#1233 After Dark: Foot Bath

Sarah is 26 years old and has type 1 diabetes. Discussions of physical and drug abuse, mental health battles and more. 

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Scott Benner 0:00
Hello friends and welcome to episode 1233 of the Juicebox Podcast

today's episode feature Sarah she's 26 years old was just diagnosed with type one diabetes in February of 2023. She suspects another autoimmune issue that presents like ra but she can't quite figure out what it is she's taking Plaquenil for it. We're going to discuss that her mental health issues, some physical abuse, and a lot more. But keep in mind with this episode, specifically, if you are an apple podcast subscriber, which means I think you pay like five bucks a month to get the show day early and you get the Pro Tip series in the bowl beginning series without ads. If you have that subscription model right now, you're gonna get this episode, unedited. And without advertisements, that means cursing and no ads. If you're subscribed right now on Apple podcast, everyone else is getting ads and beeps. But I mean, that's not really that bad for free. You know what I mean? 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. 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 touched by type one touched by type one.org and find them on Facebook and Instagram touched by type one is an organization dedicated to helping people living with type one diabetes. And they have so many different programs that are doing just that check them out at touched by type one.org Today's episode is sponsored by Medtronic diabetes, a company that's bringing people together to redefine what it means to live with diabetes. Later in this episode, I'll be speaking with Jalen, he was diagnosed with type one diabetes at 14. He's 29. Now he's going to tell you a little bit about his story. To hear more stories with Medtronic champions. Go to Medtronic diabetes.com/juice box or search the hashtag Medtronic champion on your favorite social media platform. This show is sponsored today by the glucagon that my daughter carries G voc hypo penne Find out more at G voc glucagon.com. Forward slash juicebox. My

Sarah 2:36
name is Sarah. I'm 26. I was diagnosed as type one in February and I'm here for whatever the new series is called.

Scott Benner 2:44
Who wait. So you just were diagnosed you 26 March April, May, June, July, August, September. It was in February so So eight months. If you count February, then you get an extra month when you're counting is difficult. So eight months ago type one Do you have any other autoimmune issues?

Sarah 3:04
I have an unknown rheumatological issue that I've suspected is autoimmune but they don't know what it is. How

Scott Benner 3:13
does it manifest itself? Since

Sarah 3:15
I was 13, it's mostly related to like I have a lot of flare ups around my cycle is managed right now with Plaquenil. But I mean, it was to the point when I was 23. I was basically bedridden and they were like I don't know all your tests come back clean. So it's mostly just like aching specifically around the joints. It presents like ra except no swelling.

Scott Benner 3:34
Presents like ra no swelling. Antibodies come back negative. And it only happens around your period. It's

Sarah 3:43
the worst man but I also like I click a lot like my joints are very loud and then they pop. Like when I am not consistently taking my medication because I tend to be forgetful. You can actually hear my joints get louder.

Scott Benner 3:58
The Plaquenil is what it's a is that an injectable?

Sarah 4:02
No, it's oral. It's hydroxychloroquine Oh, it's the blanket. It's something let's try this.

Scott Benner 4:11
I know that drug actually, how much has that helped you? Significantly,

Sarah 4:14
really significantly. When I was 23. I had worked up so bad because I had obviously was working still through all of this. But during COVID I quit my job because I was just so built up about everything. And during that time, it's like because I didn't have that daily reason to push myself to I have to go to work I have to do this. I deteriorated to somebody who needed help getting up out of bed very quickly

Scott Benner 4:44
immunosuppressive drug and anti parasitic. So oh, this this. This is the drug that like blew up in consciousness during COVID Because why? Because Oh, I know why? Because it's generic and it's cheap. When people said there were people who were saying this could maybe help with COVID. And then it turned into one of those, like, argument points during COVID. I remember this. Okay,

Sarah 5:08
that made researching it very difficult. And

Scott Benner 5:12
there were people like you using it for stuff like this. And then suddenly it was they were having trouble like sourcing it to is that this drug? That's the same one. Yeah. Okay, I remember this. I've actually thought about this for Arden at times. Does it have any side effects that are ill like things you wouldn't want to have happen? They

Sarah 5:31
say that it increases your sensitivity to sunlight, but I haven't noticed anything. And I very much love to bask so. And I have to get to yearly eye exams, because they say that has a chance for damage to your retinas. But other than that, but and I've been on it for three years. And I say that there's nothing but it's more of a like you're on it for 10 years, and then you have a 5% chance. I don't know the exact but it's relatively minor, but it's enough within it is a requirement to see a yearly ophthalmologist.

Scott Benner 6:04
So after 10 years, you have a 5% chance of having problems with your retinas.

Sarah 6:09
I think it's I think it's lower than that. I'm just making up numbers. Oh,

Scott Benner 6:12
well, yeah, I mean, we should definitely do that. We'll just make up numbers. I made them up about your age, and how long ago February was and everything, so we're fine. What brings you on the podcast? Like when when you said, I'll come on, what did you think you would talk about?

Sarah 6:30
I hear you speak a lot when I listened to particularly to the after dark episodes. And when you You seem interested in things about mental health. And that's something that I have a lot of experience with. And I haven't heard anybody talk about, I guess, when people talk about their mental health issues, they didn't have a core reason of like, oh, this happened. And I feel this way or like a core source of their problems. And I haven't heard anybody expressed the way that I have, I think you had one guest very briefly mentioned her negative connotations towards religion, but it was very sparse.

Scott Benner 7:04
Okay, let's like dig in a little bit. Do you have mental health struggles?

Sarah 7:08
Oh, definitely.

Scott Benner 7:09
Like, of course I do. When did they begin? What do they look like? The

Sarah 7:15
best way I could word it is I remember wanting to kill myself since I was in elementary school. So forever, basically,

Scott Benner 7:22
what does that feel like? How real is that feeling like you make plans to kill yourself, or you just have these feelings of like, I wish I wasn't alive.

Sarah 7:30
It waves. So sometimes like as of right now, I'm pretty decent. And if you catch me, like on a bad day, or whatever, it's like the other day, we were, I was making coffee. And I have one of the old style coffee pots, just the regular pour over. And there had been a clog or something and the grounds spilled up and backed up into the water tank. And I'm just, I just immediately started going, I have to do everything in this house. And that's just another thing I need to do. And I keep messing everything up and in blah, blah, blah, blah, blah, and on and on and on and on. And that always just spirals into, well, this wouldn't happen if you weren't still here. Like you're not supposed to be. Oh,

Scott Benner 8:09
wow. And how fast is that happened from like, the odd malfunction of the coffee pot that has nothing to do with you, too. We should find a verge to jump off of like, what's the is it like minutes or days? 80 seconds? Okay, then, but then do you then think I'm gonna go do it? Do you ever make a plan?

Sarah 8:30
Nonetheless, few years now, but I think the only reason I never had a honest to god attempt is because I was so convinced that I was going to screw it up. And I would end up more permanently damaged and worse off than when I started. So

Scott Benner 8:45
when you were younger, What stopped you from attempting suicide was the idea that you would screw that up like you've screwed up the coffee pot? Pretty much. Oh my gosh. Okay. And this stems from what like, do history of mental illness in your family. People are screaming and yelling at you. You've been abused anything like that? Yes,

Sarah 9:02
yes. And depending on your definition of abuse, I was never really hit. But I was in very dangerous situations. I use the word neglect more often. Your

Scott Benner 9:12
whole life neglected. Pretty much. And what does that mean? That means you're on your own to eat to go to school to clean yourself. Nobody involve themselves with you.

Sarah 9:23
Yeah. When my mother and father were still together, that was they were both drug addicts. It was very physically abusive, very dangerous. And we were split apart by foster care. And I went with my grandparents on my mother's side. And they are also drug addicts who also had a very physically abusive household, which was not conducive for a child. And then when my mother got out of prison, I got back with her and her whoever she was dating at the time, and basically from then on out, I was I think I was in third grade, maybe at this point and it was just kind of like, okay, you have to learn to be independent now fully. Oh my gosh, I always had a roof and there was almost always food. But that was

Scott Benner 10:11
like God. Do you have brothers and sisters? Five? Wow. Did they all get I

Sarah 10:19
was essentially raised as a single child after that because one went to his grandparents to went into foster care. And one went to another set of grandparents and one went to the Father. So we all went different directions. Did your

Scott Benner 10:34
mom have five kids with five different men?

Sarah 10:36
Two of them are not hers. So they're all half siblings. Oh,

Scott Benner 10:40
wait, wait. So there were three kids that were hers and two kids. She found somewhere or British?

Sarah 10:46
Were from my father's previous relationship. From

Scott Benner 10:50
you. I gotcha. Okay, so she had kids with other guys met your dad got pregnant. He brought kids with him. I got it. How old were they? When you were being moved to your grandmother's house? Do you think?

Sarah 11:03
Probably about 12 and 13. You were that old? But

Scott Benner 11:07
how old? Were your parents? Were they young parents? I

Sarah 11:09
was like four they were like probably early 20s. My mother had three children by 21. So and I was the youngest. So I think I was had right before she was 30

Scott Benner 11:23
and she was she had addiction issues.

Sarah 11:26
She still does. Okay.

Scott Benner 11:29
Wow. And then you get to the grandparents house. They're the same as your mom basically. Was there any moment when you left your mom and went to your grandparents you thought this is going to be better and then you got there and you're like oh no same place. If you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily G vo Capo pen can be administered in two simple steps even by yourself in certain situations. Show those around you where you store G vo Capo pen and how do you use it? They need to know how to use Chivo Capo pen before an emergency situation happens. Learn more about why G vo Capo pen is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys caught a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma. Visit G voc glucagon.com/risk For safety information.

Sarah 12:55
Oh no. We have visited my grandparents and my grandmother was just horrific. He was screaming and like. So my grandfather while he also was still a drug addict, he worked and he did what he could. So I think the reason that I was cared for the way that I was in that household at the time was because of him. But he worked so much to try to support because he was the only one in the house with a job and takes a lot of money to buy that many people drugs. Yeah, drugs are expensive. So he lay down on the couch for a two hour nap before he went to go drive cabs. And she'd be screaming at him saying you're such a sorry, son of a bitch blah, blah, blah, everything like that. And it was just nothing but vitriol coming from that woman's mouth, always screaming. And

Scott Benner 13:38
so you as a child, you absorb all this. That's how you feel about yourself.

Sarah 13:42
I think it was also a lot of it was she was a very religious woman.

Scott Benner 13:47
It doesn't sound like it, but go ahead.

Sarah 13:50
I know. Southern Baptists will do that to you.

Scott Benner 13:55
Screaming at that guy doing what are we talking about? Heroin, meth. What do we do?

Sarah 14:00
I think she was mostly doing pills. My grandfather, I think he was also mostly doing pills and coke. And then my aunt was living there and whatever boyfriend she at the time and she switched around between crack and whatever she could get. And so well that they were mostly doing OPERS not downers. So while

Scott Benner 14:15
we're doing pills and crack and whatever else we can find some cocaine and screaming and yelling each other and abusing everybody. We're very religious going to church. We're very religious people.

Sarah 14:25
We are we cannot listen to any sort of metal music because I don't like Satan into the home. We cannot watch Harry Potter because that's the witchcraft and that's the devil's work. We cannot associate with certain acts of people whether that be based on sexuality or race. Definitely opinions

Scott Benner 14:44
when you when you strip all that away from them. What's the core issue? How did they get to where they are?

Sarah 14:50
It's definitely in my perception of it is always having to be the victim in a situation.

Scott Benner 14:59
Okay, Do you think looking back at them and thinking about how you feel about yourself? Is it possible this is very generational?

Sarah 15:08
Oh, definitely I watched it, I watched my great grandmother have to be the victim, which followed the grandmother when my mother and then my sister is very much following in the same footpath. And I tried very hard not to do the same.

Scott Benner 15:20
By the way, foot bath is such an interesting illustration with words, because your feet are dirty, and then the bath gets dirty, and then everybody goes through it. I never heard that before. But I love that. I'll be using that at some point in my life. Thank you. I'm trying to ask a question. Isn't it funny? I'm going to ask a question, I think is insulting but I mean, after the story, like what can I say that you know, anyway?

Sarah 15:44
I'm pretty sure you won't hurt my feelings. Are they?

Scott Benner 15:46
Are they particularly smart people? Dumb think?

Sarah 15:51
I think they used to be okay intelligent. But I think the just years and years of drum usage has. My mother was never the brightest person. But I remember clearly the one time I it really clicked with me that oh, this is changing who she is. Sometime when I was in high school. She asked me how to spell house. Oh, I was like, oh, no, this is this is really affecting.

Scott Benner 16:18
You're in trouble. I'm in trouble. We're all in trouble. Yeah. Okay, I'm gonna just call me to get my to do list out and cross off all the jobs that I was hoping to have one day, I don't think I'm gonna make it to. If the lady supporting me is like house, what are all the letters in that? Give them to me in order, please? I think you're like, Oh, I I don't think I'm going to MIT anymore. What were your goals? Like? Did you have goals as a child? Or did this fall on you so quickly, that you kind of couldn't even dream like that? I

Sarah 16:50
never had any expectations for myself. I used to joke in high school that you would find me on the corner in my box. And that's if I made it that far. If the real estate would let me get a box in that neighborhood.

Scott Benner 17:03
I had the downpayment on the box, but I couldn't secure the water rights. I don't want to ask you where you lived. But is this common where you grew up?

Sarah 17:11
I'm fine, saying that I'm in the south. But in the area that I live in is very much you go two blocks down and you see people very comfortable. And then the other two blocks, you see people fighting for Section eight. Okay,

Scott Benner 17:26
I see. But like the kids you grew up with? Were they all like, I hope I can get a nice, I want one of those heavy duty moving boxes, the ones that are real thick, like was it? Was that like very common? Or do you think it was not particularly

Sarah 17:38
I was in like, I don't know what term they use. There's the type of schooling that you'd have to test into, like, you have to have a certain qualifying IQ, it's still a public school, and it gets like public funding, but you have to qualify to get in. So I was very much the odd duck out because nobody in there, with the exception of maybe one or two other kids was under middle class,

Scott Benner 18:00
I say, you were a target. As far as that as well, meaning you didn't fit into that scenario, either. And you didn't see. And so it feels like more of a failure when everyone around you is not failing or having these problems. I was

Sarah 18:12
never really ashamed of it in the sense that I ever thought of myself as a failure. It was more of what the time when I was a kid, I very much had the chip on my shoulder of look at how much I'm able to overcome. And I was very much lacking in empathy, probably because I needed to be at the time. And I'd hear the people around me and the biggest challenge that ever gone through is the loss of a pet or their parents getting divorced. And I'm like, hey, my grandfather's in a coma. And he's been on a ventilator for three years. And I'm being taken care of by two drug addicts, and I'm happy if there is something to eat in the house. So I don't, I don't really think that mommy not loving daddy anymore. Not that big of a deal. Now I understand, you know, that is something very difficult that they weren't dealing with. And that was something important to them at the time. And I'm sure, but at the time, I didn't have the sympathy for it, because it seemed like nothing. And

Scott Benner 19:14
maybe that's actually just at the level of things people aren't meant to deal with in a modern society. Like, you don't need to be, like having the experience of watching your grandmother crush up on oxy. It's not exactly, you know, like something people are supposed to live through. You know, and sure, in the beginning, you tell yourself that stuff like man, I can overcome anything. But that's really that's those are the words of somebody who's being like, oppressed by life every five seconds. Because if you don't do that, then you're gonna you feel like it's just gonna crush you. And then you know, if you don't get back up, you're dead and that whole thing happens. Did you mean it? Or was it just something you were saying? Like I'm saying like, was it just something you said to yourself to keep yourself going?

Sarah 19:57
I think I really did take pride in it. Well But I think it was because I didn't have anything else I could take pride in. Okay,

Scott Benner 20:04
no, that makes sense. Do you think if I lift you up out of your bassinet and take you somewhere where none of this is happening? Do you think you're a person who thinks about ending their life and feels terrible about the coffee grinds and everything else?

Sarah 20:18
I think it wouldn't be to the severity that I have. So I've tried different forms of therapy. And I'm better than I was, but I don't think I'm the best judge of my own character, because I think about who I was five years ago, and I said, Oh, I'm better than I was five years before. And each and every time I look back, I'm like, Oh, I was just the worst place of my life. So I don't think in the moment I'm ever good at judging how I'm doing

Scott Benner 20:46
because you're climbing out of such a deep hole. Yeah, you're like, Oh, my God, I've gone so far. But you're still in the hole.

Sarah 20:51
When I was in therapy, the first time at 19. I remember speaking to my therapist, and she was, I feel bad for her looking back because she was a recent grad. And she'd only had a handful of clients. And he probably wasn't prepared for somebody who'd had long term issues. She was doing college students, she's probably trying to deal with people having anxiety over exams, and she didn't know what to do with me. But I remember telling her Oh, I was so much worse off a couple years back. But at the time, I was an insomniac, I had been on three different medications that were not helping me. I was going through an eating disorder, and I was an alcoholic. So I don't think I was doing better. I think I was doing worse. But I was I thought I was doing better.

Scott Benner 21:34
So in your life, you've had an eating disorder. You drank too much. Is that correct? Did you do any drugs? No,

Sarah 21:42
because I knew I would like film.

Scott Benner 21:47
But you drank a lot? Oh, yeah. No,

Sarah 21:49
I would definitely consider myself an alcoholic for I'd say maybe four or five years.

Scott Benner 21:54
What does that look like drinking every day? drinking every

Sarah 21:57
day. But in the sense of well, I'm better than other alcoholics because I only drink after work.

Scott Benner 22:03
I go, Oh, well. Yeah. Well, you you got that good learning from your grandfather who did go to drive the the cab.

Sarah 22:12
Right? It doesn't matter if you can still hold the job.

Scott Benner 22:15
Yeah, so if I have a job, I'm not, I'm not a mess. Or

Sarah 22:19
you're you're doing well enough. I know that there's issues like I knew that I wasn't happier doing well. But I was doing better than other people in comparison. Because I was comparing myself to people who were doing very poorly. There

Scott Benner 22:35
might be an episode about comparison and blame there is with me and Erica, where we talk we talk about there's sometimes value in comparing yourself, you can actually bolster yourself through it. But when you start saying, I'm doing better than the, you know, man with no legs, who's the alcoholic and you're like a drug addict. And he lives in a sewer like you know, I'm doing better than him. When you do that you're lowering the bar so far, you're hurting yourself. But there's, there are moments where you can actually make yourself kind of like, feel better about things. But it's not a healthy way to do it a lot, but it's not terrible. Once in a while. It's interesting. Like how that that kind of can be. Wow, you were you drank between what ages

Sarah 23:18
19 to 24.

Scott Benner 23:21
It's a little early for all that stayed away from drugs because you saw what it did other people thought you would fall too far down a hole if you did that. Absolutely. I

Sarah 23:31
still believe that.

Scott Benner 23:32
Really? Do you do anything you smoke weed or anything like that?

Sarah 23:35
I never really did just because I've always been worried this is I've always been worried about getting popped on a drug test and losing my job. A lot about whatever job I ever had. Even if I was only making $8 an hour, I was like, Oh, I don't want to lose my job.

Scott Benner 23:49
What if McDonald's starts giving us piss tests? I'm out. They might you never know. They might get real serious about the french fries one day and then I'm out work but that's how important the work part of it is to you. This episode is sponsored by Medtronic diabetes, Medtronic diabetes.com/juice box. And now we're going to hear from Medtronic champion. Jalen.

Speaker 1 24:12
I was going straight into high school. So it was a summer getting into high school was that particularly difficult and imaginable? You know, I missed my entire summer. So I went I was going to a brand new school. I was around a bunch of new people that I had not been going to school with. So it was hard trying to balance that while also explaining to people what type one diabetes was. My hometown did not have an endocrinologist. So I was traveling over an hour to the nearest endocrinologist for children. So you know, I outside of that I didn't have any type of support in my hometown. Did

Scott Benner 24:45
you try to explain to people or did you find it easier just to stay private?

Speaker 1 24:50
I honestly I just held back I didn't really like talking about it. It was just it felt like it was just an repeating record where I was saying things and people weren't understanding it. it. And I also was still in the process of learning it. So I just kept it to myself didn't really talk about it.

Scott Benner 25:05
Did you eventually find people in real life that you could confide in. I

Speaker 1 25:09
never really got the experience until after getting to college. And then once I graduated college, it's all I see, you know, you can easily search Medtronic champions, you see people that pop up, and you're like, wow, look at all this content. And I think that's something that motivates me started embracing more, you know, how I'm able to type one diabetes, Medtronic

Scott Benner 25:30
diabetes.com/juice box to hear more stories from the Medtronic champion community.

Sarah 25:39
In the work is important just because of the money. I love how you speak about growing up with poverty and generational poverty. Because when you speak about it, I don't hear you being ashamed of it. Or sometimes I hear people say, Well, we weren't well off. And then you're like, oh, no, we were broke. We were dirt poor. And that's more of the way that I look at it. I remember getting my neighbor $20 Because our water had been shut off for a month, and they asked if we could shower at her house for the week, for

Scott Benner 26:06
20. That's not a bad deal at all. Seriously, it's like what is that like less than $2 a day, I can afford that? Well, it

Sarah 26:13
was the same thing when her power was out, she'd run an extension cord over to our house, we just tried that $20 back and forth, there

Scott Benner 26:19
was an entire winter where I would get up in the morning and take this little electric heater and drag an extension cord out of my house put the electric heater on the dashboard of my vehicle to try to melt the windshield enough that I could drive to my job before it would freeze over again, because the truck didn't have any heat in it. So I would go out there and like three jackets bundled up, I was colder driving to work than I was when I got to work. And I and I used it. So I would like I remember so like I grabbed the heater slammed the door, run the heater back in the house, throw it through the door, run back jump in the truck and drive away because I had a towel with me. And I would keep taking the condensation off the windshield because it would freeze up if I didn't. And that seemed like a fix. To me. It was like I was like this will work. Because we already had the extension cord and the heater.

Sarah 27:10
I very much understand we had a television that you can only change the channel if you had a pair of pliers. But you also needed the pair of pliers to operate the shower. So but we only had one pair of pliers. So you if somebody was taking a shower and you couldn't watch, take whatever channel it was on. That's what you were watching. You

Scott Benner 27:30
had a moment in your life where you were like I have to go get the the TV pliers so I can take a shower. Yes. Wow. Yeah, that pretty much should sum it up for anybody listening who doesn't understand what it means when you say I've never had any money? Oh, that's absolutely fascinating. Yeah, oh, you're very nice to share that. Okay. So none of that talks about the religious thing. So you think that a lot of your problems stem from the religion that you were around? It's

Sarah 27:58
not in the sense of, I am scared, I'm gonna go to hell or anything like that. And I'm not religious at this point. It's the religion was boiled down to morality. And it was, this is good. This is bad. And everything was good or bad. It was very black and white. And that morality just drilled into me very heavily. And if I was to like, summarize, what is the core of my being better? Like the entanglement of my issues, if you were to try to get to the middle of the rubber band ball, that little ball in the middle is I think I am a morally bad person, even with no evidence

Scott Benner 28:34
towards it, because you enjoyed the Harry Potter films? No, I

Sarah 28:39
don't know where the original idea stemmed from, I guess just I have an assumption. I think when I was small, it was like, all of these bad things are happening. Bad things happen to bad people as I thought, therefore, I must be bad. And I think I just internalize that. Yes,

Scott Benner 28:58
that self flagellation thing like your grandmother is thinking, if I follow the word of God, he'll save me. And because I'm not being saved, this is a reflection on who I am. Because I'm not worthy of that saving. Is that about it? I

Sarah 29:16
can't speak too much on her mindset. Because it was confusing, even to me, even to this day. I don't quite know. She she calls me sometimes and says, she leaves voicemails and I blocked her like three or four times. I don't want to talk to her. I think I've made it abundantly clear, but she just keeps finding new ways to try to contact me and she'll leave me voicemails and say, I don't understand why you don't want to speak to me. Like, you know,

Scott Benner 29:40
well as they get as people get older though. Their brains go a little mushy. How old is she? Is she in her? 70s yet? Yeah, she's in her 70s Yeah, trust me, they the front the frontal lobe begins to shrink with age. And a lot of that what I'll call piss and vinegar kind of goes away a little bit, and then they start misremember. bring things are remembering things kinder than they were. And then all of a sudden, it's like, I don't understand, like, why are we even talking about this, because they really don't remember, sometimes I

Sarah 30:08
feel like it's more of a learned behavior. Because I see the exact same thing with my mother and my sister and my mother's in her early 50s, my sister is in her early 30s. And I see them do the exact same thing. We'll

Scott Benner 30:20
pretend none of this happen. And let's start again. But if you if you started over again, with them, you'd be back in this in the footpath pretty quickly, right? It's

Sarah 30:28
very difficult. I used to have anger issues. And my mother and I would just be screaming at each other every time we wouldn't speak to each other for three weeks. And then if we intersected even for 45 seconds would be a screaming match.

Scott Benner 30:45
Do you ever remember what you were yelling about? Or was it nonsense?

Sarah 30:49
It was It was nothing. So it would be I'd be in my room and the door would be closed. And she would start screaming about Why is the door closed? What are you doing there? Why are you trying to hide for me? And then it just snowballed into, like I had a habit of wearing jackets. Because I was a teenager with an eating disorder and insecure about my body. I wore oversized clothing because I didn't want to show it and she would say, why are you doing this blah, blah, blah. And she is she would always assume that I was hiding something bigger than it really was. Reality.

Scott Benner 31:20
So to me, if I if I got your mom and your grandmother together, like on Family Feud or something like that, and we did like morality, Family Feud, and I said to them, pills, or Harry Potter, what's the bad thing? They'd go Harry Potter?

Sarah 31:33
Probably? My grandmother, definitely. My mother has skewed further from religion and more towards conspiracy. She is an avid follower of Alex Jones. Now, do tell.

Scott Benner 31:45
So how does the conspiracy support her problem? Like good? You don't I mean, like, because your grandmother's like using the religion, idea to support her ideas? How does the conspiracy support your mom's ideas?

Sarah 32:00
Very much victim, everything's out to get me there's always a plan. There's always something some sort of a cabal, and then when I say hey, maybe the things that you are believing in are problematic and causing you problems. And maybe it has nothing to do with the government controlling the weather, or the President being replaced. Or now she's really big into UFOs, and fairies and Ethereal Beings. And I don't even know what the point of those ones are. She just thinks that there are things around her.

Scott Benner 32:30
Tell me Did your mom at some point believe there were Jewish space lasers.

Sarah 32:34
She never said the word Jewish, but it was very heavily implied.

Scott Benner 32:41
So like that level, very

Sarah 32:43
much he believes if you get somebody who can speak fast enough and energetically enough, I believe that except for anything that's sensible.

Scott Benner 32:52
I had this conversation with somebody very, very recently. And we were talking about, you know, the paths that people take. And at some point, this person said, always, the problem is the internet. I said, I need to stop you. I said, I do a lot of good with the Internet. And I don't think it's the internet. I think it's the intention of the person who uses the tool. And he's like, Well, what do you mean? I said, Well, I, you know, I'm like, I do a thing. It's weird. She was talking to somebody who didn't really know when, like, a social setting. And I said, I have a podcast that helps a lot of people. And I have a Facebook group helps a lot of people. My intention was for it to help people. And so because that's my intention, it's my perspective. It's where I come from. That's the thing I've made happen. And I use the internet as a tool to accomplish that. I said, but I'm gonna have to tell you, I said, I know my ability to talk to people. And if I wanted to be and I use the example, I said, if I wanted to be like a televangelist, I'd be so good at it. I was like I said, I'd be so good at it. If I if I had the heart to do it that way. I said, My heart doesn't tell me to do that. And I said, but if it did, if I had a dark heart, I could absolutely scare the crap out of you take your money from you and leave you thanking me. It's a shame but that's what happens sometimes when people use those ideas to take advantage of other people in those situations. And then look at the trickle down effect it has all the way to you. It's fascinating really.

