doubling up, like you get bronchitis on top of something else, or you start having two problems at the same time. So I don't think he'd mind me saying this. My brother had to go to the emergency room a couple of weeks ago. And he had very terrible pain that, you know, right side pain. And he gets there. And they hit him with the drugs first, because he actually said, my brothers had some pretty, like, painful things happen to him. And he's like, I couldn't talk like I needed like to numb this before I could even explain to them what was going on. So he gets, you know, they, they, they make him comfortable. And he explains everything. They do all the tests, they can't come back with anything. But in his history, my mom has had diverticulitis in the past. And so they kind of ignore all that go over him. And then he said, there was this moment where they told him that even though he was in intense pain that was only being managed by some significant pain meds, there was nothing wrong that they could figure out and he had to leave. He did have a raised white blood count, but they just, they just kicked him out of hospital. So he went home. And the next day, he texted me and he said, I can't take it, I gotta go back. So he goes back again. And he has to stop them from basically just repeating what happened 24 hours before, he has to say, no, no, we just did all this. If you need to see it, there's, I'm sure it's in your computer, but we just did all this. I'm back because the pain is unbearable. You know, even with the medication you gave me everything else sees there for another couple of hours. They're not doing anything. He's texting me. He's like, Scott, nothing's happening. I'm just they're gonna just sit here and stare at me for a while and then tell me to go home again and go see a doctor. And I'm like, right. So I said to him, did they redraw your labs? And he said they did. And I said, tell me if the white blood cell count is still elevated. And he looks and says it's elevated. It's higher than yesterday. I said, grab the nurse and say, Would it hurt anything if I got an IV antibiotic? You know, because my white blood cell counts elevated. It was elevated yesterday. Now today, it's higher. My mom had diverticulitis in the past. She goes, hold on, I'll find out. She leaves talks, the doctor comes back. Doctor will be in to talk to you a little bit. So my brothers are Hey, doctors texted me doctors coming to see me. He calls me afterwards. He's laughing. My brother's laughing. He goes, Hey, I know what's wrong with me now. And I said, well, they figured out he goes, I have diverticulitis. And I go, what? He goes, Yeah, I floated the idea to the nurse who floated it to the doctor who came back and pretended that he had the idea that I had diverticulitis, and they're gonna give me an IV antibiotic and antibiotics to take home with me. And I was like, so I diagnosed you. And he goes, Yeah. Like, I'm the one through a text message. Who told my brother manipulate the nurse. So show manipulate the doctor so you can get the antibiotic? Because obviously, we don't know what's going on. The only thing we see is a rising white blood count. You clearly have an infection somewhere. Let's take care of it. The IV antibiotics not going to hurt you anyway, if that's not the thing, why is this not worth a try? And by the way, three days later, he was fine. Yeah, I did that
Aurora 43:18
manipulations, a good word. A lot of manipulating network. Yeah,
Scott Benner 43:24
that's what I did. I manipulate the nurse through a text through my brother so that she would tell a doctor and then but I think the fascinating part that should not be lost on this is that an hour later, the doctor walks into the room as if he's had the idea. Yeah. And then repeat to my brother. What I told my brother to tell the nurse. Yeah, jump out a window. That's the only thing I can think of when I hear stuff like that. Just give up. Yeah.
Aurora 43:50
That's my every day. Yeah.
Scott Benner 43:53
But you don't see it as bad. You see it as part of the learning process. Oh,
Aurora 43:57
no, that's, that's what I've been conditioned to. Oh,
Scott Benner 44:02
because I see it as bad. I just want to be clear.
Aurora 44:06
is like, awesome. It's hard for me because I had so much experience in our hospital with this population for a very long time before I came down as a nurse, right. So like, I was above and still am. A lot of the nurses, a lot of the nurses who have been there a long time. And I've been told that by management, which is fine. I have a very blunt personality. I'm very, like, this is what we're doing. And we're doing it right. And doesn't go over well with everybody. And so, I have been told you just have to play dumb. Which some days I comply with. Most days. I do not say the smart people say play dumb. Yeah, because you have to ask things in a way that will get the providers to think what you're wanting them to think or give you the orders you need. Yeah. Right you are advocating for for the patient. Yes. I
Scott Benner 45:08
mean, listen, I don't know what to say. I in the last year, my brother and my daughter have been in the emergency room and I have been the attending physician for both of them. Yeah. And without me, nobody helps them. They pretend to help them, they medicate them, then they throw them back out again. Aurora, my daughter was in the ER for 12 hours. And they didn't check her blood sugar while she was there.
Aurora 45:32
I know. I know. I was I listened to the podcast
Scott Benner 45:35
ever once. They never even stuck their head in and said, Hey, how you doing? How's your blood sugar?
Aurora 45:41
And that, to me is surprising. But that's an adult emergency department. And I know I know the nurses get busy. I know there was I saw I am triage train. Now I'm I'm a full fledged emergency department nurse. So I triage patients. I triaged a patient literally a couple days ago, who came and she has type one diabetes, okay. She goes, I don't feel well. I can't keep anything down. I think she came back with a virus. Okay. Not abnormal. Usually it's a day. And she I can't remember she was like eight to 11. Somewhere in that age range. I can't remember. Which, exactly, it doesn't matter. So she's like, my blood sugars have been, you know, two to three hundreds. We can't get them down. Well, the Lantus isn't working dad knows nothing. Nothing about her diabetes, nothing about her care. And she goes, this is how much insulin I take. This is how much you know antiseptic. She goes, but this abdominal pain. It feels like the last time I was in DKA. And I was like, I got you, girl. I know. I know what that feels like. I know the pain you're talking about. And so we got her back to her room, immediately her glucose, they attacked her glucose in the first check in area and it was above 300. I hand her off to the other nurse and the other nurse is supposed to get all the labs and stuff. So they got the lab she was in DKA. At that time by our senior she was in DKA. Endocrine said she's not in DKA do sick day, for whatever reason. And I don't know what happened. You know, a glucose wasn't checked two hours later. And they went in to go do Sick Day and insulin three hours later, and she was further into DKA. And so then we had to start the GK to bag insulin system.
Scott Benner 47:27
Listen, the only direction my brother got in the first day of the hospital. He's my brother has type two diabetes, which is managed very well with diet exercise, and ozempic. So my brother's a once he's in the fives, mid fives from the sevens with ozempic. He's lost, like, I don't know, 35 pounds in the last year or something like that, like everything good about my brother's health right now is coming from his GLP medication. He's in the hospital, they do the tests, then they go, Oh, we don't say anything. And then the doctor says to him, we I think maybe we should take you off the ozempic. And my brother goes, why? And he goes, he goes, I've been the guy. His words were I've heard like, almost like I was I was listening to a you know, podcast, and I heard that they can cause like intestinal blog. There's a lot of problems with intestinal blockages lately. And my brother goes, I don't have an intestinal blockage. I took a shower this morning. And the guy goes, he's like it's on there. My you asked me when's the last time I went to the bathroom went to the bathroom a couple of hours ago, like I don't have an entire not blocked at all, I promise you. And the guy says, I don't know, maybe we may we should take you off of this. So my brother goes, I'm not stopping that medication. So the only medical direction he got was come off your GLP which would have raised as a one C backup two points. And no one ever came back to say to him, Hey, don't do that. So now my brother's a bright enough guy. And he's got me to bounce it off of and other people in his life. Right? So, but there are plenty of people who would leave that hospital that day. And what they would remember is the doctor told me to stop taking the ozempic Yeah, they would have stopped. It
Aurora 49:10
had. Honestly, I don't know if that's because we come from a background of having a chronic illness or taking care of someone with a chronic illness. I'm like, No, you know,
Scott Benner 49:25
how do you not understand it, though? Like, how can you say I don't know, in medicine? And I don't know what I mean, what might be one of the most popularly understood drugs in the world right now. Like everyone that's on everyone's lips. Everyone knows what it is. And yet, you are just guessing based off a thing you might have heard once and then you give somebody medical direction about it, then find out that definitely not what the problem was. And don't go back to them and say, Hey, by the way, I know I told you to stop taking the ozempic but don't do that. Like it's fascinating. Like no wonder people have so many problems. You don't I mean, I think
Aurora 49:59
me It's just the oversaturation of patients to do providers, just too
Scott Benner 50:07
many people searching for help. And it's more than a person can keep straight in their head. Yeah, that makes sense to me, by the way. Yeah,
Aurora 50:16
I have a friend and she's very lovely. I went to nursing school with her. Her son was diagnosed with type one diabetes last May. March, somewhere in there. Anyways, I texted her and I was like, Hey, happy birthday. And she goes, Oh, my God, I was just thinking of you. We are in the emergency department. Not near me, because I went to nursing school in a different states. And she goes, we were just diagnosed with type one diabetes, I was like, Oh, I'm so sorry. And so they like, went home after some insulin because he was fine. And then did training the next day. And so she's calling or texting very frequently, that first few weeks. And in the first two weeks, I was like, listen to this podcast, this is going to tell you more information than they're ever going to tell you. And I was like, get the insulin from the doctor get what you mean, I was like, but do not listen to the doctors. Like they don't know what they're doing. They don't know anything about diabetes. And they're telling you, I'm going to say all the wrong things. Right? She is a nurse. Yes, she has patients with diabetes, she gives insulin on a daily, okay. And so I saw her a couple of months ago, and we went out for breakfast. And she's sitting there and she's complaining about like, these diabetic orders that she had the previous week, and they were completely wrong. And it took, you know, hours upon hours to get them correct. And then she was like, I just don't understand what they're doing. And I was like, um, and so how's your son's able and see, like, what's going on there? Because like, we kind of just stopped asking questions. And I was like, what's going on? She was like, over high, and this is going on, and like, he's taking meals to correct because we can only correct every three hours. And then it's just causing bigger spikes. And I was like, What are you doing? Because, hey, I love you. I love your kid. But I told you a year ago, do not listen to the doctors. So for a year, it goes on like that. You just told me from your nursing experience. You did not listen to the doctors and do not trust the doctors. But
Scott Benner 52:21
when she got put into a position she did go back. Yeah. So there's a person who should know better and didn't, I'm telling you like, what if my brother would have believed that guy? Now all of a sudden, it's six months from now he's back it is his general practitioner guy goes well, I don't understand what happened. You're, you're a one see one way back up again, what's going on? And my brother goes, Hi, I stopped taking ozempic Because the ER doctor told me to stop taking it because I might have a bowel obstruction. It just it's fascinating. By the way they had scanned him to within an inch of his life. His bowel was not obstructed. They knew that. And then the guy still said it out loud. I don't know what I'm listening. I know people are just people and you you know you go to school and you do your best you become a doctor. It doesn't make you a magician doesn't make you a god or a deity or anything like that. But isn't it incumbent upon you to know that when you're talking that I'm just the guy, I'm just the girl. And I don't know everything. And whatever I say out loud, this person across me is going to take like gospel. Yeah, like it's important not to seriously, it's important. It's nobody seems to understand lead. That's the thing that I find fascinating. The older doctors can get it but they're so damn tired. Like, it's like either had people with energy that don't know what they're talking about are exhausted. People who know what they're talking about. It can't bring themselves to do it anymore. Yeah, yeah. So what's the answer? How do you fix it?
Aurora 53:47
We all die eventually.
Scott Benner 53:50
It was gonna get you anyway, Scott. Yeah. So there's no answer. Right? This is just a this is a gray area within living and society that is probably working as well as it can and not working badly. I mean, it's obviously not. It's not where it could be. But there's no answer about how to get there. As far as anybody I've spoken to. So far. I've never had one of these conversations at the end said to somebody, what do you think we should do? And they all have a great idea. They all go I don't know. That, you know, it's the Insurance insurance fault. It's the time that doctors have with them. It's doctors egos. It's, you know, that there's too many people. You know, in
Aurora 54:26
nursing school we learn about in, I think it was the early 1900s. Okay. Nurses would go to people's homes, they would check in, and I'm not putting this on nurses because we already do everybody's job. But nurses would go to they would have a set amount. This was in New York, I believe, that amount of patients that they would see within a week, within a day, right? They had these families that they were like, the mama bear of okay, she would go in and make sure that the moms were getting enough Food so she could breastfeed, they would make sure that the patients who needed the dressing changes would do the dressing changes and make sure that like people, even if they don't have enough money are getting adequate food and just kind of like, being a part of the community that they were that they were supporting. Right. Okay. They were, they were in the community, they lived close to these people. This was their, you know, like, this is what they did, right? There was federal funding for that. And then something happened and that federal funding was lost. But in that timeframe, the health, the disease rates were better people were, you know, like, not spreading sexually transmitted diseases, because they were learning not to, you know, you know, do those things, whatever.
Scott Benner 55:43
You want to stop, go and do something. Yeah. Yeah, I do that. I'll be here. I feel like she was getting ready to say they don't let take your time. Make sure you're okay. I'm fine. I'm just drinking. I was telling the people when you walked away and felt like you were about to say, people do not to let dirty near them. And then you were like, I'm gonna stop for a second. Is that what you're gonna say?
Aurora 56:06
No, no, no, my phone is on. It's on. I put it on airplane mode, or whatever that is, you're not disturbing. So it was just a little alarming me. I was I was,
Scott Benner 56:16
Oh, you got confused in that. In that sentence? You got the alarm? Because you paused I was like, Oh, she was gonna say something hard. And she stopped yourself. But your alarm went off? What's your blood sugar 64. Most people get high when they're being interviewed.
Aurora 56:29
I did initially and I gave myself a Bolus,
Scott Benner 56:33
little too much.
Aurora 56:37
To do. No, I've calmed down. And so I'm no longer speaking adrenaline to keep keep it up. Anyways, so they had these wonderful nurses who would do the actual community outreach. And it was that of course, it was for funding. And we've never gotten back to any state close to that. And I honestly believe we, as a country were to do that. A, our nurses would be so much happier and find so much more fulfillment in what they're doing. And then our we would have less hospitalizations, we would have less heart disease, we would have less type two diabetes, right? Like
Scott Benner 57:19
you think the answer you think the answer is one on one, care with somebody who can talk you on your level and isn't rushing around and actually understands the thing. So especially like they understand the thing they're talking to you about because they don't have to know everything. They only know a few things. Not even just a few things, but like, the things that come up. Yeah, yeah. Yeah. I mean, not a bad idea, right.
Aurora 57:46
I honestly believe that. I would love it's public health nursing is what it is. I would love to do that. Okay. But public health nursing now is not that.
Scott Benner 57:57
Yeah, everything gets bastardized, eventually. Even like, walk in clinics, right? That take insurance, like, you know, eventually they become a like a grind like a mill. Yeah. And but when they first opened up, it was great. It was like you'd show up somewhere. And the doctor would be like, sitting there waiting for you and beg Hi. And now as time goes past, they seem a little more, get them in, get them out. I mean, at least there's a little more time for them, because they don't have as many people there as a as an emergency room. People seem to live, learn how to use, you know, those clinics a little bit, but you can also get a bad one. I've been in one with my son when we were in Florida. And he got sick. And my god, like it just there's just confused people everywhere. And I mean, working there, and very unhelpful. And then there's one near my home, that's actually really good. Actually, there's a type one that works in it, and she's terrific. And if I go there, when I'm sick, I'm like, is she here? And you know, she's really great. Maybe even that's a little bit about what you were talking about earlier, just your opportunity and your availability to good help and good ideas. So maybe I just live in an area that, you know, I don't know, has a better a better emergency clinic to go into not even attached to a hospital. Who knows? It's by like your idea, though. Like, what did what did you call it? community nursing? Yeah,
Aurora 59:18
it's public health nursing with like community specific outreach.
Scott Benner 59:22
They probably can't charge for that. Well, though. I don't know. That's probably the problem. So basically, it's like having a like a Facebook community, but where an actual nurse shows up and helps you. Correct?
Aurora 59:33
Yeah, I see. Which is like it's you know, you become a nurse and like, you get all these text messages from people and they're like, Wow, about, you know, how many phone calls I've gotten in the middle of the night where my sister's kids are doing something funky or they're screaming their head off and she's like, I need your help. She lives halfway across the country. Okay, let's FaceTime them. I'll look at them. Okay, they're okay. This is what you should look for. This is what you should give. If they start are doing this then go to the emergency department. Okay. Yeah. really concerned. Yeah, call your PCP tomorrow and try to get in. Right? But not everybody are good and social determinants of health, like nursing school is very expensive. Having a doctrine family, not a normal thing. Who are you going to call? Right? If you live in an A? In a lower class? Population? If that's where you are? How do you even reach that? How do you have a nurse? And your phone? To know?
Scott Benner 1:00:30
Yeah, the guy you know, to help you when you know, when you you need? When you need a I know a guy situation, the guy you know, maybe not a doctor. And then yeah, then that. All right.
