#1251 After Dark: Multiple Personalities
Ben is 30 and was diagnosed with type 1 diabetes. He talks about his experiences with bipolar disorder, addiction, and multiple personalities, sharing his journey through mental health challenges and managing diabetes.
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Scott Benner 0:00
Hello friends and welcome to episode 1251 of the Juicebox Podcast.
So today we're going to talk to Ben. He's a 30 year old systems administrator who was diagnosed with type one diabetes about two years ago. Ben has a number of different issues that we're going to speak about today, bipolar disorder, addiction, multiple personalities. And a little bit more is one maybe didn't have to be after dark but Ben cursed a lot in it. And so the intent is there even though the curses aren't. And for that reason, today's another episode of The afterdark series from the Juicebox Podcast. 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. Alright, for those of you listening on the day that the episode came out, it's Friday, it's a perfect time to sit back with your phone and take the survey AT T one D exchange.org/juice. box I know you're at your desk pretending to work, go help out with type one diabetes research, they're looking for US residents who have type one diabetes or are the caregivers of someone with type one, t one D exchange.org/juicebox. And then go become a member of the private Facebook group Juicebox Podcast type one diabetes
this episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151 for us med is where my daughter gets her diabetes supplies from and you could to use the link or number to get your free benefit check and get started today with us met Today's episode is sponsored by Medtronic diabetes, a company that's bringing together people who are redefining what it means to live with diabetes. Later in this episode, I'll be speaking with Mark. He was diagnosed with type one diabetes at 28. He's 47. Now he's going to tell you a little bit about his story. To hear more stories from the Medtronic champion community or to share your own story. Visit Medtronic diabetes.com/juice box and check out the Medtronic champion hashtag on social media. This show is sponsored today by the glucagon that my daughter carries. G voc hypo Penn. Find out more at G voc glucagon.com. Forward slash juicebox. Hey
Ben 2:38
Scott. I'm Ben Jensen. I'm a 30 year old systems administrator living in Nampa. Idaho. I was diagnosed with type one diabetes when I was 28.
Scott Benner 2:46
Two years ago. Yes. All right. Any other autoimmune or diabetes in your family? autoimmune
Ben 2:55
issues up the wazoo? I come from a family of females just about every single one of them has a thyroid problem. I couldn't tell you whether it was hypo or hyper. But yes, tons of it. My mom's side of the family. Okay, on your mom's side.
Scott Benner 3:11
You don't have hypothyroidism? No,
Ben 3:13
but I'm actually getting tested. My nurse practitioner, she just ordered a full thyroid panel. interest on I'm getting the labs drawn for that tomorrow. Interestingly enough, I just watched a tick tock video where bipolar type one can be confused with a thyroid issue. So that's why she ordered the test.
Scott Benner 3:31
So you had a little bit of an audio issue in the beginning, Ben. So the first time you introduced yourself you told people you had bipolar but you didn't the second time. So how long have you had the diagnosis
Ben 3:42
since July of this year, and it is currently November 13?
Scott Benner 3:47
Ben prior to that any psychological issues at all?
Ben 3:51
No, I was a normal guy. I kicked ass at my job. I did have addictions to and his twins at certain points that turned into binge drinking but I was able to I was a functioning addict of sorts. At work. I worked for the State Police I was one of the the lead infrastructure engineer so is there for three years.
Scott Benner 4:13
I don't know how to abuse antihistamines, can you tell me the
Ben 4:17
one that I abused was diaper diaper and hydrazine. It's commonly known as Benadryl and it's in the class of drug called a dissociative and I also believe that I have disassociative identity disorder that's formerly known as multiple personality disorder. Okay. When I would pop the antihistamines I would do them at such large doses. I would hear voices in my head, really? And yes, but I couldn't hear what they were saying. They were more like whispers that, you know, I knew where people but I couldn't quite understand if that makes sense.
Scott Benner 4:58
So while you do don't have a diagnosis before the bipolar six months ago or so. You were having issues that were concerning, but you thought they were related. Or they were related to the abuse. Is that possible?
Ben 5:13
So I didn't mention any abuse Scott. Oh, sorry. I meant
Scott Benner 5:17
I meant abusing the the antihistamines, but did I find something by mistake then?
Ben 5:22
You might have Scott, Freudian slip there. We'll get to that later, I guess. Okay.
Scott Benner 5:26
Do you think like, in hindsight, do you think that's mental health or do you think it was actually the impact from the histamine?
Ben 5:34
I think it was me coping. I found something that helped me cope. Okay. It was antihistamines, I knew that there was something wrong in my head. I believe I I've had bipolar my entire life. I've had di D my entire life. I've only become aware of these things. Since July 20. Of this year.
Scott Benner 5:51
How did it manifest earlier in your life? And what what? How did how was it written off?
Ben 5:58
Looking back on my earlier life. I believe the first personality that was born was my, my gamer personality. I was super manic into games my entire life. And everything about them like duck cones. I was on an old Flash game website back in the day, called a Pong game.com. I was super invested in the community. It just meant the world to me. World of Warcraft, I probably have, I don't know. 20,000 hours played in it. I probably had 7000 hours and Dota two. That was my first addiction. It was gaming.
Scott Benner 6:34
Actually, the the most stunning thing you've said so far is the Duck Hunt is still something a person who's 30 years old would have played That's
Ben 6:42
stupid. It was on it. I had to go downstairs in the basement. It was dark. I had to blow in the cartridge and everything. I was gonna
Scott Benner 6:49
say that. It's an old Nintendo game, isn't it? It is. Yeah,
Ben 6:53
my stepdad had it. SNES.
Scott Benner 6:58
That shocked me the rest of this is making sense. But the Duck Hunt exists and people still use it. I was like, Get out of here. So you hyper focused on those video games? I did. Okay, they were my life. And what did that do for you? Like, a lot of this is I think, in hindsight, I imagined these questions. But
Ben 7:18
what do I mean? I was a good student as well. I was in advanced placement classes during all of this. I had friends who were on the basketball team, I played soccer for like a prestigious club. I had a great upbringing. But at the same time, there was, you know, childhood abuse that I had recognized that I had been living with my entire lives. That was the cause of why I was doing all these things. What did they abuse look like? Viewers, Scott and I were talking before, and we were talking about how our day went. And I told Scott that my therapist fired me today. And he told me to save it for the air. So my therapist just fired me. Scott, where was I going with this?
Scott Benner 8:04
I well, I asked what about about the abuse? Oh, yeah,
Ben 8:10
about the abuse. Okay, so there's a scene in my head. My first memory is a child. This is my first memory. I don't know if you know what your first memory that you have on Earth, Scott. But my first memory is me in a room standing next to my brother who is now I know, he's been diagnosed with highly functioning Autism. I didn't know that until I was 30. Okay, so he has his own demons. It was me and him standing. Looking outside a window watching my dad dragged my mom down the front sidewalk of our house, down to the street. Oh my god. That's the only traumatic memory I have. I love both my mom and my dad. Mom is also related to my mental break. She's been diagnosed with early onset Alzheimer's disease. And she's very quickly losing her ability to speak.
Scott Benner 9:06
How old is she? 57. Have you ever asked either your parents about that memory?
Ben 9:14
I talked with my mom about it when I was a kid. Maybe six or seven?
Scott Benner 9:18
Did she tell you what happened? She said it happened.
Ben 9:21
I talked to her about it again. Maybe a year or two ago. I was very drunk at the time. She said it was a bad night. Yeah, why would what? Let's hope that wasn't
Scott Benner 9:31
reminiscent of a good night for. Yep. It was a one time thing. And you were just unlucky enough to see it.
Ben 9:38
I never had the courage to go that deep enough with it with my mom got my mom lost her mind the same time I did. And by the time I came to it, I she she's not capable of having these kinds of conversations any longer. She's capable of telling you what she wants for breakfast or your parents together. So They're divorced. I thought maybe
Scott Benner 10:03
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Ben 12:42
I texted him all this. I don't know if he read a text messages. But he hasn't returned. I basically confirmed the story with my brother that he saw maybe some he said he saw some. That's all he said. And I said I told my dad my first memory. And then I let him know I'm coming on your podcast. So I called him for his birthday. His birthday was November 9. He didn't answer the phone. He said he was in a meeting. So that's on him.
Scott Benner 13:12
Okay, gotcha. How old is he? Is he about your mom's age? Now
Ben 13:16
a little older? Not entirely sure. He might be close to 60 Little over.
Scott Benner 13:23
Does he have any problems with alcohol?
Ben 13:28
Not that I know of no. At the time I've heard stories that maybe he did. I know I'm a dick but I'm drunk. Stop drinking Ben is no. He's no fun guy to be around. Sometimes
Scott Benner 13:38
drinking Ben is not a fun Ben.
Ben 13:41
Well, he can be fun. If you get like, three and then once you get you know 12 He becomes a different guy. Yeah.
Scott Benner 13:49
You talked about binge drinking. You move to that after the Benadryl.
Ben 13:54
I did. Benadryl wasn't working anymore, was looking for something different. So eventually, what the Benadryl manifested into was a feeling of just impending doom. That's what I would feel when I would do these large doses of it. I'm talking I would be popping bottles of this Scott on a daily basis until my hand shook. Just
Scott Benner 14:16
drink. Is this what the kids call scissor? Sizzle? What am I doing? I'd have it wrong. Am I right? Or no?