Sarah 34:19
I definitely feel that when it comes to just the the amount of charisma that those people have. We wouldn't have money to put gas in the car. But there was a check the 700 Club on the dining room table. No

Scott Benner 34:30
kidding. Yeah, no, I could get your I could have got your mom and grandma to give me money, no trouble if, if, by the way inside, I was like, Hey, I'm gonna screw these people over and find a way to take their money, use their insecurities to take their money from them. I don't even like even with the podcast. It sounds probably mostly to people, but I take the advertising so you guys don't have to pay for the podcast. Like that's my goal. Really? And even like where this episode gets funny You came when you're like, I'm gonna curse a lot. 33 minutes in, no one has said a bad word. I think I said, No one. No one's cursed, like a warm setting up right now putting like the management stuff without ads on it behind a paywall. So that if at one point in the future, I lose my advertising for any reason, this good information about helping people with their diabetes can kind of continue to exist. But I wouldn't want you to pay for it. And I've said this a couple of times on here. But I had a company come to me a number of years ago now. And they were like, how many downloads Do you have? And I told them, and they said, We can monetize that. Imagine, I think the woman said on the phone call, imagine if you got 50 cents for every one of those downloads. And at that point, she was talking to me, I had like 4 million downloads, and I was like, I would have $2 million. And she goes, yes. And I'm like, that doesn't sound right. And she's like, No, no, and she's really selling like, you know, but of course, they get a piece of it, like she's trying to, what really happens is is that company sees me having some success. And they're like, how can we take a percentage of that person's success from them. And I had the wherewithal to say, if I start charging for downloads, I wouldn't have 4 million because there'd be people who would look at an episode and go, I don't care enough about that to pay 50 cents for it. And, and she's like, I know, you're making a big mistake. And I have to tell you, Sarah, sitting here today, with 15 million downloads total. And I think I got six and a half this year, there is that part of you that goes along? Could I have gotten 20 cents for each one of them, like like, that would have still been an insane amount of money. And then I think, doesn't matter, because it eliminates people from getting to the information. Like like, it doesn't matter if it's 20 cents, or $20. For what it is, there's gonna be somebody at that point that goes, I can't afford that, or I'm not paying that, or whatever. And then the way I think of it is, somewhere along the line, some young person like you who just was diagnosed, or some lady who was trying to help her kid or whatever, doesn't find the information, and they live a whole life, you know, tormented by their diabetes unnecessarily. And, and I don't have the heart for that. Like, I really don't, but a lot of people do. And it's it's not it's not everybody, but it's enough people to find people like your mom and dad and, and grandmother and grandfather and take advantage of them and then leave you in the situation you're in. So I don't know, it's upsetting to me. I think it's probably more upsetting to me. Because I could do it. Like I could, I could have said yes to that company. And I probably would have eliminated 50% of my downloads, and I still would have had a million I still would have, you know, I still would have made that money that year. And so I just it's not for me, the money would be I'd like to say if somebody out there is rich, and they're just like, oh my god, what a lovely thing. I'll just give Scott a million dollars, I happily take it just send it right over. But but for the moment, like I just, I don't I can't imagine that. And I don't know what would have to happen to me. For too dark in my heart enough to just go I don't care about these people. Let me try to like cash grab this. You know, it's it's it's really sad. Honestly, I feel bad for you.

Sarah 38:01
I think part of the reason that you feel that way is because you don't view things as transactional, like I have done enough good. Therefore, I am entitled to my own good.

Scott Benner 38:12
Yeah, I haven't had that thought ever. I will be like, Oh, wow, I had like a day where I got a lot of notes today. I'm like, happy for those people. But I don't sit and think I did that. Like I have to consciously step back. It is kind of an important thing. When you do like what I do, like, there's times I do have to step back and say my actions led to this good thing for this person. And you have to kind of let yourself feel it for a little bit, but you can't bask in it and then expect to be paid for it. Like that's, that would be strange to me. So when you grew up with the the this religious talk that made you feel like you're a bad person. So is that how you feel today, you're you're 26 years old, you know, you're a good person, but you can't believe it, or you actually believe you're a bad person. It

Sarah 39:01
is my first inclination to believe that I'm a bad person. So I'm hypersensitive about things. It's both emotionally and how I am perceived by people that I care about and how people act towards me. But it's only extended towards people who I choose to interact with my wife. It's not like, oh, I bumped into a stranger who probably thinks I'm horrible. It doesn't extend that far. It's I set something down too hard. And my partners in the room, maybe he thinks I'm mad at him. I didn't intend to do that. Why did I do that? I wasn't being careful enough. Now he thinks that he did something wrong. I don't want him to feel that way. Why did I do that? I'm doing

Scott Benner 39:38
it again. And in the meantime, none of that's actually happening. None of

Sarah 39:42
that has happened at all, or it'll go vice versa. He'll say, Hey, can you hand that to me? But I perceived the tone in that voice. And so I go, Oh, no, what did I do? What happened? What went wrong? What did I do again?

Scott Benner 39:56
And it comes back to you like you even if you perceived his tone is like Of course, you wouldn't think what's his problem, you'd think, what did I do wrong? Exactly.

Sarah 40:05
And it could be consulting, completely unrelated to me. So he could come home and say, I have a very bad day at work. My boss was rude. And it was horrible. And I'd say, Why am I not better? Why can't I make him feel better?

Scott Benner 40:21
Yeah, that's a lot. Jesus, sir. And you're not in therapy at the moment?

Sarah 40:26
No, my last therapist, I was at the time I was relapsing with both drinking and self harm. And I was, from my perspective, I thought I was developing compulsions, because I have had two houses burned down. And I gotten to where I was shutting the breakers off when I left the house, because I was so worried about another electrical fire. And I, one day had gotten probably 20 minutes down the road, I was on the way to work. And I couldn't remember, if I shut my stove off. I hadn't cooked in like three days, but I couldn't remember if I checked my stove off. So I had to drive all the way back to go check that so of course it was. And when I told my therapist this, she wanted to talk about my hygiene habits and make sure that I have a consistent dental routine. And that wasn't my priority at the moment. And that was one of the best therapists like find so

Scott Benner 41:27
So you're telling me that if you just would have gotten your teeth cleaned every six months that your stove definitely would have been off?

Sarah 41:32
Exactly.

Scott Benner 41:36
There you go. I am I fault. Listen, no matter what walk of life you're in, whether it's like literally people making the fries at McDonald's, or a therapist, or you know, anybody along the way, you're gonna get varying levels of, you know, proficiency out of out of people or doing a job. And but I think talk therapy in general, just getting things out, is at a, at the basis, at the basic level, it's at least valuable just to talk to somebody, you're going to feel better after you and I talk today, like, I'm going to feel better when it's over the people listen are going to feel better after it's over. It doesn't, it doesn't maybe move the needle enough and change things. But if you do it often enough, it can it can act as like, like you're letting the steam out of the pot a little bit, at the very least. But yeah, finding someone that that's actually thoughtful can see big picture and help you is is not easy. It really is

Sarah 42:35
especially I'm on Medicaid. And there's very limited amounts of I mean, to get my AMI pot, I had to contact a state senator and get the state board involved. But so finding even just a regular therapist who can accept Medicaid is very

Scott Benner 42:52
difficult find moved you like, I don't know where you are, it doesn't matter to me. If I picked you up and put you in a cabin in Wyoming that was a couple of miles from town. And you could have a simple job that paid a reasonable rate and it took care of all your bills, and you had a little money leftover and you could start over again. Would that help you? Or would you just walk into the little town somebody would say something and you'd start you'd start like a problem all over again there.

Sarah 43:22
I think it would definitely follow me because I've that he's internalized so much. I mean, even when I tried to distance myself from it, I'm once again not the best judge, I think I'm doing better than I was before. I'm not having full on breakdowns. But one thing that I learned at least because there's no telling how long I was undiagnosed, but when I'm doing the the ping pong and bouncing around, it's like, like other worldly mood swings, like anything. I remember I was walking home with my partner, and I just been crying for three straight hours and we're walking. And I just keep saying, Can I be done being upset yet? I'd like to be done being upset yet, but I'm doing the hiccuping sobs and everything and it just feels outside of you. Okay,

Scott Benner 44:19
in that moment, you know, you're not upset anymore.

Sarah 44:22
Yes.

Scott Benner 44:25
You know, you're not upset. You consciously want to stop. Can't stop it happening. What ended up bringing it to an end? Do you just exhausted? Yes. You

Sarah 44:35
just have to wait it out. And it's like that there are times where I'll get I will just suddenly feel a drop in my chest like this. You know that sound effect when they turn the sound down? Because like Nero, the emotional equivalent of that. I'll just feel that sink into my chest and then like suddenly I can't talk.

Scott Benner 44:52
Interesting. It's just kind of then you're exhausted. It's over and just can't do it anymore.

Sarah 44:58
Sometimes it's 30 40 minutes, sometimes it's the whole day.

Scott Benner 45:03
And what's the feedback from your partner? Oh, no,

Sarah 45:06
she's having big feelings.

Scott Benner 45:09
Does your partner have issues as well?

Sarah 45:12
He had a brief stint of major depression, but it's to the extent of it. He's he tries to be as understanding as he can. And he knows that there are certain things that he will never fully get, and he listens. But he doesn't know what support needs to be offered. And I don't know what support I need, because nothing has helped. Except time. Yeah.

Scott Benner 45:35
So if I asked you, like, unlike some people's problems, if I said, Look, I give you a magic wand, like what fixes this? Somebody people might be like, Oh, if I made three more dollars now or if I had this, but you you don't even know what would help you. Right, other than just for the feelings to go away?

Sarah 45:49
Well, I've been looking into ketamine therapy. Okay. I don't know if that would help.

Scott Benner 45:53
Well, do you think you're depressed? It comes and goes

Sarah 45:58
definitely, though. I think my last diagnosis was persistent depressive disorder.

Scott Benner 46:03
So you're talking about looking into what's become pretty popular, I guess in Zeitgeist now. So the idea of like, almost resetting yourself with either like low dose mushrooms like psilocybin or ketamine, they're talking a lot about those things. There's some pretty good research going on at Johns Hopkins about it, I think, in a controlled, like, I don't mean, like getting a bag of mushrooms from a guy. I'm telling you, like in a controlled environment that I think is also supported with therapy immediately afterwards, that people are finding, like their trauma, which I mean, obviously, yours is growing up the way you did, from like soldiers to people who grew up with your situations to people who have had like, I don't know, like horrible accidents, like they're able to, it seems like they're having some success, I should say, resetting people, for the lack of a better term. Is that what you've heard, I

Sarah 46:57
haven't heard it in the terms of a reset and more of it helps. Like, if your feelings are very sharp, it helps round the edges. And then they'll sharpen over time, and you have to go file down again. I gotcha. But I because I've done DBT and CBT. And those are very behavioral focused. And I am, at one point in my life, I did need coping mechanisms for focusing on my behaviors, because I've you know, not sleeping, alcohol abuse, self harm, eating disorders, those are not the coping mechanisms. So I very much need behavioral intervention at that time. But as of now, my behavior is pretty, you know, societally acceptable, I'm not doing anything to hurt myself in that sense. Now, I need emotional intervention. And I need to stop the pattern of Well, why is it that when I dropped cup on the floor, and the handle breaks off, my first thought is, Wow, what a sec. That there's no, it's no A to B to B to B, it's I dropped the cup. And, oh, I should just die instantly. I don't know how you intervene in that when it's instantaneous. Yeah. And I haven't found many resources. So far. I'm still looking for emotional train of thought intervention, like how do you out train a gut instinct?

Scott Benner 48:26
Can you trace that back to anything in your life? Like, is there a certain moment or thing that happened to you over and over again, perhaps that, that leads that feeling to pop out like that? People just blaming you constantly for things?

Sarah 48:42
I don't think I was blamed. I think very much it was seeing the abuse from my father, like towards my mother. And it was, she was always being blamed. And I think because I was in that situation, and I felt that anger was also being projected towards me just by way of being there. That I also felt that I was being blamed. I gotcha. Even though nobody ever laid a hand on me. Right?

Scott Benner 49:10
I mean, you love your mom. No, no, when did that stop?

Sarah 49:14
I can't remember ever loving her. Okay, this is a woman who told me that I should kill myself and that I would be pretty if I didn't have that tie around my middle. So she denied me medical care when I was sick and then later said that I was making up for

Scott Benner 49:30
attach it. So you so I look, I've seen a picture of you before. Are you heavy?

Sarah 49:36
I'm about 140 right now.

Scott Benner 49:38
I mean, what I'm what I'm trying to get as I don't actually care what your body looks like I'm what I'm trying to get at is was she making something up about your physical appearance so that you were like, wow, that's like so that it was like gaslighting you almost or was it at least? Did you have a couple pounds and she was like going after you for like I'm trying to figure out what her tactic was.

Sarah 49:58
I definitely He had a couple of pounds, at least from my perspective, but I also have 10 years of eating disorder on me. So I don't know if my perception is reliable on that. But

Scott Benner 50:09
so so she knows you have an eating disorder when she's talking to you about your body like that.

Sarah 50:13
She doesn't care. Okay. And then everything is about her. So like when I was when I was in DKA, in the hospital, I didn't call her I didn't tell her when my house burned down. I didn't call her I didn't tell her. But when she found out, I got a call. And it was her being so upset. And her feelings being so hurt. And I was like, Man, this is this is not about you. I don't

Scott Benner 50:40
have a house. Yeah, I don't want to hear about your problems. Have you ever tried EMDR, the rapid eye movement therapy. When

Sarah 50:47
I've looked into it, it feels it feels more akin to PTSD and people with like, vivid flashbacks. So like, if I got screened that and I immediately thought of, Oh, I feel exactly like when my father screamed at me or when my grandmother was screaming, and I'm in that moment in that time. It seems good interventional for that. But I don't really have flashbacks. So I don't think it would be very beneficial.

Scott Benner 51:15
Yeah. I mean, I don't know enough about it to speak about it. But it mean, I don't I also don't think we can't call what happened to you not traumatic. You know,

Sarah 51:24
oh, no, there are definitely some things that, like the one like I was saying, with a therapist, that was just a recent grad. I remember telling her a story from my childhood. She had to say, I'm sorry, give me a second.

Scott Benner 51:36
I need to share to collect herself. Yeah.

Sarah 51:39
She had to collect herself. And I was like, oh, okay, that's

Scott Benner 51:43
happened to be making the podcast and number of times, I'm like, okay, hold on a second. Wait. And it's, it hits you that the person telling the story. It's just, they're just like, oh, this is the thing that happened to me, and it's hitting you so viscerally. You're like, Wait, that's insane. Like, you know, like, I have to like, put those thoughts in order and relax for a second to hear the rest of it. Because it's so outside of ordinary normal kind, you know, all those things. It's hard to look at that person and realize that that's like a Tuesday for them. You

Sarah 52:14
know, it'll be so the thing about the talking that I don't really feel the emotional catharsis from saying, Oh, I experienced this traumatic thing, and it makes me feel this way

Scott Benner 52:28
to release at all. Not at

Sarah 52:30
all, because I don't really so when I think about something traumatic that happened to me when I was five. I remember it vividly. And I know that I have an aversion to mirrors to this day. And I know why I do. I know the event that caused that link to where now I'm just I have all the mirrors in my house covered up except for one. And I know why that is. But I could retell retell the story, but I'm not reliving the fear of that moment. It is just me telling a story. But I still very tangibly have that fear to this day. So I don't really

Scott Benner 53:09
know what happened that made you like, avoid mirrors.

Sarah 53:15
I don't know if my father was on some sort of a bender or whatever. But he had locked me in my mother and our guest bathroom, this house that we lived on. And he was holding a knife to her throat and making her look at herself in the mirror while he's pressing the knife to her and saying say you hate your mother say you hate your daughter say you hate God say you're sorry pieces. And this you have to do this and everything like that. And I don't think that was good to be drafted there like that. How old were you sir? Probably like five.

Scott Benner 53:47
Yeah, you made me cry finally took almost an hour. Good job. Hold on a second.

Unknown Speaker 53:53
I mean, no, no.

Scott Benner 53:57
I can do it. Didn't happen to me. Give me a minute. Just let me Oh, my God. See, that's the thing that happened to you that happen to your mom. And you're recounting it like, Oh my God. In July when I was 10 We went to Disney now. It was amazing. It just it sounds like a regular story from your life. And that's not a regular story.

Sarah 54:20
And that wasn't something super uncommon. I remember we were living in a trailer he kicked down the front door he shattered the glass coffee table cocked the shock that and said where's that tidying? And she crawled out the bathroom window and was hunched underneath the trailer. And we were just saying like, you know, please do not kill her.

Scott Benner 54:39
You just living in a mid level Netflix TV series like what the hell? Like? Seriously, that's that's not a real thing that's supposed to happen.

Sarah 54:47
Unfortunately it is.

Scott Benner 54:50
What's the Okay, here we go. You've lived through all this and seen it. I make you the king of the world. You have a I don't know whatever I give you a magic wand. How do you fix this bigger problem in society? What makes it go away?

Sarah 55:05
I feel a lot of it is education and empathy. I think empathy is a learned skill, because I think I had to learn. I don't remember being particularly empathetic when I was younger. And I remember actively working towards that in college, because I had noticed my anger issues were coming to a head. And I thought that I was getting to a point where I would hurt somebody, and I didn't want to do that to somebody else. Because I've seen what I've done to other people. And I know how it affected me. And I didn't want to do that to anybody else and be that person for somebody. So I consciously worked through becoming more empathetic and developing empathy. And I think it is very possible for people to do that. And I think people aren't as empathetic. Could be. Yeah,

Scott Benner 55:52
so if shock and daddy, for example, have been raised differently, you think that that's not the path he might have been on? I mean, drugs while this is happening, though, too.

Sarah 56:01
Oh, yeah. But apparently, he'd been doing drugs since he was, like, 15. So it's

Scott Benner 56:05
also not good for you? No, yeah. All right. I'm gonna go with drugs, by the way, is my answer for the magic wand. Because what you know, there's, I hate to say something so trite, but there's obviously a cycle going on within families. And at some point, it's got to stop. Like, are you? Do you think you'll stop it? Are you gonna have kids?

Sarah 56:24
No, I have, when, when me and my partner got together, I made it very obvious. I do not want children, if that is something that you want, I'm not willing to compromise on a life.

Scott Benner 56:34
That might be the kindest gift that somebody in your situation can give the world, which is so sad to say, like, but I don't see like, I mean, we're talking for an hour now. And I'm a reasonable person, I don't see the way out of this. Like, like, how does this stop? Do you know what I mean? Like somebody has to stop it. And so somebody either has to, like, somehow, in one generation, push all that out of their head, make a baby and not screw it up, which seems I gotta be honest with you seems kind of unlikely to me. Or a person's just got to step up and say, You know what, I can break a cycle here by not having kids, like, my family has taught this for generations. And I can go live a lovely life, and not teach it to somebody else and let it die here with me. But is that how you feel about it?

Sarah 57:23
To an extent I, I never wanted children to begin with. But part of that is also just because I find so much difficulty caring for myself. And then I doubt my ability to be like you were saying to be a good parent without just passing on different issues in the same vein, or fields,

Scott Benner 57:43
you won't know you're doing it now. Now, here's the alternate to that argument. I can, I can jump on the other side of it and say, everybody's messed up. Not in not enough people are gonna make this ultimate sacrifice to help things. And so like, why should you be the one that doesn't have kids? But at the same time, you have that empathy piece. So you're, you're trying to avoid making people feel the way you feel? And do feel.

Sarah 58:10
Is that fair? That I think that is fair. And besides chips already, so partner already got that the second way. So I think

Scott Benner 58:16
there's other guys I mean, you might end up with Yeah, I'm saying I like this one. Well, listen, your mom like three or four different guys, so it's fine.

Sarah 58:24
Well, this one doesn't hit me. So I think I'm gonna keep on wait, Sarah,

Scott Benner 58:28
where do you have you been with guys that have hit you? I

Sarah 58:32
dated a girl who treated me poorly, but it was never to the point of physical abuse.

Scott Benner 58:36
Okay. Were you scared in that relationship? Oh,

Sarah 58:40
terrified. But I think part of it was also just self flagellation, in the sense of, I was convinced that I was always doing something wrong. So I was always looking for something that I had done wrong. And this was somebody who always needed to let like, let steam off. And I already was taking the assumed role of well, I've already done something wrong. And so I was it was very easy to be like, well, yes, you did.

Scott Benner 59:08
I think. Yeah, I say you were fulfilling a need for her and she was fulfilling one for you. You knew you were a bad person needed somebody to tell you were bad. And she needed to like go off crazy and who better than a person who deserves it? Back? Kind of? Jeez, do you have sex in a relationship like that? Not really. I was gonna say that would be weird. Sometimes I think everybody just needs to go home. Calm down.

Sarah 59:39
I think that does help some people.

Scott Benner 59:43
Oh my gosh, I was one time. I don't even think I could say this on here. But the Facebook group was going crazy, like a couple of years ago. It seems to move with the moon if I'm being completely honest. And then like drunk o'clock comes in there's like, you know, drunk Facebooking And that happens right around 1030. Eastern time. I don't know if anybody knows this or not. But I just one day one of the moderators was like saying to me, like, what is happening? I said, I just texted back. And I said, I think everybody just needs to go, calm down for five seconds. I was like, This is ridiculous. I don't think I wasn't able to relay that publicly, in a way that I thought would be helpful. But I was like, you all need to relax, like find your thing. I don't know what it is. But Jesus, find your thing. But that's also by the way, from a perspective, this mind, which didn't live through the craziness that you've described, or that many people go through, like, my life sucked, like growing up, like, I'm not gonna say differently, you know, there's a lot of yelling from my dad. My mom was a little like, kind of beaten down, like not physically, but you know, she didn't want to be the one that was the focus. So if he altered us, she kind of stayed in the background. There was no money. They weren't doing drugs. Well, in fairness, I know my mom wasn't, I couldn't, I couldn't. I don't think my dad was but I would be too young to know. He wasn't a drinker. Like you know, beer sometimes, but in social situations, and only one or two like a not frequently not a drinker. Just a lot of anger, I guess, at whatever I don't, I couldn't possibly tell you what it was about. But even describing that as my upbringing, and then divorce in there, and like more poverty and like that kind of stuff, even describing that as my upbringing. My upbringing doesn't hold a candle to yours. I look like I lived in leave it the beaver compared to you. Like Nokia, I

Sarah 1:01:40
love hearing you discuss your upbringing. Because when I there's a story that you've told multiple times on the podcast about when you stood up to your father, when he kicked you and you were just like, you know, you can keep doing that. But I changed my mind. And I love hearing you discuss things like that with the difficulties in that. And then the poverty that you experienced. And, you know, I drove because I had to, that's what I was required to do in that situation to make it through and then hearing the stable and level person that I you are perceived to be at least for

Scott Benner 1:02:17
me. Appreciate that. Yeah, I could be making this all up, I guess. But no, I'm, I'm a pretty like, boring person now. Like, I get up, I do a job. I take care of the people I love. I clean the house, like my wife went away for business for three days this week, right? Yeah, a couple of people came to my house to get into one car and go away to this thing that my wife was gonna go speak at. And there's a couple of people in my house that work with my wife, but I've never really met more than just like over zoom calls and stuff like that. Kelly says to me, what are you going to do while I'm gone? So it's like Tuesday morning, she's leaving at like, 10am. She's not coming home till late on Thursday night. And I went, Oh, I mean, well, I'm gonna get ahead on the podcast, and I'm gonna cut the grass. And I'm going to have to go grocery shopping. I don't have enough food here for while you're gone. And that excited me because Kelly doesn't like seafood. I thought, oh, I can eat seafood. Like she won't complain about it smelling that'll be nice. And then Wednesday night, I got done working at like five o'clock. And I was like, I'm gonna go to a movie. I went to a movie by myself. And I had such a nice time. I talked to this lady that I met there and like, we had a lifetime like watching the movie. She and I were the only ones in the theater together. And like, we had a little conversation afterwards. And I went home, and I went to sleep. I didn't get drunk or high. I didn't the lady at the movie theater. Like Like, you don't I mean, like, I just that's pretty much me. Like I'm a pretty normal, like average person. But I still am not boring. I don't I'm not bored by life. I'm not sad. Like, I think this is what people are shooting for. But I think I'm wrong. I think most people are shooting for pills and craziness and you know, live fast. die young. And I'm, I'm like, I don't know, I just I like to help people. Make some money. Take care of the people I love. You know, make sure the laundry is done that kind of stuff. Like, I don't know, maybe that that might sound crazy to other people. Honestly. I have no idea. Yes,

Sarah 1:04:10
it sounds absolutely perfect to me. When somebody says what do you think? What do you want in your life? What do you envision? I think of myself sitting on a porch watching ducks swim on my pond and I own like maybe two acres. That is all I'm shooting for. So a life where you feel content. And well, you know, I'm gonna go cook a meal that maybe my partner doesn't like, and then I'm gonna go watch a movie by myself and then come home to a clean house. That's, that is what I strive to be contempt with content with

Scott Benner 1:04:41
when I think about retirement like older being older. I think about being somewhere physically close enough to my children to watch their lives unfold. I think about having enough money that I can go see somebody or send a gift or if my son or daughter were to call and say oh my god, I'm in so much trouble. I need five $100 I'd be able to go, here's $500. And then the rest of it is, I want to be healthy long enough to sit around with my wife and reminisce about the things we accomplished. Like I actually that's like, I know, people are like, Oh, I'm going to travel and like, I would like to go to a couple of beaches, you know, and hang out, do some stuff like that. But like, if I saw France, or England or Australia, I'd be like, that'd be great. But if it doesn't happen, I wouldn't regret that at all. I wouldn't even care. I just to me, I've always identified myself by the thoughts in my head. And it actually hurt me. I've tried to talk about a little bit in the week over the diaries, like, as I'm talking about losing weight. I think one of the things that hurt me about my weight and my health is I was an adult, is that I never like I didn't judge myself, by the way I looked. So if I gained weight, or I didn't look okay, I still my my thoughts are so crystal clear. So I was like, That's okay, this is who I am and my thoughts. And so even when I think about like how to wind my life down, I really just want to go back over the things that I experienced, like one more time, like I want to do new things, too. But the new things aren't as important as remembering that the accomplishments. And I don't know that's like how it all seems to me. I am probably pretty boring to most people, don't you think?

Sarah 1:06:20
I don't view that as you

Scott Benner 1:06:22
because you have your mom's throat but people were screaming into a mirror. So you're like, that sounds perfect.