Aurora 1:00:42
I mean, like, I've literally like, my sister has a running tab of how much money she owes me, because I'm like, $30, every time you call me with a question, because this is ridiculous,
Scott Benner 1:00:50
you know, but is it? Is she calling you because she's overmatched? Or she calling you because she really doesn't know. And she'd be one of those people in the ER, if she didn't call you? What do you think? I think a little bit of both a little bit of both taken advantage a little bit and a little bit. She doesn't know what she's doing now, which
Aurora 1:01:05
is why I literally told her and her husband this last week, because I was there visiting. I was like, $30, I'm not kidding. Because my brain and my availability is not just free to you, because I am related anymore. You got a year and a half. No more, you
Scott Benner 1:01:22
got three kids. Now, I know a doctor. And he said that's, you know, it's one of the worst things is that, and when you know him, you have to stop yourself sometimes because you're like, Oh, my God, I could just ask real quick, you know,
Aurora 1:01:32
I mean, I think it's really appropriate to set a boundary. And I mean, I gladly will do it like, sure. Of course, she's not ever gonna pay me. But, you know, like, good. People don't have that. Yeah. We didn't have a nurse in my family until i i became a nurse. You know, we didn't have anybody who graduated high school until I graduated high school. Like, really? Don't have it. Oh, yeah.
Scott Benner 1:01:57
Oh, no kidding. Oh, good for you. Congratulations. Good for your family. So if
Aurora 1:02:03
you come from a background like that, what do you do? Well, you go to the emergency department, and you sit there for four hours until you can see a doctor who's going to tell you? I don't know. I'm back if you need to.
Scott Benner 1:02:13
Yeah, all right. Well, again, I appreciate the conversation. I'm afraid they're all going to mostly go the same way. But everybody's bringing something new and different to them. Your perspective was different than others so far. So I really appreciate you taking the time to share it with me. I'm sorry, you got low in the middle of it. But thank you very much. It's it's interesting. And I will say this, because I say this all the time in these episodes. If you have an emergency situation, just go to the emergency room. Oh,
Aurora 1:02:42
for sure. Please do don't don't act like I'm not saying don't go to Superman, like kids get like I said they fall off cliffs. So go if you think you need to go go. Right.
Scott Benner 1:02:53
And it's better safe than sorry. I mean, correct. For certain, you know, it's just there's a difference between, like, you know, that old like, oh, I shot 10 units of fast acting instead of my Basal insulin, what do I do and and right away someone online, I'd be like, go to the emergency room. And I'm like, you could figure out what your carb ratio is and eat the food. Drink a bunch of juice? Yeah. Like, there's other stuff you can do. And then you'll say, Oh, that's a good idea. Like, yeah, yeah, you don't have to run to the emergency room immediately that that panic that some people have is, is interesting. Like, you know, I'm not saying if you can't get ahead of it, if you you know, if you're, you know, you shot 30 units or something like that, like I get it, you know what I mean? But you got to think for yourself a little bit once in a while, I guess, I guess, unless she can't, and then maybe you need somebody to do it for you. But that just means that people like Aurora are going to be like teaching your kids to blow their nose. And you're going to be using up the finite amount of she has to give before she falls apart in our child like really? Right, like, eventually, you're just going to run out of things to give and then yeah,
Aurora 1:03:58
and then it comes in and dies and you just like actually lose your marbles. Because who knows.
Scott Benner 1:04:06
All right. I'm gonna say goodbye. And thank you very much for your time. I appreciate it. Thank you.
Mark is an incredible example of what so many experience living with diabetes, you show up for yourself and others every day, never letting diabetes to find you. And that is what the Medtronic champion community is all about. Each of us is strong, and together, we're even stronger. To hear more stories from the Medtronic champion community or to share your own story. Visit Medtronic diabetes.com/juice box. Don't forget, we still have Mark's conversation at the very end. It's a terrific kind of mini episode about 10 minutes long. That goes deeper into some of the things that you heard Mark talking about earlier in the show. A huge thanks to us med for sponsoring This episode of The Juicebox Podcast, don't forget us med.com/juice box this is where we get our diabetes supplies from, you can as well use the link or call 888-721-1514. Use the link or call the number, get your free benefits check so that you can start getting your diabetes supplies the way we do from us med. I want to thank the ever since CGM for sponsoring this episode of The Juicebox Podcast and invite you to go to ever since cgm.com/juicebox, to learn more about this terrific device, you can head over now and just absorb everything that the website has to offer. And that way you'll know if ever sense feels right for you, ever since cgm.com/juicebox. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. And now my full conversation with Medtronic champion, Mark. Mark. How old were you when you were diagnosed with type one diabetes? I was 2828. How old are you now? 4747. So just about 20 years?
Unknown Speaker 1:06:08
Yeah, 19 years?
Scott Benner 1:06:10
What was your management style when you were diagnosed? I
Speaker 1 1:06:13
use injections for about six months. And then my endocrinologist at a navy recommended a pump.
Scott Benner 1:06:18
How long had you been in the Navy?
Unknown Speaker 1:06:19
See eight years up to that point?
Scott Benner 1:06:22
Eight years? Yeah, I've interviewed a number of people who have been diagnosed during service and most of the time they're discharged. What happened to you?
Speaker 1 1:06:30
I was medically discharged. Yeah, six months after my diagnosis.
Scott Benner 1:06:34
I don't understand the whole system. Is that like honorable? Yeah. I mean,
Speaker 1 1:06:38
essentially, if you get a medical discharge, you get a commensurate honorable discharge. I guess there could be cases where something other than that, but that's that's really how it happened. So it's an honorable discharge with but because of medical
Scott Benner 1:06:48
reasons, and that still gives you access to the VA for the rest of your life. Right?
Unknown Speaker 1:06:52
Correct. Yeah, exactly.
Scott Benner 1:06:53
Do you use the VA for your management? Yeah, I
Speaker 1 1:06:56
used to up until a few years ago, when we moved to North Carolina, it just became untenable, just the rigmarole and process to kind of get all the things I needed. You know, for diabetes management, it was far easier just to go through a private practice.
Scott Benner 1:07:09
Was it your goal to stay in the Navy for your whole life, your career? It was?
Speaker 1 1:07:12
Yeah, yeah. In fact, I think a few months before my diagnosis, my wife and I had that discussion about, you know, staying in for the long term. And, you know, we made the decision despite all the hardships and time away from home, that was what we love the most. So that's what made it that much more difficult
Scott Benner 1:07:29
was the Navy, like a lifetime goal of yours or something you came to as an adult,
Speaker 1 1:07:33
lifetime goal. I mean, as my earliest childhood memories were flying being a fighter pilot and specifically being flying on and off aircraft carriers. So you know, watching Top Gun in the ad, certainly a
Scott Benner 1:07:45
weight was a catalyst for that you've taken off and landed a jet on an aircraft carrier.
Unknown Speaker 1:07:50
Hundreds of times.
Scott Benner 1:07:52
Is there anything in life as exhilarating as that? No,
Speaker 1 1:07:55
but there there's a roller coaster I rode at. I think it was at Cedar Rapids up in Cleveland Sandusky, and they've got this roller coaster rotation from zero to like, it's like 80 or something, you go up a big hill and you come right back down. So the acceleration is pretty similar. I would say to catapult shot,
Scott Benner 1:08:13
I'm gonna guess you own a Tesla.
Speaker 1 1:08:16
I don't I I'm a boring guy. I got a hybrid rav4 I get made fun of I get called. You know, my wife says I drive like a grandpa. I'm a five miles per hour over the speed limit person. No more than that. So yeah, in the car. I'm boring guy. So
Scott Benner 1:08:30
you've never felt a need to try to replace that with something else. You
Speaker 1 1:08:34
can't replace it. It's you're replaceable. That's what I thought. So up until the point where someone you know, buys me an F 18 or allows me to get inside a two seater and fly it you can't replace it. How did
Scott Benner 1:08:45
it make you feel when you saw or maybe you haven't seen? gentleman named Pietro has his large aircraft license. He's flying for a major carrier. Now he has type one diabetes. Does that feel hopeful to
Speaker 1 1:08:54
you? Yeah, it does. You know, when I when I was diagnosed, that wasn't a possibility. The FAA prohibited commercial pilots who had type one diabetes, but I think it was 2017 when they changed their rules to allow type one diabetics to be commercial pilots. And part of the reason I did that was because of the technology advancements, specifically in pump therapy and pump management. So I don't have any aspirations of going to the commercial airlines, but one of my sons who has type one diabetes very much wants to be a commercial pilot. So, you know, in that respect, I'm very hopeful and thankful. Yeah.
Scott Benner 1:09:27
Do you fly privately now for pleasure?
Speaker 1 1:09:30
I do. Yeah. One of my favorite things to do is fly my kids to the different soccer tournaments they have all over the southeast us so last week, my wife and I and two of our boys flipped to Richmond for their soccer tournaments up there and Charlie who's my middle child has type one diabetes so you know if I can combine flying family and football and one weekend to me that's I think I've just achieved Valhalla.
Scott Benner 1:09:54
So then it sounds to me like this diagnosis was a significant course correction for you. Can you tell me how It affected your dream.
Speaker 1 1:10:01
Well, I you know, if I guess three words come to mind first, it was devastating. Everything I had done in life, everything I'd worked up to up to that point was just taken away in an instant. And I was not prepared for that at all. The second emotion was, it was scary. I hadn't thought much about life outside the Navy, certainly not life as anything else, but a fighter pilot. And Heather and I were getting ready to move to France, I was going to do an exchange tour with with the French naval air force. So we're taking French classes. So pretty quickly, I had to reinvent myself. And then probably the most important thing at the same time that all that was going on, I had to learn how to deal with type one diabetes and how to manage it effectively. The third thing that pops into my mind, I guess, is challenging, you know, new daily routines, I had to establish first with injections, and then eventually, you know, through pump management, and then learning how to count carbs and recognize highs and lows, how my body reacts to blood sugar trends based on exercise and stress and those types of things. And my goal at that time, and it still is today is to leverage technology and make sure my habit patterns are effective so that I take diabetes management from the forefront to the background.
Scott Benner 1:11:08
Have you had success with that? Do you feel like you've made the transition? Well,
Speaker 1 1:11:12
I have I mean, I believe in continuous improvement. So there's always more to do. I will say the technology since I was diagnosed specifically with pump management, it's just, it's just incredible. It takes less of me intervening. And it's really done by the pump itself and by the algorithms through the CGM is. And to me again, that should be the goal for everybody is to not have to focus so much on the daily aspects of type one, diabetes management, you know, we should let technology do that for us.
Scott Benner 1:11:41
What else have you found valuable? I've spoken to 1000s of people with type one diabetes, the one thing that took me by surprise, because I don't have type one, myself, and my daughter was very young when she was diagnosed. I didn't really understand until I launched this podcast, and then it grew into this kind of big Facebook presence. I heard people say, I don't know anybody else who has type one diabetes, I wish I knew more people. But until I saw them come together, I didn't recognize how important it was. Yeah,
Speaker 1 1:12:10
I think similarly, I didn't know anyone with type one diabetes growing up as an adult up until when I was diagnosed. And then all of a sudden, people just came out of the woodwork. And when CGM is first hit the market, certainly within the last five years. It's amazing to me and my family, how many people we've noticed with type one diabetes simply because you can see the CGM on their arm. I mean, I would say, a month does not go by where we don't run into someone at a restaurant or an amusement park or a sporting event or somewhere where we see somebody else with type one diabetes. And the other surprising aspect of that is just how quickly you make friends. And I'll give an example. We're at a soccer tournament up in Raleigh, this past Saturday and Sunday. And the referee came over to my son Charlie at the end of the game and said, Hey, I noticed that you're wearing pomp. And he lifted up a shirt and showed his pump as well and said, I've had type one diabetes since I was nine years old. I played soccer in college, I'm sure that's your aspiration. And I just want to tell you don't let type one diabetes ever stop you from achieving your dreams of what you want to do. And this gentleman was probably in his late 50s, or 60s. So just having that connection and seeing, you know, the outreach and people's willingness to share their experiences. It just means the world to us and just makes us feel like we're part of a strong community.
Scott Benner 1:13:30
So would you say that the most important things are strong technology tools, understanding how to manage yourself and a connection to others? Yeah,
Speaker 1 1:13:39
technology for sure. And knowing how to leverage it, and then the community and that community is your friends, your family caregivers, you know, for me, the Medtronic champions community, you know, all those resources that are out there to, you know, help guide away, but then help help you keep abreast on you know, the new things that are coming down the pipe, and to give you hope for eventually, you know, that we can find a cure. You
Scott Benner 1:14:01
mentioned that your son wanted to be a pilot. He also has type one diabetes, how old was he when he was diagnosed?
Speaker 1 1:14:07
So Henry was diagnosed when he was 12 years old, was just at the start of COVID. We are actually visiting my in laws in Tennessee, we woke up in the morning and he had his bed. And several years before that, we had all four of our boys tested for TrialNet. So you know, predictor of whether or not they're going to develop type one diabetes and whether or Henry and one of his brothers tested positive for a lot of the indicators. So we always kind of had an inclination that there was a high degree of possibility he would develop it, but we always had at the back of our mind as well. And so when that event happened, at the beginning of COVID, we had him take his blood sugar on my glucometer and it was over 400 And so right away, we knew that without even being diagnosed properly by endocrinologist that he was a type one diabetic, so we hurried home to get him properly diagnosed in Charlottesville, and then we just start Did the process first grieving, but then acceptance and, you know, his eventual becoming part of the team that nobody wants to join? How old is he now? He's 15 years old. Now,
Scott Benner 1:15:13
when's the first time he came to you? And said, Is this going to stop me from flying? Almost
Speaker 1 1:15:19
immediately. So like me, he's he always had aspirations of flying. In fact, he out of all four boys wanted to be in the military, that was a difficult part of the conversation and maybe something that we don't talk about as a community. But there are some things you cannot do as a type one diabetic, and that's a hard fact of life. And unfortunately, joining the military is one of those hard and fast things you cannot be you cannot join the military as a type one diabetic. So it was very difficult for him and for me and my wife to get over. Then we also started talking about being a commercial pilot. So I saw that same excitement in his eyes because like me, you know, he can be an NFA teen or a 737 or a Cirrus SR 20 That I fly, be just as happy. So he still has that passion today and still very much plans to eventually become a commercial pilot.
Scott Benner 1:16:04
I appreciate your sharing that with me. Thank you. You have four children do any others have type one?
Speaker 1 1:16:09
They do? My oldest twin Henry has type one diabetes, and my middle son Charlie has type one diabetes as well. The boys are twins. The oldest two are twins. One has type one diabetes. My middle son, who is not a twin has type one diabetes.
Scott Benner 1:16:23
I see. Is there any other autoimmune in your family? There isn't
Speaker 1 1:16:26
I'm really the only person in my family or my wife's family that we know of with any sort of autoimmune disease, certainly type one diabetes. So unfortunately, I was the first to strike it rich and unfortunately pass it along to to my sons with celiac thyroid, anything like that. Not about nothing. We're really a pretty healthy family. So this came out of nowhere for myself and for my two sons. That's really
Scott Benner 1:16:51
something. I appreciate your time very much. I appreciate you sharing this with me. Thank you very much.
Unknown Speaker 1:16:55
Anytime Scott.
Scott Benner 1:16:56
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#1163 Lip Drill
Kim is 47 years old, diagnosed with type 1 at 24.
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Scott Benner 0:00
Hello friends and welcome to episode 1163 of the Juicebox Podcast
a we're talking to Kim today she's 47 years old, diagnosed with type one diabetes at 24. And her 13 year old son also has type one diabetes. She was a singer. Wait a second, what is all this I'm looking at my own notes here she's a singer started noticing her symptoms around the time of an audition in New York and her Oh, you're gonna love this one. I remember this one. Please don't forget 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. Take the survey T one D exchange.org/juicebox. US residents who have type one diabetes or the caregivers of type one that are looking for you to fill out a 10 minute survey. It's just 10 minutes it's shorter than one of those like tests you take to find out what Hufflepuff you are you understand I'm saying T one D exchange.org/juicebox. You can do it right from your phone. Do it do it now. I commend you. When you place your first order for ag one with my link you'll get five free travel packs and a free year supply of vitamin D. Drink ag one.com/juice box
this episode of The Juicebox Podcast is sponsored by ever since the ever since CGM is more convenient requiring only one sensor every six months. It offers more flexibility with its easy on Easy Off smart transmitter and allows you to take a break when needed. Ever since cgm.com/juice box. This show is sponsored today by the glucagon that my daughter carries G voc hypo pen. Find out more at G voc glucagon.com. Forward slash juice box. Alright,
Kim 2:04
so my name is Kim. I'm 47 years old. And I was diagnosed with type one in December of 2000. And I have two kids, two boys aged 15 and 13. And my 13 year old is en and he also has type one. And he was diagnosed in May of 2018. And he was eight at the time 2018
Scott Benner 2:33
At eight. You were 47 When you were diagnosed?