Ben 14:22
I don't think I'm a kid anymore. Scott and Luke just as much as you are.
Scott Benner 14:26
You think you think you're more out of the loop than I am? Okay. I'm pretty sure that's not true. I'm up to the point in my life now where I'm asking waitresses, how old I look. Like, hey, we don't know each other. You've already gotten your tip just real quick. How do I look?
Ben 14:46
At your wife Scott.
Scott Benner 14:47
I do because I've I've held on to my dark hair. And so I think this might be the only thing saving me and I'm trying to figure out I'm going to stop going to people who are expecting tips from me start asking just random strangers on the street, maybe? I'm trying to assess my might. I don't know how I guess how old I look. Anyway, I don't think that's the thing that young people do. I don't think young people are like, Hey, I don't look 32 I, I've had a number of these conversations, people with bipolar like, like those kinds of issues. You know, I have my own thoughts that are rooted in absolutely no science, but seems like people who deal with inflammation issues seem to run into bipolar issues as well. Not with a lot of frequency. But I've always been kind of stunned by how many people when you ask them was their auto immune your family, what else is going on? And they eventually get to a bipolar Uncle, you know, it doesn't take too long, in a lot of these conversations. So especially now your mom has Alzheimer's, which I believe people call diabetes type something right? Aren't they saying?
Ben 15:52
I've heard that? Yeah.
Scott Benner 15:54
Hold on a second. Does your mom have type two by any chance?
Ben 15:57
Yes, she does. So when she was down, last time, I saw her I slapped the g7 Honor, we diagnosed it.
Scott Benner 16:06
The exact connection between Alzheimer's and type two diabetes is still in debate. However, poorly controlled blood sugar may increase the risk of developing Alzheimer's. The relationship is so strong that some of called Alzheimer's, the diabetes of the brain or type three diabetes, that's from the NIH just like three years ago, my point overall is, you know, inflammation and things go wonky. I have to be honest with you, before you gave me your backstory about how long you think you've been struggling like through your entire life, part of me was just thought like, gosh, maybe you've had a big shift because of your thyroid, maybe you're gonna find out your thyroid, your TSH is like eight or nine or something crazy high. And that because thyroid is really one of the ways that one of the symptoms of thyroid can be like really strange behavior, and like aggressiveness and agitation, that kind of stuff. And I thought I wonder if that doesn't look like bipolar, but then you said this has been going on for most of your life. And I kind of let that thought go after that. Okay,
Ben 17:08
I mean, I'm excited just to get the bloodwork done, just to see where I'm at knowing that, you know, every female in my family has a problem. So I
Scott Benner 17:17
think just making everything as well regulated as possible only can be good news for you. So yeah, it's definitely worth doing. You've never had it done before. No, no, no,
Ben 17:26
I don't I guess not. Yeah, you've only
Scott Benner 17:28
had diabetes for two years, too. How do you make out with the type one? Is that something like in the middle of all this? Are you like doing well with it? Are you struggling with that as well?
Ben 17:37
After I was diagnosed, I went from a 12 B, one C to a 4.6 and three months. Oh, and I maintain that for two years until my mental break. I'm at a 6.0 right now.
Scott Benner 17:48
What were you doing to get in the Force?
Ben 17:50
I was Scott Benner. And I can just was bowled with insulin dude. And I paid super strict attention to it. Okay,
Scott Benner 17:59
super good at it. I was manic about diabetes. Okay. Oh, so you you kind of you took that energy, and you focused it at the type one? Yep. Okay, well, it worked. Till didn't I guess
Ben 18:15
it can did. I was good at it.
Scott Benner 18:21
Did you know? While while you were doing that, while you had this incredible Uber focus about diabetes, and you had your agency in the fours? Is there any part of you that says, I have a mental instability? And I'm just using it for good right now? Or did you just think, Wow, I'm doing amazing at this?
Ben 18:39
Well, no, I knew my life was. And I would say it out loud all the time. involuntarily. I would say things like I hated my life. And it took me a while to realize that it wasn't me saying it. It was the other personalities inside of me. It was Dr. Bennett was philosopher Ben, they were saying that they hated the current state of things. So I was I was always aware that I was not happy. Okay, I just didn't I didn't see a way out.
Scott Benner 19:07
The DI D can you give more context to what that is for people.
Ben 19:12
It's a disassociative disorder where there's parts, I guess. I'll try to describe my experience of it. There are thoughts in my head that I recognize that are not my own. And there are times in my life where I know something else is dictating what I'm doing with my body. Be that sending a text message or navigating me to a crowded room to read something very important to me at the time. Everything just seems perfectly orchestrated to well orchestrated that I know that it's not me actually doing it. It's something else. The main personality primarily associated with controlling my body I believe as Mr. Congeniality he's he's my tech visionary. In addition to having all of these mental illnesses, I believe that I am becoming the visionary behind artificial general intelligence and faster than light, speed travel.
Scott Benner 20:16
Are these different personalities all together at the same time? Or do they get their moment in the sun?
Ben 20:23
They definitely get their moment in the sun like philosopher Ben, he loves seeing why and Work Chat, or maybe sending a quirky text while he's taking a Mr. Congeniality loves inspiring people to get excited about technology.
Scott Benner 20:38
Did you just say a second ago that there's a personality inside of you that believes it's the driving force behind AI technology?
Ben 20:46
Yeah, that's Mr. C.
Scott Benner 20:49
And you can you can sit with me right now and speak about that other personality as if it's another person. Correct. But if, if the dice landed in a certain way today, and he was the one who got on the call, would he talk about Ben?
Ben 21:08
I'm not sure that's a great question.
Scott Benner 21:10
Are you not aware of when other like you right now that I'm speaking to? I'm going to call you, Ben. I'm trying to understand how this works. Are there long swathes of time, or even hours or minutes where someone else is in control? And then like a movie, you come back and you don't remember what happened?
Ben 21:28
I have selected amnesia sometimes. Most of the time. It's like I'm viewing a movie. Okay, and I'm feeling I'm feeling Mr. C's feelings. I'm, I'm experiencing his thoughts through the text messages that he's sending. I say, he's on his own. He's only had a few phone calls. He hasn't spoken to many people yet.
Scott Benner 21:52
And it's not possible that you are actually working on AI on a computer somewhere. You don't know it.
Ben 21:57
That would be bitchin. But I don't think that's
Scott Benner 22:01
actually happening. It's just it's just this belief. This certain part of your mind believes that that's happening sometimes when that part of you. Yeah, so
Ben 22:13
he's convinced me, Mr. C has convinced Ben Jensen, that this is happening, and I'm along for the ride.
Scott Benner 22:20
And so you had the wherewithal to say, Everything's upside down. I'm gonna go get a therapist. I need to figure something out. But I don't understand. I'm so afraid that you're gonna tell me your therapist fired you because you're coming on a podcast.
Ben 22:34
The main reason he fired me was because he didn't like video calls.
Scott Benner 22:38
He didn't like video call like you wanted to see him over like zoom. But he wants to just see you in person. Correct?
Ben 22:44
Yeah, I'm not really busy guy. Like, I did not want to dedicate, like, freakin four hours a day. Like, you know, it'd be like four hours for an appointment on Monday morning,
Scott Benner 22:55
dude. But the traffic here because you're driving somewhere, and then you got to get there and yeah, in rush
Ben 22:59
hour. Right, right.
Scott Benner 23:00
He didn't want to do it over video. Yeah. And are you comfortable with? That's the real reason? Or is it possible that you that one of you, I don't know how to talk about this, but one of your personalities did something that was so egregious that he wanted to get away from you or made up an excuse to get away?
Ben 23:17
No, he also was an addiction therapist, and he wanted me to check myself into a 12 step program.
Scott Benner 23:27
And you're thinking your mental health needs to be addressed before the because you're drinking still. No,
Ben 23:32
I'm not drinking. You're not I haven't drank since I started smoking marijuana, Scott. Okay,
Scott Benner 23:38
so you're, you're what they call California silver. I guess. Okay. I learned so much on this podcast. Fantastic. So I pretty sure that a lot of people are going to tell you that smoking too much weed with Bipolar is not a good idea. Is that not right?
Ben 23:56
That is right. But my I mean, my life is going great right now, Scott,
Scott Benner 24:01
what is your level of expectation for your life, then?
Ben 24:04
I want to have a fulfilling day at work, where I build technology that helps people and then I want to come home and watch some ditch and ask TV with my wife and pet my dog.
Scott Benner 24:16
I can't believe it took you 23 minutes. Tell me you're married. Okay. How long have you been married?
Ben 24:21
Three years. This October. So this lucky
Scott Benner 24:25
girl got you one year before your meltdown. One year before your diabetes?
Ben 24:30
Yeah, yeah. So we got married, and we got married during COVID. And like 2020 Our plan was to go to Japan. That ended up not happening. And then we buy a house and then the month after we moved into the house, I immediately get diagnosed with diabetes. And yeah, she didn't immediately leave. She's the best.