Sarah 1:06:28
Okay, so maybe we found another thing that I'm not a good judge of, which is just what people find boring. Because I my, my partner talks about, he wants to travel, he wants to do all these things. And he's thinking about going back to school, and he used to volunteer for the Red Cross and go to like, disaster zones, and he loved every second of it. And that sounds horrible. I do not like the idea of knowing that

Scott Benner 1:06:53
I grew up in a disaster zone, I don't need you to go find another one for me, I'm okay. Yeah, I don't know. Like, to me, that sounds right. Like even like, where I actually spend money in my life is very specific places. Like it's and it's around my comfort. Like I have a really comfortable sofa. Like that's on purpose. Here's the funny thing. I don't sit in it that off, but I have it. And when I go to watch television, when the times when that happens, I sit in a really expensive, like expensive, comfortable leather sofa. And I watch a giant crystal clear television. But I'm doing it a pair of like, underwear I bought four years ago. But you know, like that. So my money is literally in my sofa. It's in my television that I watch when I sit there. But then to actually give myself the time to sit and use those things is is sort of difficult, because I get so much joy out of making the podcast. So like I am working a lot. I know I don't probably doesn't seem like work to some people. But it's an intense amount of time. It's definitely work. Yeah, it's an intense amount of time. So and my car is a little nicer than it needs to be. Because I spend a fair amount of time in my car, like driving to go help other people. So that's pretty much it. Like I don't have, like, I would tell you that the the stuff that I'm looking at everything I use to make the podcast with write everything. And I can do it in my head really quick. 714 21 3000 4005 Six, I'm sitting probably in front of about $6,000 worth of equipment. And that's it. I mean, that's a very low outlay to start a business. Do you know what I mean? Like, it's almost nothing, I don't pay rent, I don't do anything. As a matter of fact, at the end of the year, I end up paying more in taxes than other people because I don't have any overhead. Like I don't have a bill like to pay. I hired an editor and I told the accountant that handles the taxes for the podcast. And he's like, Oh, thank God, you're finally spending money on something. And I was like, what he goes, you know, you don't have anything to write off. Like, at the end of the day. Like it's nothing like my I'm very simple. Like, and I could afford to buy like tchotchkes or other stuff for the desk that maybe but I don't need them. So like I don't need them. It just it's all very like everything seems so cut and dry to me, like about stuff like that, about being wasteful. And and what nice is and like right now today like you know, like Arden didn't feel well yesterday. Like I'm worried about that. So I'm recording with you. And when I'm finished recording with you. She's away at college. So I will get on the phone. I'm going to call a doctor that's local here. I'm going to start getting her set up to come back and do you know to see that doctor when she gets home in four weeks. I'm going to wait for her to wake up. I'm going to counsel her over the phone, comfort her try to make a plan to help her get through the next four weeks. Like that kind of stuff. And it's not fun, but it's fulfilling and if We had to look backward Sarah and wonder. It's probably because no one took care of me like that when I was little, right that do things wrong motivations. Yeah, right? I'm doing that because it's the worst thing that I could remember happening to me. And so for. So therefore, I do not want to do those things to other people, but I am not. But that's not mixed with any kind of mental illness for me. And that, to me, that's the linchpin. Like, that's where it gets hard for other people when you have some sort of depression happening, or, like, you know, intrusive thoughts, which is what I mean, that's the, that's your coffee mug thing like that thought is there so quickly, it's ahead of your common sense. And you're and then that kind of the rest of it just tumbles down and you you just boom, you just fall into a black hole in two seconds. I don't know how to fix that. I'm sorry.

Sarah 1:10:49
I wasn't expecting you to fix meats that I

Scott Benner 1:10:51
didn't think you were. But I still feel bad. Like, because of how I feel towards the people around me. And it's just who I am, like, I had somebody tell me years ago, this is gonna sound crazy. They were in the diabetes space. They wanted to buy an ad for something. I forget what? And the guy goes to me, Well, you're a caregiver. And I said, why? And it's funny, I'd been a stay at home dad for 20 years. At that point, I had a blog that helped people. I was launching the podcast at that point, my whole life I had spent helping other people. And he goes here, you're a caregiver. And and I have to tell you, it's the first time it ever occurred to me, that I was at my core a person who enjoys taking care of other people. I didn't know that about myself. It's really crazy. Actually, I had a woman tell me recently that I'm very direct. And my first thought was, No, I'm not. Like, I didn't know that about myself. And as we started talking, I was like, Oh, she's right, like I am. And I'm not just direct. I'm like northeast Direct, which is even worse. And, and on top of that, I don't have a filter. Like, sometimes people are like, Oh, I really appreciate you having people on to talk about like this, or, you know, even like your conversation today. And I think what why wouldn't I? I don't even understand why, why that wouldn't be a thing someone would do. But overwhelmingly, no one talks about this stuff.

Sarah 1:12:15
When it comes to like not having a filter. I didn't realize until this year, what like a sense of privacy meant. I never had that sense of that as my personal private information. If somebody on the bus stop, who I've never seen before, never met, came up to me and said, Hey, would you like to tell me about the worst day of your life? I'd say? Sure. And I tell them, it doesn't mean anything to me. I wouldn't mind sharing it. Yeah, the very first time I ever experienced the emotion of That's none of your business is when a CDE asked to see my Dexcom graphs. No, you don't need to look at those. That's not for you. That's my just, maybe

Scott Benner 1:12:55
you want to hear about my grandmother and the pills instead. That

Sarah 1:12:59
was easy. That would have been more comfortable for me than letting this woman see my back stock.

Scott Benner 1:13:04
I kid I kid talked about that. So like any good diabetes podcast, we're an hour and 10 minutes into it. When you were dying. You were diagnosed with type one. How did who you are and the life you're living? Did it have a positive or negative impact on you taking care of your diabetes? I feel

Sarah 1:13:22
like at first it was definitely very negative. Because I was incredibly emotional. And I didn't know what I was doing wrong. But I felt because I had that overwhelming sense of we have to do better we are doing wrong. I immediately, like sought out information. I had that little one touch meter. So when I checked, it would point to the red and I was like, oh, red is bad. I'm doing something wrong. Therefore I need to find more information. Because whatever I'm doing is not right. And then changed frequently. Because I was given bare bones advice at the hospital. So I'm not

Scott Benner 1:13:57
assuming you live somewhere where you got rock solid advice. Yeah,

Sarah 1:14:00
I have when I was diagnosed, I said, Well, how do you know, I'm type one. And the nurse looked at me and said, Well, you're not obese. So you're probably type one. Okay,

Scott Benner 1:14:10
like I look into an ad for that. Maybe do anybody nothing. Okay, thank you. Isn't it funny how even the color thing makes you upset? Like red, bad, bad boom. Like, just

Sarah 1:14:21
I have when it comes to the connotations, one thing that my partner when we've been together on those five years, and he learned very early on, he used to tell me that I was great that I was wonderful. And one day I just sat down and said, Just tell me that I'm good. Like, I need you to tell me that I'm good. I don't want to hear that. I'm great. I don't want to hear that. I'm amazing. I need to hear that. I'm good. That words specifically. And that's the word he uses now and I've definitely appreciated it.

Scott Benner 1:14:46
Yeah, that's really nice. That's it's lovely to find somebody that that understands what you're saying and wants to help you too.

Sarah 1:14:52
That's something that he does say that. He's very appreciative of that I have incredibly open communication. So if he He's watching TV or playing his game or doing whatever, I'll say, Hey, I feel like you're ignoring me I need to be paid attention to, can you pay attention to me? And he'll say, Okay, let me pause my game, and I will pay attention to you. Or I'll come in and I will say, Hey, can you be more cautious with your words? Because I'm feeling very sensitive right now. And I feel like he's very easy to hurt feelings. And he'd say, Okay, well, thank you for helping me, I will do that.

Scott Benner 1:15:22
That's nice. I struggled with that a little bit. Because I've never once had like, a bad feeling towards people in my family. Like, you know what I mean? Like, people come and, you know, they have good days and bad days, whether your kids your wife, or can't your parents or something like that, I'm just very accepting of the idea that, like, you're not doing well today, or you are or whatever. And I don't judge people like that. Because of that. I'm always at the same level. Like, I never, never, I try really hard, and I'm better at as I get older, but when I was younger, I was never good at it. Taking into account how I impacted other people. Like, like, it's that I don't know how to explain this other than if we're all good, then it wouldn't matter if we were all good and happy, because we'd all be in that space. But if one person is feeling badly, and you don't realize it, even just you being upbeat, can be difficult for them. And if that makes sense or not, Oh, no. Does what you're saying? Yeah, like, everybody's not always the same volume all the time. And sometimes you're just like, overwhelmingly positive, like, Yay, couldn't feel like it to them. And I use a lot of humor in my life. And so not everybody's always up for that. And I didn't know, like, I didn't know that when I was younger. Like I and I think, ironically, that misunderstanding for me, I think that comes from a lack of self confidence, in a weird way, and I'll explain it like this. I used to think, if I was good at something, then it must be something everyone was good at. Because I couldn't imagine being excellent at something, if that makes sense. And I actually think that comes from like my upbringing, but also I grew up a fat kid. And I think that's, I think that's part of it, honestly. Like, I just never if I did, if I was good at something, I assumed everyone was good at it. And that's not true. You know, like, there are things I'm good at that other people aren't good at. But I had a lot of trouble giving myself credit for it. So that mindset also made me feel like if this is how I feel, this is how everyone else must feel. Does that make sense?

Sarah 1:17:39
I definitely from a different perspective, obviously. But the concept of I feel this way, therefore everyone else must I also have a hard time separating myself from that. I'll often turn to my partner, and I'll say, Hey, is a phrase fit for you often? Is this a person thing or a TV thing? And I'll describe a situation or an emotion? And is that something that real people do? Or is that just something they do on TV? Because I don't know?

Scott Benner 1:18:10
Oh, I wonder how many people try to mimic what they saw on television growing up to like, like, of happiness? Like This must be what happy people do. Or This must be what like, like close families do or people who don't lie to each other. Like didn't mean like, that's why probably that might It's probably why Michael J. Fox is so like, famous because he was on that TV show where, you know, everybody was smiling and happy. And you're like, Oh, this must there must be families like this out there. I'm sure there's not many of them. And those, and probably if you lived in it, you'd be like, This is a weird Stepford Wives thing. I don't think this is normal. I don't expect anybody to be perfect. And I don't expect that anyone listening has a perfect life. But your stuff is like, extra? You don't? I mean,

Sarah 1:18:59
I'd say it's challenging for sure.

Scott Benner 1:19:01
Yeah. But I also don't think it's uncommon. It's just extra. I've

Sarah 1:19:06
definitely I've met plenty of people with very similar stories to me, some people who I'd say went through abuse to like a more direct and severe degree. And it's just it all, and even with like, my siblings, we were in very similar situations. And we all turned out different and similar. So we all turned out substance abuse issues, there's not a single one of my siblings that isn't currently or in the past, like, had some sort of addiction. And she's like, Oh, I wonder where we got that from. But one thing that is really frustrating when explaining this to people is people think that if you're aware of an issue that fixes it, and that's that's not always the case. Like I can know this is a problem and I can know why I'm like this or I can know why I do this, but that does not stop it from being a problem. And that does not help me in making it the anon issue. But people think because you're self aware that Oh, you're you're halfway there. Well, I've been halfway there my entire life. So where's the other half

Scott Benner 1:20:14
right? Now that that is more of a upper middle class white lady idea, the likeable, I've given it voice. So, you know, and by the way, like, that does work for some things. For some people, it's not to be made fun of, it's just not an across the board fix for something, you can't just go, I'm a meth head. Oh, now that I've said it out loud, I guess that'll go away. Like, like, that's not, that's not how that's gonna work like that. But if you're, you know, you know, trying to deal with like, I'm, I get anxious in like, my shopping center parking lot. There's where that works for you, buddy. You know, that kind of idea. And again, I've given voice the things in my life that have helped me. And I do think it's a valuable starting point. But if it's not going to work for everybody, I think you're 100%, right? You know, I don't know, it's, uh, things are complicated, that I know for sure. And humanity is like, is the most complicated thing. And you know, just how someone treating you poorly as a child can just take your entire existence up or put you in a situation where you're constantly battling to get out of a problem, you know, to the point where you're in middle school thinking like maybe if I was dead, this would be better. Like that's, that almost feels like somebody's willfully putting you in that situation. But then you go and look at them and their situation, how they grew up, and you realize they're just a victim of the thing that came before them, just like you are, which doesn't help you. But you know, I don't know, it should give you a highlight and how to get out of it. But I think you don't get out of it. I think you'll get other people out of it. If that makes sense.

Sarah 1:21:54
I think that does. It's just, I wanted to help my sister, I wanted to help my brother, because I do think they could escape it if they wanted to. But they don't want to. And I have offered help for them. But I made it very clear that I'm not willing to sacrifice my peace to help them that I can't I can't hurt myself further, just because I want them to be better.

Scott Benner 1:22:17
So you think they can get out of it? But do you think you can get out of it?

Sarah 1:22:20
I think I am the most stable out of every one in my family. I think in terms of who is doing well. I am the shining example. I'm working. I'm in school. I'm in clinicals I'm doing everything I can I am not currently drinking. I'm I quit smoking in January. I'm taking good care of my health. I'm doing things that I'm supposed to be well,

Scott Benner 1:22:49
are you becoming a nurse?

Sarah 1:22:52
I'm going into respiratory therapy,

Scott Benner 1:22:54
respiratory therapy. Okay, I just heard you say clinicals. That's really one good for you, sir. That's fantastic. Yeah, no, you're

Sarah 1:23:00
tired. I'm working seven days a week. So I'm not really sleeping. But

Scott Benner 1:23:04
yeah, we're gonna want you to get some sleep. But no, I mean, I agree with you, like I, it feels to me, like somebody dug a hole, then went in the hole, dug another hole, then dug former holes, then through your Senate when you were two years old, and said, see if you can go find the sunlight. And you're actually getting there. You absolutely could be one of those people that I've spoken to in the past. Because you're 26. And you're young, even though you probably feel like you're 100 because of what you've been through. But I've talked to plenty of people who are 50 and 60 years old, who when they're telling their life story, tell stories like yours from when they were 1012 1520 or something like that. And when they're 60. It's a distant memory and just a part of their puzzle at that point. And they don't live in the turmoil that they lived in, back when they were telling those stories. So to me that, you know, for my money, like, I don't know how it's gonna go for you. But the only way to find out and have a real chance at success and happiness is to keep going. Like that, to me is like you could get to a place in your life one day where you look back on all that and say, those are the things that made me the, the person I am today and I like who I am. That, to me sounds like how this usually works.

Sarah 1:24:19
That's definitely what I'm striving for. Yeah, no, it

Scott Benner 1:24:23
sounds like you're doing good. It sounds like you're doing really well. Congratulations. The no drinking thing even is a big deal. It's a big leap.

Sarah 1:24:31
I'm definitely one of those people that thinks that if, if you can't have one beer, then your whole life still being controlled by alcohol. So I do drink occasionally. I just try not to get drunk and I don't want to put it on so much of a pedestal that like if I got drunk one time, in six months, then I have to start the calendar all the way over. It's like no, just keep going how you were. That day was a reminder of why you don't do this anymore. I just keep moving, I

Scott Benner 1:25:00
can't tell you how lucky I feel not to have those issues. And with alcohol specifically, I never liked it. It didn't occur to me to continue to do it. And when I hear people talk about their struggles with it, I swear to you, I just think I feel so lucky not to have that problem. Those thoughts that you have to have I, I just I've never considered it. And I'm, like, I don't know who to be thankful to for that. But it just sounds. It sounds like it's a lot, a lot of work. You know, and a lot of, I don't know what the word is really, but just struggle. It's just crazy. Yeah, really is.

Sarah 1:25:40
Struggle is a word that I use to describe, like my daily thought process to my partner. It's just like when your first instinct for things is I should purge, starve, drank, do anything, that it's just bad for your body, you are going against every instinct in your head, and you're like, No, I'm going to eat a proper meal. And I'm going to get a good night's sleep. And I'm going to do all this. And that is not your base instinct. And just because you are doing the things you're supposed to, and you're doing well, it doesn't change the urges is that I still want to do all those things. And I want to not want those things. I've been stuck in I want to not want to do them. And that's just a difficult thing to communicate with. Like, yeah, I'm doing well outside. But like, I still feel this way. I still want to do all those things. I'm still the same person who wants to hurt myself. Right?

Scott Benner 1:26:36
You're controlling, you're controlling those urges. Is that right? To the best that I can best again? Yeah. Geez. All right. What have we not talked about that we should have?

Sarah 1:26:47
Let me had a little list. I wanted to voice a small gripe that I have with the wording that you use across a couple episodes, you say that something is common sense. And you don't use this for just anything like, oh, well, that's common sense. It's common sense. And I have a particular issue with the phrasing of common sense, because I don't think that's real, I think everything is taught or learned. Okay, and I feel I've just known people who were raised in like equally neglectful household that affected their education. And so it'll be something like they were never taught how to clean or sweep or do basic math, that somebody will say it's common sense. And they don't realize that they learned it so long ago that they don't even remember that it was more.

Scott Benner 1:27:33
Yeah, no, I see what would a better reflection of that idea be? So what am I really saying? When I'm saying common sense? I'm saying things that people just intrinsically should know. Is that what I'm saying?

Sarah 1:27:46
No, because I don't I don't think that's the thing either. I think it's all critical thinking, just different levels of critical thinking.

Scott Benner 1:27:52
So. So then what's the what's the I laugh? Because I don't know what to say next. What's the what do you think? I mean, and what would be a better way of saying it?

Sarah 1:28:03
And I think your intentions are good, just because I've listened to over 900 episodes of you. I think I know what you mean, half the time. I think what you're trying to convey is so like, one situation I hear you talk about it a lot is if your blood sugar is going high, you need to take more insulin. That's common sense. But there's so many people who did it, those dots didn't connect at all. So in a sense, that is something that was taught something that was learned. So that's something that is thought about critically. So I don't know a better way to word it.

Scott Benner 1:28:33
Yeah, well, okay. And I don't either, but I'll talk through it with you for a second. So if we, if we know that insulin makes Downey and RP is opposite of Downey, then is it not common sense that you need insulin if your blood sugar's high?

Sarah 1:28:49
Not when you go back and realize that up and down are learned concepts to Oh, what the

Scott Benner 1:28:53
hell am I supposed to say? We should all just jump in a fire. Like I don't know what, like, I mean, at some point. So I guess what I mean is, I've never thought about this, but I'll talk I'll talk it through. There needs to be a base level of critical thinking, right? That happens in a split second, like so, critical thinking that doesn't take years and months of you sitting down and breaking things down and like pulling it apart, but just this happens, that happens. I'm driving a car and something comes at me my foot moves towards the brake. It's kind of it's it's not thought about, but that's the idea. I mean, let's go this is the common next step to take the obvious next step to take you drop a lot of coffee mugs, you should probably get metal coffee mugs. That would be common sense. You could stop yourself from having that experience of dropping and breaking a coffee mug by just getting a metal mug.

Sarah 1:29:45
See I did the metal ones I actually dented them and I caused them to leak so it wasn't much of a difference. I'm very clumsy or

Scott Benner 1:29:52
you keep throwing them at the floor you drop.

Sarah 1:29:55
Okay, I have unknown arthritis I dropped

Scott Benner 1:29:59
Okay. I agree. So I, yeah, I mean, you're not wrong. If I, if I'm brought if a person is brought up in a terrible enough situation and gets absolutely no direction whatsoever, and they live in a filthy house their entire life, it may never occur to them to clean their house. But I didn't grow up in a clean house. And I am very careful to clean my house. But I didn't want my kids to grow up in a house that wasn't clean. Because I wanted them to expect that they deserve to live in a clean place.

Sarah 1:30:30
I get what you're saying. It's just and this was just a small gripe, I'm not trying to, like attack who you are seem like

Scott Benner 1:30:36
a fan out there. I don't feel attacked. Don't worry about it. By the way, I keep wondering when someone's going to come on and really come after me that hasn't happened yet.

Sarah 1:30:42
Well, I'm sorry. That's my biggest gripe that I have with you just and that's just my own personal thing with that little nitpicky phrase.

Scott Benner 1:30:48
Okay, that was it.

Sarah 1:30:51
That's why I was saying about you that I'm

Scott Benner 1:30:53
pretty great. That's what I'm here. For you at least. All right. Well, I don't know what else to say. And you didn't offer any suggestions, by the way. So I don't know. I

Sarah 1:31:03
don't know a resolution, I can only identify a problem. That is part of the issue with my life. Scott.

Scott Benner 1:31:10
I'm very good at pointing out what's wrong. Leave me alone. But I don't know how to fix anything. I don't know what to do next. Well, you do, you're keeping going, that is a real value.

Sarah 1:31:20
I'm moving. I'm trying.

Scott Benner 1:31:22
There's also listen, there's a reasonable argument to be made that says that, for many people getting back to whatever, like normal would have been for them if they had not been impacted by all these other people and things around them. Maybe it's not possible. You know, maybe it's not. Or maybe it is like, it's why I said something crazy. Like, what if you just moved out into the middle of nowhere and just started over again? Like, you know, could you just go okay, none of the things or problems that I had before are here. And I'm just going to, I'm just going to reset myself, but you think they'd come back to you? Because those things are in your mind, then they're not just they're not physical impacts or human impacts. It's, I mean, I don't know, like, I don't want to be like a downer, like, you ever hear me talk to Erica on some of the episodes. And she'll go through like all of the like, you know, very modern and best practices around people's mental health. And sometimes I get to the end, and I'm like, Oh, my God, I feel like none of that's going to help anything. I have such like, it's all great. And it's worth a try. And I see that it's helped people. But I still think like can't possibly help everybody. Once

Sarah 1:32:31
you have the fifth therapist say Well, have you tried journaling? Yes, ma'am. Yes, I have. Emily, no, have you tried yoga? Uh huh.

Scott Benner 1:32:41
I have a whole journal that says my therapist is just like, keep writing it over and over again, there's one word I never used, by the way. That was me being like, like, I was writing a story for some reason. And just like, you know, like, how would that help me? How is that going to help me to it's spitballing at that point, like, I think like, much like regular physical health concerns, mental health concerns can be that way to, like, just, you know, let's just try things and see what helps. And maybe we'll find it and maybe we won't. And I think that when someone says, Have you tried journaling? Have you tried doing this? I think they're doing the same thing. Like, try this and see what happens. You know, like, Maybe this will help, like, Who the hell knows? Like, I don't want yet like, by the way, I don't want you getting lost down a K hole. But I don't know that ketamine won't help you. And I don't know that, you know, you don't have like trauma that you couldn't get rid of with psilocybin therapy. Like, I have no idea. But you know, I can tell you that 7080 years ago, if you had these, like, if you said these things out loud, their doctors that would try to shock your brain.

Sarah 1:33:46
Oh, no, my grandmother, how do you see to

Scott Benner 1:33:48
Oh, yeah, somebody had to have in your life.

Sarah 1:33:54
If AECT didn't have such a common effect of like, memory loss, and I worried about, there are so few memories that I consider to be like, positive that I do want to hold on to. I'm worried that if I went through with AECT, those would be the ones I've lose, and I've keep everything else aside, because the only reason that's holding you back, like

Scott Benner 1:34:14
what stops you you're like, you know, I'm just gonna lose the good stuff and keep the bad stuff. I do that. Like

Sarah 1:34:20
Scott when my second house burned down. I thought, why did I think this couldn't happen?

Scott Benner 1:34:27
Is it real weird? Isn't it weird? Like how things like dude, Pat, do you know how your home's burnt down?

Sarah 1:34:32
Both electrical fires are bad wiring old houses. Isn't

Scott Benner 1:34:36
that something? That's economics? Really? You know what I mean? Like, you know, get something built, it's not built well, or it's so old, and you can't afford to maintain it like that. That's all just money, I'm afraid.

Sarah 1:34:51
Oh, yeah, money is the root of a lot of things. So I'm hoping to finish school and I mean, the job that I'm going for the starting pay is $24 an hour which does and sound like much, but when I made 19, I saved over half of my pay in six months. Yeah, let's go. I, I'm used to live in on unless I think my car cost $600. And it runs on a prayer. And my home goes, the power goes out every time it rains. And I think a strong wind knocked down though. We're here for now

Scott Benner 1:35:21
you're getting there. Yeah, my son has this first job out of college. And it's a one year stint. He's 10 months into it. And he saved some, like an impressive amount of money. And I know that he did that, because he's not making a lot. And I know that he did that by limiting himself. And he talked to me about how, at the end of the week, he opens up his bank account, and he looks and he goes, Okay, I spent more money than I should have this week. Where did I do that? And then he adjusts himself. And he cooks his own meals and prepares his lunches and stuff like that to save money. And again, like, so it's interesting, like here, I think that's common sense. He got to work. He saw a bunch of young people who were just ordering like, GrubHub every day at lunch, and he sat there and when they just paid $25 For lunch, we only make this much an hour. They just gave away this portion of their day. I'm not going to do that. And then he didn't. And he steadfastly stuck to it. And when he told me that I thought, oh, that's common. That's good. That's common sense. But what you're saying is that somehow, some way we taught him that,

Sarah 1:36:25
I think that you did, because I, I know that y'all did eat out and do things like that. But it wasn't an everyday thing. You weren't always ordering DoorDash or something, and you weren't always going to a restaurant, it wasn't something so easily accessible. And I know that you weren't afraid to tell your children. No. But in a similar situation. I would have seen people doing that and be like, Don't they know that a loaf of bread cost $1? To jar peanut butters to 50?

Scott Benner 1:36:50
Yeah, no, right. Yeah. Listen, I, but I grew up, my parents were terrible with money. They were broke, and they didn't know how to manage what they had. So why do I know? Because

Sarah 1:37:00
you had to you had to learn out of necessity, because you saw what was the contrary, teaching yourself is still learning.

Scott Benner 1:37:08
Sarah, I think I have something though, that is unusual in my situation. So let me say this, if there's some level of intellect that leads you to make decisions, and those decisions lead you down paths, right. And a better decision early on would have led you down a different path. Not to say that everybody has access to those better decisions. But I'm saying that there are some people who are more intellectually challenged than others. And so therefore, their decision making process is more questionable. I grew up with people like that mother, father, not brain surgeons, okay, and didn't come from any kind of money. And then they were put in a bad situation, they made more bad decisions that led down more bad paths. How come I didn't have that happened to me as an adult, I'm adopted. I'm not them. Like my brain is not wired the way theirs is. And so even as a small child, and growing up, I'd watched my parents do things and think that was not the right thing to do. Like, we're in a bad situation here, they did x, they definitely should have done y. And then I'd watch it go bad. And I'd go, Okay, I was right about that. And so, you know, the only I know I don't like want to dig into it, but like, when I was in kindergarten, they pulled me aside and identified me and made me take IQ tests, which used to be a big thing. Because they were trying to like section out kids, they thought were smart and give them different education and public school, which by the way, was a terrible idea. And so I know my IQ, I will tell you this, it's high enough, I won't say it on the podcast. Because it's embarrassing. And it doesn't reflect my intellect. It's just my, I don't know what IQ really measures. And maybe it's both. I have no idea. But what I do know is when you put me in bad situations, I consistently make good decisions. And that's really where my intelligence works. I'm not good at math. I don't remember things about like social studies or science, I'd be terrible at science. I'd be a horrible doctor. If I had to learn the things like I mean, like the the thinking part of it, I'd be okay with the understanding ideas. But like the science I couldn't do, you don't want me involved in any way in anything mathematical. But again, I just try to the way I say it in the podcast is like if the zombies come like you find me I'm living. Like, I'll be okay. When it's over. I'll be the lady that has the zombies on a leash and they're out there killing people for me like guard dogs, or whatever happened to that TV show. And like, like, like, I'll be the Zombie Master when it's over. So I could see my parents making all these mistakes. And my common sense told me not to do that stuff. But they didn't teach it to me. It's just and so I do wonder sometimes how much all this has to do with just processing power in your brain? I

Sarah 1:40:05
do think that definitely does have a play. And I also grew the testing to get the quote unquote, gifted children in public education. I was also in that program, and it just it just felt like total Wolf. Oh, why am I here?

Scott Benner 1:40:19
So I dropped out of it. While everyone else was like, I did it for years. And as I was leaving middle school to go to high school, or as I was leaving elementary school to go to middle school, elementary school to go to middle school, I went to my parents as like a fifth grader, and said, My I need to get out of this program. And she's my mom. My mom was like, devastated. Because she's like, she thought this was the pathway to success, like, No, they've identified you, you're going to like, go on to blah, blah, blah. And I look back now I found some of the people who are in that class, they all crumbled, like the pressure that they put on those kids from, like a young age to be terrific. It didn't do well, for most of them.

Sarah 1:41:04
Oh, yeah. That's referred to as gifted kid syndrome now. Oh, really? Oh, it has a name. It's not a real. It's not a real diagnosis. But it's just like a common social media thing of like, oh, well, if you're a rack full of anxiety, and a perfectionist, I guess you were a gifted child.