Kim 2:37
No Oh, no, no, no, no, no, no 47 Now, okay, and it was 23 years ago. So I was 24 or I just turned 24. Well, my birthday is in September, and it was December. So it was Yeah, I
Scott Benner 2:53
was 24. It's my favorite part about when we talk about ages people get so oddly specific. I'm like you were 24. And people will go, Well, I had just turned 24. And I'm like, is any of this relevant? Or?
Kim 3:06
No, I know. Well, it kind of puts in perspective, like when was it in the year? And? Yeah, well,
Scott Benner 3:12
I think it's accurate. It's for the it's for people very obvious to me, that it's important to them for those small details to be correct for reasons that I think they don't see themselves as storytellers in this situation. It feels like they're their biographers, I guess to themselves, but like, but keep in mind, if you're listening to the podcast, whether you were 23, almost 24 Or just 24 When you were diagnosed, no one cares.
Kim 3:39
Makes no difference. makes literally
Scott Benner 3:41
no difference to what we're saying. Everybody gets stuck on it. It's It's fascinating to me a little bit. Yeah. Okay. So you were out of college, obviously. Yeah,
Kim 3:51
I had just finished graduate school. Actually, I went two years for graduate school after college and go off. Go ahead. And it was so I graduated that May and then this was December after that.
Scott Benner 4:06
Were you by any chance with the person you're married to now at that point?
Kim 4:10
No, no, no. We, we didn't meet till later. But yeah, I was. No, I don't think I was in a relationship at the time.
Scott Benner 4:18
Okay, so this diagnosis it comes. Are you living on your own? Are you back at home with your parents?
Kim 4:24
No, I was living on my own in a college in the Midwest. Yeah, it was in the summer through the summer. I was like doing a show and kind of started noticing some weird things. And I remember my dad saying like, hey, recognize you in the pictures, you know, because I lost a lot of weight and I guess I looked kind of gone in my face and all but then it wasn't until the fall. When I remember going like we used to go eat Mexican food a lot with my friends and I would come home Um, and, like, wonder if I was going to make it to the bathroom, you know? Cuz I mean, I guess my blood sugar was just so high and I didn't even know. And then my sister in law's a nurse and she had Thanksgiving. tested my blood says this is like a long, you know, month span, right? She tested my blood sugar to set a high on the meter. But then I had already planned to go to New York for a few days because I had some like auditions and things because I was a singer. That's what I was. I did and do and so I was I was still gonna go there were like, well, I don't know if that's a good idea. But I went, I remember having to buy like, reader's glasses because I couldn't see things. And so finally, I went home to South Carolina for Christmas. And my parents had made an appointment for me with this our family doctor, and that's who diagnosed the timeline. Yes, I
Scott Benner 6:02
was confused at first you were like, you just said a show. Like I knew that you were a performer, but I didn't know. So now I'm like getting it. So you were singing and dancing and like what like, we shooting for like Broadway type stuff or no,
Kim 6:15
no more. I'm sad, classical voice. So, you know, I performed an opera as an all in the summer to the opera company where I was living the, you know, traditional operas through the fall. And then the summertime, they did more light opera like if you know, Gilbert and Sullivan or, you know, things like that, that are a little more on the lighter side with more dancing and yeah. Oh, that's so I was in a show. There. Okay. Yeah. And started just kind of noticing things. And then I, I kind of put it together just by researching, you know, looking up symptoms that I was experiencing. And I was like, Oh, this might be something.
Scott Benner 6:57
Well, I love the blend of South Carolina and opera because you said you know, I do like OPERS and all. This is terrific. So your sister in law. So you're one of your siblings was married already. She was a nurse. Yeah,
Kim 7:15
they just got married. She's a nurse. And her mom has type two I believe in so they had Mater's lying around. And she came over when I was when I saw them at Thanksgiving, who she checked my blood sugar on the meter. And it just said, Hi. And she was like, you might want to get this checked out. And she started sending me all this, like pamphlets and stuff. Oh, Taiwan, and then. But yeah, I went to New York, and I did auditions. And I mean, I didn't I didn't even know you know, I didn't know that it was that dire of a situation. I was 24. You became
Scott Benner 7:49
you're 24 in a Duane Reade, I'm guessing by buying readers. And you don't think this might be problematic? Yes.
Kim 7:58
Well, I mean, I thought it was problematic, but I don't think I realized exactly. To the classes. Maybe I thought I just needed glasses, like all of a sudden, my eyes were bad. So oh,
Scott Benner 8:08
you know how that happens. You know how that happens for your eyes just suddenly stop working? When you're 24? You know, because Exactly. Any other type one or autoimmune in your family? Not
Kim 8:20
a lot. So my mom's okay. My mom's father's mother, her great grandmother, her grandmother, my great grandmother had type one in like that, you know, late 1800s, early 1900s. And she had 11 children and she lived in her 80s. And
Scott Benner 8:42
she didn't live into her 80s Without insulin. So when?
Kim 8:46
Yes, she well, okay, so, maybe I guess in that early 1900s Because my granddad was born in 1911. And he was like, in the middle of 11 kids, so
Scott Benner 8:57
Oh, maybe she was diagnosed. I mean, she had all I mean, if she lived at she had to have insulin, right? Oh, yeah, she hadn't. Yeah, so and that's 1921 2122 Yeah.
Kim 9:11
So around the time when I guess she was Yeah, okay. All right. Because I have children you said
Scott Benner 9:16
1800s. At first I was like and then she died when she was two like and Buffalo Bill carried her body to the gravesite like I was like I'm not sure what's happening here. So I love by the way how people with autoimmune stuff in their family like is there other type one your family like? Not a lot? Well,
Kim 9:34
I mean, like not a lot of type one. No, I
Scott Benner 9:36
know, but other people would go you know, other people who aren't indoctrinated into diabetes and autoimmune would be like, yes, there was a grandmother and like you're just not as much as you would think. How about other autoimmune? Do you look back and see it with anybody? Do you have any yourself?
Kim 9:50
I? I do I have Ashley Meadows? And my brother also just found out that he has Hashimotos give him my mom does not have any thing and her other than the grandmother with type one that's all that we know about. Like her siblings don't have anything I've asked her. My dad's side of the family I don't know so much about he so he passed right after I was diagnosed I'm sorry and so you know we didn't at that time didn't really talk much about autoimmune events didn't know about it so I don't really know much about on his side of the family but there's got to be you know, my brother has hash meadows and I have the two and you know, it's in there somewhere.
Scott Benner 10:32
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Kim 13:10
Well, we think it was a heart attack. It was son. He was 53
Scott Benner 13:14
Oh wow. I'm going to be 53 next year, so let's make up a different age where your dad died. Let's say he was 90. Okay. That sounds good way to panic me while we're watching while we're making up like oh my god, I just lost weight. Now.
Kim 13:27
You're in better shape now for sure. Oh
Scott Benner 13:29
my gosh. Oh, you you. You've seen my transformation.
Kim 13:32
I have. Yeah, I listen to your diaries. And yeah, it's fascinating.
Scott Benner 13:36
Oh, thank you my diaries where I'm like, either, like jubilant or like what is happening? Why can't this happen? Tim, I would tell you right now that I'm I'm I'm a little constipated, but we're not in the week of retirees. So
Kim 13:52
yeah, yeah, I've actually been considering the magnesium oxide myself.
Scott Benner 13:58
Oh, just for a little poopy. Yeah, that's a nice idea. I I went away this weekend and gave a talk. And I was so careful to take everything with me. And I took it while I was gone. Then I got home. And now I haven't taken it for like two days. Because when I got home, my pillowcase was empty as if that's an excuse. But I'm also like, the craziest thing happened. Can I tell you something that would never make it in the podcast if we don't talk about it right here unless it becomes like a horrible problem. Oh, gosh, yeah. I wanted to get home quickly to spend the day with my wife. So I flew out Friday morning to Orlando. I was on a plane at like 8am It was unpleasant. I'm not gonna lie to you. And I arrived in Orlando like 1010 30 I don't remember exactly. When I jumped in an Uber I was at the hotel. I did what any reasonable person does and they arrive at a hotel I unpack my bag and iron my clothes. No, no, I had to be in front of people. So I didn't want get caught with wrinkly stuff. So I took care of the irony. I went out, I grabbed a sandwich, I brought it back, I ate it by the pool, actually 20 minutes into that I thought I don't why do people live here so hot. And then then I made my way back to the room, etc, and so on. Got up the next day was brilliant all day giving my talks, but wanted to get home early for my wife, I had two options to fly on Sunday. One of them was a plane that took off at 6am. And I, like an idiot chose that flight. So I slept like four and a half hours woke up at three in the morning. And I got to the airport. Not too early. I'm not too late. It's all good. I sit down, I'm not there for five minutes, they push the flight back an hour and a half. Oh, it's like, okay, that's fine. So I stay awake, because I don't want to like you know, with my luck, they'll move the gate. And I'll wake I'll wake up and I'll be like, Wait, I don't want to go to Paraguay. You know what I mean? Like, it's gonna be like that. So I stay awake to get on the plane. We get on the plane. It's not very full. The stewardess comes around, she was hey, everybody can grab their own row. I don't know if you've ever been on a flight like that. But
Kim 16:07
yeah, where it's kind of empty. Terrific, right? And I think
Scott Benner 16:11
I'm going to sleep. So I laid down across the three seats, and curled up like a baby and I went to sleep well, it turns out the metal bar that separates the seat like under the padding, and the padding is like a loose term because it wasn't very soft. I must have laid right against something in my shoulder or my arm. And I think I pinched a nerve in my arm. And now it is four solid days later. And I have like, numbness and tingling in my hand and up my arm still. Oh my god. Yeah. So I'm pretty sure like a function of my hand. I don't want you to like think I'm like sitting here. And it's like laying off to the side. Like I have full function. But it feels it feels like it's been asleep, and it's almost done waking up. Oh, I hate that. Yeah. And I can't feel cold and hot correctly. And like water feels really ridiculous going over me. Anyway, I'm starting to panic about that. Yeah, maybe well, I'm old. So this could be it. This is how my arm falls off. You don't I mean, like for certain. Anyway. Why does this come up? Cuz? Because afterwards, I thought if I was still fat, I would have probably had enough padding for this not to happen. So I think losing weights can make me lose function in my right arm is what I'm getting. I don't know. I would have stayed chunky for that. You know what I mean? Anyway, I call the doctor. And he goes, Yeah, I'm not the right kind of doctor for that. I'll say, Oh, great.
Kim 17:47
Thanks. Wow. Okay, so
Scott Benner 17:50
who is a neurologist? Or oddly, a psychiatrist. Really ask why? Why? Well, the neurologists, for obvious reasons. The psychiatrist because apparently they're good with certain medications for depression that also helped nerve pain. Wow. I was like, Hmm, interesting. Interesting. But like a real man. I'm just going to ignore it until it goes well.
Kim 18:17
That's yeah, yeah. Yeah.
Unknown Speaker 18:19
Anyway, I
Kim 18:20
have a weird thing with my arm at the moment. And I think it's called shoulder impingement syndrome.
Scott Benner 18:27
Do you think you have a frozen shoulder? No, I
Kim 18:29
don't know. It's I don't think it's frozen shoulder. I think it's, um, I kind of, so I also should go to the doctor about it. But it's like when I try to reach above my head. Or if I try to reach behind my back, it pinches and it's kind of limited in the movement. So it's something to do with the space in between the thing that sticks out of the edge of your shoulder blade.
Scott Benner 18:58
And Kim, this just happened Arden. Really it's so crazy. You just said this. Yeah. Right. So Arden came home from college a couple of months. She's back now. But she came home for the summer. And she wasn't home long. She's like, Oh, my shoulder is killing me. And we looked and she laid on the floor because she's like, she's a walk on my back girl. So she's like walking on my back. And the muscles were like inflamed around her shoulder like sticking up. And we tried to do everything we could with it but it just wasn't going anywhere. So I took her to an orthopedic and he gets her in the office does the little put your hands out to your side raises over your head. She had limited motion it hurt moving her arm up that kind of stuff reached behind herself. He said yeah, you have like an impingement in your shoulder. He stuck a needle in her shoulder and filled her with whatever magic the put in there. The cortisone or cortisol that let me be honest, I didn't ask. Yeah, I just knew it's gonna make your blood sugar go up. For a couple of hours, which he did, but he sticks it in, like behind her shoulder blade a pretty, like meaty needle and pumps it in. She didn't feel the needle because he froze her skin first. But when he pumped the juice and she was like, Ooh, and then he took it out and had her just sit still for like, 20 I'm not lying. 2030 seconds. And he goes, Okay, try to lift your arm up over your head, and her arm shot up over her head like it was nothing.
Kim 20:26
Oh my gosh, she's
Scott Benner 20:27
like, that's amazing. So,
Kim 20:30
so did it then did it go away for good? Does she have any other issues with it? Now?
Scott Benner 20:35
It's only been a few weeks, but she hasn't complained about it. Wow. She's also a college now. So I don't talk to her as much. Yeah.
Kim 20:42
Yeah, that's the same thing. You know, you can't reach over your head. You can't do the thing where you like pull your arm in front of you and just stretch your arm. It hurts to like clasp a bra strap. That movement. Yeah, so
Scott Benner 20:54
apparently go to ortho Pedic that does shoulders, Hill, shoot cortisone or whatever the hell it is, like steroid in your shoulder. You're gonna need like 200 Basal insulin. Yeah, percentage for a few about three days afterwards. It was hard to Bolus for things for three days, like she was getting a lot, a lot of insulin. And then you do physical therapy to strengthen around it. And apparently that's the fix.
Kim 21:17
Wow. Okay. Well, that's good.
Scott Benner 21:20
Yeah. You got insurance? I mean, yeah, dancer. I don't know. You might not have any money. Yeah. And
Kim 21:25
then I got I'm a professor now. So
Unknown Speaker 21:27
what do you think?
Kim 21:29
I teach voice lessons and big music school in the Midwest? And yeah, I'm on the voice faculty there.
Scott Benner 21:37
Ken. We're gonna get to your diabetes and your and by the way, and your kids diabetes in a second. But can I ask one question before we move on? Yes. Why is my voice so pleasing in a spoken word, but I can't sing it all.
Kim 21:49
Ah, have you tried? I'm sure you can sing your you have a very resonant voice. And I mean, I would have you tried. Do you? Do you sing at all? I mean to myself, and it sounds bad. Yeah. Well, that's to you that maybe not anybody. No, no
Scott Benner 22:07
other people have commented.
Kim 22:11
Well, you should think about, like, let your singing voice kind of sit where you're speaking voices. That's kind of in the same resonant place.
Scott Benner 22:19
So I can't I can't feature I gotta be in the background, right? Yeah, maybe.
Kim 22:23
I mean, you know, speaking is more of your thing. But you know, you can work on it. It feels
Scott Benner 22:28
like I have to learn how to play bass so I can you know, Master doing Master of Puppets in my Metallica cover band? That seems like the only thing I'm gonna get out of this. Is that right? Maybe this why that lady made me sing in the chorus when I was little.
Kim 22:42
Because you have a very resonant speaking voice and they probably assume oh, she forced I have a booming singing voice.
Scott Benner 22:48
Nowadays, by the way, it would have been probably illegal the way she forced me to be in the course.
Kim 22:53
Oh, no.
Scott Benner 22:54
She's strong arm me. Okay, so I'm never going to be like, feature. Like, I can't do like, Lady Gaga or something like that. I'm going to be in the background like adding depth to the song. Yeah,
Kim 23:10
yes, you're going to be in the choir. And when they need the low notes, that's gonna be you. That
Scott Benner 23:14
doesn't sound like a lot of fun for me. Do people do that?
Kim 23:18
Are you to be maybe be a bear term, you know, which is a not the highest male voice but the middle kind of in the middle.
Scott Benner 23:25
I don't know. You're trying to be nice, but I hear what you're saying. I can't sing. It's fine.
Kim 23:30
I don't know. I'm not hurt you. I bet you could.
Scott Benner 23:32
Could you like coach me up enough to like, get me somewhere? Do you think? Yes. Really? Yes. That's what you do for a living but in college? Yeah,
Kim 23:43
I'm at a college. Yeah.
Scott Benner 23:44
How many people show up to sing at college, and can't do it. percentage wise, like, like, are bad singers, but don't know it? Well,
Kim 23:53
I mean, in the school that I'm in, you have to audition, you have to prove that you you know, have a singing voice. And you know, most of them are there because they want to pursue singing in some form or fashion. But it's interesting. A lot of them can definitely singing but like I'll have freshmen come in that, you know, don't know how to read music. They can't, you know, look at the music on the page and know what the notes are. So a lot of people can just think for fun, but they don't really know. The other parts that go into it.