Scott Benner 24:50
Yeah, that was her mistake then but okay, so she hung around. I don't imagine that many people think it's appropriate or possible to have a conversation like this and joke around the same time, but I disagree. She hangs around, but then it's not much longer before it like, let me ask you this. The person you married, does that person know you're having any issues with mental health? Oh,
Ben 25:17
yes, she's completely aware. And she's the most nurturing soul in the world. She's the reason I'm alive.
Scott Benner 25:23
Okay. Does she have any mental health issues?
Ben 25:26
I don't think she does. She is solid as a rock. I cannot wait to have a child with this woman. And because all of my bad genes will just be eaten by her rock solid jeans
Scott Benner 25:35
type. And I don't know if that's how that works. We might want to like, hold off on that idea until we have some more answers. But, but I hear what you're saying. She's She's She's legit person. Yeah. And very supportive and helpful. So how does she help you? Like, is she the person you go to? And you say, I think I'm having a breakdown here. And here's what's happening. Yeah, she's
Ben 25:55
my best friend. Yeah. And
Scott Benner 25:56
what how does she help you in that moment?
Ben 26:00
She let me freak out. She let me spend some money. Um, she let me try to organize the best World of Warcraft raid of all time.
Scott Benner 26:10
And the magic card might work for a while. Yes,
Ben 26:14
yeah, she let me have my fun. Right now we're going
Scott Benner 26:18
to hear from a member of the Medtronic champion community. This episode of The Juicebox Podcast is sponsored by Medtronic diabetes. And this is Mark.
David 26:27
I use injections for about six months. And then my endocrinologist at a navy recommended a pump. How
Scott Benner 26:33
long had you been in the Navy? Eight years up to that point? I've interviewed a number of people who have been diagnosed during service and most of the time they're discharged. What happened to you?
David 26:42
I was medically discharged. Yeah, six months after my diagnosis.
Scott Benner 26:46
Was it your goal to stay in the Navy for your whole life? Your career was? Yeah,
David 26:50
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 most.
Scott Benner 27:03
Was the Navy, like a lifetime goal of yours?
David 27:07
lifetime goal. I mean, as my earliest childhood memories, were flying, being a fighter pilot,
Scott Benner 27:13
how did your diagnosis impact your lifelong dream?
David 27:16
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 away 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.
Scott Benner 27:41
You can hear more stories from Medtronic champions, and share your own story at Medtronic diabetes.com/juice box.
Ben 27:49
And then what I did to initially get myself checked into the hospital the first time was I I called my friend and I tried to recruit him for this tech company to build AI. It was Mr. Congeniality first phone call. And right after that phone call, my friend told me I needed to go to the emergency room. So that's when I told my wife with my friend Daniel said, and my friend, Daniel hit, his mom had bipolar. So he knew quite a bit about it. Yeah, he recognized. Yeah, he recognized it immediately. So he was the good friend that had the check myself in.
Scott Benner 28:28
That's lovely. Good for him. Yeah, that's nice of you, too. It's nice that you were able to listen to him and, and, and that he was willing to speak up and say something. Yeah, he
Ben 28:36
he recognized it immediately.
Scott Benner 28:38
Do you remember that phone call? I do. What were you What do you think you said that made him go up.
Ben 28:46
It was just my it was my intonation. It was how intense I was. It was the things I was saying. I want to whip out my skin Pisidian Swan River Scott. That's my inspiration for space travel.
Scott Benner 29:00
That's what you said. He went, Oh, yeah. Yeah, I recognize this from my mom. I'm so my mom wants. My mom once said she was gonna urinate into a stream to change how coupons were used. And I thought, oh, yeah, I've heard this before. Okay, so he tells you you turn right to your wife and say my friend Daniel just told me I don't seem well. Yeah, I need to go to the ER immediately. She didn't know you didn't sound well.
Ben 29:32
She was outside when the phone call was happening. So she did not hear it and I did I lost it. I screamed and she heard the scream.
Scott Benner 29:44
Was he the first person that ever intimated to you that you have a mental health issue? Yes. As upsetting
Ben 29:52
were relieving, relieving that I hit it so well, I guess. Oh, I see.
Scott Benner 29:57
You're like I can't believe he's the first person that said figure this out.
Ben 30:02
I mean, I didn't even I didn't know there was, you know, at the top. I didn't know any of this was going on. I wish somebody else would have said something. I heard he was the first guy that said something, you know? Yeah,
Scott Benner 30:11
no, I understand your jump to your brother for a second highly functioning. Autism. Yeah. Okay. Does he have any other issues? Or is that that I'm aware of?
Ben 30:25
No, you speak. Yeah, he can speak he holds down a job. He's a he's a sous chef at a good country club.
Scott Benner 30:31
I'm sorry. I meant to you to speak. Do you have a relationship? Yeah, yeah. We have a relationship. Okay. And you told him about this. Oh,
Ben 30:40
about Yeah, he knows about Mr. Congeniality and like my plans and my companies and all that stuff.
Scott Benner 30:47
He was probably pissed when he realized you guys bought a business together and you don't even remember it. He's probably like, over my head when we were not packing startups into diamonds. I thought we were going to be rich. But I have the recipe right here to start us insulin urine. Pressure, like you told me this was gonna work. So are you on any medications for any of this?
Ben 31:13
Yeah, I'm on like half of the pharmacy. But where do you want to start? Well,
Scott Benner 31:17
who's prescribing it?
Ben 31:18
My psychiatric nurse practitioner.
Scott Benner 31:21
Okay. What did you start with that didn't help what did you move to what's been happening so
Ben 31:26
they started me on Seroquel, which hits me like a brick get house got, and it'll just knock me out. And that's about all it does. It didn't really do anything to help the manic behavior. Okay, that was at the first Psychiatric Hospital where I feel like they mismanaged my diabetes. For the first hospital stay, they had me only on Seroquel. And they only got the dosage up to 200 milligrams, they were worried about pushing it higher because of type one, it really set my appetite
Scott Benner 31:58
gotcha to, hey, this is gonna seem like a weird detour for a second. But, you know, let me do this. I hear this happens a lot. And I'm just going to this is my opportunity to make a stand in the world. You've misused the term brick shithouse printed house specifically is speaking about a woman whose bust to waist to hip ratio is a certain way. So if you're a chesty, hippie with a thin waist, you may be built like a brick house. I know this is not important to the conversation. But I just felt weird that you'd be going through life not knowing that. So it's
Ben 32:32
interesting. I'm going to type it into Google a little later and get a better you check
Scott Benner 32:35
me if you want, Ben, but trust me. I grew up around a person who used that phrase a lot. It's not one of my parents, in case somebody's wondering. And that is definitely what that means. I can't believe I just I was like, we can't let this go. An article built more robustly than its function requires implies an element of indestructibility. Yeah, that's not how I heard it was how it goes. It's isn't that interesting? I have an ear of voluptuous woman with large round buttocks and bust. Yeah, that's how I knew it. Okay, that's that we're moving on now. Then. You start with this medication hits you really hard and makes you tired, but doesn't do anything. Other than that, they add something else after that?
Ben 33:20
No, my wife had to break me out of the psych ward, because they were mismanaging my diabetes. Okay, so that happened, and then get out. And then I start manically texting my old supervisor at the State Police. Because I didn't really trust anybody in the government. I was very paranoid at this point, Scott. And I was like, trying to get him to send me a cop car. That could take me to a hospital that was going to treat me better. Okay, so he ended up calling it a wellness check. And then that that wellness check brought me to the second hospital
Scott Benner 33:57
is that when you lost your job, so or no, or did that? No,
Ben 34:02
no. My wife is the most nurturing soul in the world through this entire time. She put like she did all the necessary paperwork to getting filed with short term disability. I was receiving my full paycheck.
Scott Benner 34:12
Are you back at that job? No.
Ben 34:13
I am no good. Yes, I've been back since October 16. Wow.
Scott Benner 34:17
Congratulations. That's a that's a lot to get through to get back to that place.
Ben 34:21
And I'm up for a promotion, Scott first year. Yeah. Well,
Scott Benner 34:24
I mean, as far as you know, unless somebody in your head is just telling you that and it's not really happening.
Ben 34:30
You know, that would be unfortunate. But that's the reality I live in. I
Scott Benner 34:33
guess. Ben goes into the office one day he goes my check looks exactly the same as last month. I don't understand. I'm the grand Pooh bah. Now why am I not being paid better? The
Ben 34:43
Grand Tour. I had a I had a supervisor his name was used to say that.
Scott Benner 34:50
It's amazing. Also to the editor, why don't we take out the man's last name just in case? That's okay. So he had some Flintstones right. Friends I think you're way too young for that.
Ben 35:03
Now I watched the Flintstones Did you? Maybe too, like I was too young to understand the Flintstones but I saw the Flintstones you know I saw the pictures on the screen. I
Scott Benner 35:14
don't know if Fred was the grant No there was oh my god this is a rabbit hole. I don't think he's healthy for you or I but I think the Grand Poobah was the guy who ran the club. And it was the water buff. Oh, alright, I'm gonna figure this out. Let's
Ben 35:30
deep dive this dude.