Scott Benner 1:41:18
I don't know, I got the hell away from it. I was like, This is not good. I'm leaving. And so I went back into like, Gen pop, I guess he was a prison term. And back with everybody, and I was much better off. I thought, you know, and then truth be told, it really is. The only thing that helps me get all the way out of that hole is meeting my wife, who was willing to judge me on my thoughts and who I was not where I came from, or what I had, she was ahead of me, like she grew up in a more like, a household that that really put a premium on education. So she was in college, she had kind of ascended out of that hole a little farther than I had. And she was willing to, like, stand shoulder to shoulder with me in public and say, This is my boyfriend, even though like, socially, I did not. I didn't belong with her, if that makes sense. And so like, you know, to the naked eye, and so she was willing to like judge me on who I was, and my thoughts that allowed me to jump up a level, and then reset myself. If that makes sense. It might sound like both. I've no idea. But that's how I say

Sarah 1:42:31
it doesn't sound like it's from a different perspective, I changed a lot about how I care for myself and how I act for my partner. Because when I got into this relationship, I said, okay, if I'm really going to take this seriously, I don't think a healthy relationship. Common loving home is one where when she gets too stressed out, she hits her head on the wall sometimes and down to fifth and Morgan. So maybe we don't want to do that. So I stopped drinking when we moved in together, and I started bettering myself in the expense that I could. And I'm not saying that I've always done it perfectly, but I do what I can to care for myself mostly, and motivation of not wanting to be the person that harmed somebody else. I do think I'd be in a completely different situation without him because I wouldn't have the motivation to be doing better. No,

Scott Benner 1:43:23
I understand. I have to tell you that talking to you. And conversations like this one makes me want to stay alive for 50 more years and put you on the books for another conversation like 20 years from now I want to be like, Hey, let's get you. Let's get you set up for 2043. And, and do another podcast because I think you're going to be in a great place. And sadly, I'll be dead. So I won't know. But

Sarah 1:43:43
I live another 50 years. Now.

Scott Benner 1:43:47
I'm definitely not getting 50. But will I be alive in 20 years? I don't think I can make a podcast and 20 years. So

Sarah 1:43:54
maybe you'll have enough bankroll at that time. You can hire people to press record for you schedule everything, do everything. All you got to do is talk.

Scott Benner 1:44:00
There it is Scott say what you think what she said her mom and oh my god. All right. Well, Sara, thank you. I really appreciate you doing this with me. I can't tell you how kind it was. Let me just share a story that I think a lot of people will resonate with. And the ones who don't will might give him something to think about. So thank you very much

Jaylen is an incredible example of what's so many experience living with diabetes. You show up for yourself and others every day, never letting diabetes define 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 where to share your own story, visit Medtronic diabetes.com/juicebox And look out online for the hashtag Medtronic champion. A huge Thanks to touched by type one for sponsoring this episode of The Juicebox Podcast. Check them out on their website touched by type one.org or on Facebook and Instagram. A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Capo pen at G voc glucagon.com. Forward slash juicebox. you spell that GVOKEGLUC AG o n.com. Forward slash juicebox. 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 runway recording.com

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#1232 Ask Scott and Jenny: Chapter Twenty-Three

Scott and Jenny Smith, CDE answer your diabetes questions.

•     How do you keep a straight line on a CGM?

•     With so many variables that can impact blood sugar, how do you know when to dose more insulin?

•     What are the pros and cons of seeing an endocrinologist versus a general medicine doctor?

•     How does diabetes affect a child’s learning? Highs and lows in particular.

•     How do you approach doctors who discourage patients from having a tight range, especially when there is no burnout?

•     What are the long-term consequences of hypoglycemia?

•     How close is too close for a CGM and a pump site to be together?

•     How do you train your type 1 kid to wake up for a hypo?

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

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends, welcome to episode 1232 of the Juicebox Podcast

welcome back to another episode of Ask Scott and Jenny today Jenny Smith and I are going to answer the questions sent in by you the listeners. And don't forget, you can hire Jenny at integrated diabetes.com 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. Don't forget if you'd like to save 30% at cozy earth.com You can use the offer code juice box at checkout to save 30% off of your entire cart. But if you want an extra little surprise go to juicebox podcast.com and click on the link on the front page. 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 guys the surveys were down last month at T one D exchange.org/juice. Box I'm not blaming anybody you were probably busy school was ending etc. But now you're just sitting around staring at your kids and wondering when the hell they're gonna leave you alone. So go find 10 minutes where you can be all by yourself T one D exchange.org/juice box take that survey please. This show is sponsored today by the glucagon that my daughter carries G voc hypo penne Find out more at G voc glucagon.com forward slash juicebox. 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 med 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. 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. Jenny, we are pushing through our ask Scott and Jenny questions I think pushing through is not the right phrase doesn't make us sound like we're here willfully.

Jennifer Smith, CDE 2:49
Correct. It does not even remember that I'm always like, what are we doing today? Scott?

Scott Benner 2:54
Yeah, that's okay. Well, we're gonna we're on topic or whatever. Well, there's no topic. We're just gonna go through people's questions. I'm just going through this document full of questions from people who listen to the podcast, so you're ready to jump in? Yes. Let's start with something a little nebulous. How do you keep a straight line on the CGM? Seriously, I am listening to the podcast and we are continually improving. And we've come so far, primarily because of the podcast. That's nice, truthfully, but the line just isn't straight. I just would like it to be straighter. And although our highs are less high, now, they are still higher than I'd like. So how do you keep a flatter graph? I mean,

Jennifer Smith, CDE 3:39
this is the one thing that I hear over and over and over and over in questions. Look at my numbers. They're not stable. They're not flat, and like you kind of standard deviation of 19. And you're averaging a 102 blood sugar. How much more stable? Do you want that to be? Exactly? I mean, I'm not saying this from a you know, it's not judgment, but it's like, we have to look at this as well, without any information about what this person's data or their data for their child. Maybe it is much more variability or much higher standard deviation than they really want. Great. Could you contain that a little more? Probably. And it does take work. It takes effort. It takes some experimentation with sounds like you know, this person is doing but a straight flat line. Even in somebody without diabetes. That's not the goal. The goal isn't straight straight. Yeah. Nobody's I mean, overnight, maybe right overnight, where there aren't the variables of exercise and food and extra Bolus, insulin and everything. Those are the drivers of the up and down. But in that environment, sure. Stable straight. Absolutely. That would be lovely to aim for. During the daytime. You're looking for more gentle rolls through the day, with a lot less variability a lot less. I started at 100 It goes to 190. Maybe it starts at 100. And it only goes up to 150. That's, that's improvement. Again, you're not looking at 100 stays 100.

Scott Benner 5:10
Yeah. So I think what can happen if you're listening to the podcast is that I don't talk about diabetes from like, this is kind of okay situation, I give you what looks good, right? You know, right, golden, and you try to get to it on your way to it. It's not going to be perfect right away. And so what I see in this question is progress. You know, that's, yeah, absolutely. I started somewhere, it's getting better. How come I can't get to it? And I just think that the answer is time and experience. Yep. If you have the, the nuts and bolts, if you have Pre-Bolus thing, and, you know, timing and amount, and using insulin and stuff like that, then it's just at that point, it becomes repetition. Rack, you know, it becomes not getting complacent and saying, Okay, well, when we eat this, my blood sugar goes to 250. And that's just going to be that. Like, it's like, I wonder what would work here? Is it more insulin? Is it a little longer? Pre-Bolus? Do I should I come back in 45 minutes an hour later and try to get ahead of a fat rise, like that kind of stuff. But I do take your point, too, that some people can get overwhelmed with the idea of just this incredibly flat, right line that's supposed to be at I don't know, 85 forever and ever. And I mean, a person who doesn't have diabetes won't see that. Correct?

Jennifer Smith, CDE 6:32
Yeah, right. And even if you look at those who are following more of the low carb or even the ketogenic, their lines are not flat, so to speak. I mean, flat really means almost no, no variance. Yeah, at all. Right. So while their numbers look more stable, and I guess within a smaller, you know, standard deviation, there still is some little bit of up and down to that. So agreed. Sounds like progress has certainly been made for this person who's asking. And the goal again, then is I think it's even more defined by what are your target goals? Yeah. Where are you aiming to be above on the lower end? And where do you really want to try most often, to kind of hit a top end and not really sit there, but to have it come back down to the mid ground,

Scott Benner 7:20
I take a lot of direction from something you said to me a long time ago, about more like rolling hills, getting rid of sharp peaks, that kind of an idea. I mean, obviously, if you have a meal and your blood sugar jumps to 250, and you know, in 15 or 20 minutes, you didn't meet the need, you know, and it popped up. And now our goal was, let's get it back down without getting low, you know, as quickly as we can. I mean, listen, if you're eating a standard diet, right, like, I mean, I'm not talking about that either, unless you're gonna be like, very ultra low carb or something like that. And probably mixing in some old timey insulin in there too, and doing some other things. Yeah. Which is not not doable. I always kind of look at, like, thresholds. So for me, if Arden goes 141 50 and rolls back down again, at food I go, I wasn't perfect, but it's very good. And reasonable. Also, I don't want the 150 to be for three hours. I'm talking about, right, maybe a 40 minute window, you know what I mean? Just like kinda up and kind of down. Okay, right. And

Jennifer Smith, CDE 8:25
the exact in that example, too, if she's starting at 140, she grazes 150. And then over, you know, an hour she comes back down and she lands at 140. Bolus did its job, right. And your timing did its job, something else might not be quite right. If it doesn't get back down to target, which might be 100 instead of 140. Right. But again, your little bump up and down. Yeah,

Scott Benner 8:47
was lovely. My example actually, I'm maybe I misspoke. I'm talking about she's between 80 and 100, or something and she eats and she rolls the 140 and goes back if Arden was 140 all day, I would definitely I would be like yes, I know you're missing something.

Unknown Speaker 9:02
Something's not right. But

Scott Benner 9:03
again, not messing it up. Just something's you said it better. There's something's not right. Basil is not right. We haven't corrected in the right place. There's food we didn't account for somehow with insulin, right? Because if I'm stable at 140, all day, I certainly could be stable at 90. Yeah, you know, it's just somewhere along there, something's moved. So I would say to people, like, if you're on it, if you if you've got a background, you're building your understanding. I think the next goal is just to kind of give yourself some grace and just chill out and let time pass a little bit. Now if it's getting worse and worse and worse, higher and higher. You might have to worry about your weight, what you're doing, I think, correct

Jennifer Smith, CDE 9:41
and doses maybe things have adjusted maybe if this is a child the child is grown or they've added something else into the mix in terms of activities, or stress or whatever it might be right. But again, I know the big bottom line is that flat, completely flat with no variance is really not. It's not the goal that you're aiming for unless you really just don't want to eat anything.

Scott Benner 10:08
Never have a carbohydrate again in your life which is again you want to I'd start with me just you know Yeah. If you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be ready with G voc hypo pen. My daughter carries G voc hypo pen everywhere she goes, because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily, G voc hypo pen can be administered in two simple steps even by yourself in certain situations. Show those around you where you store Chivo Capo pen and how to use it. They need to know how to use G Bo Capo pen before an emergency situation happens. Learn more about why G vo Capo pen is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma visit G voc glucagon.com/risk For safety information. 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 med. You open up the email to big button it 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/juice box using that number or my link helps to support the production of the Juicebox Podcast. Right now we're gonna hear from a member of the Medtronic champion community. This episode of The Juicebox Podcast is sponsored by Medtronic diabetes. And this is Mark.

David 12:59
I use injections for about six months. And then my endocrinologist and a navy recommended a pump. How long had

Scott Benner 13:05
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?

David 13:15
I was medically discharged. Yeah, six months after my diagnosis. Was

Scott Benner 13:18
it your goal to stay in the Navy for your whole life? Your career was

David 13:22
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 loved the

Scott Benner 13:36
most. Was the Navy, like a lifetime goal of yours?

David 13:39
lifetime goal. I mean, as my earliest childhood memories were flying, being a fighter pilot,

Scott Benner 13:45
how did your diagnosis impact your lifelong dream?

David 13:48
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 pike and to give you hope for eventually that we can find a cure. And

Scott Benner 14:13
you can hear more stories from Medtronic champions and share your own story at Medtronic diabetes.com/juice box. So with so many variables that can impact blood sugars, how do you know when to dose more insulin? I can imagine this will get easier once I have a pump and I can slightly give my daughter more insulin but today we Pre-Bolus Traumeel or BGB for lunch was 116 but two hours later, it was 350 It's infuriating. And I don't know why this happens or what to do.

Jennifer Smith, CDE 14:46
Yeah, well, that sounds like the wrong dose. Yeah, man. It sounds like they're working on Pre-Bolus Right, that that was in the picture. You had a starting blood sugar that was in a nice place to begin with, especially if this you know, is a child Old that who is eating carbohydrates. And if your blood sugar is in the three hundreds after and I would say that the follow up to that is if you're in the three hundreds or if you're in the two hundreds, and it sits stuck there. Remember the Bolus, his job is to work that blood sugar back down, at least close enough to the target that you're aiming for. And if it does not, then the Bolus is the problem. Your timing, maybe you needed five more minutes. But a blood sugar shift of that much really indicates a deficit of insulin.

Scott Benner 15:30
Yeah. It seems simple to me. But yeah, I think that's the answer. If you if the food is overpowering the insulin to that degree, then there wasn't enough insulin there to resist it.

Jennifer Smith, CDE 15:41
And I will say that, for some kiddos, again, this is MDI. And there is a little bit of a difference, because you could potentially to get rid of those more extreme high blood sugars or to stay under a high value that you're aiming for after a meal, you may end up making the insulin to carb ratio more aggressive. But because you can't get the precision of dosing there, what you may end up having to do is on the back end, as that as that Bolus is bringing the blood sugar down, you may have to have an uncovered snack, in order for that to actually work all around, right? Because the dosing can't be as teeny tiny as might be needed to give just a little more. But on the back end, you have to kind of cover the extra then for MTI to be

Scott Benner 16:30
tougher with little kids, because such a small amount can move you so greatly, but I mean, 350 is to me, like Jenny said, it feels like way too high. You didn't cover the food correctly. Now, if that person was here to say to me, Hey, I counted those carbs, right? Like I did it right, then you start looking at, is there something about this food specifically, that needs more than Yes, other foods that have this carbohydrate count, which can happen all the time, like some foods are just, you know, they just need more. And so you have to do what they what they need not,

Jennifer Smith, CDE 17:02
not me or some little kids to you know, who really have a hard time. I mean, again, it sounds like they're doing Pre-Bolus Here in this example. But some kids, it's really hard for them to wait for that Bolus to start working, right maybe even the length of time that you as the observer or the caregiver knows you should wait. And in those I mean, I think you did you did with the glucose goddess, right? Yeah, interviewed her. That's where some of those kind of hacks if you will really become beneficial. Have your child start with the protein at the mealtime, have them start with the protein and the vegetables if they really can't wait, and especially if there's something more high glycemic, that's coming, put it at the end of the meal, so that you get a little bit of cushion for digestion and letting the insulin start to have a little bit more, you know, pull action. I've

Scott Benner 17:53
heard back from a number of people who have done some of those hacks, just you know, eating foods in different orders that they've they've reported back they've had some really interesting and beneficial experiences. So nice. Okay, what are the pros and cons of seeing an endo as an adult? Who has type one? Alright, hold on, this person has type one diabetes, she's saying what's the point of me seeing an endo? When I already have to see my other provider twice a year? And I'm getting meds from them? What am I gaining from my endocrinologist at this point? I go back and forth about this. So why can't I just get my doctor, I had this diabetes thing for freaking ever. Why can't I just get my doctor to give me some scripts? I know what I need? I think that's the question.

Jennifer Smith, CDE 18:34
It sounds like it? Yeah, it's a good question. I would say if you really feel like there is something that you need some extra help with, in the realm of diabetes, or maybe you have diabetes, and you have thyroid condition as well, or any of the other autoimmune types of conditions, then an endocrinologist really would be the more beneficial kind of person to go to truly, because while a general medicine doctor knows about all conditions, they really have general information about those conditions. When you have specialized needs, a specialist should be able to take the deeper dive with you answer more in depth questions, if there's additional medication, you know, even in the realm of using some of these newer injectable non insulin medications for things, primary care again, no is like the tip of the iceberg of information if you're going to really get the best benefit of some of these alternatives, going to an endocrinologist and not all of them will fit the bill you may have to search around right? And maybe that's the reason this person really relies on their primary care, because they feel like they don't really get anything extra from their endo anyway, which could be a little give and take there. Are you going to your endo and asking questions and they're just not able to answer. Search around find somebody new because you should have somebody like that on your team. However, if you're not really asking any questions you're expecting Um, to like, pull everything out of you, then maybe it's not an equal relationship. Right?

Scott Benner 20:05
I was gonna say that if in the scenario, the endo is just useless to them, you know, like not giving good information, there's still some benefits. For instance, I don't think a regular doctor would remind you once a year to get your vision checked. Typically, like little stuff like that, like, you know, if a new glucagon comes out, yeah, your regular doctor is not going to know about that. That's the little stuff there, I would think about like, I would think my concern would be not being enveloped in diabetes, and then getting left behind somehow, also, I don't know this person's situation. Now if this person is writing to us, and she's got, you know, a five, eight, A, one C, and she's just rolling through life, then my might say, yeah, you probably don't need an endo. Right. You don't have any big questions, but at this same person's rockin and eight right now, right here, your GPS, okay with that? I mean, maybe an endo would at least ping you every once in a while and go, hey, could we wrecked try a pump? Could we do this? Have you considered this? Like, you know, they're gonna know not to be happy with that number? And

Jennifer Smith, CDE 21:08
with that, again, depending on where the management looks like it is, is the primary care even looking at that? Do they have the tech that's available within their clinical, you know, space or their portals? Does it allow them to review CGM and pump data or even something like the hidden pen data or some of the smart device data? If it doesn't, you're really out on your own. Looking at all of that by yourself? Yeah, they may be able to write your scripts and write the labs that you know they think are needed, and you know, that you should be getting, maybe they even remind you go to the podiatrist every single year, right. But outside of that, the deeper things like you said, glucagon, goodness, you know how many people with type two diabetes on insulin are never ever told ever?

Scott Benner 21:55
About glucagon? Yeah, those are people who are going to an endocrinologist.

Jennifer Smith, CDE 22:00
And some of them are, some of them are going to primary care. And that's my point. You know, they may not, they may not know. So,

Scott Benner 22:05
like, I get the frustration. This person is not helping me move forward. Yes. But I think that then your point, go find somebody who will not stop completely. It's it feels to me, like there's more of a chance for something to tumble away from you. Without having that interaction. Now, maybe you're getting that interaction somewhere else. That's fine. Like I, you know, funny. I don't think anybody would think it was odd that I would say this, but I still feel weird about it. Like, even though I'm the one who has and runs a really big Facebook group for diabetes. I get with people think that and go Why would I help? You know, why not a community from it's really helpful. So if you have like community somewhere and you're hearing about things somewhere, that's fine, but I just don't want people to get complacent. That's my, my bigger concern. Okay, right. Well, here's a fast one that doesn't need an answer. How do I adjust settings on loop? We need an update with Kenny. Oh, remember my fox in the loop house episodes. And I am including this little thing here to tell you that there is a series with Kenny coming up at the end of 2024. That's fun. Oh, there you go. You just wait for that. Sorry, the answer is not in here right now. Next question. How does diabetes affect a child's learning in particular highs and lows? I have found my daughter seems to hit a wall. So she seems to hit a wall when her blood sugar gets around. 10 Oh, am Oh, oh, this person's 10 millimoles. That's a 181 80 blood sugar. It seems like anything she learned before she can no longer remember. And everything is just too hard to comprehend. The thing is, this affects my daughter's mostly during math. It stresses her out. When she gets stressed. Her blood sugar goes up more. I don't know how to help her with this. It's like when she's high. She has ADHD symptoms. And short term memory is no good. She can't retain anything I can outperform when she needs to. So Jenny, you and I have an episode about this. It's called altered minds. Maybe?

Jennifer Smith, CDE 24:04
Oh, okay. Maybe I do remember having a conversation about it. I mean, some of the questions and I think it we brought it in that conversation, it revolves around how often are they being pulled in school by a nurse or are being pulled out of that class, or a class to go and take care of something that is blood sugar relative, because then they're, they're kind of lagging in what the other students are actually getting, because they're not getting instructed in it. And they may have to play catch up on their own. So that's not really relative to the number in blood sugar, but it's more relative to the loss of what they're supposed to be getting by sitting in class. If this person seems to be more, I guess, mindful of when their child learns best, and it's When blood sugar is in what they're considering a target range. And, I mean, again, we've discussed the high levels and the low levels, you know, touching a high I level and then turning around and coming down isn't as detrimental as hanging high, right? Because that also means that your brain either hanging high or hanging too low, it doesn't really get the right amount of energy to retain and you know, incorporate all of that stuff on top of what they've already learned.

Scott Benner 25:20
I found it interesting. By the way, the episode we did was episode 485 is called altered minds. God, it was like three years ago time ago. God, Am I old, what's happening? Okay, let's not think about that right now. It came up because I noticed, and I'm sure you've noticed, and everybody else has noticed, too, but people don't believe this. They don't believe that wildly higher or lower blood sugars, impact people, or they don't want to believe it. I don't understand. I can never really wrap my mind around it. But a lot of people act like it's an excuse you're trying to use. Right? Right. My blood sugar's high. I can't I can't pay attention. That's an excuse. Well, it's not. And so we went into some great depths to talk about that in that episode. So I would say to this person's question, I completely believe this. You know, if the kids blood sugars, like you said, if it's like 9180, back to 90 again, then I don't see it as much but one ad for an hour or two hours. I don't disbelieve that at all. I've I've mentioned a million times that watching Arden in sports, her butcher got to a certain level, and she literally slowed down when she was running. Yeah, and her hand eye coordination changed and all this stuff. So here's what I would say. Imagine you've had a big turkey dinner. And you got that dopey feeling, and then someone brought algebra to you. Yeah, that's what it seems like to me. So

Jennifer Smith, CDE 26:41
or is teaching, you know, some type of fact for the first time, that's supposed to be building on what you've already known. But if all those things that you've already been taught, were built in certain levels of glucose, your reception for some of that stuff. I mean, it all builds on itself, what you learn, it builds, it builds, it builds. And so depending on where the blood sugar, even the variability in if you've got a child, or a teen who's got a blood sugar that looks like the Rocky Mountains up, down, up, down, up, down, up, down, and it's all day long. Absolutely, that's going to have an impact on their learning capacity that's happening

Scott Benner 27:18
right now. Don't hear that and go, Oh, I'm a terrible parent, like just No, yeah, go do the like, go to the Pro Tip series and learn how to stop that from happening. That's all, you know, again, get to it as quickly as you can. But at the same time, it is what it is. You're not gonna learn it overnight. I guess, again,

Jennifer Smith, CDE 27:34
this person sort of also brings in the fact that this particular class also stresses their child. Yeah,

Scott Benner 27:41
right in the process of it happening adds to it again. Now. That's true. I don't know how to help with that. But I have been married a long time. And I know just telling her to calm down is not the answer. No, it has not worked out when I was married in the first decade. Yeah,

Jennifer Smith, CDE 27:56
and those are, you know, those are some of the things with school aged kids that we look at, maybe this class is every Thursday, and Friday, or every Tuesday and Wednesday, or whatever it is. Sometimes if you look at your child's class schedule, you can actually tell that there's some pattern to times of day, one in particular that I always see in kids records is their weekend mornings look beautiful, flat and stable. They might even have like, a three times carb amount pancake breakfast on a Saturday, that looks nice and beautiful. And they get right into lunch looking lovely. Whereas their low carb breakfast on their school days, does completely the opposite. And it's the transition into their school day. It's either the anticipation or the excitement, kind of doesn't really matter matter. inch to age. But again, it might be relevant to dosing around a class like that. That's a really stressful class. Maybe that class causes a rise in blood sugar of 100 points, every time they cut goes and sits down. We'll assume that the class is almost like carbohydrate, then I never have to dose for it.

Scott Benner 29:05
You could try to come at it with an increased Basal if you timed it. Well, you could Bolus for the class if that's gonna happen. I you know, anyway, yes. Higher blood sugars can create situations the way you described. And yes, stress and anxiety or excitement can make your blood sugar go up. So I think, by the way, it's worth pointing out as we get away from that question, good on her for noticing it. Absolutely. Because a lot of people just go I don't know what's happening. Magic diabetes came again. Yeah, you're actually seeing what's happening, which is really cool. Okay, I have two here. I like both of them. How do you approach doctors who discourage patients from having a tight range, especially when there is no burnout? They don't seem to believe patients are getting good numbers without it being a huge burden to them. How can we get them to be supportive of having In a tighter range with with fewer lows, especially in front of our kids. This happens Jenny, this happens all the time. It does. Yeah, this is one of those things that I I used to be shocked by. But now I'm just shocked when I don't hear about it. Somebody all, I always get a note that says, Oh my God, listen, podcast, everything got so much better. So excited to go to the doctor, I went to the doctor, Doctor yelled at me for 15 minutes. I was like, what happened? Yeah, you must have gotten to these numbers by having lows

Jennifer Smith, CDE 30:27
in there reminds me too, that a lot of times doctors are still using that average of an E one C as a hallmark of how are you doing. And if you have an A one, c, that is 5.4, let's say pull a number out of a hat, that number to the doctor represents some stress in management, something is too overwhelming, you are on top of it way too often, you're just visually watching it 24/7, or there must be some low blood sugar. So rather than that doctor actually even looking at your data, they just make a call based on that one average that an ANC represents. So if that were the case, you know, for this particular question, then your job is to come with the records that suggest Hey, you know, we're doing really well, I my kid is in multiple sports, he has all the enjoyment of life that he could possibly need. We're doing this, you know, look at our records, we have, you know, 1%, low blood sugars, and they're not lower than 60. And, you know, my kid is not sitting out because we don't want his blood sugar to move. I think those are the explanations that in your mind, you're living them. So you may not have to verbalize them. But to somebody who's just looking at one number, you may have to just explain, hey, we're good.

Scott Benner 31:47
I think you have to have the wherewithal, it's tough to because can you imagine putting all this effort into something maybe for six months. And then you're finally like, this is my day, the person who judges me is going to be happy, then that judge the person is not happy. And it probably throws you off for a second. But I would just be like, Hey, let me stop you here, I get what you're saying. I see that you think it must be I 24/7 I must be staring at this thing. And like, you know, turning knobs and everything. But that's not we're not at that spot. Like it's just going well for us. We seem to know how to use the insulin and how to cover food and activity and we're doing great and so appreciate your, you know, yeah, right. But yeah, gonna be careful. If you're listening to this. Some of you before you can get that out of your mouth, they're gonna snatch the pump from you and start turning dials to take your insulin away to make your blood sugar higher. And then that's a and Jenny, I'm gonna use some colloquial language here. That's a mindfuck of its own. Okay, because now the doctors like let's make your agency higher. Because, right, you're gonna have a really horrible low or you're going to burn out. And everybody's not the same. Like, I appreciate that. Maybe you've met other people who have burned out doing this. That's not our situation. I have a bigger grasp of this. Yeah, right. Right.

Jennifer Smith, CDE 33:02
This might be kind of like a blanket statement. But quite honestly, any doctor who takes your pump from you to turn the knobs and dials, that is somebody to not stay with it. Really, it is, again, my personal opinion. Because to me, my devices, they're like a piece of my body. Right? That's like removing my arm and fiddling with it to make the muscle bigger, because you want it to look bigger, right? Don't Don't take my body part. If you think I should change something, I'll bring up my settings, we can talk about it. And I may make that adjustment. But I'm going to do it myself. Because one, I use this product every single day. I push the buttons by myself all the time. Don't push my buttons for me. Right? Right. That's a really big discussion to have. Because I think it's very unfair, somebody to take something from you that You very well know how to use.

Scott Benner 33:58
And if you don't know how to use it. And they do that. Now you don't know what happened. They probably don't know how what happened. They did either by the way. They're just like, let's see what this does. And now you're both lost, because you were already wasn't going well. Now you've changed something else. If it doesn't fix it. How do you even know where you moved from? Or what did you next?