Scott Benner 24:29
So how many people show up at the audition that you're like, Why would you come here like
Kim 24:33
oh, yeah, yeah, we get we definitely get those.
Scott Benner 24:36
But they don't know is that correct? Yeah.
Kim 24:39
You know, often sometimes they don't know sometimes, you know, their grandmother has always said oh, you have such a nice singing voice and then that maybe they're just not meant to like really pursue it. Yeah. You know, in a professional level. Yeah. them you know, they come in you're like why? Why are you here like you shouldn't This isn't for you how be
Scott Benner 25:00
like if I showed up at an NBA tryout is how it feels sometimes. Yeah. Yeah. How many people have a pleasing singing voice, and it's technically fine, but soloists, and they don't know that about themselves either. Yeah,
Kim 25:16
that that happens to where it's just kind of, I don't know, they just, well, it becomes kind of just academic, where they're not really making music, they're not being musical. So you can teach that and we have, you know, that's why you work with. So you have a singing teacher, and you know, a technical thing, teacher, that's what I do. But then we have people that are voice coaches that work more on the musical things, you know, how to express the music. And that can help.
Scott Benner 25:47
I always think how sad it must be for your voice to actually sound good. And yet, when you sing, it doesn't evoke anything from people. They, like, you know, how close you are to the mountaintop at that point. Right? It's upsetting to me. And
Kim 26:04
some of that comes with how they're using their voice. You know, sometimes they think, Well, I'm just gonna haul off and sing and try to be really loud. It just becomes like pressure and you feel like you're being yelled at.
Scott Benner 26:18
I know what you mean. Yeah.
Kim 26:20
Where it's just like, Okay, you're loud, right? That's all you know, then yeah, you can learn how to use your voice really effectively, where it just kind of pierces your audience more than it's more pleasing,
Scott Benner 26:33
like, like Janis Joplin is yelling at me, but I don't feel like I'm being yelled at.
Kim 26:37
Right. Yeah, right. Definitely. Uh, she had her own way of doing things. And I'm not always the healthiest, but something and people I mean, people love to, you know,
Scott Benner 26:49
I gotcha. Okay. So you're diagnosed in 2000. As an adult, what's the transition like, from Hey, I thought I was going to be a singer and a dancer to live diabetes.
Kim 27:01
Well, I mean, that didn't change like I, I kept going. But then I remember. So I think I, I started with like, hemozoin, I think. And then kind of quickly after that went to Novolog and Lantus. But I remember carrying it around with me. And it was kind of one of those things like, well, this is just what I have to do, you know, but I still kept. I mean, I was out of school at the time, but I was staying in the city where I was at graduate school and performing with the opera company there and doing some teaching. And yeah, I just, I think I was maybe a little bit of like, well, I don't really know what I'm doing. But I'm just gonna keep going. It didn't really stop me so much in a way of like, I didn't feel like like, I can't do this anymore.
Scott Benner 27:54
Okay. So your personality didn't like, lend itself to you getting bowled over by the scenario. But then your father passes? Yeah, yeah. Does that impact the diabetes at
Kim 28:05
all? It did. I mean, you know, I was still at a time where I wasn't checking it all the time. At that time, you know, and so I don't really know, specifically, from day to day, but I remember when he died, you know, it was traumatic and shocking and awful. But I had people telling me, like, you need to be careful, you know, you might, this might really affect you. Because I was fairly newly diagnosed at that time. And so I don't really I don't know, specifically, but he was the one that was with me when I got diagnosed, and was kind of just like, there to, you know, as the support person through the beginnings of it, even though I wasn't living at home, like I was in touch with him a lot. And so I think I just kind of kept going, because I knew that that was what he would want. Yeah, but it didn't. I mean, I moved. I lived in Boston, I lived in New York for a while, like I was on my own for a good bit, and maybe just like, not really knowing exactly what you were
Scott Benner 29:15
doing, what I'm doing what what were your goals, like, like health wise with diabetes? What were you trying to accomplish while you were living in those places? Like was it a one C driven? Was it how you felt? Yeah,
Kim 29:26
it was, it was kind of both I you know, I made sure that I was in with doctors quickly. Wherever I was living. It was definitely a one C driven. That was the big focus. And then also, you know, I remember, I would keep the little log books and I wanted it to be under 200. And, you know, I mean, those are my Yeah, I definitely had the goal of trying to stay under 200 and I wanted my agency. My agency when I was diagnosed was around seven Something I wasn't I never went into hospital like, it was just with my family doctor tried things over the phone and I would report back to them what was going on? And yeah, it was, I think a Wednesday was always the
Scott Benner 30:15
floor. And do you look back now? Do you have any? any complications at all? No, no. Okay. You feel like you. Whatever you were doing was working for you. Yeah,
Kim 30:27
yeah. Yeah. Excellent. Yeah. Even though what I mean, like now, you know, the difference now, being able to see, you know, with the Dexcom. And all that means, I look back and I'm like, I was just kind of like, looking through the wind a little bit and just kind of checking my meter when they told me that I should be checking it. But it wasn't as continuous as knowing what I where I am now tell
Scott Benner 30:51
people the feeling of getting a CGM for the first time and having lived so long without one. Yeah,
Kim 30:57
so that was interesting. Because when I first got the CGM, it was hard to, you know, see on the screen when, if I was going up, or if I was sitting too high. I felt like, oh, gosh, I'm gonna even get in trouble or something, or I didn't want I didn't like seeing that. So much difficult for you.
Scott Benner 31:20
Yeah, like, like, literally like feeling like, oh, gosh, this isn't going right. And having it in your face was hard.
Kim 31:25
Yes. Okay. And I remember I had the, like, the little separate receiver that was like, a rectangle shape. And it was on the little leather pouch thing.
Scott Benner 31:36
Yeah, I'm actually looking at one right now, because I found a drawer and I'm trying to decide if I should just throw it away or not.
Kim 31:41
Oh, yeah, I still have mine. I think that because that was what the G for I started with the g4, right. But I kept that on me, you know, I would check it. But then I remember when it was possible to put it on the phone through the app. I didn't want to do that, because I wanted to kind of keep it separate, like I didn't want, you know, just have to see it all the time on my phone in front of me that I would just play this as the separate thing. Like, I'll keep my diabetes kind of over here. And I was still, you know, very conscious of trying to stay in range and keeping up with everything I was doing, but it was it was hard to get used to sing all the time. Felt
Scott Benner 32:22
like pressure. Yeah, yeah. It does. Does it feel like that now? Oh, no. Hmm. Good. Now, you see the benefits of having it and yes, yeah, definitely. So when you when do you get the Hashimotos diagnosis? That
Kim 32:39
was pretty soon after I was diagnosed. So let's see. 2000. So I, I moved to Okay, so, September 11 happened, and I was in New York City. So I only stayed there for like three months and then moved to Boston. And I had a great doctor at the hospital there. And it was when I was living there. So it was, you know, maybe a year and a half or so later.
Scott Benner 33:09
And you're doing Synthroid for that. Yes. What are your TSH goals? Where does your doctor keep you at?
Kim 33:17
I just recently found out that my app was above five. So yeah. So yeah, so it's been a while right that I've been on the Synthroid and everything has been now, I'm gonna give you a plug because I love thyroid series, I learned so much from that. And I had always looked at the range, you know, they give you right to stay in range when you have the bloodwork done. So now I'm a little more like I want it to be like low, you know, under too good for you. Is that happening though? So now it's happening, but there was a while so at the beginning of this year, I had some blood work done. I was having a lot of weird symptoms. When I was having a lot of like heart stuff going on, like palpitations. Yeah, it was like PVCs for you ventricular contractions. So that freaks me out because you know, it's used in my family. Exactly. Exactly. So I was really freaked out last summer with all of that going on. Um, you know, that I was sent to a cardiologist and a stress test and all this stuff and it was just really freaking me out and then in January, I started with a new nurse practitioner like a functional medicine kind of person and she did a lot of blood work and turned out my TSH was five some five point something because it had been, I mean, probably, for whatever reason, over six months since my last blood test, so the thin so she increased the center way and that fixed it all up. So last time I had it taken it was like just under one and that the PVCs has stopped and all of those issues that I was having I think all were coming from the elevated levels
Scott Benner 35:18
in hindsight Did you have any other thyroid related issues that have cleared hair for
Kim 35:23
hair? My hair was falling out like crazy weight? Weight Gain yes tired? Yes, sleeping all the time. Like I couldn't make kids will make fun of me because I couldn't sit in front of the television without falling asleep. So
Scott Benner 35:38
that didn't happen to you. Your kids would make fun of you for something else just
Kim 35:43
I mean, I'm not like I'm asleep a lot anyway. You know, I'm I'm I fall asleep a lot at night regardless. Yeah, like it was more it was definitely more so
Scott Benner 35:53
go away with the T TSH come down. Or is it still with you?
Kim 35:58
I still fall asleep but I think like the functioning through the day is much better. I don't feel exhausted like it was before.
Scott Benner 36:07
Yeah, don't overlook asking about like T three supplementing to Yeah.
Kim 36:13
In the those first tests, like she checked the T three and it was okay.
Scott Benner 36:19
Remember when your TSH was okay, but you were falling asleep on the sofa? Yeah.
Kim 36:27
But I go because they're definitely the tired thing for sure linger. So I wonder.
Scott Benner 36:34
I'm telling you. Arden is not an upright living human being without Saito. Okay. She would just persevere through horrible exhaustion and sleep forever, and then get up and be exhausted. And then you add the T three and it's much different for
Kim 36:52
and is does she take it because they saw like the deficit in her blood work or it just helps her
Scott Benner 36:58
no matter what she took it because I said you have to help her. This isn't working. She Yeah, yeah, we had her TSH under two and she's still exhausted. Yeah, so sometimes you make it but you can't take it up. You can't use it. And so by kind of giving you a little more it sort of overloads the preceptors. And you actually get it. Yeah, that makes sense. Yeah, might as well try. Yeah, you might need a very little bit. And if you have too much sight ml you'll know because you're like clench your teeth and like your heart or race like it's not, it's not a thing you'll you won't know is wrong. If it's wrong, that's for sure. Okay, yeah. Sounds like fun. Right. clenching your teeth. My gosh, well, I
Kim 37:44
mean, I, I have found that I'm doing that now. clenching my teeth. I don't know why. I was just talking to my dentist about that. Actually.
Scott Benner 37:55
I'll say something that sounds like a little hippie ish. But look into some people take something called skullcap for teeth grinding. Oh, it's just a second. It's an I'll tell you what it is in a second. Okay, and then we're gonna ask about your son. I'm typing you're gonna get a lot of pictures the guys with hats on at first. It's harder to type with a half Nam arm in case you're wondering.
Kim 38:23
Oh my gosh, I bet so definitely is your is your computer like your keyboard kind of elevated or is it on the I guess it doesn't really matter. You're still having to lift your arms.
Scott Benner 38:34
My arm is like so, skullcaps, the supplement. It's not a like a like anything crazy. Let me see. Let me see what's in it. By Sun takes it for teeth grinding. Chinese skullcap is just a root a ground up root sculpt sculpts malaria bowel. Obviously it's nothing I can't say. But it's a ground up route and people sometimes take it traditionally used to promote good night's sleep supports a relaxation and steady nerves. That all sounds like a lot of hocus pocus but you can try it is inexpensive and it helps with you if it if it helps you the teeth grinding. Say thank you. And if it doesn't stop buying it. Yeah, and I'm not a doctor. So yeah, there we go. All right,
Kim 39:26
I'll look into that is because interesting because I don't tend I don't think I do it. While I'm sleeping so much. I think it's just kind of like a nervous tic or something that I've kind of developed fun to the day. I'll just kind of realize, Oh, my teeth are achy. You know, me or my molars are?
Scott Benner 39:42
Oh, yeah. Oh, you're really biting down? Yeah. Oh, no kidding.
Kim 39:48
Yeah, I don't really realize it until I kind of look back and I'm
Scott Benner 39:51
like, Oh, you're gonna crack a molar and end up with a root canal? You know? Yeah, no, we don't. I don't want to deal with that. Okay. All right. So you live in your life with your Diabetes, you meet a boy, he ruins your life and marries you. You go along and you make some kids, when when your son's diagnosed, do you think? Well, yeah, obviously, where do you think, Wow, I'm bowled over by this.
Kim 40:13
Okay, so when I was having children like thinking about it now, it didn't really occur to me much. I mean, I just was more thinking about, can I have kids, you know, because you hear all the people saying, you know, the older thoughts of, it's not possible. But so he was born, he was fine. And then we did travel that. And this was probably when he was about one and a half or two. And he came back with four of the antibodies. And that at that moment, I was like, Oh, my gosh, like this could really happen. And I think a lot of the kind of upset feeling of the possibility of all of it happen then. So we kept we went and did one of the glucose tolerance tests to kind of start in with the trial stuff. But he didn't really have a handle that Well, I mean, at least with the, the IV, like the process of doing it. So I think we maybe did it twice, and then just decided, like, if it's gonna happen, it's gonna happen. And I know this is really helpful for other people along the way, but it just wasn't working out so well, for us to continue doing that. So
Scott Benner 41:34
I hear what you say your kids soft? No, I'm just kidding.
Kim 41:39
Mom was soft.
Scott Benner 41:41
Yeah, I hear you. Yeah. But when he gets those that return from the trial that he's got for, I mean, it's four, there's only five markers, right? Yeah. So there, they tell you, it's a, it's reasonably certain he'll get type one.
Kim 41:55
They've said it's a possibility. And it might, you know, just something to kind of keep an eye on. So they can, they suggested, you're gonna keep checking as a one C, because at the time, he was like, low fours. And so we just kind of every time we would go to the pediatrician, and be like, you know, this is what they showed, and we need to kind of keep looking at this. And so, like, once a year, I think he would get an agency check. And it was going along, okay. And then we, it was he was in second grade. And it was spring break. And we were at Disney World. And he was having a hard time staying in lines, you know, without having to leave to go use the bathroom. And he was wetting the bed more, and he was never a bed wetter. And so we came back home, and I noticed, you know, he was drinking a lot of water, and that I was kind of, I think in a little denial, which I have some regret about now looking back on it, because I probably waited a little bit longer than I should have to before he was actually diagnosed. But you know, my brain was telling me oh, it's okay. Like, he's not drinking as much water as he was. And he hasn't wet the bed in a while. So maybe it's not not too bad. But turned out we went to just a ragged so he had a birthday in April. And it was like right after that, you know, he had his like, normal checkup with the pediatrician. And she noticed that his weight was lower than it was at the year before that checkup.
Scott Benner 43:34
That's a major indicator for a growing child. So it is
Kim 43:37
yeah, definitely. But she didn't go to the type one she went to, well, you know, maybe there's something going on with growth things or growth hormones or something like that. So she said, Let's just keep an eye on it. Just let me know, you know, maybe keep weighing him at home, let me know. And I went home and I was like, No, like this. I know what this is. Yeah. And so I had my moment of like, being really upset and kind of grieving the childhood that he was about to change, you know, and call the doctor back the next morning and said, I want to bring him in and get his agency checked and get a you know, finger stick.
Scott Benner 44:22
By the way, you have a meter your house, but okay,
Kim 44:25
I know. I know that I knew
Scott Benner 44:29
you weren't up for finding out where, you
Kim 44:31
know, I didn't want to I didn't want to know, I was I was too. too nervous about it. Yeah. And, you know, interest. It's just interesting that, you know, the pediatrician didn't go to that.
Scott Benner 44:42
Well, also you have a thyroid issue. And he's not growing that mean that even is an indicator there. So, right.
Kim 44:50
So we went back the next day, it was a Friday and she you know, the blood sugar didn't read on the meter. It was the one that they had couldn't read that high. And his agency was like 14. She said, you're gonna go to the hospital. And where we live the biggest, like Children's Hospital is about an hour away. Okay, so we had to drive up there. And I took him in. But by that time, like, the day before I had my, I'm really upset about all this, and I have to cry about it. But that day, I was like, Okay, I know what this is, you know, we're gonna get this figured out. And so we did. We went to the hospital, and he was not in DKA. But he was, you know, sportin agency to stay there a couple of days.
Scott Benner 45:41
Your other children don't have markers. Is that right? That's right. Yeah. Which, which Gilberton solvent play does this most represent in your mind?
Kim 45:53
Oh, beautifully, like, happy and kind of political soccer.
Scott Benner 46:00
doesn't line up with your, your current experience at all? Right? Yeah, I'm not a Gilbert and Sullivan dork, like some people are. So I didn't know, I couldn't make a good reference. I thought maybe you could whip one out. But nevertheless, now
Kim 46:12
this is this was definitely more of a drama, for sure.