Scott Benner 35:34
I assume there's a part of your personality that is just like Yes. Let's find out more about this is how I fix
Ben 35:41
problems at work, Scott when Microsoft consultants I Google things. Alright,
Scott Benner 35:45
so Fred and Barney belong to like a gentleman's club called the loyal order of the water buffaloes. And this is actually still from my memory. And then the Grand Poobah was like the person who like the ranking member of the loader, the loyal order of the water buffaloes. That's I think that might be the only that might be where that phrase is from. Oh my god, do you want to know the the poor Boss Name It was Sam slag heap. That was the character that given the cartoon. And you know what
Ben 36:19
I realized? I didn't I didn't I don't want to know any of this. No
Scott Benner 36:23
one does. No one does. The Flintstones was the cartoon rip off of the honeymooners.
Ben 36:29
Did you know that the honeymooners I'll have to Google this one as well, Scott. Okay.
Scott Benner 36:33
All right. Yeah, you're pretty young. Alright. So let's get back to you. What's life like right now?
Ben 36:39
Life is amazing. I'm going to work. We're kind of in a holding pattern right now. Actually. The wife's FMLA is coming up. And it seems like we're going to have to be moving at some point to help take care of mom who has Alzheimer's. The wife has volunteered to be her primary caretaker. She's the most nurturing soul in the world. And she actually has experience in dementia care. It's what she did before. She became a phlebotomist.
Scott Benner 37:13
Interesting. So she is not phlebotomy rising people right now, which just means drawing their blood. And why is she on FMLA? To help you she was yes to help me. Okay, she's out on FMLA to help you that's coming up on being done now. And you're thinking maybe she'll leave her job or work at part time and then sit with your mom.
Ben 37:32
She's gonna go back to work after her FMLA is over. Okay. She's currently driving me to work right now. And to all my appointments, I'm not allowed to drive on some of the medication that I'm on. She's wooburn. You. Yes,
Scott Benner 37:47
you should make her an Uber driver. I don't want to tell you how to get around tax problems, but make her an Uber driver, You're her only client. And then the anyway, there's a way in there to save some money, but it would probably be a lot of work. She's gonna go are you going to be able to drive again soon.
Ben 38:02
So the the main medication preventing me from driving Xanax. And I think I have my anxiety to the point where I don't need it during the day. I'm currently only using it to help my sleep. I'm kind of a chronic insomniac. And it has been helping me on nights where I get up after you know, sleeping for three hours, and I can't get back to sleep, or one of those will just knock me out. So as long as I'm not on it during the day, I should be able to drive myself but I also have accommodations from I have all the paperwork submitted for work to exempt me from driving, in case so I can be 100% remote if I want to be
Scott Benner 38:43
I say I understand. Do you deal with the multiple personalities like on a daily basis? Or is that a thing? It's not happening right now?
Ben 38:51
It's something that you don't I try not to pay attention to. It's just it just happens. They get triggered and they pop out. Okay. You know,
Scott Benner 39:00
does it feel like a part of your personality is just stronger in that moment? Or does it literally feel like, like an exorcist situation where you're in a dark closet and somebody else is controlling? You know,
Ben 39:13
I feel I feel like I am then I say
Scott Benner 39:17
okay, that's who you are. Now, you now have all this? Yeah, energy or ideas or whatever. Can you do you have it down? Did you know how many there are?
Ben 39:27
So we have philosopher Ben, Dr. Ben, Mr. Congeniality and gamer Ben.
Scott Benner 39:36
Do they name themselves or do you name them?
Ben 39:38
I named them Mr. Congeniality. He's natural name was the schemer because he would just sit there and troll my vape and then send like 1000 Discord messages. So he was pretty creepy guy. So I renamed him to Mr. Congeniality after one of my favorite chick flicks.
Scott Benner 39:55
Okay, with Sandra Bullock. Yes. course. Right? And they, Oh,
Ben 40:02
I almost this is how I slayed at the psych ward Scott It was nothing but 40 year old women, and they all loved my favorite movies
Scott Benner 40:13
where you weren't picking these ladies up or you know, well,
Ben 40:17
I was just talking to him. Okay, okay. I just wanted to be sure. I
Scott Benner 40:20
want to be clear. You don't have any weird thoughts about me? You don't hear me in your head or anything like that ever? No. Okay. If you do you please don't tell me okay? Please don't. Don't send me a message that says that. I swear to you bad if you've ever sent me a message that says, I heard you last night. And I'm on my way to make the star das diamonds. I'm gonna, I'm gonna block you. I just want you to be clear. All
Ben 40:43
right, keep that in mind. I'll send an internal memo about
Scott Benner 40:47
No, no problem at all. It's interesting, man. How are you? How are you so good natured about all this?
Ben 40:53
I just have to keep up my end of the bargain. Dude, I have to keep going. Because because I believe in Mr. C, I believe in his vision. I believe that I can be on the team that that solves the problem of human consciousness. What is the problem? How do you put life in the software? Okay,
Scott Benner 41:16
how do you how do you make it so that something that I'm interacting with on a computer is sentient? Yes. And that's important why?
Ben 41:29
To solve complex problems? For example, timers disease.
Scott Benner 41:33
Yeah. Okay. I was gonna say for example, what is it you're looking for to solve? Alzheimer's
Ben 41:38
disease is the big one. Right?
Scott Benner 41:41
It's very relevant to me. Yeah, of course. grand plans is part of some mental illness isn't part of yours. Oh, 100%. Yeah. Did you have thoughts like that when you were younger?
Ben 41:55
When I was younger, I idolized Steve Jobs. Yeah, I did.
Scott Benner 42:03
So like, do big things change the world? That kind of stuff? Yep. Think different. Has anybody ever said grandiose delusional disorder to you know,
Ben 42:12
you're the first person does that shock? You?
Scott Benner 42:14
Know, I could because I am an idiot. I might be 100%. Wrong. I might not know anything of what I'm talking about. All right. Yeah. I just wondered if the if it was something had ever come up that? Well, I guess my question is, are you actually doing anything that would impact AI? Not
Ben 42:29
currently. No, I'm right now getting myself mentally fit to even get into the field.
Scott Benner 42:37
I see. Okay. You don't have this delusion right now that you are currently working towards making AI sentient? You just think it would be a thing you'd like to get involved in?
Ben 42:48
Correct. Got it. And I think I've already identified the people that I want to do it with. Is
Scott Benner 42:53
Daniel one of them? Yes. Is he still returning your halls?
Ben 42:57
He is. One of my best friends are
Scott Benner 43:00
good guy. That's excellent. So have you had that conversation since your diagnosis and and getting on some medications and getting back to the part where you aren't now? Have you actually spoken to Daniel and said, Look, when I'm getting myself together? This is what I want to do. And he said, Yeah, man I'm in.
Ben 43:14
He's not in. That's I'll always be courting Daniel, but he's down with me following my own dreams.
Scott Benner 43:23
Nice. Very nice. Okay, how do you manage your diabetes with all this going on?
Ben 43:29
I've been doing a pretty good job at it with the six a one C for at least for me. Part of that is due to medication circle does make me hungry. Part of that is just binge eating. Part of it is also just not hyper focusing on it, which I think is probably healthy for me. To a point. Oh, for sure. You know, seeing that 681 C yesterday. I do want to get
Scott Benner 43:53
you like to see in the fives. Are you seeing spikes? After meals? What do you think? What do you think caused the rise in your agency?
Ben 44:01
So after my experience at the first hospital, I'm just like, super sketchy to have a bunch of insulin in my system at night. So I've been just kind of Binging at night and not dosing properly for it eating later
Scott Benner 44:15
at night not covering it with insulin, making your blood sugar higher brain up here, I want to say yeah, and in the hospital, they gave you too much. Did you have a seizure?
Ben 44:23
No, but I had to keep shoveling food at a time where I didn't want to eat. It was very distressing. I stayed up for five days straight and at first hospital. Geez. On
Scott Benner 44:35
purpose. Yeah. Or was it just part of the manic thing or were you trying not to like go to so it was
Ben 44:41
definitely related to the mania but it was also motivated by fear. I thought that I was going to go low. And the I mean, the blood sugar logs prove it. Yeah,
Scott Benner 44:49
they don't it's you know, a number of people know over exaggeration. A number of people have come on the podcast and talked about having children with type one who have needed institutional eyes, a number of different kinds, and how hard it is to get an institution that will take responsibility for diabetes even.
Ben 45:07
Yeah, it's the last thing they want to take care of man. Yeah,
Scott Benner 45:11
maybe you understand, but when you need the care, you need the care. So it's hard. It's hard to accept that they're just like diabetes. No, no, thank you. You can't come here. But I mean, at least found a place to take you. But how long were you there before your wife sprung you?
Ben 45:27
It was only like five days. It help it all. That first place did not help me at all. Okay. I met some good people. But like, I love the people at the sideboard. There's a couple of nurses I really related to as well. One reminded me and my grandmother. But no, I don't have many good memories from the first sideboard. Okay.
Scott Benner 45:49
So the second thing you tried was more valuable, or was that just the nurse practitioner that you're seeing now?