Jennifer Smith, CDE 34:16
Or why it was fixed? Yeah. Why did you adjust this versus that? You

Scott Benner 34:21
made me think of something? Not to the question. But I'm going to talk about here. I think this is really interesting. Something about the way you just talked about don't take that from me. You're changing my thoughts. I realized like, like, you're basically saying to someone give me this thing that we've attached to you and I am going to decide what's about to happen to your body next. Right? And you won't know because I did it like so the unknown that so I never thought of it that way. Isn't it interesting? I've never ever thought about that way once. If I take Arden's pump from her and I go hey, I'm just going to do this. That's why adult type ones say things like Does she know you made that change is that Okay, it's about autonomy. It's not about Oh, right. It's not about diabetes at all.

Jennifer Smith, CDE 35:07
Oh, wow. Yeah. Because I think, you know, again, life with what is now almost 36 years with type one, I very much feel like my products are part of me. That's a weird thing. Because there are I call them like, my boys always have called them like my robot parts, right? But they even somebody who has a prosthetic limb, for example, like I would never, ever, as a provider, ask somebody if I can take their body part from them to check it out? Like no, that's, that's, it's the same thing for somebody with diabetes feeling

Scott Benner 35:43
that, like it would be as if, if I said to you, hey, give me your insulin pump Jenny, and I'm going to decide to make you 10% happier, or I'm going to make you 15% More aggressive, or less emotional, or like, oh, that's got to be the same weird feeling you have if you go on like an SSRI, and people talk about like, I don't feel my highs or lows anymore in that like, weird, disconnected feeling like you put this thing in your mouth, and then all of a sudden, you experience the world differently. Correct. Okay, well, this seems like a thing that I probably should have recognized 15 years ago. But I made a note to talk to Eric about I think this is a lovely, lovely concept to go deeper into with a therapist. That would be great to hear really interesting. Okay, look at us learning. Well, me, you are probably just, I always tell Erica, when we're doing stuff that every episode should be called. Watch Erica, watch Scott realize something that was taught in freshman psychology that he doesn't know.

Jennifer Smith, CDE 36:43
Because Scott wasn't paying attention. I

Scott Benner 36:45
wasn't even there. I just had that feeling now, like you might have been looking at me like, yes, really never occurred to you. How about you? Okay. All right. Here's the question. Why don't we just tattoo this on people's foreheads? Oh, I hear this so much. What are the long term consequences of having too many low blood sugars? I hear there is a cognitive impact. But I don't know more. But it seems like it's not discussed enough. Seems like it's not as discussed as much as the consequences of higher blood sugars. So what are the long term effects of hypoglycemia? And every time we try to talk about this, the problem ends up very similar, right, like there, first of all, are no long term studies. There's no, right. That's

Jennifer Smith, CDE 37:27
the hard thing. Yeah, it really is. I get this question a lot, actually, again, with the women that I work with in pregnancy, we focus heavily on highs similar to outside of that right outside of pregnancy. But a lot of the doctors also focus on spending too much time low. Okay, then, yes, we could address that. But unfortunately, in terms of studies, there are not numerous published studies about the long term impact of low blood sugars on the cognitive function then of the child Once born, right. And the studies that are there actually define define the the number of lows under a blood sugar of 50 as being the resultant reason for cognitive impairment or assumed connection of cognitive impairment. And so when we're looking at, like, when you're living with a blood sugar 55, that's, you shouldn't bottom line, you should die. Don't do it. Don't do that. But again, the studies aren't, they're suggesting, oh, a blood sugar of 68. That sucks sustained, is that creating long term, there's nothing to prove that it isn't. But there's really nothing to prove that it is, in fact, that's a many people without diabetes, wake up with a blood sugar somewhere between 65 and 95. Right?

Scott Benner 38:46
It would be inhumane to take a control group of people drive their blood sugar down with manmade insulin, keep it there, and then wait to see if it gives them problems. That's why you're not going to see a study about that. Right. And everything else is, you know, to some point up for interpretation, because you can say to somebody like I'm seeing a cognitive decline in you. Did you have a lot of lows when you were young? Like, you know, I mean, what are you going to do? That's not a thing you can really track? So we know, it's 70 the number that we just know, you're okay. Up above it. Like, is that just the

Jennifer Smith, CDE 39:20
why it's the bottom line? Yeah, that's really and you know, in terms of long term, I think we need more long term studies because some of the information that is out there, like if you go to CDC and some of the other, you know, general research reporting kind of databases, they have low blood sugars, in terms of frequency of them length of them over and over types of effect, leading to the potential for a risk of dementia later in life or the earlier onset of dementia. And again, a lot of them also are done in type two diabetes, but blood sugar to blood sugar Diabetes, diabetes, so we kind of put them all in St. Pat's. Are

Scott Benner 40:04
you willing to tell people what number you worry for yourself? Like, where do you go, Oh, I can't let this be.

Jennifer Smith, CDE 40:11
Huh, I'm comfortable. But I think it also, I like to be above 65. That's a, again, an easy statement. If I am sitting and working at my desk, if I'm sitting in like, doing not much reading a book or whatever, and I'm sitting at 68. And it's a nice flat, stable 68, I'm gonna leave it alone. Like, why am I going to do something about that, because I also, and maybe in the past on more of a manual pump, maybe I would have knowing what's coming in the hours ahead, done something correctively. But now that I have an algorithm AI D algorithm based system, it's really not gonna honestly even sit there long, because I've got my target set above that, and it should be kind of bias

Scott Benner 40:56
a little way, it's gonna let you write some natural body function is going to bring your blood sugar back up. And

Jennifer Smith, CDE 41:01
I think because we have enough of those on the market, regardless of the system that you're using, I think all of them are very conservative in terms of the low blood sugar values that, you know, to sit there for a lengthy period of time, likely not going to happen with most of these systems. And a lot of people are still in the know about, well, my blood sugar is dropping, I need to treat it and with an AI D type of system. Do you mean, like, treat it in? It's too hot?

Scott Benner 41:30
I mean, I guess I'll share too. For Arden, I think a lot of it is about I don't want her to get dizzy. Right? That's sort of the way I feel about it. And, of course, so much about it is also just like you said, it's direction like is this a very stable number that's not moving? Is it never gonna go down from here, because there's no insulin on board. That makes a big difference to you know, if I see again, on an algorithm, if I see art and dip below 70 into that, like mid 60s range, I'll just wait and see what happens. I'll go look, and I'll be like, Oh, this thing already knew this was gonna happen. It's been taking basil away for 20 minutes. And so, you know, I think in the next couple of, you know, the next couple of checks, it's going to start to head back up again, based on what I know, but also know that CGM is are still a little behind reality. And so like, there's I don't know how to say that this makes me feel better. When I see the 65. I think, well, it's not 65. Now, it was a few minutes ago, maybe right? And everything I'm looking at makes me feel like it's heading in the right direction. Now, if I saw 65, and everything I was looking at made me feel like it was going to keep going lower than I would react and

Jennifer Smith, CDE 42:43
he would, yeah, absolutely. And I have to say, you know, in terms of asking about like a target, I would say I have targets also based on certain scenarios in my day, right? If I'm heading out to go and do something with my boys in the afternoon, or whatever, I have numbers above which I would really prefer to be or a stability place that I would prefer to be. From a driving perspective, I always like to be at least 80. Yeah. So there are some, I guess adjustments to where I would navigate and make an adjustment to get my blood sugar to start coming up. Yeah, even if I didn't have my algorithm system. So

Scott Benner 43:23
I want to say if Jenny's number sounds like if you heard 80, and you were like, cute lady. Just think of it as aspirational. That's really how I think of the whole podcast, like, if you're not there, just know that that's possible. And then get as close to it as you can and are comfortable with like that, to me is how to think about this stuff. And

Jennifer Smith, CDE 43:43
he's done. You know, I've worked with a number of people, not just guys, but people who are in construction, right? There are some places that you may have to navigate your targets, especially again, if you're eating a typical, like diet, right intake, that we may have to adjust your targets from an overall safety standpoint, so that you don't get that like that dizziness, or that sort of fumbling with your fingers or lack of cognition, you know, to be able to actually 10 stories up in the air. You're watching on the steel beam, right? You're sitting at

Scott Benner 44:18
a desk talking to people about diabetes, so you can just be like, I'm gonna have a sip of juice right now. And you know, and if you get woozy, you're gonna fall off of your stool, not off of a, you know, a building, right? So right, it makes sense. Couple of quick ones here. This is an easy one. How close is too close for a CGM and a pump site to be together? Oh,

Jennifer Smith, CDE 44:37
that's a good question. Most of the systems they suggest about five inches three to five inches is what I what I know. Do I know people wear them closer without any issue? I do. Do I know that? We in our own office space have tried wearing them closer just to see absolutely we have and from our my personal This is not Linux, from my personal experience doesn't seem to matter without. I've worn them close together, especially when I was using when I trialed and was using Omnipod five, because of that very important piece that they sort of hammer into you is that line of sight, right? So I followed all the rules, I was a sheep, I followed them to a tee initially. And really, like I had that that sensor sight on and I kind of moved my pad around that sensor pretty close so that it would always have that direct line of sight. Again, I really didn't pay attention to the three to five inch distance because yeah, what's realistic? actually sat around like

Scott Benner 45:45
that goes where it goes. I don't know, I'm not speaking for anybody specifically, I just know that what they have to tell you in the literature is what they tested during the FDA trial. So Correct. Yes. doesn't always mean it won't work. i The example I will always use is that you're not supposed to use a Peter in an insulin pump. But we've been doing it for like, 10 years. So

Jennifer Smith, CDE 46:07
correct. And you're in a pod? Yeah. I mean, a piedras should absolutely not be used in the tandem pumps.

Scott Benner 46:14
There's doesn't isn't it interesting there. It doesn't work in an omni pod. It's fine. It does. Except it's not FDA approved for that. Correct. Right. Yeah. Which means that on the pod never tried a Piedra in the pumping testing.

Jennifer Smith, CDE 46:28
Right. They just said don't use it. Yeah. They said,

Scott Benner 46:31
We don't have the money to test that. So go to hell.

Jennifer Smith, CDE 46:37
We can't test this piece.

Scott Benner 46:38
time or the money for your pager, which none of you are using except Scott and five other people. So yeah, by the way, you should try it. It's pretty good. Do you? Are you real tight on time? Are we can I have like 510 minutes? I'm gonna give you one last one that okay. I just don't know that there's an answer to oh, how do you train your type one kid to wake up for a Hypo? Oh,

Unknown Speaker 47:00
do you wake up for your hypose? I do. What happens? alarms,

Scott Benner 47:07
you feel it? Jesus talk to you what happens? Exactly because of

Jennifer Smith, CDE 47:11
so alarms? I think a lot of it may or may have some relevance. I mean, adulthood. I'm also a mom, think once your mom and a feather on the floor wakes you up? So quite honestly. Right? Exactly. Like I used for children. I slept, I could have slept, the train could have taken half the house off. And I was like dead to the world. Outside of my alarms, my alarms, I always have woken to my alarms, right? I from a, I guess from a maybe what my brain remembers, I try like on a monthly basis to change the alert sound, a different sound to a different sound so that it's always something different. That's waking me up, right? I also have the volume turned up so that I can hear it from kiddo standpoint. Kids sleep hard. If you've ever got I mean, most people who have kids who have diabetes, go in and have a problem even like waking their kid enough to like, drink part of a juice box or whatever. Some don't even wake their kid they can like put the juice box in and they just suck and they like fall back. And they're

Speaker 1 48:18
still asleep, essentially. A banana in her sleep. Yeah. Right. Yeah. So

Jennifer Smith, CDE 48:23
So it tells you in this question, it tells you how hard kids sleep. And so I don't know, in terms of training, some of it could be relative to using some of the devices that vibrate isn't a sugar pixel has something that connects to the device that you can slide underneath your pillow and it actually vibrates along with the very alarming noise that goes off i That's the sugar pixel, right. Is that sugar pixel? I

Scott Benner 48:52
believe so. Yeah. Like this little vibrating pad. Listen, there's all kinds of things you can try. Here's what I learned. I raised the kid from two years old to she's just about 20. She didn't wake up for anything. It didn't matter. It was on us. Like, right. She left for college, and half of me thought she'll be dead in three days. Like yeah, like, I mean, what's gonna we're gonna leave this. We're gonna hear anything. Oh, she should be dead by Thursday. You know, and what she reports back to me is that once she knew it was on her, she wakes up. And I was I don't know if that's a maturity thing or and now having said that, there have been, I mean, she's been she's half almost completely done her sophomore year. Wow. In college, and there are in the last two years, I'm gonna guess probably 2025 times I've had to wake her up. Sure. You know, like, I've had to call her and be like a Arden you're low. And she's dead. But and trust me, it's this. Hey, Arden. Your love. Low L oh, you're low juice. Drink get juice. Okay. But then she I'm like, stay on the phone. I'll be okay. And then she hangs up, then I sit there in a panic for 10 Min. Like, did she fall by? Numbers? Yeah. Drink the juice? I don't know, what I would tell you is, I don't know how you train somebody to do that, like, people are different in any mean. They

Jennifer Smith, CDE 50:20
are you can try many things. I mean, it's almost like, you know, like the potty train. I like the overnight potty train. Let

Scott Benner 50:25
me throw Cheerios at them when they're little kids, right? Some

Jennifer Smith, CDE 50:28
kids just get it pretty easily. And other kids, you really have to wake them up, like every couple of hours, right? Or the alarm is going off. You hear the alarm? And you know, maybe the training is that you go in the room and you put the alarm right by their ear. I mean, these are all like, I don't know, option as

Scott Benner 50:46
an adult. Have you ever woken up in the morning looking at your CGM and been like, Oh, my God, I was late last night? I had no idea. I'm gonna say yes. But you don't recall it.

Jennifer Smith, CDE 50:55
But I don't recall it. And again, low defined on a term of I was low. Now with an algorithm for like, you know, seven plus years? No, probably before that. Yes. Yeah, absolutely. Before there was anything. Yes. Now I also have a husband who is also a lighter sleeper. And so he hears my alarm.

Scott Benner 51:20
Wake up, wake up. Yeah, I have to tell you, I've had probably three times in my life, woken up in the morning thought, Oh, my God, I slept all night. It's great. To get on my phone. I'm looking through things. And you see that overnight for like 45 minutes Arden's budget or was like 40. And you think, Oh, my God, I didn't know that at all. That's crazy. And then the first thing you do is you look to see if she's still reporting a blood sugar. Because if she is she still alive? And like, Oh, my God, so I get that, like feeling that leg. I slept through it. It's my fault. We're all gonna die. Like, like that feeling. But I just overall, I have not found it to be that much of a concern. I think the most comforting thing I can say that with a lot of planning, don't get me wrong. Right. Yeah. But putting the right things in the right order. It hasn't been that much of an issue. If you don't do all those things. It's obviously could be a huge problem. Yeah. You know, I assume that people will say the show are putting a lot of effort into this stuff. So they

Jennifer Smith, CDE 52:19
are I mean, from what I've heard and seen, and with all the questions that always come in like this, there's a lot of, especially for parents of kids think there's a lot of consideration, you have Forward Look, you're saying yes, I'm doing this now. I'm happy to do it. I'm the parent, they're my child, I will 100% Do this for them. But at some point, they're not going to want to be here with me. Right? Some point they're going to want to be at a friend's house or a sporting event over a weekend or something that I'm not going to be there. Yeah. And I have to be able to have confidence that they're going to be able to acknowledge an alarm or an alert, I understand it. Absolutely. I

Scott Benner 53:00
would say to you're going to feel like that's not fair. The world's not fair. You're gonna have all those feelings. You gotta get past that because this just is what it is. So I appreciate that. Okay. Well, I appreciate you sharing all of your thoughts with me today. Thank you very much.

Unknown Speaker 53:15
Yes, thank you. I'll talk to you soon.

Scott Benner 53:25
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 where to share your own story. Visit Medtronic diabetes.com/juice box. A huge thank you to one of today's sponsors, GE voc glucagon. Find out more about Chivo Capo pen at G voc glucagon.com. Ford slash juicebox. They spell that GVOKEGLUC AG o n.com. Forward slash juice box. Arden has been getting her diabetes supplies from us med for three years. You can as well us med.com/juice box or call 888-721-1514 My thanks to us med for sponsoring this episode and for being longtime sponsors of the Juicebox Podcast. There are links in the show notes and links at juicebox podcast.com to us Med and all of the sponsors. If you have type two or pre diabetes, that type two diabetes Pro Tip series from the Juicebox Podcast is exactly what you're looking for. Do you have a friend or a family member who is struggling to understand their type two and how to manage it? This series is for them seven episodes to get you on track and up to speed In episode 860 series intro 864 guilt and shame, Episode 869 medical team 874 fuelling plan, Episode 880 diabetes technology episode 85 GLP ones metformin and insulin, and an episode 889 We talk about movement. This episode is with me and Jenny Smith. Of course, you know Jenny is a Certified diabetes Care and Education Specialist. She's a registered and licensed dietitian, and Jenny has had type one diabetes for over 30 years. Too many people don't understand their type two diabetes, and this series aims to fix that. Share it with a friend or get started today. 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.

Unknown Speaker 55:52
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#1231 Grand Rounds: Oncologist

"Alex" is the mother of a type 1 and an oncologist.

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

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends, welcome to episode 1231 of the Juicebox Podcast

Welcome back this is another episode in the Grand Rounds series you probably know by now in the Grand Rounds series, we don't use the person's real name and their voice has been changed to protect their identity. Today we're going to talk to Alex. She is a 37 year old medical oncologist from Israel. And we're going to talk about the health care system type one diabetes, and so much more. One of Alex's children has type one was diagnosed just two years ago. There is a lot of spirited conversation in this episode. 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. When you place your first order for ag one with my link, you'll get five free travel packs and a free year's supply of vitamin D. Drink ag one.com/juice box. Hey, I'm looking for you to give just a little bit of your time. T one D exchange.org/juicebox. Join the registry complete the survey help with type one diabetes research. You just have to be a US resident who has type one or is the caregiver of someone with type one. T one D exchange.org/juicebox. 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 high or low. On body vibe alerts. You don't even know what that means. Do you ever since cgm.com/juicebox Go find out today's episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at contour next one.com/juicebox. Alex, what's your job? What do you do for a living?

Anonymous Female Speaker 2:20
I'm an oncologist.

Scott Benner 2:23
oncologist. What is and was your training like to get that job? What did you have to do where I

Anonymous Female Speaker 2:32
live? There's six years in medical school, you get into medical school right away, you don't have an undergrad, and then you do one your internship before you get your degree. And after seven years, you're a doctor. And then you have to do your specialties. oncology is five and a half years it's straight through it's been a sub specialty.

Scott Benner 2:50
It took you from the day you began coming out of out of school until you were I guess certified as a oncologist. 12 and a half years. Yeah.

Anonymous Female Speaker 3:02
Kids in the middle. So a bit longer than that. Oh, so

Scott Benner 3:05
there was a gap of time in there. You took a little time off to wear maternity leave. Yeah. Okay. All right. And now how long have you been practicing?

Anonymous Female Speaker 3:12
I finished my residency about two years ago, two years

Scott Benner 3:16
ago. What would you say? Day to day your job is like what do you what do you do most days?

Anonymous Female Speaker 3:22
So after you finish residency, it's mostly working in the outpatient clinic in the hospital. So it's same patients in the outpatient clinic. And then they get therapy in in the daycare center.

Scott Benner 3:36
So we're talking about like, let's see, okay, clinic, a clinic that does what infusions so

Anonymous Female Speaker 3:44
it's in the hospital. And it's always connected to like a big hospital, okay, like the infusion centers. So it's not like an America that they're also like smaller practices that have their own infusion center.

Scott Benner 3:54
I see. I see. So you see people for chemotherapy? Yeah, yeah. And follow up visits. If I think I have cancer. Are you a person I come to? Or are you in a difficult

Anonymous Female Speaker 4:06
situation when you guys send oncologist, you already have a diagnosis, or there's somebody already found that you have cancer, and then you go on colleges to figure out what the treatment plan should be. And for the follow up afterwards,

Scott Benner 4:17
are you a surgeon as well? Yep. No,

Anonymous Female Speaker 4:19
okay. I'm a medical oncologist, medical oncologist. Great.

Scott Benner 4:22
You said you stopped in the middle there to have some kids. How many did you make? I

Anonymous Female Speaker 4:27
have four kids. One was in medical school. One was in the internship year and two during residency. Geez,

Scott Benner 4:34
I must have made it harder. No.

Anonymous Female Speaker 4:39
But everybody starts University later. And it's all because you do either national service or army before you start. So I started at age 21. And I was one of the younger ones.

Scott Benner 4:49
How long is that army then? Is it one year? No. So

Anonymous Female Speaker 4:52
for boys, it's three years and for girls, it's two years. I did national service for two years instead of doing army. I

Scott Benner 4:59
see national service

Anonymous Female Speaker 5:00
means it's like kind of being like a volunteer in different. Okay, organization

Scott Benner 5:07
go somewhere build a house, they go, Well, something like that. Well, it's more like

Anonymous Female Speaker 5:11
working in schools or working like I worked in the Epilepsy Foundation here for one year and I worked in school, the second year Gotcha. To be like at risk kids,

Scott Benner 5:20
what drew you to oncology what made you want to do that? So

Anonymous Female Speaker 5:24
I really believe in patients making their own decisions about treatments and end of life. And I feel like I'm college kind of incorporates that. I also think that in oncology, there is like you have a long term relationship with your patients that you don't have with a lot of other fields.

Scott Benner 5:40
I see which one of these kids got type one diabetes.

Anonymous Female Speaker 5:44
Number two, how old number two on the lottery. She's nine now she was diagnosed when she was seven. Oh,

Scott Benner 5:52
wow. So a half a year into your practicing. She got type one.

Anonymous Female Speaker 5:59
So she actually got it's been more than two years. So she's actually got type one at the end and end of my residency, I say, but I'd already finished like my board certification. So it's a little easier.

Scott Benner 6:11
Is there other autoimmune or type one in your family? So

Anonymous Female Speaker 6:14
until then, we didn't have like, I would have told you that we're all completely healthy. But she was diagnosed with celiac, but at the same time, it was the same blood test. And afterwards, we were diagnosed me, my husband and another kid with celiac. And I have Hashimoto and my husband had psoriasis, which isn't exactly autoimmune miss out on Flim Flam. Ettore. My youngest might have been illegal. So

Scott Benner 6:41
we're running autoimmune struggle. You didn't know you had Hashimotos.

Anonymous Female Speaker 6:45
Know that. I knew, but I never considered it if you'd have asked me. Am I healthy? I always said yes. Like, and I gave birth and they said, No. Do you have anything, any medications you take? And I was like, Oh, no. And I'm like, Oh, wait, I do have something because it's just something that's so common. How

Scott Benner 6:57
old when you were diagnosed with that? 24? Okay, so how old are you now?

Anonymous Female Speaker 7:04
37?

Scott Benner 7:05
Might you laugh?

Anonymous Female Speaker 7:06
Because I can never remember.

Scott Benner 7:07
Like, okay, so you've had it Hashimotos for a while. And even though it's auto immune, if I would have asked you the day your daughter was diagnosed, are there any other autoimmune issues in your family? You might have skipped right over Hashimotos? No,

Anonymous Female Speaker 7:22
I asked me like that I would have skipped over. But it's not like I thought about it.

Scott Benner 7:29
Okay, so it was a surprise. Obviously, when you look at your family line, your husband's in yours. Do you see any other autoimmune? No, no, just the two of you getting together might have been the soup that made

Anonymous Female Speaker 7:43
like we didn't even know we both had celiac before. It would have been a cute dating story. But it didn't happen like that.

Scott Benner 7:47
So can I ask I'm so sorry. This is a weird, like path to go down. But you just ladder running to the bathroom? You didn't know why or was it not affecting No,

Anonymous Female Speaker 7:57
once you have one kid who has celiac or person in the family? So you do screening for all the like, first degree relatives? So we all did screening? And my husband is symptomatic. And I think it's just people didn't look for it as much when we were younger. Yeah. So he just like lived with it, because that's the way his body worked.

Scott Benner 8:16
I take I mean, listen, I think that's a valid answer. I think that's it, people don't understand I'm older than you fairly significantly. And I'll

Anonymous Female Speaker 8:23
tell people like You're like one half generation, I guess above are wondering, I

Scott Benner 8:27
mean, I'm 52. I don't know what that means. But like, all I know is that no one ever considered my health. Like I was either sick, like with a cold or something broke, but nobody talked about nutrition or how your body worked, or what was normal, or what level like that was just not a thing anybody spoke about, you would have been like a majorly hippie if you talked about that in my family in the 70s. You know what I mean? Okay, so you've had this job now for a couple of years, you're obviously on a cold wind episode. So we usually skip ahead a little bit here. Instead of telling fun stories and stuff like that, what makes you reach out and say, I think I have something to add to this cold wind series. Contour next one.com/juice box, that's the link you'll use. To find out more about the contour next gen blood glucose meter. When you get there, there's a little bit at the top, you can click right on blood glucose monitoring, I'll do it with you go to meters, click on any of the meters. I'll click on the Next Gen and you're going to get more information. It's easy to use and highly accurate. smartlight provides a simple understanding of your blood glucose levels. And of course was second chance sampling technology you can save money with fewer wasted test strips, as if all that wasn't enough. The contour next gen also has a compatible app for an easy way to share and see your blood glucose results. Contour next one.com/juicebox And if you scroll down at that link, you're gonna see things like a Buy Now button. You could register your meter after you purchase it or what is this Download a coupon Oh, receive a free Contour Next One blood glucose meter. Do tell contour next one.com/juicebox head over there now get the same accurate and reliable meter that we use. today's podcast is sponsored by the ever since CGM boasting a six month sensor. The ever sent 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 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.

Anonymous Female Speaker 11:35
It's really interesting, because you know, every doctor kind of has like their traumatic patient, like the patient that you feel like you could have saved, she would have done something different. And I'm not even talking about like negligence and getting sued. But just like human error, I guess it could be either or. So mine is actually patient who died of decay. Who had type one. And I think that it kind of shows are like understood from that how much we don't understand type one. And that was even before my daughter had type one.

Scott Benner 12:06
You're helping a person with cancer. Yeah,

Anonymous Female Speaker 12:09
so it was like on oncology Ward, right. So we're just in colleges, and she was getting a therapy that she wasn't eating. During the therapy. It was hard for her to eat and she was in pain. So they gave her a lot of morphine. And then she kind of started going downhill. And they decide to center up to be in the ward so we could kind of watch her give her fluids. They took off her fentanyl patches. And they said like if she's kind of seems like she's in pain, like just give her a little bit of morphine. And I was the on call resident we did 26 hour shifts. When they called me the middle the night and they said, You know, I think she's in pain. So like I went to see her, give her a little bit more fit. And she looked really off. So I took my tests, but sadly, the blood gases didn't. They weren't good. So I never got that back. And then they call me like two hours later that she died there is that she's not breathing. And we went to resuscitated her. And we didn't really know what happened when they checked her blood from the ICU. So she had a lot of ketones and they couldn't figure out why. And then they finally figured out that she was type one. And what happened was is that she wasn't eating. And she her blood sugar's were running low. So she took off her pump, and she wasn't getting an insulin. And that means that her blood sugar's weren't high, because that's something that we would notice in the hospital. She didn't say that she was that insulin was a medication that she had to get. And she took it off before. So it was like normoglycemic DK, which was something that I didn't know existed before that. So she died a few a few days later. And ICU. This

Scott Benner 13:47
feeling you have, there's something you could have done? Was it as strong then as it is after your daughter's diagnosis.

Anonymous Female Speaker 13:56
Now it was really strong. Then I did a whole kind of mortality and morbidity meeting with the doctors bass, I kind of researched it. And they understood that type one wasn't something that was just like, okay, you know, they have they have type two diabetes, or they have high cholesterol or they have high blood pressure, that it's something that you really need to notice.