Scott Benner 46:15
How did your husband handle it? Oh, he
Kim 46:17
was great. I mean, he's, he's, he's more of like the, okay, let's just get this done. Like, let's go pack. Gotta go. I'm gonna take. So he stayed home. And my other son had a baseball game that night. And so he took him to the baseball game, and I got in the car, or the and off we went. And I think I kind of went into it. Like, I know all about this, you know, like, this is my thing. Right? I'm gonna, I know what to do. I'll take care of him. And, you know, my husband and my other son came and did all of the education stuff with us, you know, and because he knew, you know, my husband knew a little bit about all the stuff that I was going through, but not really intimately. I mean, you know, like, he wasn't watching my blood sugar numbers. He wasn't telling me what to Bolus by myself. He knew what to do for a low. But that was
Scott Benner 47:13
18 years, though of living together with that, and he really doesn't have a ton of information about it.
Kim 47:18
Right? Well, okay, I'm gonna tell you a quick story. So we met at a summer theater, in name, Dirty Dancing, but for singing offers
Scott Benner 47:29
what happened? Go ahead.
Kim 47:32
So the, we went back the next summer. And, you know, I mean, I, so I met him. This was 2003. And I have been, so about two and a half to three years, right. I've been doing all this. And so one night, I don't really know exactly what happened. But this was the one and only time that I've ever kind of passed out from a low blood sugar. And so he called 911. And they came and I remember waking up, like, being really upset that somebody had drank all of my orange juice, because I guess he was trying to pour the orange juice in my mouth. And well turned out. So I went to the ER, and you know, everything was okay. The next day, but he proposed to me the next day. And so he had all it was all planned, like he this was all coming in, and I just had to throw this
Scott Benner 48:26
past out during the moment when you were gonna get proposed to
Kim 48:30
Oh, it was the next day. He was to propose to me this was the night before he should
Scott Benner 48:34
have pushed it off a little bit, don't you think? Boys? Yeah. Only, by the way, only a boy would watch you pass out from a low blood sugar call 911 for you. You have to go through all that and go yeah, we're still gonna go through with the thing. Yeah. Any girl, any girl in that situation? Be like, I'm going to replan this for another time?
Kim 48:57
Maybe not today. But no, it all worked out. I mean, it was, you know, it was great. It was a great moment. But it was just because I remember we, I called my mom, you know, the next morning and he, I think called his parents to tell them but my mom obviously thought that I would be calling to tell her the good news, but I was calling to tell her about our trip to the emergency room. And so but she didn't say anything. So then when I called her back later to say Oh, actually, you know, we're engaged.
Scott Benner 49:25
Oh, your mom knew he was gonna propose. Yeah. How lucky that she doesn't blow it when you call.
Kim 49:31
I know. He very easily could have you imagine
Scott Benner 49:35
you say hello. And she's like, Oh my god. I'm so excited. You're like, what? I went to the house. How do you even know about this? Exactly. Yes, exactly. Was that a decent ring? Kim or Oh, it's great ring. Oh, then I guess it's fine.
Kim 49:49
today. Yeah, yeah.
Scott Benner 49:52
Yeah, that's hilarious.
Kim 49:54
That was the extent of you know, his experience. Yeah,
Scott Benner 49:57
he tried to drown you with orange juice. And that didn't work. He's like, I know how to ruin her life. Um, make her married. Right? Oh my god. Yeah, I'm joking. Marriage doesn't ruin your life in case you're not married. You're listening. Yeah, well. I just love. I love to giggle about it. So people who aren't married sit there going, oh my god, what is it? I don't know. You'll find out.
Kim 50:26
Yeah, we're 20 years in together on this.
Scott Benner 50:29
It's lovely. I've been married 27 years. Oh, wow.
Kim 50:32
Yeah. That's all everything's fine. A lot of days there.
Scott Benner 50:37
Yeah, no one's dead. What do you think of that?
Kim 50:40
That's all aim for that.
Scott Benner 50:42
My wife had to get up this morning at 2am to be on a call. That is like a conference call that's happening in Switzerland. And last night, she had to go to bed at eight, like eight at night to do that. And the last thing I said to her was, hey, when your alarm goes off at two, please do not wake me up.
Kim 51:05
I will not get up with you. Yeah, we joked about that, too. Sometimes Brian has to get up early for trips or whatever, like, national things to like, so if you wake up, and you could just go down and make me some tea. And I'm like, No, I'm not. He's joking. But like, I will not get out.
Scott Benner 51:21
She was gonna ask me. I don't know. She was gonna ask me help with the dogs. I could see it coming a mile away. And I was like, that's not gonna happen. You're gonna get up earlier and take care of the dogs yourself. Leave me the hell out of this. I'll be Suzy 20 years ago, she would have said this. Me. I would like yeah, I'll get on your schedule, and I'll get up with you. It'll be fine. Yeah, that's not happening. No, not anymore. So. Okay, so your son's diagnosed? I wonder how much if any comfort does he have from the fact that you have diabetes? Is that like a benefit or a detraction? Do you think?
Kim 51:54
I think it was a benefit? Because so think, talking back to that Dexcom receiver, for some reason, he always called it a Lucy wallet. I don't know where it came from.
Scott Benner 52:05
Dealing with his spare time. Let me let me Google that. Go ahead.
Kim 52:08
No, I think it's just something that he came up with.
Scott Benner 52:11
I think it's drug paraphernalia. He knows about Hold on. No, turns out it's not anything. Nevermind.
Kim 52:18
Yeah, so he always referred to it as the Lucy wallet. And he would kind of, you know, look at it and play with it and close it up. And so I remember telling him, you're gonna get your own loosey wallet, you know, and you're gonna do the things that I do, and you're gonna take insulin like I do. And so I think it was he was familiar enough with it to know what it was, and it wasn't gonna be this big, scary, unknown thing. And he was very much also, like, we got to the hospital, and they were showing him how to, you know, giving them the shots and checking his blood sugar. And he was like, so I'll have to do is just take a shower and a half to eat. It's like, I can do this, you know, and he very much had a, this is no big deal kind of attitude at the time.
Scott Benner 53:06
What's that attitude now?
Kim 53:09
Now, he would like to not have to deal with it. Exactly. Yeah. I mean, he's good about it. He He knows what his goals are, as far as staying in range, and Pre-Bolus Singh and all of that, but it just doesn't always happen.
Scott Benner 53:28
Oh, he's 1313. Yeah. 13. And
Kim 53:32
he's growing, you know, I mean, he's growing now for sure. And, you know, so we've got a lot of hormones surging and oh, so great. And some days are not and,
Scott Benner 53:43
yeah, what I meant to ask you about that. So when you gave him Synthroid, did he start growing?
Kim 53:48
So he, he's not taking Synthroid, he does have Hashimotos okay. They haven't put him on any center yet. And I'm like, somewhat, you know, I keep wondering, maybe if they should, yeah, what's his TSH, his TSH the last time we just had it checked and it was in the upper twos like 2.9 something Yeah,
Scott Benner 54:09
why not? A little bit is the small side because he want to be on the small side.
Kim 54:14
Well, he not now and he's always been average for his age group. You know, every time you look up the height averages but my older son is huge. Like he's six three, and has always been really tall. And so Ian has always seemed small compared to Thomas, but if you look at averages, like he's always been right where he's supposed to be right in the middle, you know, sometimes I wonder if maybe it's the Hashimotos because we just so after I had all that bloodwork done and realized that my TSH was off. I went back to look at Ian's and I didn't even realize that he had the Hashimotos because nobody even really talked about it but it was discovered when he was diagnosed, but nobody, nobody talks about it in his they mean they'll check his TSH they'll check in for celiac disease and range and that's it stays in range and that's it but how she met us was never brought up.
Scott Benner 55:12
Does he have any symptoms? No, I
Kim 55:15
mean other than he has, has an always has had really dry skin. And I wonder if that might be a
Scott Benner 55:22
symptom. Let's get the TSH down. That's yeah.
Kim 55:26
And I mean, yeah, I don't know if that would be what he needed every day. Would it just be a
Scott Benner 55:31
it's every day you get? It's a small it's just a small dose. That's all a small dose. Yeah. I want to tell you there's a crazy amount of wallets with Lucille Ball available on the internet. Oh, really? I mean, just is is Lucille Ball still very popular figure in the world? Because my God Do you have your options? If you want a Lucille Ball wallet? That is hilarious. I'm not kidding. And by the way, only one with the peanuts on it. And and it's not even Lucia Peppermint Patty Lucy.
Kim 56:06
I mean, that's that's not I don't think that she's not really well known. And today's
Scott Benner 56:12
you wouldn't think you'd be most people. Well, yeah, you're old. But I mean, most people can't care about this, right? Yeah. I don't know. I don't like this at all. I might call this episode Lucille Ball wallet.
Kim 56:28
I really, I wish I knew where he pulled that from. But he's, he pulls a lot of stuff out of his mind that I don't know where it comes from.
Scott Benner 56:35
Lucy. What was the cause? Balls? I mean, Kim, maybe it's something about a pouch. Who knows what's going on here? I don't know. By the way before I forget to say this. I know people who are from South Carolina who have two boys and their boys names are in and Thomas. What? Yeah, freaked me out when you said that. When you when you said Thomas just now is like, Oh my God, why do I know that? And yeah. Is that like a thing there? And she calls him Thomas. Not Tom.
Kim 57:02
Yeah. Right. So my dad was Thomas. So that's where we got it from? He went by Tom. But yeah, Thomas is Thomas R. Thomas. Yeah, that's why and the. I mean, a lot of because I haven't lived in South Carolina since I left together. Weird.
Scott Benner 57:18
Listen, if Thomas was the one with type one, this episode would definitely be called Thomas is our Thomas is our Thomas, because that's what you just said. And I would definitely, definitely make that the title instead. So so your son's about where I expect a 13 year old to be with diabetes. He's like, this sucks. And I don't want to do this is to not have to think about it. Yeah, of course. Is he using an algorithm? are you what are both using? Yes, we
Kim 57:42
both have the tandem with control IQ.
Scott Benner 57:45
With G six right now?
Kim 57:47
Yes. Yeah. Right now. Yeah. We actually just had that the email about do you want to be in the trial group that, you know, tries out the g7? Would you say yes, yeah, I said yes. Yeah, they sent out? Yeah, I guess they're gonna just randomly pick some people to give it a try and see how it goes. Yeah,
Scott Benner 58:08
that's nice. Yeah. So you'll love the g7. It is tiny.
Kim 58:12
That's good. Yeah. I mean, for me, yeah, I don't really care so much. But I think Ian will definitely appreciate that. Because he can, you know, he always wants to make sure like his, because he wears it on his arm, and he wants to make sure it's covered up with his shirt. So
Scott Benner 58:27
it'll be much easier to conceal if that's what he wants to do. Yeah, yeah. It's really, it's pretty great. It's very flat, and much smaller. So good stuff. Have
Kim 58:38
you had any of the issues that some people have talked about with like the range and connectivity and things like
Scott Benner 58:45
Sikkim? Let me just say a thing here that I feel like is obvious. But I guess it isn't. When companies make new stuff, they still tinker with it after it's out. Yeah. So if you've been using Dexcom, for a long time, for example, you'll know that in the first few months of the iteration, the first iteration of something new, they still like, it's never the same product six months later, as it is the day it comes out. And I think those are software adjustments that they're making, obviously, because the hardware is is set, right? So I don't pay a lot of attention when stuff comes out. And they're like, this doesn't like the Bluetooth isn't whatever people said like Yeah, yeah, I just get the thing. And then we'll use it. And so did our didn't notice a Bluetooth issue. She did not. We had I think we we had a couple of sensors in the very beginning that were like full board out of the box, and then we haven't had that problem again. Maybe two of them. And so, but I don't know if maybe Arden just lives with her phone up or like maybe she's just never gonna have a Bluetooth problem because she's not walking away from her phone. Yeah, but I think You know, I would tell you that Arden's using G seven now with she's used it with Lupe, and she's now using it with Iaps. And we don't have any trouble with it all.
Kim 1:00:10
Okay,
Scott Benner 1:00:11
yeah. So, I mean, I'm also, I don't know, I don't focus on that stuff. I guess like I get. If it was a problem for us, then you probably hear me constantly going like this thing doesn't work. Yeah. But she, she's not having an issue with it. That's good. Yeah. But I think some people like to walk away from their phones a lot. And then they're like, my CGM doesn't work. And then like, well, it's Bluetooth. Bluetooth sucks to begin with, you know, so? I don't know. Yeah, I wouldn't. I mean, from my experience, I don't think there's anything to worry about.
Kim 1:00:43
Yeah. I mean, I'm eager to get it. And I think as long as it works well enough to be able to keep up, you know, with the algorithm and stuff then. Yeah, well, fine.
Scott Benner 1:00:53
I also think because you're online, you have that thought, because people complain. People love to complain. Right?
Kim 1:01:00
Well, that complain are louder. Yeah. Yeah. Don't have issues. And you're
Scott Benner 1:01:04
aware of it. Somebody listening right now, who's never been on Facebook is like, what Bluetooth issue? I've been using this thing forever. And it's fine. You know? So people like to talk about, well, listen, when something goes wrong, you try to figure out I mean, I don't blame people for onto the internet and being like, Hey, what's going on, but the thing that doesn't happen is they don't come online and say, Hey, I have a 19 year old iPhone. I've dropped it in the toilet six times. And my my walls are made out of concrete my house and I'm having trouble with Bluetooth. You know, like, you don't get their full story. Not that say that some people aren't using brand new phones, and it's just not working for them? I don't know. But I don't know. Like, it's, it's a weird thing to me. Like if your phone doesn't do a thing that you know, that you expected to do you don't then I don't know. Like if your phone's not connecting well, to your headphones. You think, oh, there's something wrong with the headphones, but it very well might be just Bluetooth. And it's not nothing's fault. It's I don't know. I sound like I'm not making sense. But no, I understand what you mean. Yeah, you don't I mean, like, it's just, there's a lot of variables, you don't know what they all are. And when people are complaining online, you don't know what their variables are. And if theirs will be yours, but not necessarily the new product. Yeah, I'm gonna go out on a limb and say if it didn't work, the FDA wouldn't let us put it out.
Kim 1:02:25
Yeah, and I remember you did, I guess you had a chat with the guy from DICE calm or something. And he mentioned that they were still kind of futzing with it. Yeah,
Scott Benner 1:02:34
they turned a little like the turning dials behind the scenes, that I've actually in past iterations of it. I think, if I'm speaking out of school, I'm sorry, but I think they improved accuracy, just by improving their soft, like the algorithm that they're using. Oh, wow, you know, which is crazy. So. So it's the, you know, the filaments in your skin and it's in your interstitial fluid, it's making the reading. But then they were able to make an adjustment on the algorithm side, like to their to their software, basically, I don't know if it's actually called software, because it's probably as printed on a circuit board somewhere. Anyway, I'm not very technical, but they were actually able to change that to do a more accurate interpretation of what it was reading. And so you didn't have to change the wire or anything that was on your side, like on the on the physical side, and they were still able to make accuracy better. This is going back a generation or so ago. Be others. There's a lot to be done there. A lot I don't understand for sure. But smaller, easier to use shorter warmup time, and you can pop one on before putting the other one on or taking the other one off. So simply say stated If Arden's got one on our left hip, and it's going to run out four hours from now, she can put a new one on her right hip, just put the the applicator aside, hold on to it. And then hours later, disconnect the one that's operating. Reconnect the new one. And now you've been wearing it for a couple of hours. And it's more accurate.
Kim 1:04:12
Oh, that's great. And then you don't have a gap? Yeah,
Scott Benner 1:04:14
no, it's like basically no gaps soaking.
Kim 1:04:17
That's cool. Yeah,
Scott Benner 1:04:19
I don't know if soaking is a word everybody knows. But yeah, you put on your CGM. And I think most people know in the first sometimes 12 hours or so like CGM can be like a little strange when you first put them on. And that's what they refer to as like a soaking in period. So you can kind of live soak it without losing your numbers from the the already operating sensor. Yeah, that's great. And it's got a something very simple which words are escaping me now? An amount of time between when it stops working and when it actually stops working a grace period. Yeah, there's a grace period. Yes. Like God came I couldn't find the word Grace Period have saved my life. I have that trouble too well, also in fairness, I'm sitting here thinking my pinkies numb. So distract. I'm a little distracted with the idea that I'm not gonna be able to feel my arm one day, but I hope I think it's gonna get better cam, don't
Kim 1:05:16
you? Yes, definitely it has to. Why does it have to kind of take a nap like,
Scott Benner 1:05:21
you know, that's exactly see your wit you realize I agree I woke up and I was like what's wrong with my arm? And I was like, ah, that'll go away in a second. And I'm walking to the airport, and I'm like, This is not getting any better. And then I'm like out to my car. And I'm like, Hey, what the hell? Thought I was just trying to get some goddamn sleep. This isn't fair. I actually thought I help people with diabetes this weekend. Is this my gift? Oh, I get it.