Ben 45:56
So I went to the hospital again. So after I got sprung out, and I was basically texting my boss, and then I checked myself in the ER again, and they got me into a local hot
Scott Benner 46:07
boss helped you with a wellness check. And then that got you. Okay, yeah,
Ben 46:10
that got you where you are now, which I have on video. By the way, if you want to watch Scott,
Scott Benner 46:14
wait, you have wait. You have first of all, I do not want to see but what do you have on video? The wellness check. You have? Were you videoing them when they were there? No, they have their dashcam on? Oh, have you watched it? Yes. Do you look out of your mind? Yes. Is it wasn't surprising to to see yourself that way? Yes,
Ben 46:36
there's some footage at the hospital is very shocking. To watch.
Scott Benner 46:39
What how so? Were you trying to fly it? No,
Ben 46:42
it's just me screaming at the sky talking about like saying Dix every three three words
Scott Benner 46:48
saying terrible things. You didn't ask them to be part of the AI contingent?
Ben 46:52
No, I'm not sure that entered into the equation. I was trying to get them over to a barbecue at my house. Actually,
Scott Benner 46:58
wait a minute, you're yelling. First of all, you can't call a guy dick and then expect them to go to a barbecue with you. But so you were trying to get him to come to a barbecue? Yeah,
Ben 47:06
I was throwing a huge party because we because I discovered artificial intelligence. I wanted him to come to my house that Saturday.
Scott Benner 47:11
Oh, wow. Do you think that's what you'd actually do? First of all, I don't want to say this. It might break your heart. They're already working on AI. You're not going to be discovering anything, but But you were telling him that you broke the code on this sentient being. And in real barbecue is how you're gonna see now you've got me stuck. We don't want to go out to my steak, get a nice red, go to a restaurant have a steak, something like that. So we're gonna be a barbecue.
Ben 47:34
It was gonna be a Twitch stream. I was gonna stream it on Twitch. It had to be at my house where I had internet. That's
Scott Benner 47:39
when you knew you were out of your mind? Yes. Okay.
Ben 47:42
I mean, like, I'm thinking of all this while while they're driving me to the hospital. So clearly, none of it was going to happen. Right? So you
Scott Benner 47:49
were actually trying to come up with a way to get him to go like so even though you kind of gave yourself over to the process immediately. You're trying to get out of it. Well, I'm sitting there, just the guy. Okay. And that's his life. Yeah, and you feel bad now looking back at it? Yes. Yeah. He chose the job. But yeah, you don't I mean, it's nice. I
Ben 48:10
think he had he had a good time. There were some good moments in that video.
Scott Benner 48:13
You think you look back you see him having fun a little bit? There. Were
Ben 48:17
there were a few there were some giggles we had some laughs would
Scott Benner 48:20
you be chalk holing? My my burger or gas or how do you cook at the barbecue?
Ben 48:26
For burgers? Definitely gas but for for the steaks, 100% charcoal, you know smoke though? Just the charcoal. So we smoke on a Trager and not very well mind you. We haven't gotten the pork but quite right.
Scott Benner 48:41
Now it's about time, man. Low and slow. Low temperatures long time. That's what takes care of it. The seasonings here. They're just it's not you don't have to put a lot on the port but this season. Have you tried it? Why don't you just go? Oh god, what's his name? Aaron. He's got a video online about smoking and pork, but I'll think of it later and tell you Well, how'd you find the podcast? I found you in the hospital when I got diagnosed with type one. Yep. Okay, so you just digging around like you do like Googling, trying to figure out how do I help myself? Find a podcast start listening to it. You enjoy it or it just has good information and you think I was just this is wrong. Am I good information
Ben 49:29
for Oh, no. I loved the podcasts. I love the after dark series. All the tips. I listened to many episodes. Okay. Very cool. Yeah. Like the I think the episode that you did with Jonathan. I listened to that before I had bipolar and I still think it's one of your best episodes.
Scott Benner 49:43
It was good, wasn't it?
Ben 49:45
I haven't heard from Jonathan a while. Something special happened in that episode.
Scott Benner 49:49
Every once in a while he sends me a message and just tells me he's okay. But then he won't respond. So let's get to know here. Is that weird to look back you were listening to somebody who had bipolar. You probably had it and didn't know it. It is weird. Yeah. I can imagine like when you think back on it now, does it make you feel any certain way?
Ben 50:14
I'll have to maybe re listen to the episode. But yeah, I definitely. It definitely makes sense that. Like, I remembered the episode. Like it stuck with me. Yeah. Like when I got the diagnosis. I remember Jonathan. Well, when
Scott Benner 50:30
you were listening, you didn't think I recognize this in myself? No,
Ben 50:34
I didn't at all. I just I love this story. Yeah. And I love how you got it out of them.
Scott Benner 50:39
Thank you. It was hard. If I remember correctly, he was did an amazing job. Thank you. He was quiet. You have a ton of energy today. I don't really need to do a whole lot then. So you're making this easy on me. I appreciate that. By the way, especially on a Monday, although you came at me pretty manically online, you know that? I did. You're very like it was friendly. But you were aggressive, friendly. Like I am going to be on the podcast, I have this going on. I want to be on the podcast. And I was like, Alright, and then I had this, like, normally, you would have gotten a link that would have found you would have found availability sometime in August of next year in 2024. And instead, I sent you the VIP link, because I wasn't sure how long you were going to have that energy. So I wanted to get you on fast.
Ben 51:25
Oh, wow. Well, I really appreciate it.
Scott Benner 51:27
No, that's cool. I just I was managing you. I'm being honest with you. I was managing you because I wasn't sure how long this part would last for you. Does that make sense? It does. Yeah. So I just have enough experience with this to know that if I hit you at the wrong time, then you're going to like cancel or reschedule or not show up or something like that. Or maybe you won't, maybe you're maybe got your medications in a good spot. And maybe you'll ride this for ever and ever, which would be
Ben 51:55
amazing. I feel like my meds are perfect. So I'm just ready to kill it.
Scott Benner 51:59
Yeah, no, I actually think that because you're on here talking about what you're specifically talking about. The conversation has that flavor. I also believe that you could have come on here and said like, Hey, Scott, I want to talk about I don't know, Pre-Bolus thing. And we could have like, dug into it and had a conversation. And at no point I would have thought like, I think Ben might have like some mental health issues. Like do you understand what I mean by that?
Ben 52:24
Yeah, I could have given shown you a different side of me if I if I wanted to. It feels
Scott Benner 52:29
like you could you that that that is my point. Whereas there are some people I've had on who I don't think could have hidden it with a tarp and you know, I don't know like it just sometimes I think it's not as high level as it is other times.
Ben 52:45
I let all my co workers know how bad nuts I am. And they still love me. How did you let them know? Each one had their own individual way? It's probably too cute to describe.
Scott Benner 52:57
Wait, just give me one of them. Equity me too cute.
Ben 53:01
Let me I'd have to log in my work computer.
Scott Benner 53:03
You can't remember this. You want to read me something? Yes, I would have to read you a message. You don't have to do that. It's okay. Basically,
Ben 53:13
there's a network admin at work who craves a patwon Daniel is my patwon at work, okay. He's also one of my best friends. And there's a network guy at my job that craves that relationship. And I identified at the company, somebody that could be his patwon.
Scott Benner 53:36
And I
Ben 53:38
picked up so Mr. C, picked up on a word that this man said the word was subnet. And I bounced on that. Like, I wasn't like, Oh, dude, I just jumped on him. And I got him hyped up and he fixed the printer ticket. And then all he wanted was a shot to be on Cameron's team. And I think I gave it to a man I put his name in Cameron's mind. And he closed the ticket for me. And then he gave me at work. We have these things called impressions. It's like when you've touched somebody's day you they they'll give you an impression and be like, Oh, Scott, you know, he helped me with this today. Thank you, Scott. And then everybody sees it and there's a big leaderboard, dude. And before I went on short term disability, I was at the top of that leaderboard, something I was very proud of because I was always farming these impressions from people. Were
Scott Benner 54:35
you trying to get them or do you think you were just helpful and they just wanted to give them to you? Oh,
Ben 54:40
both. I wanted them but I was also the most helpful guy in the room.
Scott Benner 54:46
Okay, because of that energy you think because energy right? But you were also kind of hyper focused on winning the leaderboard? Yes, God very much so is That's still a concern for you guys. When you going back?
Ben 55:04
What do you mean a concern?
Scott Benner 55:05
Like, are you gonna go back and try to be that person again? Or just? Are you just going to let things shake out and be how they're gonna be?
Ben 55:10
Oh, no, I'm still gonna be myself. I still want to be at the top of that leaderboard. I still want to be the most helpful guy in the company. Nice. Getting money for the No, but you get your name put in a hat. And every year you might be flown out on an all expense. Paid trip vacation.
Scott Benner 55:25
Oh, so every time somebody what is that weekly? Now it's a yearly thing. But I mean, like, how many names go into the hat at the end of the year?
Ben 55:34
I'm not really sure. I think it's however many impressions there are. Oh, so like, if I get 30 I get 30 tickets.
Scott Benner 55:40
Oh, and then they pull one out and whoever wins the trip? Yeah. Nice. I would do that. I help a lot of people. How come nobody sent me on a trip?