Scott Benner 14:16
How was she in the system without physicians knowing she had type one. So

Anonymous Female Speaker 14:21
she was brought up like this, she was getting treatment. She wasn't an inpatient, and then she was sent straight to the ward, just like that we could kind of help her out. Yeah, again, they assume that she had an overdose of morphine

Scott Benner 14:36
or fentanyl or whatever. Okay.

Anonymous Female Speaker 14:38
And she, so nobody really did a full intake. But I will say that even if she would have said to me, yeah, I have diabetes, I would have been like, okay, so you have diabetes. You know, like you ask, what medications you take, and like, I wouldn't have thought to say, Hey, if you have type one diabetes, how come you don't have insulin on your medications?

Scott Benner 14:58
You think if you knew she had had type one. And you might have checked her blood sugar but then seen it be at a certain number and then

Anonymous Female Speaker 15:06
they knew she had diabetes. It checked her blood sugar was normal. Okay.

Scott Benner 15:09
Is this the first time you're seeing her when when you interact that night? Yeah, yeah. Okay. Yeah, that's crazy. And no one, it just doesn't click for anybody that you can have

Anonymous Female Speaker 15:20
click for anybody. It's like it's a went through, like, usually you have a lot of people looking at something and then somebody's going to figure something out before something bad happens. Yeah, so I was just like the last one when the really bad thing happened. But nobody realized that. And if I put it in other perspective, and I'm not taking the responsibility off of me, or like, the doctors in general, I feel like when you're tightline, it's really important. Like you have to know about your disease. And you have to know that insulin is a medication that you take, and that you cannot take off your pump for a day or two, you know, you have to know that you always have to have Basal insulin,

Scott Benner 15:56
right, retrospectively, do you know how long she had type one for

Anonymous Female Speaker 16:02
years and years and years? And I think that that's also people who are older, like I find in the hospital, that people who are like in their 70s or 60s and they have a pump? I feel like they don't know quite as much about diabetes, people who are maybe diagnosed today. Yeah,

Scott Benner 16:18
I think that's true. I also can see where if loaded on morphine. She was thinking, my blood sugar is low. I can't get too low. I'll take this pump off for a little while. Then

Anonymous Female Speaker 16:31
she wasn't actually loaded on morphine. And it was just decay. Oh, it was she was? Oh, I don't think I don't think that the morphine issue was at all an issue. She was going downhill because she was starting to be in decay, I think was misdiagnosed.

Scott Benner 16:44
I see. I see. I see. Wow, geez. Yeah, listen, for people listening. Please don't take your palms off. Please, please, please. But isn't it crazy that even a person who has been living with it forever doesn't know, I need this insulin? I have to have it. I can't be without a background of insulin. Yeah,

Anonymous Female Speaker 17:03
and doesn't even look at it as a medication that they have to put on. Like that they have to tell you about. Yeah, it's just like something that they have in the background. And it's funny, because one funny half, I did that. A few years later, I had a patient who had type one. And I went to visit him in the hospital. And also he had been getting chemotherapy and infusion center and his blood tests were off. And so he also he went off to the war to be an inpatient. And I went to visit and just to see how he was doing because he wasn't doing very well. And I knew he had type one. And this is after my daughter was diagnosed, I was super vigilant. And I said, he said to me, Oh, by the way, I don't have infusion sets here. When am I going to go home? Cuz I haven't had my pump on since yesterday. Wait. And I said what? And he said, Yeah, I you know, I came out and it was an infusion center. And then I didn't know that I was going to be admitted. So I you know, when what am I going to be able to go home because I don't pump on that

Scott Benner 18:01
lack of urgency. It fries my mind a little bit. Like I have just beaten into my daughter's head that if that pump runs out of insulin, and you didn't expect it to if it falls off, everything in life doesn't matter anymore, you stop what you're doing head directly to insulin and get another pump on. Right? Right. It's one of the non negotiables of our of our, our existence and to hear somebody say Oh, my thing got knocked off a day and a half ago. And

Anonymous Female Speaker 18:34
again, the reason that he thought that is because his blood sugar's were normal, because he also he was in liver failure. And he wasn't really eating, and his struggles were normal. So he didn't need to get insulin from the nurse. In other words, whenever they came to check his sugar, it was normal. And he didn't feel like he needed to get insulin as a correction.

Scott Benner 18:52
DK is not attached to a number and it can happen very, very quickly. Yeah, yeah. Yeah. And so is it fair to say that? Do you meet more people with diabetes? Who understand it? Or who don't understand it? Or is it very age, or generational? First

Anonymous Female Speaker 19:07
of all, in general, and cancer, like most patients are older, and type one is relatively rare disease so thoroughly, I meet so many type ones. So it's hard for me to say, but I mean, most of the people I meet are 50 and

Scott Benner 19:19
getting away from type one for a minute What are like what are your bone chilling stories that have more to do with I can't believe a physician didn't understand this, then it does diabetes.

Anonymous Female Speaker 19:32
I think I have other things that like stand out to me that like I'll never forget. And again, the reason I don't forget these is because for me the decay patient was like my trauma. Yeah. And afterwards, it's just a habit type one so I'm super vigilant about type one. Yeah.

Scott Benner 19:52
In your intake you the things you want to talk about. I'm very interested because of the perspective you set this up at like B Basically a doctor's perspective before and after having a personal experience with the disease. And but your first thing on your on your list is Doctor bashing. So what did you want to say about that? Well,

Anonymous Female Speaker 20:12
if I did the doctor bashing, by the way, I'll say one more thing about that patient that I had, that I called endocrinologist for the patient who was having normal blood sugars, but didn't have his insulin pump on. And the endocrinologist said, and I said to him, he's type one. And he hadn't had insulin for two days for almost two days. Like, how much basil Should I give him? And he said, What are you talking about his sugars are normal. And the reason I mentioned this is that even Endocrinol she was an endocrinologist in endocrinologist and training others as a sub specialty. And after he talked to his boss, he did get back to me with the number of units. But even endocrinologist don't see type one very often adult endocrinologists. It's more

Scott Benner 20:55
about type two for them. Yeah, yeah, it's diabetes.

Anonymous Female Speaker 21:00
Yeah. And it's hard. Like, even for that, like, it's hard to see. Like, when there's a situation that's super serious, like I was saying to him, like, they're the situation yet. It's super serious. And I need to know, you know, what I should do? And if it would have been anyone else, they would have been said, okay,

Scott Benner 21:15
yeah. But he sees that number and just goes, I don't need insulin. Yeah,

Anonymous Female Speaker 21:19
yeah. And again, I mean, I hope that throughout his training hall, get trained better. And he probably learned from that patient. But most doctors wouldn't have known to even make the call to the endocrinologist. And yeah, many endocrinologist when they definitely want to have, you know, set him know, talk to your attending physician.

Scott Benner 21:39
Doesn't that frees you though? Like when I when you see, it's funny, like when you said that? I'm almost stunned, like to the point where I can't think for a second, trying to imagine all these people out in the world who are counting on all of these physicians. And a basic idea like that. I don't care if they were new or not a basic idea, like that's not understood, like what chance do we all have? You know, so

Anonymous Female Speaker 22:06
I brought that up before the doctor bashing just because I want to say that I do appreciate that doctors definitely need more education, but I feel like the education they need. First of all, it depends on what your specialty is. In other words, there's a difference between family doctors or pediatrician and an endocrinologist, as opposed to an oncologist or surgeon or orthopedic surgeon, you know, people need to know different things. And I feel like most doctors, they don't need to know the ins and outs of diabetes, they need to know when they need to ask. And others. That's how medicine works. Because the specialties, like once I'm an oncologist, I really don't know general medicine anymore. And even within oncology, I'm a GI oncologist. And I can understand about breast cancer. But even now, and it's been three years since my boards, I can't I don't feel like I can treat it well anymore. Because I don't know the new data that's coming out.

Scott Benner 23:00
Let me say this before we go any further, because I've been doing this series for a bit now. And I live in two different hemispheres of my thinking on this by first is on the ground level at a human level, you're the one saying you know, you need to know. And then I pull back. And I look at all the stories that have been told to me. And I've tried to incorporate everybody's perspectives. And I think that doctors are in an unwinnable situation, because there's so much to know. And they're just people. So they have to be able to hear all the things you're saying, connect the dots correctly, then reach into their, you know, computer bank of understanding, pull out the right answers, apply them correctly, somehow communicate them well to you, you have to do them correctly, it's pretty much impossible, right? You're asking a person to do the job of a computer, which by the way, is going to lead me to say over and over again, probably over the next couple of years on the podcast. I think that the nature of being a physician is going to be changed significantly by AI. I

Anonymous Female Speaker 24:05
disagree. Go ahead. I disagree on that. It's not that I don't think that AI is going to be incorporated into doctors worlds. And like I think in general, everybody's going to learn kind of how to use it in a way that actually benefits people in society. I think that with doctors when you meet it, first of all, a lot of being a doctor is being able to relate information. And also to get the information out to the patient. In other words, the patient. Yeah, they can put some stuff into computer, but they forgot to tell you a lot of really important things, for instance, not telling you that they need insulin, or not telling you that like they came for something and you kind of asked him questions. And then like 15 minutes later, they mentioned something that's super serious, but they didn't even think to tell you that before and it's not something that you would have thought to ask. Yeah, so I think that we're very far from like computers being go through that.

Scott Benner 25:00
Well, that's incredibly common. Obviously, it's people just not telling the whole story. I've just recently had, I did this thing the other night for myself, right, I took this long standing issue, I've had my life. And I opened up a chat GPT four o window where I was actually speaking to the computer, and it was speaking back to me. And I said to him, Hey, I'd like to have a long form conversation about a health issue I've been having for 20 years. And I don't know that I'm gonna get all the information out. So let's have a back and forth. And then I did that I actually just talked to the it was my phone actually talked to my phone for 20 minutes. First of all, it was one of the more cogent conversations I've had in the last six months, which was upsetting to some degree. And I started thinking like, maybe I should start talking to my phone about what what I thought about the movie I just saw, because maybe it'll be better than some of the friends I have. It went back and forth. It asked questions. I, as I went along, would go, Oh, you know what, I forgot to mention this. And then I added that. And what I realized was that the the AI, it hears everything I say, it's not biased, and it doesn't forget. So even if I mentioned something, and then I make a left, turn in the conversation, and never get back to it, it doesn't forget that I said that, right. I'm almost trying to say that AI has. I feel bad for doctors now. Because now I'm recognizing more and more. We're asking them to know everything, and then be able to recall it. And that's not fair. And I don't see how anybody could do that.

Anonymous Female Speaker 26:31
Does that make sense? Right? Which is why like, it's, you know, you've mentioned before in the podcast, but if it sounds like a horse, right? That's what it is? Yeah. Because in the end, like you have to go with what's common first. And it's not that you're forgetting that there can be other things is that your first checking or trying to treat what's common? And then if that doesn't work, then you have to go back and kind of ask more questions and reread the notes and think again,

Scott Benner 26:57
what is that? A I had a conversation with your husband? 20 years ago, don't you think it would have come up and said, hey, you know, you might have celiac,

Anonymous Female Speaker 27:04
I think it wouldn't have been hard for anybody.

Scott Benner 27:08
They're like, listen, we didn't want to stop eating bread, leave us alone. But you don't I mean, like, I wonder if and I take your point, like, I'm sitting here trying to be very thoughtful about it. And I'm having this very Intel conversation with the AI. Most people are going to go, my head hurts. And then where do you go from there with that, right? Like they might read my doctor,

Anonymous Female Speaker 27:28
you have the basic questions that you're supposed to ask to try to figure out. What kind of headache is it? First of all, there's something dangerous, you know, or not, and something that's emergent. And then from there, you keep going to try to figure out what it is based on differential diagnosis that you have in your head.

Scott Benner 27:42
But I can't teach the AI to differential diagnosis, know that you can definitely listen, I know it's your job, and you still have like, 25 more years, you got to make money. I'm going to plant my flag in this one for the future. So I can come back to it. If I'm wrong. That's, that's fair. I think that doctors jobs are going to shift to be the human eyes, on the algorithms, understanding of what's going on.

Anonymous Female Speaker 28:07
I will say the beauty of oncology is that it's as opposed to other like to internal medicine, or I'm not trying to diagnose and I'm trying to figure things out so much. I'm trying to figure out what the patient how they want to be treated, and how to treat side effects that they have and how to treat things that have to do with the cancer. Yeah, so I think that my job is pretty safe.

Scott Benner 28:27
Because at no point are we going to put a person in front of a computer screen and say here make her feel better. So like, you know, like,

Anonymous Female Speaker 28:34
this is your prognosis, what would you like to do now?

Scott Benner 28:37
Also, I think Modern medicine is insanely good at some things, right? Like the mechanical stuff, like surgery and emergency care. I think it's it's Nexen. It's second to none. It's amazing. You know what I mean? But it's when you get into that diagnostic stuff that's beyond normal. Or when it gets into, I mean, something like type one diabetes care, which is so much more, what would you call it? Like, it's my it's more art than science? Maybe?

Anonymous Female Speaker 29:05
You know what I mean? And I think also that type one is really different than other diseases. And it's one of the only ones I think are the only one that I know of that it's really like you at home have to make decisions all the time and to change your dose. And what how much you're giving now how much you're giving afterwards. You can't wait the three months to see the endocrinologist to figure out your trends. It's like you have to change it by yourself. Yeah. And I think in most other like I can't think of anything else that's like that, that it's not the doctor actually designed to give you a medication and telling you when to take it and how much to take it. So type one is really different even in other chronic illnesses or illnesses in general. Why

Scott Benner 29:51
I wonder then, why do we try we doctors? Why do we try to give static advice for something that's so clearly Ever changing. So I

Anonymous Female Speaker 30:01
don't, I think there's two answers to that one, I don't feel like I got static advice, good. When she was diagnosed, it was kind of clear, like even the person who did the pump training for us. So she also had type one. And she said, you'll see like, you'll start changing things in your pumps on your company, see, the things are kind of going wonky for your Basal if you're, you know, you'll make changes. And the doctor was also really clear to him in the beginning, I called him every single day, he said, Call me every morning, tell me what her number was when she woke up, and we'll decide on the Basal dose and, and at that, you know, every night call me and tell me what her what her numbers were throughout the day. So in that sense, he was definitely saying that's ever changing. And he was also taking responsibility for him. And I don't know how he does that with every patient. Yeah. And I think different patients at different points feel more comfortable saying, Can I change about myself or I'm going to for

Scott Benner 30:54
you, when the phone calls went away, when it was no longer comfortable to call somebody every morning? Like, where did you get the confidence to keep doing that as things changed.

Anonymous Female Speaker 31:03
So I think it helps to be a doctor, first of all, okay. In other words, like, I never started with, like, not having confidence, I didn't know, I didn't know about type one, I knew that there was basil on it, there was Bolus, like I knew the basics. But I think that, I mean, it's not as scary to use medications to make changes when it's something that you do for other people every day. And I also think it's like, they gave us the basics. And then when I thought we went on a pump, about a month and a half after we were after she was diagnosed, she was on the Omnipod dash. So I just like I knew what he was going to say. I mean, I knew that I was going to say, Oh, she's going up higher, about nine o'clock. So we'll say oh, so change the basil at seven. So eventually, I said, you still want to keep me keep calling you.

Scott Benner 31:53
I think the point is, is maybe at the core of everything, I'll say all the time that the people who find the courage and the knowledge to make adjustments to their insulin, without a doctor are the ones who end up succeeding the best, you know, like it just that autonomy and confidence. I mean, obviously, it's a need. But if you it's almost like telling somebody, like you can make your thermostat 68 degrees. But if you want to change it, you're gonna have to wait 90 days, and then drive to where I am. And then talk to me about why you want to change your thermostat. And for you know, what happens if it gets warm or cold during that time and you want to move the thermostat back and forth, you look at it, you go I know, this thing could make me warmer or colder, but I'm not allowed to touch it without going and talking to the person that I really think that?

Anonymous Female Speaker 32:40
Yeah, I mean, I only have, you know, my experience with endocrinologist that we're with. And that's definitely not the way you know, like, he never had an expectation that we wouldn't change things. And I think the opposite. He has an expectation that if you have the capabilities to do it that you will don't and he only doesn't do that, or people don't change it. Some people just don't have the capability, let's say to do it or to do it in a safe way or to understand it as well. Maybe, right. Sure.

Scott Benner 33:08
Well, don't you think you you got the autonomy? Because you were a doctor? No, no, you think that you think this doctor tells everybody the same thing? Yeah, okay. Yeah. Well, you got a good doctor, then. So then that's the next part of this whole Doctor thing. Right.

Anonymous Female Speaker 33:21
So it's really complicated, though, to say that because I didn't, it's not that I get a lot of information. And I think maybe this goes back to the doctor bashing is that I think that you have to have realistic expectations, like also, with what you expect the doctors to know what you expect them to explain to you when you're first diagnosed and a little bit afterwards. And that doctors have reasons sometimes. And it's not that they don't know necessarily about why they're not saying things, for sure. And in the beginning, you know, you can't have all that information in the beginning. And we left the hospital without a Dexcom. And I have to say that I don't think it's a good thing to leave the hospital for Dexcom, which I know is a minority opinion. Because I think it did two things. One is that it made me not nervous to not have my Dexcom working because we didn't do it for two months without a Dexcom my daughter felt her lows in school. We don't have a school nurse. She was seven and she could still do it and she could fingerprick herself in class if she didn't feel good. And also I think that it was kind of good to just like get the basics down card counting my daughter after she was diagnosed. She would eat five to six bowls of cereal in the morning. Yeah, because she's starting now one bowl of cereal spikes really high hours afterwards. So I can only imagine what those five to six bowls were doing. And to me I checked her you know, before her snack at school, and then we will just correct and move on. Otherwise we would give the correction get the carbs. And that was it. Yeah. And I think that if I would have seen all that data, and I can only imagine that she was sitting Get the three hundreds for those two and a half hours until she went down to 200. And something when I gave a correction, I think it's okay to wait those few months. And to just get the basics down.

Scott Benner 35:11
I'll play devil's advocate because it's fun. I think you have the luxury of feeling that way because nothing bad happened.

Anonymous Female Speaker 35:17
I don't think that something bad happens from having high blood sugars for a few hours. Definitely not for a few months.

Scott Benner 35:25
I don't mean high blood sugars. I mean, like, in the first six months of my daughter's diagnosis, she had a seizure. If she was I just

Anonymous Female Speaker 35:33
I want to say something about that. Yeah, totally different. Totally different if you have a toddler. I'm talking to older kids. Okay. Like, I think that having a toddler is completely different. You can't communicate with them, for them. Definitely impossible at the Dexcom 100%.

Scott Benner 35:48
But let me ask you, let's just again, what if on one of those mornings with all that cereal, your daughter had a honeymoon moment and you had pumped in enough insulin to cover seven bowls of cereal and then she went to school and passed out. Do you think you'd be saying it's okay, not to have a CGM? Because it's good. You get to learn. But

Anonymous Female Speaker 36:07
what I think is that she checked herself and she knew how to treat her lows and it gave confidence.

Scott Benner 36:13
Oh, I agree. Listen, everything you said there's value to like, I 100% agree. Like,

Anonymous Female Speaker 36:18
I don't think that would happen. In other words, it's she went she started honeymooning, right. Like she had anyone for about a month. And in that month, we didn't have a Dexcom. And it drove me crazy. Because we were at the park and suddenly she wasn't feeling good. And she was 40. Like we had bad loads or, you know, she went to sleep and she wasn't feeling well. So I checked her sugar when she went into bed. And she was 30. It's not that we didn't have loads. I didn't. We didn't have it kind of showed me that. Yes, she would feel her low. And yes, we can deal with it. Despite the fact that I don't know how fast she's falling. Yeah, so we gave us carbs. And we checked her again, after 10 minutes. And then we gave more carbs if we needed to know as seizures are few and far between.

Scott Benner 36:59
In general, you think so

Anonymous Female Speaker 37:01
it's not that nothing bad can happen. But I think that in this in the month, usually after you're diagnosed or definitely in the first few weeks, you're usually your blood sugar was so high that until you start hunting money, you're usually not going to have crazy lows. Okay, so I think it's okay to have at least those two weeks of you know, going home, figuring out what you're doing, and not seeing all the data. And again, it's not that I think that it's good to not have the alarms is that I think that seeing so much data, maybe isn't the best thing when you come out of the hospital.

Scott Benner 37:33
It's and listen, I'm not arguing with you. I will say that. I mean, call me back in 20 years, maybe is the way I'm gonna say this, but like, I, my, my daughter has had one. She had one seizure when she was six months old. We just didn't know what we were doing. We had a high carb meal, we thought we did the right thing. She took a nap and had a seizure in her sleep. It happened again a couple of years later on activity. So we were at an amusement park all day out in the heat. At the end of the day, she saw a vendor holding like, like popsicles. She asked for one, we Bolus for it. She had a seizure two hours later. I know now, by the way that I you know at the end of all that. All that it was super, like I didn't need to give her any insulin for it. Right. I know that now. She didn't have another one again until the night of her senior prom. On a day when she heard very little food and had very little insulin was wearing life saving equipment and all that other stuff. What I'm going to tell you is I 1,000,000% believe and agree with your message. I really do. And I think that the only reason you're able to deliver it is because you didn't have one of those random things happen to you because I don't think you were a CGM. For most of the time you were it for the moment that you can't plan for that you don't see coming. That's my feeling. And you just haven't had one of those moments yet when I hope you never do. Like but

Anonymous Female Speaker 39:09
now we're on the CGM. But again, I think that when you're when you're diagnosed and your sugar's are super high, it takes time for them to come down. So I think that you do have a leeway of at least two weeks where it's okay. You don't have to be stressed about getting a CGM because I see people writing you know, like, don't leave the hospital without one. It's okay to leave the hospital without one. You know you you have to

Scott Benner 39:32
Yeah, no, I take your point like it doesn't like I do see your sad one

Anonymous Female Speaker 39:36
after two months. Yeah, we and we didn't have and I would have wanted to have one even before when just when she was honeymooning and I knew that she was having lows. We were no

Scott Benner 39:45
I think it's a good conversation to hash them. I also don't think there's a right answer and I think that the right answer is for whatever ends up working for you. What I'm saying is it also has to do a lot with your personality like for some people were like look, all that data would be overwhelming. There are other people would be like I'd find all the data comforting, like so your personality, the situation you're in, etc. But I hear what you're saying, If you can't get one right away, like, please don't act like it's the end of the world, you can test you can be careful, you can put safeguards in. And there's a lot to learn along the way. You know, I'm agreeing with you, and at the same time trying to have a conversation, right? Yeah. Yeah, yeah. Okay.

Anonymous Female Speaker 40:21
All right. And by the way, like in terms of Outlook, like if my daughter had a seizure, right, what I freak out or not, then and also afterwards, also, in that sense, like being a doctor, I think, and it's possible, it's my personality, without being a doctor, but like, the way that I look at illness and death, and I'm not saying deaths from diabetes, but in general, fatal illnesses and chronic illnesses. I think it's different than like, you were talking before, about, like how modern medicine is amazing in a lot of ways. And I think that it kind of got us used to thinking that everything is fixable. And that, like illness and death is something that's traumatic and not natural. I think that I have a different perspective on that also. So it's also like, if we need to use glucagon, I hope we don't need to, but I'm not sure exactly what my reaction would be. And if it would be freaking out afterwards for the next 10 years.

Scott Benner 41:15
Yeah, I don't know. I also don't think it happens to some people at all. Like, I mean, it didn't happen to Arden. Like she had that seizure a couple of years ago. And, you know, she was shocked for a couple of days, maybe three days, actually, like, she was like, 17 years old, like she slept on our bed for a couple of nights afterwards. And then one day, she just got up, and she's like, I'm gonna go in my room. And I was like, okay, and then we talked and we talked a day or so later, we talked about on the episode where she just said, like, I've thought it through, I didn't do anything wrong. And that seemed to comfort her. For so many days and weeks and months and years, I do the same things over and over again. And I was okay. Yes, there was a variable in here that like, she's like, but it's uncommon, and I don't think it's gonna happen again. So I'm gonna go back to my life. Whereas somebody who's maybe bent towards depression or anxiety that could end up making them scared for a decade, like, and I've seen it happen, you know what I mean? So, it's interesting to talk about blanket statements overtop of such a moving target over top of so many different personalities and experiences and, and that's why there's no like one size fits all accommodation, for sure. Yeah, that's just my perspective. No, I love it. Are you kidding me is fantastic. I need to listen without these conversations. I don't know if you know this. The podcast is boring. And then nobody listens. And then Scott's got to get a real job. And I don't want to do that. So imagine if I worked at a store or something like that, where you came into? I would chat chat. Talking to the customer. Yeah, great. Oh my god, I'd be the most popular cashier. I'd be like, I'd be like, hey, what do you know about this? And then we start talking about something crazy. I heard on a podcast probably. But anyway, so Okay, so on your list now what's the nondiabetic? You? Here's your list, I'll give it to everybody. Dr. bashing, nondiabetic number. Parenting versus body autonomy. I love this one. I want to make sure we get to that. Why don't we do that one next? What do you mean by that? And you say parenting versus body autonomy? Because I have a lot of that. Can I say one more thing about the doctor bashing? You want to do some? He's heard but doctor you want to know, Dr. Bash, but

Anonymous Female Speaker 43:23
I didn't say the other. Is that, like, I tried listening to the Grand Rounds, and I couldn't I stopped in the middle of the of the first real one. Okay. And, and I think that, I think, again, that you really have to take in perspective, like what you expect of a doctor and what you expect of yourself. And I really feel like we talked about a little bit in the beginning, but that like, it's, it's your illness, and it's like, I'm freaked out that my daughter is gonna go to the hospital when I'm old and can't go with her. And nobody's going to know, you know, how to advocate for her. Yeah. But in a normal world, or person, that you're not by yourself. And either you can advocate for yourself or have family member advocate for you. Like, I feel like that's really like where the education needs to be. And education for doctors again, like has to be a kind of mentioned before, like, it's, it's how to not miss something that's important. And that's true about every illness, and not only type one diabetes. And it's knowing that you have to call the endocrinologist if you're going into surgery with somebody who came in with type one diabetes, and they're not conscious, and they can't talk to you and say things are, you know, how you're supposed to do their sugars when they're in the ward and they're getting, I don't know, TPN or they're getting glucose in there, you know?

Scott Benner 44:42
So, I think you being a physician and the nature of your personality, it gives you a certain perspective, obviously, but let me let me ask a couple of questions and see if you see a thru line here. Once a week, three men in a truck come down my street and take my garbage away. If they took To the cans and not the third can do I have to go outside and advocate for them to take all the garbage? I

Anonymous Female Speaker 45:05
think first of all that you could say, maybe they didn't take it because one of them had to go to the hospital suddenly. Yeah. But

Scott Benner 45:11
but you know what I'm saying? Like, it's the I didn't see this once.

Anonymous Female Speaker 45:14
I'm not saying that I that the doctors don't have responsibility. I think that the expectation that they'll have so much responsibility or so much knowledge, that that's not realistic. I agree with you. Yeah. And that, therefore, mostly, you have to have it and they have to know, hey, this is something that we have to check out. And it's also knowing a doctor has to be able to ask the patient. Oh, you have type one. You know, how do you get your insulin? Oh, they have a pump and CGM. Okay, during your hospital stay? Do you want to take care of it? Or do you want us to take care of it. And that has to be a conversation that can be had with the doctors. And it doesn't have to do with them understanding it has to do with them understanding what type one the type of disease it is, right? And that a patient who's awake and take care of their diabetes better than they can. And also in the hospital, generally patients, like when kids are sick, or people I just know about kids, I have a kid and I'm not the one that's type one. But it's really hard to manage blood sugars. And it's really hard to manage blood sugars for somebody else. Yeah. And I think that you also have to have grace in the hospital that in the end they are when you're in the hospital, they're trying not to kill you, if you came in for diabetes, they really know how to take care, right? They know how to take care of DKA really well. But if you went in for something that's not connected to diabetes, they're taking care of that thing that they have to take care of. And they're making sure that your diabetes is decent and decent is decent in hospital hospital, not decent in the life.