Kim 1:05:56
Thank you so much, Kim.
Scott Benner 1:05:58
Is there anything we haven't talked about that we should have? Because I still have one more thing I want to do with you.
Kim 1:06:01
I mean, I think we've talked about a lot other than, you know, I was just gonna, like, mention the the interesting paradigm, or I don't know what the right word is, but of like being type one mom, and then the type one kid, kind of paying a little more attention to the type one kids sometimes and you know, it's an interesting balance of remembering. I need to take care of myself, you know, because I'll be really focused on, you know, especially back when you did like the calculation episodes, you know, of the math. Yeah, the math. Yeah. I really went in and tried to make sure like, all of his settings, were good for where he is based on those equations. And then I find myself going, Oh, maybe I should do that for myself. Do you think
Scott Benner 1:06:52
it only takes me five more minutes? Can you are already doing it?
Kim 1:06:56
I know. But it's interesting, because, you know, I don't know if it becomes because He's younger? And, you know, I don't know, it's I never went through puberty with all of this, in my life of diabetes has been a little bit more stable. I think maybe because of I mean, you know, still having the monthly stuff, but I don't know, I think I just want to make sure that he is set up well, right. So yeah, I just have to remember sometimes you also how diabetes, this
Scott Benner 1:07:25
isn't some weird psychological thing. You're not punishing yourself. martyring yourself anything like that?
Kim 1:07:29
No, no, no, no. I think it's just he is the first focus for me sometimes. Yeah. Well, you should remind myself that I also have to, yeah.
Scott Benner 1:07:43
Yeah, I mean, plus, he doesn't care. If you're like, we're gonna make an adjustment. She he's probably like, what I don't, I don't care.
Kim 1:07:50
I just take the pump. I don't whatever. I'm busy.
Scott Benner 1:07:53
I was talking to Arden yesterday, like she calls a lot like, so we FaceTime. And, um, and so like, she's doing homework, she's telling us all about her day when her day went so well at school. And the entire time she's talking, I'm thinking, you need to change your pump. Like, I see, it's been happening for three hours. Now the pump is the site's gone. It's just it's done. Like, you know, like you're almost out of insulin, the site's not working as well. If you just change your pod right now, your blood sugar is going to come right back to where it belongs. And I did not say anything. I was so good. And I because if I would have said already that she would be like, I know dad, like I'm not still i I'm an adult, I'm taking care of this. What do you think take care of when you're not here, like I would have got that whole thing. And it would have been upsetting to her and I don't want to upset her. So I just I swallowed it. But then, Kim later last night, I FaceTimed her and she was like now down to like, there was like 19 units left in the pod. And yeah, the the units aside, the pod was just clearly not working well at that site anymore. So she calls me back. She called us in the shower, and we're talking while she's drying her hair and stuff like that. And I still don't mention it. And she's like, I'm gonna I said, So what's up for tonight? She tells me about her evening, and she's going to eat and everything. And I said, Oh, do you have class in the morning? And she says, No, I don't. I said, Okay, good. I was worried because I, you know, because I think you're gonna run out of insulin before the morning. And then, but I said, but if you know, if you don't have class the morning, maybe it'll make it overnight. And then I just let it go. So I actually like, reminded her that she needed a pump without reminding her that she needed the pump. Like it wasn't super smooth, but it wasn't bad. I'm gonna just drop this. Let me just mention it off on the side here like but not directly. And then I don't know, maybe two hours later, I saw her blood sugar like go back like tight into a tight range. And I looked on my Nightscout and I could see that her pump now had like it was full. So she put a new pump on my and I was like I did it. I tricked her A
Kim 1:10:01
very subtly, very, like, you're not gonna get her upset so she can't talk back to you.
Scott Benner 1:10:07
Also, I don't want to say this Kim in a way that makes people upset, but I deal with my daughter differently than I deal with my son. Like, I tried, where this is gonna get me in trouble being direct with Arden worked really well until she became a lady. Yeah, and now being direct with her doesn't work the same way. Uh huh. And whereas I could just if that was my son, I could have just said, Hey, you got to do this thing. Don't forget. And he go, yeah, and that would have been the end of it. Right? So anyway, my wife's like, you can't just say it to her. I'm like, That's ridiculous. And she's like, Well, are you ever gonna learn and I was like, probably not, but I'll keep trying. Yeah, I might try it with my wife, though. I think she was like secretly telling me the same
Kim 1:10:49
thing about herself is how you need to talk to
Scott Benner 1:10:53
just talk around it a little odd. So, so exhausting, but okay. All right. All right, Kim. So here's my last question. Okay. If I came into your classroom, somehow I got through the I got through and you what, what are some like things you would teach me? Like? Like, there are practice things I could do. And can I do some of them right now with you before we get off the pot? Yes.
Kim 1:11:18
Oh my gosh. Well, okay, so so we do a lot of vocal eases, you know, like warm ups things to kind of practice.
Scott Benner 1:11:27
I'm ready.
Kim 1:11:30
Well, I don't know how to do a lip trill I'll often just in the microphone, you do lip trill. Like that, but you got to sustain it.
Scott Benner 1:11:39
Wait, hold on. How the hell do you do that?
Kim 1:11:44
Like that. Yeah. But see if you can. For how long? Am I afraid a little longer? How long? Well, I mean, like we'll do
Scott Benner 1:11:55
a lot of air control, then that's what I'm working on.
Kim 1:11:57
Actually, that's a big part of it.
Scott Benner 1:12:01
It's hard. I
Kim 1:12:06
think about just getting the literal going like without a note, and it just
Scott Benner 1:12:14
Oh, I almost had it there. My lips get dry and then they stopped bouncing. Can I believe them? That might help. People know that I sit next to a giant jug of Vaseline when I make this podcast to keep my lips dry. Also, how do people keep their mouth wet when they're singing?
Kim 1:12:33
Well, just hydration. There's no answer. Like I can't just take a pill. Oh, no, unfortunately.
Scott Benner 1:12:38
I thought you knew something. But okay, hold on. Oh, can I bring in fresh air through my nose? While I'm doing it? Ah, next you want the air to me moving out? Yeah. Oh, it's a lot about a deep breath.
Kim 1:12:59
Yes, you need a deep breath
Okay, that's probably better because it's about you know, using the air is a big part of it.
Scott Benner 1:13:12
Okay, it's going to help me all make the podcast or know. Well, well
Kim 1:13:16
then. So when you do the lip trill you want to think of? So do you feel the sound if you feel the sound in your throat, you don't want that. You want to feel that the sound is kind of all at the lips, at the lips and in front of you.
Scott Benner 1:13:35
I got better. Okay. Yeah. So I stopped stop emanating from my chest. I'm not making a noise. The lips are making the noise. Exactly. I got it. Okay, what's another one? Tommy? Yeah.
Kim 1:13:47
Okay, let's see. You can also do Mmm Hmm. Well, so a lot of times if you I mean, can you think of a phrase that you like that you could sing? Do you know song? Oh
Scott Benner 1:13:58
my god. Hold on. I'm writing down to call this episode elliptical.
Saw Oh, so here here. This is interesting. Can we segue for a second? My wife gets so pissed at me. I don't know the words to songs. Oh, but recently, I heard someone speaking about this. And they said something that I resonated with. He said I hear the words as another instrument as music and that's how I hear it. The words are like rhythm and, and and beat. They're not. I don't care what they're saying. The word seemed like music to me. Yeah. So as you asked me that question. I'm like, I don't know the words that any songs even my favorite songs. So just give me one and I'll do yours.
Kim 1:14:52
Well, I mean, you can even just like on Happy Birthday. Okay. All right. Because what you want to be able to do event She is to like, sing the phrase with the lip trill. So then you're getting the air going, how enough?
Scott Benner 1:15:06
I was cursed. How? What do you mean? Like I need to make words while my lips are bouncing? No, no, no, no. Oh, oh
Kim 1:15:21
damn you then you're, I'm up an octave. You're not gonna be you're gonna be lower
Scott Benner 1:15:31
Oh, I had it for a second. Okay,
Kim 1:15:33
so you can't see me but I have my hands kind of on either side of my like if you're going to call out you know, hey, with your hands up around your mouth. Hold your hands there while you do the lip trill. And just think of all the sound being in the front, like kind of called out megaphones. He
Scott Benner 1:15:58
came at what point am I gonna pass the hell out from this? Because I'm getting lightheaded.
Kim 1:16:06
Are you gonna have to start paying me for my time?
Scott Benner 1:16:09
Oh, yeah, he would just the meter start running, you're like, that's enough, buddy. A few extra minute, I just keep thinking what you're gonna hear next is this. And that's gonna be my head slamming off this when I pass out. But it's
Kim 1:16:21
funny, because I'll have students that say that too. They're like, this is so much more air than I'm used to. And it's a rush, you know, generates the, like the there's going to come through the vocal folds. And that's what vibrates the folds. And yeah,
Scott Benner 1:16:33
you know, my biggest problem, honestly, with all this is that when I definitely think this is not a story I've ever told the podcast, but when I was five years old, I got new dress shoes. And we were poor. So that was exciting. So I was coming down the stairs at my grandmother's house. And my uncle was across the room. And he was like, Hey, I heard you got new dress shoes. And I like an idiot raised my foot up to show them to him and then fell down the stairs. Oh, no way. My nose has never been the same since then. Oh my god. Yeah. So I don't do well. Drawing air through my nose. Mm hmm. I probably need that like deviated septum surgery. Yeah, yeah. But I'm 52. And I think what if I just made it to the end? It didn't have to do that. But I think I wonder how it would change my voice actually.
Kim 1:17:34
Yeah, it's interesting. I've had a few students with that. And they've had the surgery and then their voice is different because like the the resonating cavities and all change. Yeah. Because the space is in there is changing. Yeah. When
Scott Benner 1:17:47
I go off on a rant, I don't breathe through it. It's it's like almost weird. Because I can't. I can't I can't draw air in through my nose without it feeling forced. Wow. So anyway, yeah, my uncle needed to see my shoes. And now I can't breathe, but he's dead. So I want you can't blame it on the uncle anymore. He's been gone for a while. So but yeah, but anyway, like, like, it feels like if somebody gave me a breathe right strip, but it was made out of like a, like an industrial clamp. Maybe I could breathe better. I used to. I used to do a you know the nose spray that open? Like, like, opens up the like your nose? Yes. There were times I'd have to do that before I made the podcast. So I could kind of breathe while I was doing. I've taught myself how to do it differently now, though, but wow. Yeah. There's a little inside
Kim 1:18:40
baseball breathing through your mouth. I mean, you can breathe through your mouth, but then it gets dry. And
Scott Benner 1:18:45
yeah, like I can breathe through my nose. Fine, but not while I'm speaking. So I would probably be a terrible singer. I probably pass out in two seconds. It'd be like, Oh, he sounds so amazing. But it keeps falling over. All right. Well, I think we all know that I should keep talking and not saying it's bad. Yeah. But
Kim 1:19:05
still, but even with your speaking voice, you know? Think about it. Because you don't really want to feel it in your throat. You know, you want to feel it. In the front of the face where it feels like resin. Like if you were gonna, huh, like hum. Do you feel Can you feel buzzy in the front of the face?
Scott Benner 1:19:22
I got it. Yeah, I do feel it. Yeah. So then try to keep
Kim 1:19:25
your speaking was there. Okay. You know, it's taking pressure off the vocal folds. And it's odd.
Scott Benner 1:19:33
That's where I speak from, honestly, because when I do the, the bumpers and the opens and I like I don't know if people realize it or not, but I'm sort of making fun of radio announcers when I do the opens of my podcast. I'm like this episode of The Juicebox Podcast. Yeah, like I'm just, I'm just abusing myself. I don't know what you guys think to be perfectly honest. But, but I just, I wanted there to be some difference between In my voice is overthinking, but I wanted there to be some difference in my voice when I'm selling to you than versus when I'm just speaking to you. But my voice is so kind of deep and right here. I can't actually change it that much. So I had to go for like over the top to make that happen. Yeah,
Kim 1:20:18
yeah. That makes sense. Yeah. Yeah. Just. Yeah. If you ever feel if your voice is getting tired, or sore mouth, do you ever experienced that?
Scott Benner 1:20:29
No, the only time I have troubles I, I once had to give a talk over a weekend during Shabbos. And so there was no, no microphones in the room. And I had to project my own voice in a room for like, 400 people. Oh, yeah, I was. I was fried after that. Yes,
Kim 1:20:46
that you can do that. By thinking of it all being Hmm. You know, find the buzzy place in the front of your face and let your voice sit there. And instead of feeling like that, because that's how I will project know. You know, instead of it feel like you have to kind of be Yeah, all or Yeah,
Scott Benner 1:21:04
it feels like it almost feels like it's coming from the back of your neck. I don't know. Like another way to say that. But yes, yeah, way more talk about how people's voices sound and most people care about I'm gonna say, so I'm gonna let you go now. Most people are like, I have a thought. I don't even bother to think if it's right. And then it comes out of my mouth. That's talking, you people are overcomplicating this, right. So
Kim 1:21:30
when you do it for your living, you know, you have to take care of yourself.
Scott Benner 1:21:35
Yeah, no, it's it's a crazy thing. I usually record every day of the week. So even like getting sick. Like there's sometimes I feel myself getting sick and I'm like, oh, no, no, no, no, that can't happen. Today, Oh, no. You know when that can happen later when I'm dead. Not now. I'm gonna be time for this. Like so. Yeah, I got sick during the remastering of the Pro Tip series. And I have to be honest, the opens are great because that because my voice was like
Kim 1:22:01
extra. Yeah, yeah. Yeah. I just
Scott Benner 1:22:06
had to record in like shorter bursts. And then then breathe and then record and then edit it together. So anyway, thank you can I really appreciate you having this conversation with me? Thank you very much. A lot of fun. Oh, good. I'm glad. Hold on for me one second. Sure.
A huge thank you to ever since CGM for sponsoring this episode of the podcast. Are you tired of having to change your sensor every seven to 14 days. With the ever since CGM, you just replace it once every six months via a simple in office visit. Learn more and get started today at ever since cgm.com/juicebox. A huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juice box. They spell that GVOKEGL You see ag o n.com. Forward slash juice box. If you're living with type one diabetes, the afterdark collection from the Juicebox Podcast is the only place to hear the stories that no one else talks about. From drugs to depression, self harm, trauma, addiction, and so much more. Go to juicebox podcast.com up in the menu and click on after dark. There you'll see a full list of all of the after dark episodes. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com
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#1162 Grand Rounds: Hodgepodge
Scott and Jenny finish up the Grand Rounds series.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - Radio Public, Amazon Alexa or wherever they get audio.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends, welcome to episode 1162 of the Juicebox Podcast.
Today, Jenny and I finish up the Grand Rounds series with something I'm calling hodgepodge because it's kind of all of the questions that were left plus some conversation. If you're a doctor who's listened to this, I hope it helped, please share it with someone else and reach out to me, I'd love to have you on the show. 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. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community check out Juicebox Podcast type one diabetes on Facebook. Don't forget to save 40% off of your entire order at Cozi earth.com. All you have to do is use the offer code juice box at checkout that's juice box at checkout to save 40% at cosy earth.com and go fill out that survey AT T one D exchange.org/juicebox.
This episode of The Juicebox Podcast is sponsored by the insulin pump that my daughter wears Omni pod. Learn more and get started today with the Omni pod dash or the Omni pod five at my link Omni pod.com/juice box. This episode of The Juicebox Podcast is sponsored by the ever sent CGM and implantable six month sensor is what you get with ever since. But you get so much more exceptional and consistent accuracy over six months, and distinct on body vibe alerts when you're higher low on body vibe alerts. You don't even know what that means. Do you ever since cgm.com/juicebox Go find out. Jenny. This may be our last Grand Rounds episode for a bit you and I
Jennifer Smith, CDE 2:21
oh yeah, I thought we were I thought we were done. So it's kind of a yeah, great buttoning
Scott Benner 2:27
up, we're gonna call it so we know hospital diagnosis, insulin safety foods, CGM BGMs, pumps, humanity, communication management, pregnancy school nurses. And what I have left is just marked on my list as this part will be long. To get means more conversational. And then I'm actually going to do like a wrap up episode that I won't bother you for a while just kind of like go over the the high marks because there won't be any, you know, any conversation back and forth.