Ben 55:51
Well, you're self employed. You can send yourself on a trip. Yeah,
Scott Benner 55:55
I mean, I see what you're saying. Now I am. I do work on myself. But nevermind, I don't know what I meant. I just think I wanted to free. I don't even have a point. I was just like, oh, I would like to go away. I never leave this room. You know, I heard somebody say something the other day about health that really was overly simplified and yet struck me hard. He said sitting is the new smoking. And I thought oh, and I'm dead. Because I sit here and make this podcast a
Ben 56:22
lot. You got to get a standing desk, bro. I've been standing up this whole time. You're
Scott Benner 56:26
standing. Yes. I have a standing desk. I just don't like I've never done a county use it man. So our homeless I get. So I've never done this before. I had
Ben 56:38
a comfortable Hi, hold on.
Scott Benner 56:42
It's going up. I actually I have a standing desk. I never use it. Alright, hold on. It's gonna go. You were not prepared for this. I'm sorry. You'll get here. Alright, so it's getting up pretty high now. Wow. Look how high it goes. All right, then I'd have to stand up. doesn't feel like it's gonna be healthy. But okay, so I'm standing up. I'm gonna move my microphone.
Ben 57:09
You sound like a new man.
Scott Benner 57:10
Okay, do I sound the same? You know?
Ben 57:13
You sound better of me. I think I think you do.
Scott Benner 57:20
Okay, so I am standing my hands behind my back.
Ben 57:23
Does it feel good? It doesn't
Scott Benner 57:25
feel any different. Just feels like I'm standing. I think the problem is the reason I've never thought to do it is because if during the conversation, I want to sit down then I got to like, readjust the desk and you heard all the noise. It makes it everything. And I think that would just be like, not a good idea. Yeah. Other than that, do I feel weird? I do feel a little strange. I've never done this before. Standing and also
Ben 57:52
is your mic like attached to your desk? Yeah. Okay, so I see I opted for a headset. This conversation is not encumbered.
Scott Benner 58:02
Well, that's a good idea. That's a good idea for a layman. But I'm I'm speaking into a pretty expensive microphone.
Ben 58:08
Like I can't I didn't imagine what's on the other side. I'm a visionary Scott. Yeah.
Scott Benner 58:12
Oh, you can't imagine it because of your vision. Actually, I wish it was higher. And if I go a little higher than this thing will fall off. Anyway. God dammit then. All right, I'm gonna do the rest of the interview standing up. But this is probably the last time this is ever going to happen. Because now I'm already like spreading my legs apart to make my height different. And the thing with my hands behind my back is freaking me out does it? I've gotten Scott Benner uncomfortable. So yes, yeah, I am uncomfortable. Oh, wow. It really does throw me off. It's interesting. Okay. What have we not talked about that
Ben 58:44
we should have? I think I got everything I wanted to say out you did? I'm gonna look I did not
Scott Benner 58:50
look at your notes Hold on. Stories from the psych ward. drug and alcohol abuse use emotional trauma. bipolar diagnosis. Alright. We are well, yeah, do well, right. We did. Well, we did good as non English as we did. Well, yeah. Also, I've now figured out that I care about fewer and less in when people like, as an example, like counting something like there are here there's six pens in front of me. If I take one away, I have fewer pens, not less pens, but I have a bottle of water in front of me. And if I take a drink out of it, I have less water, not fewer water. And Ultra aware of people using that incorrectly all of a sudden.
Ben 59:40
Are you sure you don't have a mental illness? Scott?
Scott Benner 59:41
Fine. Actually, I'm just yeah, I'm over exaggerating things about my life so that I can talk about them on podcast and just trying to explain Hey, yeah, gotcha. Yeah, I don't hear any voices gonna go over the things that don't happen to me Ben. I like when some people say what I find if you want to like really no. Is when when people want to reach out to me to tell me that I seem like I have ADHD or Scott, are you sure you don't have autism? Or Scott, are you sure? Like, I think they're just projecting mostly. Does that make sense? It does.
Ben 1:00:15
Yeah. 100%. Yeah. Because that's what I was doing right there.
Scott Benner 1:00:18
The Oh, for sure. Yeah. But I'm just also, I mean, I don't have any of the issues that would go along with those ideas. Like just be you know, like, people are like, Scott jumps around in the in the conversation, sometimes I really just follow the conversation. Yours and my conversation would seem to other people to jump around. But that's just me realizing that if I tried to put our conversation on a path that I think it would be best on, you're going to struggle with it. So I follow your path. Does that make sense? It does. Yeah. And when I talked to like, you know, like a, like a middle aged mom from the middle of the country whose life is ultra normal. And she's used to telling chronological stories, though, you've talked to a hell of a lot of people at this point. Yeah. Then I follow their they follow their path. And I ask questions that keep them on the path that they're comfortable with, if that makes sense. Does Yeah. So I don't want to give away too many of the backroom secrets of my incredible success, Ben, but that is one of them right there. Ben, can I say something that I have no business saying? You're welcome. I am Welcome to say it. You're welcome. Okay. I want you to get the blessing of three people you trust before you get pregnant. Okay, Does that seem fair? That seems fair. Okay. You might not be the best arbiter of whether or not that's a good decision or not. And if you bring another person into it, it's a lifelong situation. So if you are my son, which you are not, but ironically, I am old enough to be your father, right? You're 30? Yes. If I had a baby when I was 22, it could be you, Ben. Okay. So I would tell you like real sincerely, that you need to find a couple of people who you love and trust who love you, who are as honest as Daniel is with you. And when you go to make this decision, say to them, this is what I'm thinking of doing it. And I really want an outside perspective is I don't know your wife. And it's fine. She's rock solid. I trust you and your assessment of her. But she might be trying to make you happy, too. And I don't know, it's just it would be you seem like a really sweet person. And I think you would hold it against yourself, if anything happening with you impacted a baby or if it was transferred, I think I think it would, it would be bothersome to you. So I want to make sure that that's not your situation before you do something like that. That fair. That sounds fair to me. All right. It really is none of my business. And I feel badly saying it. But I'm actually going to apologize. But it still felt like there are times I have these conversations and I want to make sure I say the things I'm thinking so
Ben 1:03:10
anyway. I mean, that's why I came on dude, I came on to talk to Scott Benner, you want to get a little bit of my? Yeah, I only call them on here tonight. hear your opinion?
Scott Benner 1:03:20
Ben, do you know I'm thinking of starting a second podcast? Yeah, I'm thinking of starting a second podcast where I can put the conversations that don't fit into here. And I've just been told by this is gonna sound pompous. But I've been told by a lot of people that this is their favorite podcast, not their favorite diabetes podcast. Does that make sense? No,
Ben 1:03:42
I totally understand. I think the same is true with me like I come here for you not diabetes. Thank you. And I come for the conversations that you have
Scott Benner 1:03:50
with people. Yeah. And so I'm thinking of starting another podcast that just that is not contingent on you having diabetes for for me to have a conversation with somebody. I
Ben 1:04:01
think that's amazing.
Scott Benner 1:04:02
Thank you. Can I share the title I'm considering with you? You can't. Okay. So first of all, there are a lot of podcasts. And because of that every title you can almost think of has already been soaked up by somebody or in some situations, multiple times. There are a shortage of words even to use in your titles because people overuse words, like I said to somebody like Hey, I think I'm making to make a secondary podcast. What should I call it and then I call call juicebox. uncensored, or like the words like uncensored, untethered, like stuff like that have been used over and over and over again, like it would just, you'd get lost. So I was first on what matters, because it was the thing my kids used to say, when they were like both of my children use the phrase what matters when what they meant was that like, you can never kind of tell what they meant. Like it was See, they're like, that doesn't matter. Why does that matter? But when they were super young, they go what matters? And I was like, Oh, that's interesting. We'll do that. But a quick, quick search tells me 123456 At least the nine podcasts use that phrase in their title. Sounds like I can't do that. So here's what I came up with. I'm gonna go with maybe I'm workshopping it with you right now. I'm trying to think the best I've got so far. Because I mean, I like it. Yeah, it's not great, though. You know which one's the best right now? smartlace. It's such a simple, not word word that sticks in your head. You know what I mean? Like, do you listen to smartlace podcast? I don't know. I don't but you're aware of it, though. I'm not You're not.
Ben 1:05:54
I'm not. No,
Scott Benner 1:05:56
I'm sorry. Don't worry about it. It's a Jason Bateman. You know Jason Bateman. Movie Star, right. Yeah, him and two of his friends who are also famous. Make this podcast. I knew it. I just think the name is smart. Like Smartlist is like, Oh, smartlace sticks in your head. It's funny kind of has a couple of different meanings. Anyway, trying to think is from a three stooges skit. You know who the Three Stooges are? I do. All right. And I think curly goes, I'm trying to think but nothing's happening. I just think that's hilarious. I don't know. I don't know. Like, I can't come up with anything. Right now. What's holding me back from doing this is that I can't find a name for it.
Ben 1:06:39
That's the worst part about it is naming things. Is it really? Yeah, I think trying to think is good. Because it, there's kind of a message of always improving behind it. Right?
Scott Benner 1:06:51
That's what I land on is that it's like, hey, I want to I want to try to think about this, or I want to try to expand myself on this. I'm trying to think but it's hard. Yeah.