Scott Benner 46:38
But how are somebody supposed to know that like, so? If I'm just a family or an adult, and I've been alive for 20 or 30 years, and so far, health care has been one time I got the flu and I went to the guy and he gave me Tamiflu, or I fell in my arm broke and I went to the guy and he fixed my arm. How is all the sudden? How am I supposed to know all the sudden that the All Knowing all seeing magic Doctor Who makes more money than me drives better car than me, went to more school than I did says they know all about medicine. How am I supposed to know they don't know where that they don't have good news

Anonymous Female Speaker 47:10
is in Israel, we make very little money. Public health care system. Everybody thinks that they know the best thing for everybody in this country. And they will tell you that and nobody's GCR speaks with respect. So we don't have that problem.

Scott Benner 47:25
I know a lot of Jewish people, and if I can make everybody Jewish, then I would assume that they can advocate for themselves. But

Anonymous Female Speaker 47:32
what about the people? What about the people who were also very nice.

Scott Benner 47:37
I didn't mean it that way. I just I but but but you know what I'm saying? I'll

Anonymous Female Speaker 47:41
tell you how. Because because when you're in the hospital that flick a blip in your month or your year. And then you go you have a primary care doctor care doctor, and you have an endocrinologist, and they're seeing your agencies and they're seeing the endocrinologist is looking at your trends. But even the family doctor sees your agency went up from I don't know 6.3 to seven. Yeah, they're supposed to notice that they're supposed to say to you, hey, what's going on? Maybe you need to go back to the endocrinologist. Maybe we can talk about and figure out what's going on. But that's not for the hospital that's for your you're not supposed to leave the hospital or at the hospital isn't your primary care and diabetes is really something that has to be handled in primary care.

Scott Benner 48:17
Yeah. But how are people supposed to know that? Because their

Anonymous Female Speaker 48:21
doctor sees it. I see people say once see, it's like, I don't have an oncologist. I'm not taking care of it. I see that somebody has an ailment, see, let's say they're coming, somebody had colon cancer, they're coming to me, and they're healthy. Now they don't have cancer. And they're just coming for a checkup. And they did blood tests for me, right? I care about specific things. And I don't care about the diabetes. So when I see that they have an A one C of seven, I write to their family care doctor, that they need to go see it to diabetes clinic. And I asked them is who's you know, who's taking care of your sugar is taking care of your diabetes?

Scott Benner 48:53
I'm not being clear. I don't think if I go to a hospital, how am I supposed to know that's not where I get this care? Doesn't that seem like the place where you get that care? If you were a person on the outside was not connected to the medical industry at all. You're not a doctor, you're not. You don't go to

Anonymous Female Speaker 49:08
the hospital and you just have a flu, you go to the hospital because you have something serious. So I don't think anybody thinks of a hospital as a place that that's like where you get regular care.

Scott Benner 49:17
I swear to you I think you're wrong. Though I think that people think I don't think they think of the hospital and the doctor's office and an emergency care center. I don't think they think of them as anything different. I think it's I think they believe it's the place they go where people who know better than them are. And when you get there

Anonymous Female Speaker 49:34
better than them about specific issues. Yeah. And again, I find that that's something that that people have to be educated. Yeah.

Scott Benner 49:42
How are we going to do that? How are we going to do that? By

Anonymous Female Speaker 49:47
talking about how about learning about their disease and actually, you know, going on Google and looking, you know, looking for answers asking your doctor questions.

Scott Benner 49:56
I heard an actor on a podcast the other day told me that straight lines aren't a real thing. I heard another I heard a basketball player telling me that the globe is threat flat, you want them to know about this too, like they don't people don't know about anything they don't know, inside of my sphere, the world I've set up for myself, I'm all knowledgeable. If you take me outside of my sphere, I don't know a damn thing about anything. And so what I'm saying is that people have never been sick a day in their life. Just think that when they get to the hospital, everyone they're talking to knows everything that they need to know. And the where that problem comes in, is that obviously those people don't know everything. But if I think they do, then I take what they say as gospel, I also believe there's nothing else because you don't go to the doctor, and he tells you, hey, you have to take one of these pills every day at 8am on an empty stomach, take it Monday through Friday for the rest of your life, you don't imagine that they left something out.

Anonymous Female Speaker 50:51
I think times are changing. First of all, it could be different cultural things. But I think that it's not the same, you know, like they talk about a lot and you know, in medical school, and that people don't come to the doctor anymore like that. Maybe it's people who are older, but not people who are younger. And again, it's not that I don't, I don't think that you need to advocate in the sense of arguing with the doctor on call, or that you need to know what you need them to be aware of. And what things are really important to

Scott Benner 51:21
dig into this for me, what does advocating mean to you? If I have to advocate for myself? What is it I have to do?

Anonymous Female Speaker 51:29
First of all, to me, it's even at the start, the doctor comes and asks how you are so you know, you have to put your type one diabetes, in the front of that conversation, right? When you're sitting in the ER, it's only if you if the doctor is not doing those basic things, right. That's when you have to advocate in a way that's maybe or arguing or standing up for yourself. So in general that in life, you have to stand up for yourself, that's just the way it is, you know, an ER has a million people in it. And in the end, and it's sad, but you have to make yourself heard.

Scott Benner 52:04
So you just said if the doctor doesn't do what they're supposed to do I have to make them do it. How do I know what they're supposed to do? No,

Anonymous Female Speaker 52:11
you don't have to know what they have to do what they're supposed to do in terms of your stomach ache, you need to know your type one diabetes, you need to know your chronic illnesses that if something goes wrong, you can die it. That's, that's you need to know what that means. And then type one, you know what that means, right? You know, you have to be getting insulin, you know that you have to be checking your blood sugar, right?

Scott Benner 52:30
Is there a world where I should expect a doctor doesn't know that.

Anonymous Female Speaker 52:35
Again, I think that in type one, as opposed to type two, that they won't necessarily notice in the same way, if a type two is in the ER, right? For 24 hours, it's not the biggest deal in the world, if they didn't quite get the insulin dose that they were supposed to be getting, right 24 hours, it's not, it's not gonna be the end of the world, I don't think that you can expect that the ER doc is going to notice that your pump is off and that you're not getting your insulin because when you're in the ER you don't, they don't ask you for your like, they don't give you your basic medications, at least not here. That's if you go to the ward. So then you sit down, you know, and you write in all the medications and you have all those orders. But if you're in the ER, you have to tell the doctor if there's something that you need to get that as well. It's not something that just happens.

Scott Benner 53:19
So I should trust the doctor yes or no,

Anonymous Female Speaker 53:22
I think that you should trust doctors. And I think that discussion with the doctor starts from trust.

Scott Benner 53:27
So let me keep going. So I have type two diabetes, I've been told by a doctor already that it's very important for me to take my insulin every day, keep my blood sugar's in a certain place. And then I go to the ER for, I don't know, I can't fart, whatever. And now I'm in the ER and for a whole day, they don't care that my blood sugars are high. And then they're really, there's

Anonymous Female Speaker 53:47
no way that they're gonna let you be riding so high. They'll give you corrections. It happens all the time. You're there for 24 hours. Yeah, you should tell them when it's eight o'clock at night or nine. Whenever you take your long acting, you should say to them, Listen, I actually got my long acting, and then the doctor will put in the orders for that. But you can't expect the doctor to remember that you're tied to and that you're on MDI and that you're supposed to get your land and that you've been in the ER for more than 24 hours. So you have to get some time in that timeframe.

Scott Benner 54:13
Right? No, I agree that the person should say that I agree that the person should recognize that they need to take their insulin on their own. But also, they may be thinking that you're going to take care of it. And also my my bigger point was is that if, if a doctor has told me, Hey, my blood sugar should be between 90 and 120. That's optimal. And then I get to the hospital and my blood sugar's are 180 to 220 and they go It's okay, while you're here, it's fine. How do I not go home then and think, oh, maybe 180 to 220 is okay, maybe the first doctor was wrong.

Anonymous Female Speaker 54:44
I think that I think that there. Obviously there's a lot of space for educating doctors, but I think educating doctors is educating that. In other words like that a doctor should be able to know to say to a patient like when you're in the ER Then as your sugars are higher, you know, when you go home, you'll go back to doing what you usually do or go back to your endocrinologist if it's been working out.

Scott Benner 55:07
I'm just saying that how how do we not expect that that person who's now been through that hospital experience doesn't leave? They're believing that a higher blood

Anonymous Female Speaker 55:16
sugar's Okay, still have a family doctor, they still have somebody who's checking their labs, one every once in a while, and somebody who's been to the ER should definitely their family doctor should know that that happened. So there's always supposed to be somebody who's catching that.

Scott Benner 55:29
Do you really think that happens, though? Do you think people leave the ER and then call their GP?

Anonymous Female Speaker 55:33
I think that's supposed to happen. That's what No, but I think that that's where, like the issue of like, how can you make the healthcare system better? It's not for all doctors to know about type one diabetes, it's to be able to have a situation where, yeah, you go into the hospital, and then you, you know, like, somehow gets sent to your GP or your GP knows, or they tell you, you know, you have to take this back to your GP, you know, you get you got a discharge paper, you know, usually like by us, it says, you know, you know, bring this to your family

Scott Benner 56:04
doctor, you're ignoring the the human aspect of it afterwards, nobody's going to do that. They think they're okay, now they left the ER, the pain is gone. They farted

Anonymous Female Speaker 56:11
there think that the people who think like that are also gonna have a really hard time controlling the type one diabetes, because they're not involved. Well, yeah.

Scott Benner 56:18
Oh, but that's my point. My point is, is that of the like, I don't know what it is now. 1.8 million Americans that have type one diabetes, a very small percentage of them even use an insulin pump where no one is.

Anonymous Female Speaker 56:30
But if you see somebody in the ER, right, who came because of DKA, because somebody like that is probably going to have high sugars when they come right. And they should get an endo consult, and they should get they should get an appointment for them to chronologist.

Scott Benner 56:41
But what if I ended up with the Endo? Who didn't know that the person needed basil? And even though their blood sugar was lower? Well,

Anonymous Female Speaker 56:47
that's I'm saying there is that obviously, like doctors need to, but I think that what you hear here, right, is you're hearing people who have bad experiences, and not as much most of the people who are having a decent or good experience. And that's just the reality of having

Scott Benner 57:04
I think most people are having bad experiences, and few people are having good experiences. And I think the numbers about people's a one sees, like, bear that out. Like, I think that I do a podcast for a very small section of people. And that most people who have type one diabetes are not even hearing this.

Anonymous Female Speaker 57:22
Probably, but I think that that's also why doctors need to be able to give rules that will keep health decent, and not necessarily the best. But even if it's really, really late, so I'm sorry. No, I don't have a problem.

Scott Benner 57:37
I love this conversation, by the way. And I really appreciate you having it with me because a spirited conversation like this is the only way to get the idea into people's heads. Because I'm not certainly saying that there aren't great physicians. And I'm not saying that people don't drop the ball in their own care all the time. That obviously happens. I'm just saying from a human point of view, I don't think you can set up a system that relies on the average person to understand what they're supposed to do for themselves.

Anonymous Female Speaker 58:04
So I think that in America, the system is much more complicated and not good system, right? Because, you know, everybody, you have your insurance and you have the some other nobody's really talking to each other. But I think it works differently in other countries and that there's something to learn. I

Scott Benner 58:21
would imagine there's something to learn from everybody. Yeah. For certain. Okay. Okay. Parenting versus body autonomy. This is another one, I have to

Anonymous Female Speaker 58:27
say I do want to talk about the diabetic goals, though. Save two minutes for that.

Scott Benner 58:31
It doesn't have to be just an hour. Do you? Can you go a little over?

Anonymous Female Speaker 58:35
Yeah, no, I'm fine. I'm fine. Just like that. Did you ask it that? And like, was there anything else you wanted to say? I

Scott Benner 58:40
like that you listen, okay. Okay. So parenting versus body autonomy. What made you say that? So

Anonymous Female Speaker 58:45
I feel like a lot of people, you know, like, they're like, oh, you know, fine. You know, it's been five years, and my kids ready for a pump now. So what are you guys talking about? Or like, you know, we're definitely no, it's, it's her body and or his body and their decision? And I've heard you kind of say it also, I think, but I really don't agree with that. And I think that parenting as a whole is deciding what's best for your child, in many, many aspects, right? We push them to do the things that we think will be good for them. We choose a lot of things for them. And I think that the issue of going on a pump is that your kid can't know what it feels like to be on a pump, and what it can help with if they didn't try it. Now, when you go on a pump, you have to know that whenever you change something, right, going from a pump to an algorithm pump or going you know, back to MDI is always going to take a while of figuring things out. Because different things work differently. And you can't expect to be on a pump for one month and be like, Oh, it does work or doesn't work. So I think that you have to push your kid out there. It's like I didn't ask my daughter she wanted a pump. I said to her, Listen, I didn't even ask her what pumps she wanted. I looked at the pump Um, so I checked what I thought would be best for her. And then I said, Hey, look at this video online, we're gonna get a pump soon. And when you get a pump, you'll be able, I feel like a pump is really important, you know, and diabetes has a lot of disordered eating and eating disorders, right. And I feel like a pump is really, really important for that. It helps you keep your eating just being natural. When you're hungry, you eat when you're not hungry, you don't eat and if you want another bowl of pasta in same meal, you just give yourself a little bit more insulin. Yeah. And especially like now we change to lume. Jeff, so even more, so it's like, we don't have to Pre-Bolus. And that makes it even more natural, except for unless she's high, and we have to bring her down first. So I don't think I think it's not, I think it's the wrong thing to do.

Scott Benner 1:00:46
This is boring. We agree. So this is so boring now, because you and I agree.

Anonymous Female Speaker 1:00:51
We agree that but I feel like I feel like on the Facebook page, but it's a minority opinion. And yeah, maybe to you here, I don't know,

Scott Benner 1:01:00
somehow my body my choice got mixed in with it's their body, if they don't want to wear something they don't have to. That would be nice if they didn't have diabetes, like like, and I would agree with you, you know, but

Anonymous Female Speaker 1:01:11
again, if your kid is on a POM for three months, so you've already you know, you've given it a shot, and they don't like it. So yeah, go back to MDI. Because they they understand, like, my daughter understands that if she doesn't want the palm, then she's going to have to do a lot of injections. Yeah. And that will have to do corrections with an injection. And also, especially for little kids. And definitely during honeymooning when you can only give full units. Sometimes she didn't want to eat a snack that was 30 cars when she was a one to three ratio. And like a pump gives you all all these things besides like actually be able to, you know, change your basil and to do a lot of different things and to have an algorithm, like just having a POM. It makes life a lot more normal. And you can't know what that feels like until you've tried it. Yeah,

Scott Benner 1:01:55
I listen, I agree. I also think if somebody doesn't want to use a pump, they shouldn't. But I don't know that we make a six year old in charge of that decision. I don't know what Listen, my son doesn't have diabetes, but he's 24. And the other day we were talking about software, he's looking for jobs and stuff. And I asked him a question. And he goes through I don't know, in my head. I'm like 14. And I'm like, exactly. I think the way I've said it over and over again in the podcast is I don't know many other big life changing decisions that you let 10 year olds make. Right? Yeah,

Anonymous Female Speaker 1:02:26
I think like it's not only about like a pump. It's also what we wanted to change the type of ends though, when we wanted to start looping. So she was dead set against it. She liked her PDM she knew how to use it. She didn't want to learn how to press other buttons, and she really didn't want to do it. But again, like I didn't ask her like, Hey, do you think we should try this thing? I said, Sir, listen, I found something I think will be better for us. And we're gonna give it a shot. And we're gonna see how it is. And if you tell me later that you don't like it.

Scott Benner 1:02:52
So we'll go back. This is how I do it, too. That's exactly how I do it. I also even now that Arden's older, she's 20. Soon, she'll be 20 in a couple of months. And just recently, she got low at school, and we were texting her and she's like, stop texting me. And I said, answer me, and I won't text you. And she's like, you don't need to do this. And I said, Oh, you don't want me to do this. That's fine. I said, start paying for school yourself. And it'll be fine. I was like, but right now, if you want me to pay for college, when I text you about this, you text me back. That's it small price to pay. Right, Alex? What are we asking for? So you don't have to pay the money. She just has to text me back. Right? And then we had a conversation later where my wife and I explained to her like, look, I understand that it might be it sucks. Like you're sitting down, you're working you're distracted, you know, you already fixed your blood sugar, right? Like it's been taken care of the number just hasn't bounced yet. And now we're bothering you. So the blood sugar, so you got low that sucked. You had to fix the blood sugar that sucked. It took you away from what you were doing that suck. And now all of a sudden, here we come. And it's just it feels unnecessary. Like but you don't know our side of it. I understand your side of it. I understand. It's not perfect. I wish it was I'm sorry. It's like this. But we can't just sit here wondering if you're about to die and not do anything. Right? And so that's what this is. And if you don't want this to be that, then that is to say that you don't want us to parent you anymore. And if that's what you want, then I really don't want to pay for college. If you're if you're that autonomous, that's rock and roll I go get a loan. Okay, listen, and I gotta be honest with you after school's over. I'm gonna look for another reason to be able to like to get her to like tell me she's okay. But be yeah, like I take I

Anonymous Female Speaker 1:04:40
think we kind of split on on the parenting.

Scott Benner 1:04:45
I tried to make a bombastic description of what it is but I don't think kids like don't get me wrong if art and push back hard enough I'd say alright, this is obviously something you don't want them we're gonna but we can't stay in this current setup. If that's not Part of it. So we're gonna have to change the set, which I assume is going to happen over time to begin with. But your points more about younger kids, your kid, you know, diagnostics, I

Anonymous Female Speaker 1:05:09
think that it's really different when you have an older kid. And even in the teenage years, it's, you know, possibly letting your kid to a lot of things that it's not the way that you would do it. And that's still fine. As long as I like basic rules that you agree on. I haven't gotten to the teenage years. So we can talk in five years. And I'll let you know if

Scott Benner 1:05:25
that works, right. You're looking for an equilibrium of safe and healthy. Yeah, that's what you're looking for. Yeah. But I loved your approach. Like, look, I found this thing. I think it might be better. We're going to try it. If it's if because what you know, is that very likely, it's not going to be a problem.

Anonymous Female Speaker 1:05:40
So within within a few days, she didn't care what buttons she was pushing. And it was really nice for her that I didn't text her call her as much when she was high or low because Luke was taking care of it. Exactly. And also, she only needed one device instead of two, which also makes a difference.

Scott Benner 1:05:57
Fantastic. I hear a high blood sugar. What number does that that Beeping?

Anonymous Female Speaker 1:06:01
Beeping? I heard two beeps. Hi, oh, this brings us right into diabetic goals. She Oh, she's 214.

Scott Benner 1:06:11
Now, do you tell her to Bolus? She's asleep?

Anonymous Female Speaker 1:06:15
It's 10 o'clock at night, you know?

Scott Benner 1:06:16
So are you gonna count on the algorithm to try to bring it down? No.

Anonymous Female Speaker 1:06:19
First of all, we changed her. We changed her pump right before we got on.

Scott Benner 1:06:24
Oh, so she's got like a little rise from the change in the cannula. Oh,

Anonymous Female Speaker 1:06:27
I think probably that and I already see that my husband lost quite a bit. I mean, he does like micro bolusing. Cuz when she's asleep, I don't want to crash. Sure.

Scott Benner 1:06:38
I'm a fan of Bolus.

Anonymous Female Speaker 1:06:40
Like we can see like if we think that loop is being aggressive enough or not.

Scott Benner 1:06:45
Especially with like loop or IEPs after a pump change if there's suggested insulin I like to see it in, because the site's not always

Anonymous Female Speaker 1:06:55
perfect. Right. Right. It's hard to say because sometimes it works really well afterwards. It works even better, because the pump site before it wasn't working, and then loop is being aggressive. And then she crashes. Exactly, yeah, let it ride for a little bit.

Scott Benner 1:07:07
So your point is, how are we supposed to expect a document and all that? All right, what's your next thing? What What are you talking about next outcomes? Or what are you going to say?

Anonymous Female Speaker 1:07:18
Oh, about the diabetic goals and straight lines. And we're not going to agree on this. So I

Scott Benner 1:07:22
bet you I bet you think something about me that I don't think about myself, but go ahead.

Anonymous Female Speaker 1:07:27
No, I'm sure. I think that, like there's a lot of talk right about mental health versus health and straight lines or small bombs, or what high alarm should be or if my numbers as a diabetic should be the same as non diabetic numbers to keep your child safe, which that you have said before. And I don't think that that's the right way of looking at it. I think that, you know, in all the studies, and it's kind of like you say with the TSH, right, like how they decide that that's the normal range, right? They did studies and they figured out what most people had. And that became the normal range in diabetes ated studies, and they saw when the when people started having different, you know, retinopathy and nephropathy and different things, right. And that's what they decided, you know, what the goal should be, if you don't want to have complications, and where that starts happening is what became the non diabetic, you know, the pre diabetes versus the diabetes, and afterwards, and those studies are really old. But I still think that you can learn from that you can learn a lot from that. And I don't think that there's a problem with a range of 70 to 180. And I don't think that there's a problem. Again, timing range, I feel like, obviously, you want to have the most that you can, but I think that you know, having, I don't know if somebody posted in so that they had a 6.3, a one C and an 80%, time range of 70 to 180. Those are really good numbers. And I don't think that they need to think or feel like it has to get better. And if they get better, your health is necessarily going to be better. Like my daughter's a one C went from five, six to five, eight less than, let's say, right? So and her title range went down from I don't know, 89 to 87%, or something like that. And I end within normal, the 70 to 180. And it hasn't been shown that that's going to affect your health. And I think that's important to know, like, what's evidence based medicine? And what's things that we think makes sense and a lot of things that we think makes sense, there are trials, and then they find out that it doesn't and that happens in oncology all the time, right? There's this like, amazing Dragon, I'm sure that's going to be amazing. And then they do a phase three trial and it doesn't work. So I think that it's not like being okay with being 200 for whatever that I don't know 7% of the day is or that that's not actually what's going to be causing the complications, or maybe even making your lifespan less and And let's say it is like let's you argue that it is going to make it a little bit shorter. If you're going to live to 84 instead of 86. Do you feel like that's really a shorter lifespan, like when I give somebody chemotherapy for testicular cancer, that's what happens. There's, they're cured. But they do die a little bit earlier than other people. Right? But nobody looks at that as being like, oh, you know, they just lost years of their life. Yeah,

Scott Benner 1:10:24
no, I mean, I agree with what you're saying. I think that the problem becomes the Hey, it'll probably be okay. Is great until it's not, and then there's no time machine and you can't go back. And so don't

Anonymous Female Speaker 1:10:36
think it's so it will probably be okay. Like, it's been, Shawn, that your chances for complications with an agency of seven. They decided even better if you cut that line at 6.5. And again, that's without CGM, and time and range and things that are super important, right? Like you can assume that those people in the trials, that part of the agency was they were having lows that were lower than we have, right. So yeah, some people for sure CGM and highs that were higher. So probably like even that data isn't showing you what it means to be in range now, like what it means to have an agency now of a 6.3. Like ar 6.3 is

Scott Benner 1:11:13
probably better. Yeah, so put yourself in my perspective, instead of yours. You're one very well understood person who's raising a kid with diabetes, right? And I think what you're saying makes a ton of sense. And I can tell you that my daughter has excursions up to 180, or 200. And we don't fret about them and everything else, okay. But if you're me, and you're talking to everybody at the same time, and they can't talk back, and I don't know who they are, if I start telling them, Hey, don't worry, a seven a one C is good. Do you not think that when they get to an eight, they'll be like, it's not bad? It's only one higher than seven? No,

Anonymous Female Speaker 1:11:47
I think that if you say that, you know, the ATA says that your agency should be below six and a half, and you have to work really hard to get there. Right? And that that's what's so important. Instead of thinking that it's, it may be that's for sure, or better. Yeah, I would say the way it sounds is that's for sure. That's for sure better to be in the fives or to want to be in this non diabetic range, right? That, to me is problematic when you're talking to so many people that you don't know, because in the end it like I saw posts on on Facebook, that kind of like, I'm a lurker, I only opened a Facebook account when we all got celiac, because I needed groups to know like, what's gluten free and what's not. And then I just added the diabetes Griffes to it. So I've never posted anything. But like, sometimes I see people who post things. And it's like almost a saying like, for me, this is a good number. No, it's not for you. It's for everybody having a six, three, a one C and having whatever was, you know, above a 70% range. Those are actual good numbers. You know, you don't have to apologize for that. You don't have to feel like people who answer like, Oh, it's a good start. Like it's not a good start. It's a good place to be. And I think that you can understand that without thinking that if I went from my six, three to six, nine, but that's not okay. And that I have to figure things out how to bring it back below that 6.5. So

Scott Benner 1:13:04
you're talking about health, and I'm talking about like psychology a little bit. So like, if you're, if you're, here's your kid gets into school, and they're in third grade, and they're getting a C in their class, do you go, that's great. That's average, you're doing great.

Anonymous Female Speaker 1:13:22
So it depends what I think that they can do, right? Like, my, my son is really good at math. And my daughter is really good at art and not so good at math. And they have like different things that they're good at. So what are my expectations from my son, in certain situations are different. And so you're talking to a huge audience, which I think makes it hard, obviously, to figure it out that I want to give people credit, that they're smart, and especially the people who are listening to the podcast, that are smarter, better diabetes, so that they know that they're trying to be healthy. That's why they're listening.

Scott Benner 1:13:59
Alex, it feels to me a little bit like you are coming at two different ideas from two different. So earlier in the conversation, you said, people need to advocate for themselves, they can, you know, they can handle it, they can do it. Like all this stuff. Like they're the ones that have to take control for themselves. But if I tell them that a five, five a one C is excellent, and a six is very good, and a six and a half is good, and a seven is even good. You don't think that they can modulate for themselves and decide where they want because

Anonymous Female Speaker 1:14:26
I think that you're giving a 6.2 b. And I think they should be getting an A based on I think that they should be feeling like they're in a really good, a really good place. And I find that the more that your numbers are arranged, it's also easier to keep them even more in range. If they're doing a good job in the Pre-Bolus thing. It could even get better and maybe it'll change influence and all get even better but it means that they're doing a good job and if they say six to their entire life. That's me.

Scott Benner 1:14:54
So I agree with you. I think if you had a six to budge, Agency for your whole life, York rocking it. It's fantastic if

Anonymous Female Speaker 1:15:01
you have type one if you don't have to replenish, right, but I also

Scott Benner 1:15:04
take, I take credence in the people who go like, but look, I don't have diabetes, am I anyone sees 4.9? So like, that's two full points over. How do I know that that's not going to lead to neuropathy when I'm 50? And I think the truth is, you don't know that or not. And I

Anonymous Female Speaker 1:15:21
know statistics. In other words, I know that statistically, obviously, there are people, right, who can have really good a onesies with soft some sort of complications. And obviously, there's, you know, the human body is super

Scott Benner 1:15:32
complex, but your statistics aren't going to help me if it happens to me. But you're, you're

Anonymous Female Speaker 1:15:36
telling everybody that it's better to have a 5.6 a one C? Who said that that's that that's better. And that's not making people, like you say people can handle it. But I'm not sure if that's really putting too

Scott Benner 1:15:49
they can handle some things, but not this.

Anonymous Female Speaker 1:15:52
No, you're saying In other words, that it's okay for people to feel like that's not the best and that they should be doing better? And I'm not sure that that's a mental toll. That's correct. When I don't think that you're right.

Scott Benner 1:16:03
Do you think that hold on? Do you think I've told people that if they don't have a five, five, they're failing?