Jennifer Smith, CDE 2:57
You're never bothering me. Remember, I
Scott Benner 2:58
know I know don't but we have other things that bother my to do list for Jenny's got other stuff on it, we got to keep moving. Okay. So I have this note here from someone that just says, I wish that they took more of a whole health approach with me, instead of just viewing my diabetes as separate. I wish they understood that everything seems to affect my blood sugar. And the diabetes is more than just my blood sugar being affected. I wish they understood that sometimes you can do everything right, diabetes is still you know, everything doesn't turn out the way you want. Also, I have other health issues, other autoimmune issues, and that also affects my diabetes care. I wish they understood that because it's tiring. I wish they understood that I don't want to come in every three months that's not fun that I hate waiting 45 minutes after my appointment time for them to spend five minutes with me and then not offer anything valuable. Yes, I wish they would run the lab work in the office I wish they would let me have the results without making me make oh my god a second appointment to get the results. And then when I get there, tell me you're so healthy, nothing's wrong. Do you have any questions?
Jennifer Smith, CDE 4:07
That last bit about the labs if I was going to restructure anything in terms of medical like visits regardless of the condition that you're talking about? It would be that if you're coming in for a visit labs will be done ahead of this visit that's on the doctor to order that right I mean the person with diabetes or whatever else needs to be evaluated you know health wise for the person sure they they should have an idea of what is kind of do or what hasn't been looked at in a while but that's really on the doctor to have that order in and then the person knows my appointment is March 1, I need to go in the end of February I need to get the labs done because then the second appointment isn't needed.
Scott Benner 4:54
Discuss that's not right. That's not like a I don't want to say scam but that's not like a billing thing is it trying to Get in there twice? I
Jennifer Smith, CDE 5:01
don't believe so I think it's not proper thinking about what would be most beneficial timewise. And to make the best use of the visit in terms of strategizing, right and talking through what might be some of the things that we do need to address, well look, you know, cholesterol levels, or a one C or vitamin D, they've changed. We've got something that we need to talk about here, right? If you have to come back, and it's really annoying for the person whose life is now interrupted twice, yeah, every
Scott Benner 5:31
three months, right? I'm kind of like baffled by how it's not obvious that a person in the office just takes the schedule every day, I don't know three weeks in advance and call somebody on the phone and says, Hey, Jenny, you're coming in three weeks from now, doctors got the labs here for you. Where would you like me to send off the script? Go ahead and get that blood draw for us? Right, you know, don't come in without that test. Right? It would take not much to do that. And then not much to get people accustomed to it as well.
Jennifer Smith, CDE 6:00
And what do we have today, we have so much automation in systems, that doesn't even have to be a phone call. Yeah, that could be an online, like my chart, or whatever electronic medical health system you're using, that could absolutely be built into that electronic record system that visits here coincide with these type of labs, the note gets sent to the person via email or text or through their online, you know, record portal, they get the notification. And they're the ones that then they have to make the appointment to come in for the labs. But at least it's a notification, it's a reminder to do so.
Scott Benner 6:37
Yeah, around here, labs are easy, you just me basically just walk into like a quest, or LabCorp or something like that. And you hold your script in the hand. And that's that, or my doctor sometimes just sends it electronically, and you show up and you say, Hey, this is my name. There should be orders in here for me. Yeah, that makes sense. But all the rest of it to get to hear what that person is really saying. Understanding that other autoimmune impacts management that blood sugar is not the whole thing. Like those little like, that seemed like little things, if you really listen to the way this person lays this out, this is the entirety of their struggle right here. You know, like, just if you could just understand these concepts, and not I'm guessing fight me on them all the time, all the way, you make my life better, not just this appointment better.
Jennifer Smith, CDE 7:25
I mean, what I honestly hear is the fact that anyone caring for somebody with diabetes, it's a whole picture look, but what it makes me really consider is that they need to, they need to listen to the variables and really, like listen to all the things that in a day could have impact, including many other health conditions, whether it's thyroid, or it could be any other autoimmune conditions that may have an impact on energy levels, or sleep, or other medications that you're taking that may impact the way that your insulin or other medications for diabetes. There are many, many layers right to evaluate. And it isn't just blood sugar,
Scott Benner 8:09
right? Well, you're some more stuff. today's podcast is sponsored by the ever since CGM. Boasting a six month sensor. The Eversense CGM offers you these key advantages distinct on body vibe alerts when higher low, a consistent and exceptional accuracy over a six month period. And you only need two sensors per year. No longer will you have to carry your CGM supplies with you. You won't have to be concerned about your adhesive not lasting, accidentally knocking off a sensor or wasting a sensor when you have to replace your transmitter. That's right. There's no more weekly or bi weekly hassles of sensor changes. Not with the ever sent CGM. It's implantable and it's accurate ever since cgm.com/juicebox. The ever since CGM is the first and only long term CGM ever since sits comfortably right under the skin and your upper arm and it lasts way longer than any other CGM sensor. Never again will you have to worry about your sensor falling off before the end of its life. So if you want an incredibly accurate CGM that can't get knocked off, and won't fall off. You're looking for the ever since CGM ever since cgm.com/juicebox. Today's episode of The Juicebox Podcast is sponsored by Omni pod. And before I tell you about Omni pod, the device I'd like to tell you about Omni pod, the company. I approached on the pod in 2015 and asked them to buy an ad on a podcast that I hadn't even begun to make yet. Because the podcast didn't have any listeners. All I could promise them was that I was going to try to help people living with type one diabetes, and that was enough for Omni pod. They bought their first ad And I use that money to support myself while I was growing the Juicebox Podcast. You might even say that Omni pod is the firm foundation of the Juicebox Podcast. And it's actually the firm foundation of how my daughter manages her type one diabetes every day. Omni pod.com/juicebox whether you want the Omni pod five, or the Omni pod dash, using my link, lets Omni pod know what a good decision they made in 2015 and continue to make to this day. Omni pod is easy to use, easy to fill, easy to wear. And I know that because my daughter has been wearing one every day since she was four years old, and she will be 20 this year. There is not enough time in an ad for me to tell you everything that I know about Omni pod. But please take a look. Omni pod.com/juice box. I think Omni pod could be a good friend to you. Just like it has been to my daughter and my family. This is gonna be a nice hodgepodge episode I like this person just says I wish they would acknowledge that this takes an entire team, not just me to take care of you know, no one should be discharged from a hospital without all their follow up appointments handled with their diabetes education, registered dietitian, probably a mental health professional this person says continually reassessing readiness to learn a patient coming to you with questions about things they have read or heard. Those people are ready for a deeper dive, right? That's why they're coming to you and saying these things. They want to be more empowered, this is your opportunity to do that for them treat this patient as though they are the primary member of this healthcare team. I like that idea. Like we're a team, but you're the leader as the person with diabetes, right? They should have input on their treatment plan. This is what I have found helpful during the 24 years that I've dealt with this for both my son and now myself. That's good advice. Yeah, if you're I don't have anything to say about that. Other than if you're a doctor, and you were treating the person, like you know, a microphone in the room that just is listening to you and they're not really part of it. I think that's the outcome you're gonna get most times is people feeling disconnected and unheard. But what I
Jennifer Smith, CDE 12:11
also hear kind of behind that is in being heard, you have to analyze from the person and say, Are they ready for the next level? Right? You have to know where they are, what they're talking about, where they're asking to get to, because if they're at no starting step number two, and they really want to know, answers that are really like ninja level. Right? You have to say, Okay, I absolutely, we need to get to that. But we're kind of right here, we need to address this. First, we need to move up here. We need to inch forward and so that you really can grasp what you want to know about. Because that's a level of understanding and application of medication adjustment and whatnot. That you're you're not really a yet with what I see happening.
Scott Benner 13:04
I know for sure. Hey, just because this person says just because someone has bad numbers in quotes, doesn't mean they aren't trying their best.
Jennifer Smith, CDE 13:13
I hate that word. I
Scott Benner 13:14
did. I did too. But like this is the obviously this is this person's experience, right? They feel like I'm coming in there with numbers that somebody's judging is not being good. But I am trying. And I'm trying sincerely like she's like, sometimes I screw things up. But sometimes I just don't know what I'm doing. Sure. Sometimes I just get the math wrong. Sometimes the Chick fil A gives us regular Dr. Pepper instead of diet. Sounds like a personal remembering, yes. When I get to my appointment, I am also not going to remember that two months ago, Chick fil A gave me regular Dr. Pepper instead aside, so don't ask me about that, right? Anyway, this never goes away. There's going to be awful days. And you know, you got to do better at it. It does get easier, but you have to as a doctor appreciate the journey that it takes to go from, you know, being diagnosed, not probably given having, you know, gotten great direction, living through it day to day when you don't know what you're doing, eventually, hopefully figuring right out. And then that Diet Dr. Pepper comes for you. And now this doctor goes, Hey, what happened here? What's this? Right, you know, and that feels terrible after being through that whole thing. And I think
Jennifer Smith, CDE 14:30
that might be the that picking apart component. You know, what happened here two months ago. I think it's the clinicians way to try to get into some type of education about what could have been done differently. It's never really asked in the right way. It's always asked in a sense of the person with diabetes feels like they're being like, blamed. Like what did you do here? Right when the person's like God I have no idea what happened there. In that sense. It's more the broad picture of what are we looking at? What trends what sticks out? And can you remember anything about what kind of sticks out that you didn't really want to happen? And if not, then again, it's more, it's more generalized.
Scott Benner 15:18
This next person makes such a an interesting statement. She says, look, a lot of people in the US and probably other places to struggle to pay for their supplies. I'd love a pump. I'd love a CGM. I really would, but I can't afford it. So now, you know, I'm struggling financially, you're coming to me with hereby these things that you can't afford, I can't afford them. That's hard for me, then I get treated like, Well, I'm not interested in my care, right? And then and this is a quote, then you put me on that? Wait, then the docs are gonna get us all killed with their stupid type two style management that they give people on MDI. Oh, no. So that right, right. So that's, that's this person's comment. So obviously, what happened was somebody said, Hey, get this. And she said, I can't afford that. And they were like, Oh, you're not serious about this, then just, you know, hear some level mirin, you know, beyond. And I will
Jennifer Smith, CDE 16:09
also say that that, then that team, that clinical team doesn't know a lot about the products and what is available for people who have less or don't have good insurance coverage or can't afford, because a lot of the different companies have programs to assist. Yeah. So the doctors should know that. That's
Scott Benner 16:35
the problem with everybody being so siloed all the time, though. Yeah. Like, you know, the doctors, like, hey, get a pump you I can't afford it. They're okay. They just move to the next they don't say, oh, did you know that? You know, this company has an Access Program, or, you know, they have everyone, everyone I've ever been involved with, or heard about has access programs. 100%.
Jennifer Smith, CDE 16:53
And I will guarantee that if they are being visited by a rep from any of the companies, they have been told about the Access Program, yeah. 10 years ago, when I was working with an endocrine practice, our reps that came in consistently gave us information about the access programs and the discounts, and the the, you know, the little discount cards or codes or whatever was available.
Scott Benner 17:18
And some of them are significant, by the way. Yeah, like, I've seen like $500 items reduced to 20 bucks with a coupon, like, you know, so, again, but it's almost only half of the problem. The first part is you should have helped her find out how to do this. And correct when you couldn't figure it out or didn't want to figure it out? Why do you relegate her to like second class status as far as her management goes, and if I'm going to add on one for me, you could have still taught her how to take care of herself with MDI, because plenty of people do it well, but they also know how to use insulin. So then you have to educate like, it's a, you know, it's an if this, then that series, oh, by the way, going back to another thought here. It doesn't mean they would have gotten good direction, even if she could have afforded a pump because this person says I work in an ICU. And my kid has type one diabetes. So I'm aware of this enough that I was paying attention on the day that a person came in in DKA. In their early 20s. The endo had put them on an Omnipod five saw an algorithm based pump. Okay, but they were using libre because Dexcom wasn't covered. So they couldn't do the algorithm. But the person signed up for the whole thing because they wanted the automation.
Jennifer Smith, CDE 18:29
By God. Did they think that they were getting automated delivery because they had a system and a CGM. And he told them,
Scott Benner 18:39
yeah, you got it. There you go, Oh, my God. It's running around and automated the kids running around and automated and the pumps not talking. And it's not giving any, which is how he ended up in TK. So anyway, scrolling on. I wish they would have told me, I wish they would have known that I would have been willing to go much farther. This is a motivated person. I'm an adult who doesn't mind injections, I would have diluted insulin if I needed to. I would have used vials and syringes, I would have been willing to finger Poke 20 times a day. I just didn't know about any of that. Until I found this podcast. I thought that half unit pens with four needles and six test strips. was all I needed to stay healthy. Wow, how about that?
Jennifer Smith, CDE 19:23
Yeah, that's actually what I was gonna say. I mean, even for somebody who, let's say they really can't afford a CGM, even with all of this stuff. Test strips can be written as a script for plenty a day. Even the generic ones which are good enough to give you enough information to go by through the course of the day. With MDI, you can absolutely make it work. Yeah, no, have somebody guide you through that.
Scott Benner 19:49
But that person statement is more about saying that vial syringes and a couple of test trips a day was all I needed, that means that they were told, shoot this to inject this at a meal, check every once in a while, which by the way, doctors have the funniest way of having you check your blood sugar in this scenario when it's going to be the best, of course. So that yeah, that's always fascinate like, look, you're good. But, you know, maybe you wouldn't think to test yourself two hours prior to see that you're 300 After the meal, and then it came back down again. Right? Right. It's really sad that this person goes on to say, I'm just compelled to send this in, because I didn't realize that I was being set up with bare minimum to survive. Like, I actually thought I was out there just killing it. You don't I mean, that's sad. And
Jennifer Smith, CDE 20:35
in this day, and age, bare minimum, that person's bare minimum was what it was eons ago, when that was the standard, there was nothing different to be able to do. So the fact that people are being told this bare minimum at this point, with the technology and the programs that are available to be able to get and use things appropriately. That's really sad. Yeah.
Scott Benner 21:00
Let's see, I wish my doctor knew that you can have you know, quote unquote, non diabetic a one sees without being consistently low. Every time I have a one C under six, this doctor scours my clarity report looking for lows. And even if I have less than 1% lows, I get a warning about how dangerously I'm acting with a six. I don't even know what to say. I mean, you know, I'm gonna get upset, Jenny, I'm trying not to it's Friday. But if you are a doctor, and you find yourself going, Oh, I've done that. You really need to learn more so that you don't say stupid things to people, this person is having massive amounts of success. And you're yelling at him about it. You know what I mean? That's crazy. Yeah.
Jennifer Smith, CDE 21:43
And the opposite of that. The other really sad thing is that, I wouldn't say endocrinology, but definitely more of the just general medicine, unfortunately, wouldn't even look at a problem with a blood sugar or within a onesie of sick, right?
Scott Benner 21:58
They wouldn't say, hey, maybe five is available to you right now. They just Yeah. Or maybe
Jennifer Smith, CDE 22:02
that's not in the range of somebody who doesn't have something going on with their blood sugar. It is being mismanaged. If you're a one C is six, and you don't have a diagnosis of diabetes. Oh,
Scott Benner 22:13
I see what you're saying. Yeah. Oh, you're thinking people? Oh, I see what you're saying. A regular GP. It's just gonna be like a six. That's fine. That's just Jesus coming for you one day, but it's not a problem today. Don't worry about it. You know, that attitude? I mean, it was like, Oh, yeah. Oh, watch it. We'll watch it. I had somebody the other day. Tell me a doctor told him they were watching. Oh, no, we're watching. We're watching for me to fall over. I had a woman tell me the other day about her thyroid. And she said, I hated my doctor. Tell me we're gonna we're gonna put a watch on this five TSH, I was like a watch. I said, What are your symptoms? My hair's falling out. I'm tired. I can't get rested. My fingernails are breaking. I've lost my sex drive. I like she like rattled off. 10 things. She told the doctor and a doctor goes, We're gonna keep an eye on that. I kept an eye on it already helped me. Right, right. Same thing with a diabetes like a six a one. See how you're alright, that's not too bad. Yeah, this lady says that would really really nice if we stopped acting like talking about the digestion of fat and protein for people using insulin was an advanced topic. Oh, yeah, I have been brushed off and treated as if I was an idiot for suggesting that fat and or protein could be impacting high blood sugars. That's off course. And we'll just say it again. If you're listening, and you think though, that doesn't impact it, you're wrong. So learn more,
Jennifer Smith, CDE 23:34
because it's all about carbohydrate. Yeah, I mean, in there, it is all about carbohydrate. So why would we need to talk about fat and protein? my soapbox to get on is that nobody is guided in how much they need. In terms of portion. Just count your carbs and take your insulin and the other stuff, just eat it? Well, so I can eat a cow. It
Scott Benner 23:57
doesn't affect my blush. Like if you're a physician and you've got somebody in front of you who's type one who wasn't before. It might be you know, instead of just complaining about it on social media or at dinner or whatever, bitching about it in your to yourself when you're driving home in your car that people don't eat? Well, why don't you say hey, listen, this is a great time to go over this. Before type one diabetes, you were killing yourself very, very slowly. You wouldn't have even noticed it happened in probably and then one day you would have been like, Oh, what's that feeling? Then you would have been gone. But now you have type one. So we're going to pay really close attention to what you're eating. This is the part where I tell you that that is six portions not one portion, you know like that. Yeah, like that. You don't need 6000 calories a day. You know, like you know that all this other stuff and you're we're gonna see it now and you're in your in your blood sugar right away like you didn't know before, because you didn't have type one, but now we're looking, what a great opportunity for you to make some adjustments here right and be healthier beyond diabetes. Right? You know, but if I said that to a doctor, and I know that because I've done it that you like, they're gonna say to me people don't listen. Which is like saying, I don't know what it's like it's saying it's like saying that you're a half a mile from a cliff that no one can see. And you know, it's there. And you see people walking and falling off the cliff. But you don't bother telling anybody Hey, slow down. There's a cliff coming cuz some people don't listen to you,
Jennifer Smith, CDE 25:22
or turn the other way. Don't go that way. Let's
Speaker 1 25:27
make an adjustment now. But But the bigger point is that like, well, it's not worth me opening my mouth, because they might not listen to me. First of all, what else are you doing? Isn't that your whole goddamn job? Right? Everyone's not gonna listen. It doesn't mean it's not incumbent upon you to say it. Also, it's will seem disconnected. But parenting, same thing. You don't just get to say it once. And it happens. Oh, no, it's your goddamn lifelong job to stand there and go. Oh, my God. Okay. Put that away. This trash has got to go out. You can't leave that on the floor. Please don't hit your sister. Right? Like, like, you don't just get to say that one time, and it's over. Like, and if you think that, then I don't know what you expected when you became a doctor. You don't I mean, right. Yeah, right.