Ben 1:06:59
And what conversations do you envision having just anything? Like you'll you'll just talk to anybody?
Scott Benner 1:07:04
I think so I think I'm just going to open the podcast up to anybody who wants to have a conversation about anything. And just talk, I am really of the belief that people's stories are interesting. And that they don't have to be famous or of note for people to listen to them. I think that the things that are popular are people who you've heard of, right, like, you know, comedians get very popular. A lot of comedians that have podcasts, for example, right. They go on each other's podcasts all the time, they basically make each other famous by like going back and forth on their podcasts that they build their name recognition that way, but I go listen to them. And I'm not that interested in what they're saying. And then I talked to somebody like you, or Jonathan, or just some, you know, I put up an episode today called celiac shock. It's called celiac shock, because I'm interviewing this woman who's got three kids, one of them has type one, the kids got celiac. And when they go to the doctor, the doctor says, hey, well, we should test you and your husband who for celiac disease, and that process of bringing him into the doctor's office shows that he is an insane alcoholic. She's unaware of it. And he's got cirrhosis, and he's in kidney like encroaching on kidney failure. If I'm if I'm remembering correctly, and this kid celiac diagnosis saves this guy's life. Because they said he was on his way out from the drinking, like, believe it or not Miss 30s, right. And she's telling this whole story. And I think I don't care that nobody knows her name. Like this is interesting, and impactful and meaningful to people. And I just think you get better conversations out of people who are just normal people, if you know how to talk to them. I think that a lot of people don't interview normal people because their interviewing skills suck. And they need a famous person who already knows how to talk when they're being recorded. Does that make sense? It makes complete sense area. So I think you can have these conversations with anybody. And that's what I'm going to try to do. Just pick random people and figure out their stories. Like you didn't tell me you were abused. That wasn't in your notes and I don't know that you were gonna say it or not, but like I got to it, and I think I can do that with other stuff as well.
Ben 1:09:22
I agree. Yeah, it's not you can I
Scott Benner 1:09:23
don't think I'm going to turn like a computer into a sentient being and save everybody but I'm also more stable in your
Ben 1:09:32
that is true. That is definitely true.
Scott Benner 1:09:34
Is there a world where where this goes backwards? Could you one day be 55 years old and look back as oh my god you remember that time in my 30s when this was happening to me, but I'm just not that I'm not there anymore. Like I'm I'm more of what you might consider normal at this point. Oh 100%
Ben 1:09:55
I have I would like to think I have one of the most open minds in the world.
Scott Benner 1:10:00
What do you think gets you to that? Is it therapy? Is it medication? Is it health changes? Like have you changed your diet? Have you gone down like bro science and been like I'm taking out like, butter. It's not grass fed or like, you know, you're doing it that stuff.
Ben 1:10:15
Daniels recommended meditation. So um, you know, I'm doing that I'm also, you know, just trying to read books, generally go on long walks, just things that that helped me calm down. So I'm kind of going down the self improvement path right now.
Scott Benner 1:10:33
I will say this, when you get your TSH back, would you email it to me? Sure. Yes. If it's out of whack, I'd like to, I'd like to put that in the podcast. Okay, yeah. Just because, you know, I mean, my son has a hypothyroidism Hashimotos. And part of the diagnosis was six months before we got the diagnosis. I said to my wife, hey, he's acting really strange. Like his personality was off. And he was just agitated, aggressive for no reason sometimes around like, even in conversationally, you don't mean like, you start talking about something he just like, felt like he was out of his mind for a second. You're like what's going on, man? And that is something that can happen to a person who's you know, got like, bad thyroid labs. I just want to know if that's part of it. But even just eating clean, and like, I don't want to come off as like a hippie, but like, addressing like gut health. Like, do you think your gut works? Well, do you like the way you digest and eliminate?
Ben 1:11:31
Digested eliminate has been great since I started? Since I stopped drinking? Yeah, the diet can definitely be cleaned up. I've just been binging on sweets lately.
Scott Benner 1:11:41
Yeah, maybe get rid of the sugar. See if that doesn't help you that kind of stuff? For sure.
Ben 1:11:45
I mean, and I've gone on low carb, lower carb diets before, and I've done them with great success.
Scott Benner 1:11:52
So maybe there's more things to do for yourself. Just from a nutrition standpoint, that might be helpful. I'm saying even with your mental health. Yeah, yeah.
Ben 1:11:59
And that, you know, that that's something that every doctor I talked to emphasizes is that diabetes affects the mind. That's why they're very careful with my medication. They have this crazy program. I have a doctor just for my pills. That's her only job. She has this crazy program that just runs all these calculations and figures out what medication is safe for me based off all these side effects. That's interesting. So I'm on a very tailored medication dose for me. And this is kind of where we're at.
Scott Benner 1:12:29
Good for you. Oh, that's good. I'm glad you're getting that kind of care. That's excellent. Yeah,
Ben 1:12:34
she's one of my favorite doctors.
Scott Benner 1:12:35
Yeah, no kidding. Well, that's a great idea. I didn't know that people did that. It's it's a lot to keep track of for the regular practitioner and you see a bunch of diff practitioners, so why not have one person whose responsibility it is? Yeah, they're called mid managers. Oh, wow. That's good for you. Oh, good, good. Good. All right. Well, then I'm going to wish you well, and if we have talked about everything, I appreciate you going over my flight of fancy at the end here about maybe I'll start another podcast. Yeah. Good luck with that, man. Thank you. I appreciate it. I seriously the name thing is the hardest part, which is ridiculous, because it doesn't really matter.
Ben 1:13:13
We'll see. Like, you're big enough. Don't you have guys at this point? People like advertising guys. Like you'd be like, hey, Ken, like you don't have a guy you can just like run a brand name by they're
Scott Benner 1:13:23
all gonna do the same thing. They're gonna pick words. They're gonna pick buzzwords and keywords, and they're just gonna like in your Melton to everybody else.
Ben 1:13:30
You think so? Dude,
Scott Benner 1:13:32
I started this podcast right? 2015 January, when I started it, the words juice box did not appear in podcast titles. And now there's like nine of them. Your trendsetter? Know, it's when you get popular people knock off the words in your title to try to like to try to get some of your juice. It's just, I didn't mean that. But you know what I mean? So like, if I typed I have a, I'm not going to tell you what, what site I use. But when I type just the word juice in to a place where I can track all podcasts. There are 1-234-567-8910 returns. I'm one of them. The minute you add a B to juice. There are now 369 11 returns that all use the word juice box. And they're called the Juicebox Podcast. So mind Juicebox Podcast, type one diabetes. When I first started it, it was just Juicebox Podcast. I added the type one for search reasons. But there's juice box juice box radio, the juice box juice box with a capital J and a capital B podcast. Then there's Juicebox Podcast with no space between box and podcast. There's the Juicebox Podcast, the Juicebox Podcast, one word, juice box a musical. Good that's how many times how many.
Ben 1:14:51
How developed are these podcasts like they also
Scott Benner 1:14:55
let's pick one that I've seen forever. Here's one the Juicebox Podcast, all they did was add the word VA. They have not put out an episode since 2020. Do you think they're making any money off of that? No, they're not. The Juicebox Podcast all one word. So that now this is somebody took that and put it in front of my title. And now these people took the Juicebox Podcast and squish it together to one word, they haven't put up a post since 2021. Doesn't look like they ever had enough to attract an advertiser. Here's a new one Juicebox Podcast one word. And this person is has put up four episodes, but hasn't put one up in five months. So that's over already. My goal for this podcast is to help people grow and to also grow myself, I feel the best way to do that is by seeing other people's perspectives. Oh, sounds like a 21 year old. On we found how to make a podcast let's see here.
Ben 1:16:09
That could have been something I wrote. Trust
Scott Benner 1:16:11
me, a lot of these could be the juice box hasn't had an episode since 2020. It just goes on and on. So my goal here of like when I picking a new title, is I type something in here like like I told you what matters earlier. I was like, I can't do that. There's like eight people using it. But trying just the word trying. That's a big one. Adding think to it. There's nothing there.
Ben 1:16:43
And you think the search problem is such a big one, that the name is really that important?
Scott Benner 1:16:48
No. I think that if I pick a word that everybody else uses, then my idea for my podcast is pedestrian.
Ben 1:16:55
You're that attached to the just the name. The
Scott Benner 1:16:59
name is more of an indication of my idea than anything else. Does that make sense? It
Ben 1:17:05
makes no sense to me. Yeah. It seems like you're you're very fixated on the name, though, in a way I can appreciate.
Scott Benner 1:17:11
I don't want to have an idea that everybody else is happening. Because then what's the point? Like? Why is my podcast popular? Why do you think Ben?
Ben 1:17:23
I think it's because you know how to talk to people. Probably
Scott Benner 1:17:26
a big part of it. But that's not that's what makes it good. Not what makes it popular. What made it popular was I was first. And I separated myself from other diabetes content by not using the word diabetes in my title. That's why I'm popular first and unique. I have longevity because I'm good at it. Does that make sense? It does. Yeah. So as I'm trying to consider about putting up another podcast, if I can't figure out a way to be those things, then it won't work. Then why don't I just like, Yeah, I don't know.