Anonymous Female Speaker 1:16:08
No, I think that when you talk to people on the podcast, and they say their numbers, right, so you're so you're always very, very nice and specific about you know, and even when people post on Facebook, right, like if somebody said, like, oh, they managed to get from a nine to seven. Yeah, that is amazing. And that, that is a place where I would say, That's so great. Like, I'm sure you're gonna also manage to get down to 6.5. But it's when they got down to that below the 6.5. But I think that we have a different reaction to it. I

Scott Benner 1:16:36
mean, I the only thing I can tell you is that this is interesting. For me, obviously, and I'm interested in your perspective. I don't feel like I do that. And I don't think that I completely understand what you're saying. And I don't disagree with it. I reject the idea that I'm doing it. So

Anonymous Female Speaker 1:16:55
I'm I'm not sure. First of all, you know, people talk in different ways, right? And depends on the episode that you're listening to Sure. But I think that you can see in the Facebook group, how people perceive it, or at least the people who are really active on how you perceive it. Know how other people are perceiving it, you've they perceive their own diabetes. Okay.

Scott Benner 1:17:16
So so like if I, if I were to say to somebody like, hey, like, they said, Oh, I I started off at 11. And I have a 6590. My God, what a great start. That's amazing. You're reading that is, there's more to go. I'm saying in six months, look what happened already? What a great start to this whole thing.

Anonymous Female Speaker 1:17:37
Yeah, I think that you could read that comment, either way, or like other comments that you can't read different ways like that.

Scott Benner 1:17:43
So I don't so I genuinely,

Anonymous Female Speaker 1:17:47
like do. Do you not think that it's better to be in a non diabetic range? Because you think that eventually, I see no, I don't think you're out.

Scott Benner 1:17:57
I don't think it's better to be a five five than to be a CICs. Using just two random numbers. I don't think it's better to be a five five than a 6.5, for example, but I think is, is that if it turns out that it is when you find out, it will be too late.

Anonymous Female Speaker 1:18:13
But you already know that if you're below a 6.5, that your chance of complications are small, especially if you're keeping your time in range. So you're doing better than the people who are on the study is

Scott Benner 1:18:23
the chance not better if there's less sugar floating through your blood. That's I'm

Anonymous Female Speaker 1:18:27
saying, like you, you have to prove what you're saying, as opposed to disprove what's already been shown. So I'm sure they're gonna have to do major studies, but it's gonna take years you think that's gonna happen. Even with CGM? Yeah, they're definitely going to be going to be studies about people after CGM 100 People have complications. So

Scott Benner 1:18:45
in between now and then, all the people who don't get the benefit of the new study, if they end up being a person that has complications, oh, well, we didn't have a study. So we didn't know what to say to them.

Anonymous Female Speaker 1:18:58
No, we have a study that says that their risk is super small. If they're, if their kids are a one, C well below 16, I would tell

Scott Benner 1:19:07
you that I've spoken to people who, who exist inside of these agencies. And what I think you have is numbers that they think people can aim for. I'll tell

Anonymous Female Speaker 1:19:17
you, I had a really honest conversation with endocrinologist. Last time we went, we were the last patients so he had a lot of time. And he was asking me stuff about cancer. And I asked him about, like I said, like, what do you really think, you know, like, what? And it was a conversation that was doctor to doctor not doctor to patients? And he he doesn't think that that's correct. In other words, I think there's a difference between again saying that a seven is okay. Right, like good job and not actually looking at first of all, again, timing range and how low do you go when you're low and how high are you going when you're high and are you roller coastering or not? Right? Things that even if your timing range is okay. It's not healthy to be in a roller coaster. You're going from 60 to 200. And your time and range is decent, but you keep going up and down. That's not healthy for your, for your blood vessels. 1,000%. Right. So I think that when you're looking at all those things like he doesn't think that, that it's better to be lower. And also you had somebody on who was talking about that she thinks it's really bad for the brain to be low. But she actually actually also like writes about relevant things like a pancreas. And I think that, like, people should be worried about lows. For sure, yeah. Like even being, even being 60 for a long time might not be good for the brain in the same way as maybe being six and a half a one C isn't so good. Six, we know that 55 Right. 55 chosen because we know that that's a bad number, right? But it's probably not good to sit too low for very long trying to get

Scott Benner 1:20:53
are good numbers. I agree with everything you're saying just so you understand. So you understand that the part that I think that You're disregarding is that people aren't going to come to these things the way you're hoping they're going to like just because that's how they should do it isn't how they're actually going to do it. And I agree, I think

Anonymous Female Speaker 1:21:12
having a conversation about it. In other words, like I think it's that these are things that have to be said and have to be said like, I mean, again, you're talking to podcasters, I see something that gets lost that I see on the Facebook group, that it's like concerning to me, and I think there's things that have to be said, what's, what's evidence based, right? What's what we think the truth is somewhere in the middle.

Scott Benner 1:21:36
Okay, so I can agree with that as well. Let me ask you this question. Here's where you're outside of your depth a little bit. If I made a podcast, where every time, every time something like that came up, we went into a 10 minute excursion to explain it specifically. Do you know how many people would listen to this podcast?

Anonymous Female Speaker 1:21:56
Nobody explained specifically a few times, because the other side of it is talked about a lot. It's

Scott Benner 1:22:03
in the Pro Tip series. It's in the bowl beginning series, it's in all the that exists in all the management series, like both sides of the argument isn't isn't all of that I

Anonymous Female Speaker 1:22:12
don't listen to the management one so much.

Scott Benner 1:22:17
I put it there, like so. I can't, if

Anonymous Female Speaker 1:22:21
I'm saying like people in the end, like they listen to your podcasts, they listen to, you know, a ton of stories and like the end of demand management. I didn't listen to the protests at the beginning, but I didn't listen to the rest of them. But I think that like throughout time, like I've heard it a lot. Yes, I know when I'm in my car, and I'm getting annoyed. So

Scott Benner 1:22:39
it's fantastic. Well, listen, I appreciate what you're saying. And I don't discount it. I think I have said those things before. I think that everybody can't hear every word of this. And so that's where you get into the bigger problem. I can't force you to listen to the whole thing. You may get one episode where you don't get exactly what you need as a as a point of, you know, example, I got a review the other day and somebody's like, you're a misogynist. And I'm like what the hell and and I and so I looked to find out what happened. Some person I was interviewing use the word fan girl, I didn't even say it. Someone else said it. And now I'm a misogynist, because that person said fan girl and bla bla bla bla bla, and I'm like, Oh my God, if you listen to the episode, before that, you'd think I was you'd think I was Mother Teresa. But now today, because you heard that you think this. So there's no way for this is an ongoing conversation. People.

Anonymous Female Speaker 1:23:32
I just feel like that's part of the conversation. Like half I listen to the podcasts a lot on my way to work. Yeah. So it's not that I'm listening to just like what episode. And I think that it's really important that you say, it's important for people to realize that you can get a five point 6.8 A one C with eating everything, my daughter also eats everything, like art and right, and that you can do it. In other words, there are certain things that's really important to hear that, yeah, you can have a really good agency, you can have really good time and range, and you can still eat what you want. And you can still kind of eat like a normal person to think that those are really important things to be heard. And I just think that that also has to be heard somewhere in the middle. So

Scott Benner 1:24:10
I'm gonna, I'm gonna tell you something that I've said on the podcast number of times, I can't say it every day, because then nobody would listen, here's where my thought process comes from this. I think that generally speaking, we teach to the lowest common denominator. And I think that that's a disservice to everybody, not just to the people who are not the lowest common denominator. So my example would be if there's 20 kids in a classroom, and two of them are challenged, and five of them are a little below average, and five of them are average, and three of them are above average. And you know, the rest of them are brilliant. We dumb things down so that nobody gets left behind. But I think what that ends up doing is it's a disservice to the people, first of all, who you think the things need to be dumbed down for because you're treating them like you can't possibly understand this. And then everyone else gets sub standard information because we're busy talking down to people who we think can't handle it. And so I see the podcast as aspirational. Like, when I talk about that stuff there, I think of it as aspirational like you can, if you understand the timing of insulin correctly, and you have these tools, and you have this understanding, and you maybe eat a certain way that to help yourself, you could quite easily have a one C and the fives, and it would be very stable. And you could achieve it without Lowe's. Is that easy? It is not. You know, do I want you that

Anonymous Female Speaker 1:25:35
you can but you don't. You don't have to in order to be healthy. That's your opinion. But I would put on with it. But that's your

Scott Benner 1:25:42
opinion. Yeah. And so what I'm saying is, you're welcome to your opinion, you should share it with everybody you want. If I tell people that, and 10 years from now 20,000 People come back to me and say, I can't feel my feet, asshole. You said a seven was okay, what am I going to do? And so I'm telling you that I think it's doable. I also think if you have a six a one, C, you're doing great. I think if you have a six and a half a one, so you're doing great, I think if you have an eight a one C, and that's the best you can do, you're doing great. Like I believe that all the way through. I'm not saying one of these numbers is better than the other. I'm saying that if you have the right tools and the right understanding, you can probably put your a one C and your variability pretty close to where you want it to be. And then that's up to you to decide what to do with it, I can't come make you do it and or tell you that it's that important to do. And you might be 1,000,000% Correct. Maybe you can roll around a whole lifetime with a six and a half a one C and never have a complication. But there will also people that will have them and we will have complications. And I'm not comfortable saying you're going to be okay, because not everybody is going to be okay. And some of those people will have complications because they kept their agency where they kept it. And so here are the tools to put it

Anonymous Female Speaker 1:27:03
into the five, eight, maybe not, maybe maybe not exactly. Yeah, but we're

Scott Benner 1:27:07
both in the maybe maybe not situation. And in your scenario,

Anonymous Female Speaker 1:27:11
that in my scenario there, there is a lot of data to say that it's a safe place to be yes. And when you look at people, you're never 100%, right? When somebody has cancer, and they say to me, you know, like, What are my chances? I don't like giving numbers. And I usually say to you, it doesn't matter what the statistics are because you're 100% of yourself. Yeah. Right. So it doesn't matter to you if 90 Other people were fine, or if you're in that 10%. And it's also what I think. And I think that that's okay to say also about diabetes, bad things happen for many, many reasons. And there can be a lot of reasons why you're more susceptible to different complications. And it's not only the diabetes playing a role. Sure. And, and the data is there, that your chances of having complications are low, if you keep your agency below six and a half, and I would say more than you, I would say if you haven't ate a onesie, that's not good. And I would want you to be working harder to figure out a way that you can do a little bit better, whether it's talking to your endocrinologist, whether it's I don't know finding somebody else, some sort of coach to try to figure that out. Because I don't think that that's a good place to be. Right? Unless

Scott Benner 1:28:18
you've been in 11 Your whole life and you just got it to an eight, and then it's great.

Anonymous Female Speaker 1:28:22
Oh, then you're doing great, because you're a start. And there I feel like it's okay to say, Wow, great job. Amazing. Alex,

Scott Benner 1:28:28
you would have a very thorough, valuable podcast that no one listened to. And I know that because do you know the ADA has a podcast? That you didn't know that you want to know why you didn't know that no one listens to it. That's why it's true.

Anonymous Female Speaker 1:28:46
The reason that I listened to your podcast is because diabetes is really lonely. And that's the reason I started listening to it. And I hope that there's somebody out there listening to me say that, that's saying, Oh, we can calm down a little bit. Like if we felt if I was that person who wrote that post, and I got those responses. And I felt like oh, crap, like, I have to be crazy right now that maybe you can take a breath.

Scott Benner 1:29:10
I agree that perspective, I want to tell you this too. I think that when you look at the Facebook group, you are mostly looking at newer diagnose people. And so their fear is more amped up. And I do think if they stop and actually listen through the podcast, they would get to the place where you are, like with your understanding, but I think you're at your place because you're a physician. This is gonna seem out of left field for a second. But if you're running a country, for example, okay, you make decisions based on the greater good, right? If I if I can make a decision today as the leader of a country that keeps 90% of my citizens safe. And the other option keeps 80% of them safe. Well, I'm going to make the decision that keeps 90% of them safe, but 10% of the population is going to think I don't care about them. And that is a hard way to live. like being the person in that decision make. And I can see that from an outsider, like, that's a horrible decision to make. But somebody has to make it. I'm glad there's someone there to make it. I think that's the perspective you're thinking about this from, which is like weak. Like, we can put everybody into a situation where most of them will do well. And hopefully, that will be fine. And I'm just saying that I'm okay with that. I understand that big decisions have to be made. But I'm not comfortable being the person who says that in this context, in this context, I think you should know that while there is absolutely no data right now, to tell you that a five five a one C is better than a six and that a six is better than a six and a half. I know there's no data that says that. And it's very possible that you're 1,000,000%. Right. My point is, is that if you're not right, or if that data's comes up one day that proves us wrong, then it's too late. And I would read what happened.

Anonymous Female Speaker 1:30:55
Yeah, what happens if the way that you tell it right causes a fraction of the people to have a lot of anxiety, a fraction of the people to have more lows in the 60s? Not 40s? Okay, then they would have otherwise had, and those things cause complications and those things take years off your life. Also, why do you think that's happening? To be afraid of that? Also,

Scott Benner 1:31:21
why do you think that's happening?

Anonymous Female Speaker 1:31:22
Why do I think it causes people? No, no.

Scott Benner 1:31:24
Why? Why do you think that's happening? As a result of the podcast? Because it's not, as far as I can tell.

Anonymous Female Speaker 1:31:31
I don't know if it's not or not. And sometimes I get the feeling in the group that, that maybe some people do feel like that

Scott Benner 1:31:39
you think people are running around with 50? blood sugar's because they want their agency to be low.

Anonymous Female Speaker 1:31:44
No, but people are more okay with having 5% lows than having 5% highs.

Scott Benner 1:31:50
I think they have 5% lows, and they still have 5% highs.

Anonymous Female Speaker 1:31:54
Maybe Yeah, this is fun, feel worse about the high

Scott Benner 1:31:57
you and I should get married so we could kill each other? That'd be fantastic.

Anonymous Female Speaker 1:32:02
I thought you agree with me this whole time? It's like I told you this last one is gonna kill it. No, no, no,

Scott Benner 1:32:07
no, I don't not agree. So listen, I want to be really sincere. I take your point, I understand your concern. I think if you were me for five minutes, you'd soften it a little bit.

Anonymous Female Speaker 1:32:20
I think that you're right that my physicians outlook, right, my being a doctor. So it helps me maybe to feel okay with that with certain risks, and to be worried about other risks. The

Scott Benner 1:32:30
best part about our conversation is that hopefully, for anybody listening, what they realized is while they're busy fighting in their own lives, about whatever they're fighting about with other people is that neither you nor I is wrong. Yep, a blend of what you and I are saying is what's important. And I can only come at this podcast from my perspective. And in fairness to me, I've also had 1000s of conversations with people with diabetes. And so I do have maybe more than you or maybe even more than other doctors, I do have a feeling about how most people come off and what their concerns are, and what they're like, the bigger more human pictures are like, even when you and I were talking about the ER, like you were coming from a medical perspective, I was trying to come from a human perspective. And it's not that you don't see the human side of it. And it's not that I don't see the medical side of it, it's just that my perspective is more skewed towards. I've talked to a lot of people who go into a hospital, they expect to be faced with people who understand what they need, and very often they are not. And even though you told a story about an endocrinologist who didn't even understand how to Basal a patient, you still argued on his behalf before the other side of it, because that's your perspective. And I think that's very valid, because

Anonymous Female Speaker 1:33:50
I know that his boss, the one who I talk to about my 2k patient Senate, right, super smart. And I don't know if she if that's when he talked to but the person that I talked to after that patient, I saw how super smart she was. Yeah, and how much she knew. And I think that, again, healthcare is different, where you're living, right? You're living in a place that's a big city or not. And the doctors are calm are different. But I think that most most of the healthcare, at least here it's pretty darn decent. Oh,

Scott Benner 1:34:24
I think healthcare is great, right up until you get into these drill down situations where nobody knows what they're talking about. And you think that they do in this series where your episode will be. There is an ER nurse in America who has type one diabetes who said the words I'd be safer having a seizure at your house Scott than in the ER I work in. Now. How is that possible? How is that possible? Did you hear her tell the story of a person who worked in the hospital have a low blood sugar and they tried to send them out for a CTS instead of checking his blood sugar's make

Anonymous Female Speaker 1:34:54
me wonder, Where does she work? Where are these doctors coming from because even all like the stories about misdiagnosed type twos. I mean, that was really basic in medical school. If you have someone who doesn't look like they're type two in terms of the other, you know, their physical attributes and stuff like that. I'm not saying that somebody who's overweight can't have type one. I'm saying we didn't like learn, right that if somebody doesn't look like they would be type two, whether they're young, right there below 40, their weight is in, you know, they're not overweight, they're active, that you should look for something else that you should look for, maybe they should look for type one that you should look for ladder, like those were things that we learned in medical school, and I went to medical school 15 years ago, right?

Scott Benner 1:35:36
She was standing in that er saying he has diabetes, we should check his blood sugar. And nobody, no one would listen

Anonymous Female Speaker 1:35:42
to her. You got to look at the system that's cranking out the doctors because that I don't that I think it's negligence. I don't think that, of course, most of the time. But that's the type of care that people, but that's what you want to believe. And I think I see, it's what I see in two hospitals that have pretty hospitals that I've worked at, right where you are.

Scott Benner 1:36:01
Yeah, but my point is, is if that exists anywhere, it's not okay. Right? Yes. Ah, so, should we act like it's not happening?

Anonymous Female Speaker 1:36:14
No, but I think that doing, trying to educate doctors, as always, you want to educate doctors, right? First of all, checking somebody's blood sugar, right? When they're having seizure, or when they look like they're having a stroke. Like, again, that's basic medicine. But it's not, like, not something weird or crazy, right? So if they don't know what to do that that's really problematic. Yeah. And again, I think that the educating doctors is more educating, like, these serious conditions can become very serious very quickly. And you have to know that they can become very serious very quickly. I agree with that. When somebody says those words, type one diabetes, the first thing you want to do is just check their sugar for a second, just to figure out where they are, does it have to do with diabetes does not have to do with diabetes, and not a whole again, I only listened to half of the first Grand Rounds, but a lot, a lot less, a lot less and a lot more respect, I would say or to what doctors are able to do. And there's

Scott Benner 1:37:13
plenty of good doctors. And I would expect that if they listened to the Grand Rounds series, they'd say, Well, that's not how I do that. But I do see that other people do it that way. If they're insulted by that, I don't know what to tell them. Like go fix your profession, if you don't want people to say this. But you have no idea how many like positive notes, I got back about that series from people with type one diabetes, who have been through the healthcare system and treated poorly and left to die, and all the other things. And they're like, Thank God keep saying this, because maybe a doctor who is bad at it will hear it or maybe a person who has type one diabetes will go into a hospital,

Anonymous Female Speaker 1:37:46
they won't be able to hear her though, when it's stuff like that. They'll be able to hear it when it said,

Scott Benner 1:37:51
how should we say it to them? How do we tell them they're bad at their job? And they don't understand anything?

Anonymous Female Speaker 1:37:55
I think that you don't want to say like that.

Scott Benner 1:37:58
Yeah, no, I don't I hear you. How do you tell? Like I would

Anonymous Female Speaker 1:38:02
want the Grand Rounds series, right to be something that I could send to my colleagues who I do respect and I do think are good doctors, right? And just like as i Hey, like, listen to this, it like really puts perspective on tape. While I'm like I listened to one of the one of the people talk about doing a PET CT with type one diabetes, somebody who had cancer. And then she got diabetes through immunotherapy. Yeah. And it was really interesting to know them and colleges to just like, see that perspective of like, what am I asking of somebody when I'm asking them to do a PET CT, and they have type one diabetes. And I think that that's the like, I want the good doctors to also be able to listen to it and not be like, Oh, that's not me. But to be able to listen to it and say, like, Oh, interesting.

Scott Benner 1:38:45
I could incorporate this, I'm gonna tell you a secret. I didn't really expect doctors to listen to the Grand Rounds series, I wanted to couch the conversation in a perspective that let people know that you may or may not get a learn a doctor, and that it is up to you to take care of yourself. And here are some examples of why. And I did think it would catch some doctors, which by the way it has I don't know if you've noticed, but the series has expanded to include other doctors who have come on want to add their voice to they did listen to right. Oh, I see. And so and and how were they they were pretty good conversations, huh? Yeah,

Anonymous Female Speaker 1:39:19
come off smart. And they come off as doctors know what they're doing.

Scott Benner 1:39:23
Yeah. And I agree with you completely. Except I think people need to know that through randomness. They could land in the ER who doesn't even understand how to treat their hypoglycemia where that they're even experiencing again, but

Anonymous Female Speaker 1:39:36
I don't want somebody to think that the ER is a place where they should be getting health care advice about their diabetes, you should not listen to any doctor who's talking to you about your diabetes, except your primary care in your endocrinologist because people will say incorrect things are you

Scott Benner 1:39:48
just expanded beyond what I said? Do you not think that people in an ER should know if you're experiencing hypoglycemia and how to treat it?

Anonymous Female Speaker 1:39:54
No, no, I'm saying yes. I don't want you to listen if that er Doc's sound too. It's like, Hey, I wouldn't see a seven, you should really be making these changes. Don't listen to them. Because they don't have enough experience. Who do I listen so to your endocrinologist, and you're one of my, and well, and because diabetes is a disease where in the end, you do no more than your endocrinologist and my endocrinologist told me like I asked him for to Moloch to go along with the loom Jeff to sit it went sting as much as I saw that some people do that, but they mix it. Yeah. And I was worried that if it stung that she wouldn't my daughter wouldn't give it a chance. Right? Right. So I asked him for it. And he said, learn new things every day. Right? Yeah. And that he learns more from his patients, you know, like, in the end, diabetes is a disease that it's ours. And we're gonna know more than endocrinologist. And there's nothing you can do about it, right. And what you have to do is to look for places where you feel like you get good information, I agree with you looking for information and reading it, and listening to different podcasts and looking at different groups and leaving the groups where you feel like there isn't good information.

Scott Benner 1:41:04
Well, this has been fun. I've enjoyed this more than many things that I've done in quite some time. Also, I think when you listen back to it, you're gonna hear where I expertly helped you to make my point for me. So. But

Anonymous Female Speaker 1:41:17
I don't know if I want to listen back at all. Maybe I'm thinking that I got you to see my point.

Scott Benner 1:41:26
I know, right? I know, I can't wait to find out what it is. Serious seriously, you and I should make a podcast together where we just argue about my podcast, and I think it would be fantastic. I think I think that would be more popular than this. But being sincere Alex being sincere. I'm doing my best to spread good information to people. And my assumption is they will pick it up and take it where they can and where they can't. And I do. I do imagine that there are some people that hear it, and it makes them anxious. And I hope that they stop listening, if that happens to them, Why

Anonymous Female Speaker 1:41:58
I hope that they listen to this episode, and they say hmm, we don't have to be so anxious, we can take the good and leave the stuff that's not good for us.

Scott Benner 1:42:04
I also as the person who's been making the podcast for the last 10 years, don't think that I've left people with the idea that if they're a once he's not five, five, they're not doing well. And, and so. But what I would say to you, moreover, is that I have done a thing with this podcast that no one else has ever done. I've brought diabetes information to people in a mass and made it entertaining, so that they come back and learn more and stay in the conversation longer and have more experiences that they won't get to have in their normal life. And I've I watched for, I'd say probably seven or eight years while I blogged in the diabetes space. I watched companies try to do it, they tried to build communities, they couldn't do it. Some of them would build a community for five seconds. They couldn't maintain it. They'd fractionalized they'd fall apart, etc. I have a 50,000 person Facebook group, and it adds 150 new people every three days. And that's not because most people are anxious or scared when they're there. And I could show you 1000s of emails from people who write to me saying that I saved their life or their child's life. And I don't think of myself that way. But they do. And so I take your point. But I think that overwhelmingly, that's not what's happening. And I think that partly the reason you feel that way is because you're a newer diagnosed parent. And I imagine that five or six years from now, you won't feel the same way if you're still in that Facebook group. But that's just been my experiencing

Anonymous Female Speaker 1:43:30
watching that I wouldn't feel that other people are anxious.

Scott Benner 1:43:33
You you I think right now your anxiety is helping you feel

Anonymous Female Speaker 1:43:37
super nice, anxious person. Okay. That's

Scott Benner 1:43:41
fine. I'm good. Again, that's just my

Anonymous Female Speaker 1:43:43
I, I get Yeah, it worries me when I see how people answer sometimes, or things that are said for them. I'm, I'm really super calm about diabetes.

Scott Benner 1:43:54
So So here, let me tell you some things you don't know. When you see a Facebook post that has 20 comments in it. I actually know how many people read the post. So yes, you hear from three people who are like, Oh my God, this makes me anxious or whatever, however, that makes you feel. But what you don't see are the literal 1000s of people who read through the post, and don't feel anxious about it. So there are three anxious people and I feel bad for them. And I hope that there's something else out here that helps them not feel that way. But I'll trade those three anxious people for 7000 other people who now No, I'm not talking

Anonymous Female Speaker 1:44:32
about the people who write in the post, the person who posted it, the person posted on a group, right? Yeah, but you really you really want it to be a group of support. I'm worried about that person, not about other people. You should scroll over what you don't want to read.

Scott Benner 1:44:46
Well Wait, what about their post is concerning, like given example.

Anonymous Female Speaker 1:44:51
Like somebody put their graph up and they're like, How can I fix this? I forgot what it was like the spikes or something right and And people came in with like a lot of different things. And I will say the person who asked it sound sounded a little bit more newly diagnosed and sounded a little bit anxious. And the graph with 90 plus percent in range. Yeah. And I think that,

Scott Benner 1:45:15
but they want to make it better.

Anonymous Female Speaker 1:45:17
So it's fine. It's fine. If you want to make it better, I just would have wished that there would have been more than one person who came on to say, Wow, that's a really great graph, just so you know, you know, and they're, you know, there are a lot of different ways to try to, you know, make it even more stable. But

Scott Benner 1:45:33
they didn't ask if this is a great gap Gara, they asked, How do I make this better?

Anonymous Female Speaker 1:45:38
I forget how I was asked, but it didn't sound like that to me. Again, I don't It's not like I don't actually remember each post that I saw and why it felt like

Scott Benner 1:45:47
I don't obviously know the exact post you're talking about. But I know posts like that. And what I'm going to tell you is that you have to respect people and answer the question they ask. Like, you can't sit if somebody comes in and says, How do I Bolus for this thing. And it's a giant cupcake with three cupcakes stuck to it and ice cream on top of it. You don't come in and say if you ate low carb wouldn't be a problem. Like, right, because I totally, that's not the question they asked. So if I come in with a great graph, and I say, hey, how do I improve this graph? My expectation again,

Anonymous Female Speaker 1:46:18
we're talking about something that like I can't I don't actually remember what the posts are let

Scott Benner 1:46:22
you come up with the example. But okay, that's part out. You should No, no, take this part out. You should have your own podcast. He should call it arguing with Alex, I think it would be fantastic. And every week, someone just comes on, you pick a topic out of a top hat and you start arguing about it. Oh, my God, I've listened to that. You were terrific.

Anonymous Female Speaker 1:46:42
I only know a lot about two things. Oncology and diabetes.

Scott Benner 1:46:47
Would that stop you from arguing about something you didn't know about? Yes. Oh, wow. Good for you. I would argue about anything. I think it's funny because great. I so enjoyed this so much so that I have to pay overtime for the editing and I don't even care. So sorry, unless you want to send me a couple of dollars. But I'll make out.

Anonymous Female Speaker 1:47:06
I explained that doctors don't make money here. So

Scott Benner 1:47:11
I so appreciate you doing this. I hope that comes through. I thought this was fantastic discount.

Anonymous Female Speaker 1:47:17
Thank you for having me. Oh, it's

Scott Benner 1:47:18
a pleasure. Hold on one second for me.

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 sent 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. I'd like to thank the blood glucose meter that my daughter carries the contour next gen blood glucose meter. Learn more and get started today at contour next one.com/juicebox. And don't forget, you may be paying more through your insurance right now for the meter you have than you would pay for the contour next gen in cash. There are links in the show notes of the audio app you're listening in right now. And links at juicebox podcast.com To contour and all of the sponsors. 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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