Jennifer Smith, CDE 26:09
It's much like it. That's a very good connection. It's like being a parent who constantly has to tell your child, the underwear go in the thing right here that on the floor in front of it, it goes in the basket, right? Or we don't leave toothpaste, spit in the sink. We rinse it down right away.
Scott Benner 26:30
We're not going to look at an eight a one C and go, Hey, that's not so bad. Yeah, yeah, it's not so bad if you're on your way to better, but if that's where you're gonna live for the rest of your life, it's going to catch up to you pretty quickly, it just right. There's a lot of repeat, and nobody talks about it that way. And I even listen, I'll go out on a limb here. And I'll even say I understand that socially for the last couple of years. Maybe we've drifted away from being honest with people all the time. Is that a fair way to say that, like, I have been protecting people's feelings a little bit, Jenny is making a face because I know there's a private conversation we had recently that we can't talk about on here. But no, it's still your job. Like you're not supposed to hurt people's feelings. You're not supposed to treat them poorly. But they deserve good information. And they deserve tools. And they deserve direction, like and if you have to repeat it over and over again. You don't just get to say, oh, here comes Scott. He don't listen, I'm not gonna say it again. I'm still paying you. Right? You're my insurance company's pocket do your job. You don't I mean, if I don't listen to you, it's on me. But come on. I don't know. It's very upsetting all this. There's no way any doctors are left listening to this, Jenny.
Jennifer Smith, CDE 27:39
I really hope that they're, I mean, you know, if I was a clinician, I guess I just I mean, I know my personality. I am very much if you've got something, and I don't know much about it. And I could do better than I would rather sit here and be like, out I was really wrong. Like man, like, you know, I can do better. I can clean this up. I can turn this around, I can do better for whatever the job is that I have. I can do better. Right? But that's an that's the attitude. I think anybody who's in healthcare should really have what are you in this for? Are you in this to improve people's lives,
Scott Benner 28:15
I did a recording this morning with a anesthesiologist, who has been diagnosed with type one later in life. She's had it now for about five years, she came down to talk about what an anesthesiologist should know. And I'm actually going to make it part of this series, which I was terrific, right. And she's lovely. And we had a great conversation. But at one point, she said this thing that I hear people say all the time, she you know, she goes well, you know, there's a lot of burnout in health care. And I'm like, yeah, there's a lot of burnout in factory work, too. But you don't get to like not run the crane and pick up the piece of steel and put it where it goes. Because you're just sick of it. You don't you mean like I actually said to her, these are my words, Jenny. I said, if if people work for me, you motherfuckers would be upset because I'd fire y'all. Like Like, I don't I don't want to hear i I'm burned out what? You make over six figures. go on vacation. Like Like, I don't know, take a walk smoke weed, leave me out of it. Do your job anymore.
Jennifer Smith, CDE 29:12
Make changes in your organization. If you're burned out, that means that something in the organizational structure of your day to day
Scott Benner 29:20
schedule, how you're beating you up? Yeah, correct. Yeah,
Jennifer Smith, CDE 29:23
beating you up so much that you're feeling burned out. And absolutely, that needs to be taken care of. But it doesn't mean that the people then that you're taking care of in your practice. Yeah.
Scott Benner 29:33
Do you know that during that recording, I turned to a browser window, I opened up chat GTP don't laugh for a minute, okay. And I said, please tell me what an anesthesiologist should know about how insulin pumps work and what how they should manage them during surgery, and it spit out something that I read back to her and she goes That's all accurate. So, my point to her was, if people keep making the same mistakes over and over again, we just need one person to write down the rules, maybe start an email chain, right? Like every day, you guys get an email to remind you about people with type one diabetes and pumps. And this is it or people who come in with, I don't know, like, you know, hypertension, like, here's the thing to remember. And she said, some people don't read their emails, I'm like, what what point is there going to be like, what are we going to hold people to account to do their job? You don't I mean, and I get there's human failings, which I don't even mean in a pejorative way. Like I understand there are limitations of people. But as an organization, I get if Jenny's tired on a Thursday, or if I'm in a bad mood last week, or something like that, but just the whole organization take a dive, like, like, how does that happen? And it just seems like, I mean, I hate to say this, it just seems like laziness to me. I mean, am I being harsh? look good? You know, just, I think what I said to her was, she's like, well, people have to come in and advocate for themselves, which I don't know how doctors don't hear. That should be insulting to them like that. I'm so bad at my job, someone has to come in and remind me of what it is when I get there that I'm supposed to be doing. Yeah. But I said, like, I don't go get four new tires and remind the guy when I dropped off my keys to put the lug nuts back on, I just assumed that's going to happen. Like, do you mean, like, do I have to assume a doctor's not gonna follow through? Or do the thing like, come on? Doesn't make any sense to me at all? So yeah,
Jennifer Smith, CDE 31:27
I mean, I think in general ordering and those kinds of things. I think a lot of it is so already organized within a lot of the electronic medical kind of charting and whatnot, that things get checked off pretty easily, and may not be something that gets revisited then. Right?
Scott Benner 31:48
Yeah. Actually, thinking about that electronic aspect of it. This was something I brought up to, I didn't quite say it this way, then. But I, I'm thinking to say it now, if you're a doctor, and you have some dreams of your kid, being a doctor, the way you're doing your job, right now, you're making the profession, it's not going to work the same way, they're going to put, they are going to put a chat bot in charge of the medicine, and you're going to be a technician making the same dollar everybody else is making. So if you like your $300,000 a year, and you want your kid to have it to maybe do a job that makes us all think this is a profession that should keep going in this direction, because right now it feels like you're being overpaid, to give me an eight, a one C and have me out of here in my mid 50s. Like that's how it feels, if I have diabetes, right?
Jennifer Smith, CDE 32:29
Well, and with the way that things are going, you know, with AI, quite honestly, there are going to be algorithms that now take some of that job out, right. At some point, there will be algorithms that evaluate glucose trends that evaluate insulin pump data, and give some feedback. And then at that point, like you really do become kind of just a prescriber. Yeah,
Scott Benner 32:56
you're a technician, right? You're not You're not a doctor anymore. You're the person that understands all the words enough to like, point me in the towards the right room where I gotta pay and stuff like somebody
Jennifer Smith, CDE 33:05
with diabetes myself, I would rather have a very personal conversation with a person and get their feedback. Sure, it would be lovely, if a computer could just spit out, Hey, I see these problems, fix this, change this do this. That would be nice. But for some of those variables and things that you just can't teach personality, right? To a computer, it's
Scott Benner 33:31
starting to seem like you can't teach personality to a lot of physicians either. So but I sorry, I know being smart is tough, probably all little like, you know, awkward and everything, but it's but but listen, I'm pretty smart. And I've got a personality, like, just try harder. I'm not saying I think computers should just become doctors. I'm saying that I think we're gonna get forced in that direction. Right? Because the physicians aren't giving enough pushback. Otherwise you're not it's they feel like union people who are like add spine. We don't want to be in a union anymore, like you want to hold on to your union, or do you want it to go a different way? And I think you're right, though, I think that moving it to a computer knowing the actual answer, but you still needed to come through a person. It's another Kenny that's another example of maybe we maybe that doesn't need to be a doctor, maybe it needs to be an actual person who is good at connecting with human beings and understands the medicine just enough to be a bridge for that. There's a guy on here one time, his name Sam fold. And Sam is the general manager of the Philadelphia Phillies. Wow. But he also played baseball for like nine years professionally. But he also went to what like pretty much almost an Ivy League school for economics. So he was a very interesting and different blend of intelligent and baseball player. And the reason he's the general manager the Phillies now is because the first job they gave him was to be a bridge between the analytics and the guy holding the bat. Sure, and now I'm not wondering if this isn't the same Same way, this is gonna go one day, like we knew you don't I mean, we need a, we need a person down the middle who understands both sides, they don't need to be a nine year trained physician to agree that chat gfpt got this one, right or whatever that's gonna happen in the future. And as crazy as that sounds to people, and Jenny knows that I'm doing this, but it's a very slow process, and it's in the background. But my last, the last thing I want to do with this podcast is leave behind a chatbot that has taught itself off of the entirety of the 1000s of hours of the podcast. And I'm already having these amazing experiences where I'm just teaching it like the Pro Tip series. And by teaching I mean, you're just feeding it into it, you're hard pressed to ask it a diabetes question, it doesn't have a good answer to just from learning from listening to all of our conversations, you, me and all the other people who come on here, it's really, really fascinating, like, so I think I can leave something like that behind. If I can do that. I'm assuming a hospital can figure it out. Of course. Yeah. So this is my last thought. I'm going to put it in this episode. And let's talk it through for a couple of minutes. And then we'll be on our merry way. And thank everybody for listening to the Grand Rounds, episodes, etc. While you and I were recording this, I jotted down in my notes, follow one patient a month to learn Oh, and we didn't really go over it. But I found myself thinking that every doctor should just find one patient that has a glucose monitor and is interested in helping and say to them, Hey, can I follow your CGM for a month? Could we text once in a while, I might text you and say, Hey, tell me what just happened. Now, when your blood sugar did this? Or did you just eat it feels like you just ate and or, you know, I saw you ate but you didn't get high. What happened here just a month, I swear to God, one month, I know nobody's gonna do this. For me, he's gonna tell me it's a HIPAA violation or some crap, I don't care. I'm telling you, if you followed one person a month, and you did it for a year, you would learn a lot, you could be on this podcast next year putting me to shame talking about diabetes. So and anybody you would learn so much in just just that one idea, and it's so doable. It's free. And it would take a limited amount of effort on the doctors part part and on a patient's part. And you all know one patient who's cool that you could approach about this, you know what I mean? And it
Jennifer Smith, CDE 37:21
also teaches you an awful lot about the actual product,
Scott Benner 37:24
right? Yeah, you might learn how it works, you
Jennifer Smith, CDE 37:27
might actually learn some of the ins and outs of that particular CGM, or some of the ins and outs of that particular pump and what you thought it would do. And then when you actually see it performing in the here, and now real time, you can say, Well, God, that recommendation I've been giving
Scott Benner 37:47
what the hell I'm talking about, I saw my daughter's graph today. Just her graph. I looked at it, I thought, Oh, she ran out of insulin. And it's her day off. It's her sleeping day, right? Because this is their one day off a week from school. And I was like, there's no doubt in my mind. She is asleep. And she ran out of insulin. I knew in 15 minutes by looking at a graph. I called her up, I woke her up was like, Hey, is your pump empty? And she goes, Oh, thank you. And she was just like that. I knew that from looking at a graph. And you'd be amazed at what you'd learn. If you just follow along for a month, right? And then let them go and then go pick somebody else. Now we'll do it with a kid or talk to their mom, like, you know what I mean? Like, I swear to God in a year, you would, you'd be a genius at this. And it wouldn't cost you anything, you wouldn't have to go to a meeting on a Saturday, like all the stuff that I hear, you know, and you maybe you wouldn't feel so burned out, Jenny, if you were actually helping people and not walking around all the time feeling like, Oh, nobody listens to me. And this sucks. And why am I bothering? So? I don't know. All sounds like common sense to me. But they'll say,
Jennifer Smith, CDE 38:53
Oh, that's a common sense. You bring up something that many people are not unique.
Scott Benner 39:00
Story. When you think of this series, we have a couple of minutes before you have to go. Did you enjoy making this? Do you think it of course, do you think it hit the mark? Or do you think that doctors would listen that and be like, Don't bash me because they call it doctor bashing if you're critical of them?
Jennifer Smith, CDE 39:13
Well, you know, and I think if you have an open mind that you would start listening to this to begin with, or you feel like you are missing something. I would expect that you're going to gain something out of this, even if it's just one episode that really hit and you're like, oh, yeah, that makes sense. Yeah. And depending on what type of physician you are, you know, emergency department or, you know, a specific, you know, specialty like endocrine or whatever it might be. I would have again my personality. Yeah, I would have been very, very excited to be able to hear something that I could have gotten something out of even even if it made me feel like ah, I'm clearly not hitting the mark here. I can do better than this. Right? Yeah,
Scott Benner 39:56
I hope so. I really do. I hope also that they heard that Really, if you have a type two using insulin, it's enough of the same game that you could use some a lot of the same concepts to help those people because I, you know, you are going to hear some people say, well, type ones are such a small portion of the of the population, I can't put that much effort into learning for this many people, but a lot of what you're gonna know and help a type one with, you could help us type two with as well. And that's it. You know, if mass appeal is your is your game, then? You know, there you go. Absolutely. Yeah, I mean, until they start putting GLP into the water, I guess which will be.
Jennifer Smith, CDE 40:33
Personally, I really hope that I have to filter all my while. I'm
Scott Benner 40:37
not advocating for that I am what I, what I actually think is it's funny, I'm in between on that idea. I'm seeing GLP has helped people with type one and type two diabetes all over the place. And I am for whatever makes you healthier. But at the same time, I think we're going to eventually do the thing where we skip over the value in this thing, and then just start mass, giving it out to everybody to try to avoid the problem to begin with. Which is I mean, maybe is a reasonable answer, but I don't know. It's it's so far in the future. It just it always scares me that when something's easy, we stopped thinking about it. You know what I mean? So, anyway,
Jennifer Smith, CDE 41:13
no, I think the series was, I think it was needed. And for whoever grabs it and really listens to it and can step back from an ego and say, I can get something from this. I don't agree with this. But I do agree with that. Or I can you know, take something away from this. I think it was important.
Scott Benner 41:30
I do too. I my bigger hope. And my bigger my my more reasonable expectation is that we're hitting people who are younger and just in med school or thinking about going to med school and maybe you're gonna this is going to be a thing that helps the next generation of people maybe more than this, but I hope not. I hope everybody got something from it. Anyway, I always enjoy working with you and doing these things. So I can't thank you enough for helping me. Of course, you know, I
Jennifer Smith, CDE 41:55
always enjoy it as well. Thank you
Scott Benner 42:02
a huge thanks to Omnipod not just my longest sponsor, but my first one Omni pod.com/juice box if you love the podcast, and you love tubeless insulin pumps, this link is for you. Omni pod.com/juice box. I want to thank the ever since CGM for sponsoring this episode of The Juicebox Podcast. Learn more about its implantable sensor, smart transmitter and terrific mobile application at ever since cgm.com/juicebox. Get the only implantable sensor for long term wear get ever since.
If you're ready to level up your diabetes care, the diabetes Pro Tip series from the Juicebox Podcast focuses on simple strategies for living well with type one. The pro tip episodes contain easy to understand concepts that will increase your knowledge of how insulin works and so much more. My daughter has had an A one C between five two and six for since 2014 with zero diet restrictions, and some of those years include her in college. This information works for children, adults, and for the newly diagnosed and for those who have been struggling for years. Go to juicebox podcast.com and click on diabetes pro tip in the menu or head over to Episode 1000 of the Juicebox Podcast to get started today. With the episode newly diagnosed we're starting over and then continue right on to Episode 1025. That's the entire Pro Tip Series, Episode 1002 1025. If you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective, the bold beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CDC es a registered dietitian and a type one for over 35 years. And in the bowl beginning series Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698. In your podcast player, where you can go to juicebox podcast.com and click on bold beginnings in the menu. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com
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