Ben 1:18:04
Put those episodes. You're not starting from scratch on the platform, right? Oh, not
Scott Benner 1:18:08
at all. Like I'm gonna and this is the only way I'll tell people about it. By the way is I'll just, I'll get on the podcast one day, and I'll say, Hey, guys, I started another podcast. It's not about diabetes. This is the title, you can check it out if you want to. That's all I'm going to do. Because growth, boom growth isn't good for this. For me, if I was famous than it would be, then you'd want boom growth. And you'd want to walk around going like I don't know. I'm Tom singer, and Bert kreischer And listen to two bears one cave, because everyone does, you know, and you'd be like, yeah, the machine. I know that guy. And then you go listen, right? And like that, that works for that. Because it's comedy, and it's just conversational, and comedy, and you know them. They're famous. But I need people who like me to listen to me, because that's how they tell other people about it. Because I can't just go out and say, I'm Scott, listen to my podcast. I'm not big enough for that. I'll never be big enough for that. So my growth is going to come through word of mouth. Does that make sense? Of course it does. Yeah, that's the only way it works. When you're not famous. When you're famous. You just do it. That's
Ben 1:19:11
how I found you on Reddit was word of word of mouth. Somebody else recommended you I have to
Scott Benner 1:19:15
say I'm, I always take a moment to say this. I'm very grateful for how red it is red. It's really supportive the podcast. And I always really appreciate because I'm not a Reddit person. And I don't I don't go there for no reason other than I just don't. But when people come into the private Facebook group, I heard about you on Reddit is one of the major ways that I see people come into the private Facebook group. So yeah, they've always been really good to me. I appreciate it. Thank you, Reddit. Because you don't want people on Reddit to be angry at you because it goes the wrong
Ben 1:19:45
way or no, definitely not.
Scott Benner 1:19:49
But yeah, no, I sincerely I've always appreciate that. All right, Ben. So I don't know if I'll ever make a second podcast or not, but if I do, it'll have a weird name and it'll be different and Got a little obtuse? Well,
Ben 1:20:02
I'm excited for it. Do not listen. Thank
Scott Benner 1:20:03
you, I appreciate it. And I want to wish you a ton of luck. It sounds like you're on a on a better path and, and you got good support around you. Don't let the thing with your mom. That's gonna be a lot of pressure and stress but do your best not to not to absorb it if you can do it. Well, thank you. Of course. Hold on for me one second. Okay. Good. 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, G voc glucagon, find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox you spell that GVOKEGLUC AG o n.com. Forward slash juice box. A huge thanks to us med for sponsoring this episode of The Juicebox Podcast. Don't forget us med.com/juice box this is where we get our diabetes supplies from you can as well use the link or call 888721151 for use the link or call the number get your free benefits check so that you can start getting your diabetes supplies the way we do from us med if you're living with type one diabetes, the afterdark collection from the Juicebox Podcast is the only place to hear the stories that no one else talks about. From drugs to depression, self harm, trauma, addiction, and so much more. Go to juicebox podcast.com up in the menu and click on after dark. There you'll see a full list of all of the afterdark episodes. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com
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#1250 Resilience: Connection, Critical Awareness, and Hope
Psychological Impacts of Diabetes with Erika Forsyth, MFT, LMFT
Erica Forsythe discusses trauma and resilience in diabetes management. They explore the importance of connection, vulnerability, and critical awareness in overcoming adversity. Offers valuable insights and practical advice for those living with diabetes.
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
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends and welcome to episode 1250 of the Juicebox Podcast.
For those of you who have been enjoying the resilience series, this is the fourth and final part. And if you're just tripping over now go back there's three other parts. This is resilience in four parts with Erica Forsythe, Licensed Marriage and Family Therapist in person with type one diabetes. Check out Erica at Erica forsythe.com. I know that Facebook has a bad reputation. But please give the private Facebook group for the Juicebox Podcast. A healthy once over Juicebox Podcast type one diabetes. The group now has 47,000 members in it, it gets 150 new members a day, just completely free. And at the very least you can watch other people talk about diabetes, and everybody is welcome type one type two gestational loved ones, everyone is welcome. Go up into the feature tab of the private Facebook group. And there you'll see lists upon lists of all of the management series that are available to you for free in the Juicebox Podcast, becoming a member of that group. I really think it will help you.
Touched by type one.org touched by type one is sponsoring this episode of The Juicebox Podcast and I'm going to be speaking at their big in person event in Orlando, Florida coming up very soon. There are still tickets available. They're absolutely free. It's a wonderful event touched by type one.org. Go to the program's tab and get yourself your free tickets. This episode of The Juicebox Podcast is sponsored by the ever since CGM. And sure all CGM systems use Transcutaneous sensors that are inserted into the skin and lasts seven to 14 days. But the Eversense sensor is inserted completely under the skin lasting six months ever since cgm.com/juicebox. This episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter, learn more and get started today at contour next one.com/juicebox. Erica, we're back. This is the fourth part of our resilience series. You and I were just talking Off mic a little bit about this first little bit is is it going to stay here in this episode? Are we going to put it in the end of the third one? So let's get started and just see how it all flows first. Yes, that
Erika Forsyth, MFT, LMFT 2:43
sounds great. Okay.
Scott Benner 2:45
Why did you say that? Like what what about this part that's coming up made you go? Ooh, should this have been in the third one?
Erika Forsyth, MFT, LMFT 2:51
Great. That's good question. Yeah, I think because in our last episode, and the previous episode that we recorded, we were reviewing kind of the different layers, so to speak of trauma, whether it was a first, you know, a one event capital T trauma, a kind of repeated pattern of small t trauma, or were you experiencing pain as a result of doing something for the first time. And then this next part, I think we were debating whether to include it last time or not, because we had talked about a lot of different things is really thinking about that the formal diagnosis of PTSD, Post Traumatic Stress Disorder, in response to a diagnosis of diabetes or any other chronic illness. That's why I'm wondering, would it be fit better? In our previous recording
Scott Benner 3:38
session? Okay, so we'll see. Yeah, we'll jump into it. We'll see how it flows. Okay, go ahead.
Erika Forsyth, MFT, LMFT 3:42
So we have discussed and research has proven that PTSD or trauma or long term adversity does impact your systems of your body. And that does increase your risk of health issues, right, and no mental health issues physical illness and mental health issues. But if we look at that, inversely, medical diagnosis of illness or disease, and we talking about cardiovascular disease, lung disease, cancer or autoimmune diseases, obviously we know that can be traumatic and leads to true experiences of PTSD. And as I thought it would be important to recognize research that was done by Donald Edmondson in 2014. And his research showed and highlighted that an estimated 12 to 25% of people diagnosed with a life threatening illness go on to develop PTSD. And so in that category, he created what is called the enduring somatic threat model of PTSD. So ESD for short, so I thought it'd be interesting for us to kind of understand what does that mean, what does that look like and how is it different from typical PTSD Okay, yeah, okay. Okay, so here's some differences. So, PTSD results from a discrete and external event that we've talked about the war example, we've talked about, you know, whether it's an abuse or a one time rape incident or assault. So the source of that threat is external. And it's important to know that has a beginning and an end. Okay. So with the enduring somatic threat model that results from the diagnosis and treatment of a life threatening illness, such as we know, cancer, heart attack, diabetes, and the source of the threat is internal versus this external thing that happened to you one time, it's an internal somatic threat that is entering and without a definite end. So he really, through his research, recognize that kind of validating all the things that we've been talking about, that you can experience PTSD from this threat that is internal, and doesn't have an ending. So those are kind of the major differences of kind of classic PTSD versus this ESP model. Okay, should I keep going?
Scott Benner 6:08
Yeah, I Okay, I just want to make sure I understand the internal somatic threat. So I just asked our our chat GPT overlord about it. Let's see, the concept is often associated with various physical sensations or symptoms that the individual interprets as signals of a serious medical condition or health threat. Internal somatic threats can trigger anxiety, stress, fear, particularly in individuals with heightened health anxiety, or somatic symptom disorders, key aspects, physical sensations, perception of harm, physiological impact, behavioral responses, underlying conditions. Okay. I just wanted to like, give that a little more of a definition. But yeah, no,
Erika Forsyth, MFT, LMFT 6:50
that's good. So the occurrence and the time perspective is significant, right, because we have this past, present and future experience. So from the diabetes perspective, you have the diagnosis, and we talked about how that is, can be a capital T, one time event, trauma in and of itself. And then we have the past, present medical intervention, and the fear of when we talk about future recurrence that can be we often think about, like, you know, you go through cancer, you go through the treatment, you are in remission, but then you're living with this anticipation of future recurrence. But I'm also I know, this can happen with diabetes of, for example, having a seizure, right. And then you're experiencing all of these symptoms, and doing your best to prevent it. And we'll get into that a little bit more. So your experience is hyper vigilance, where we think about hyper vigilance with PTSD. And we talked about this example, in one of the previous episodes, have you hear that the boom of the motorcycle blast or a car like, what is that like backfiring, and that instantly, if you have PTSD from war combat, that sound instantly takes your mind and body back to that one time past incident of being in combat. In this E at the ESP model, the vigilance is to the internal sensation or symptom in one's body. So if we're going back to the seizure example, you start to either you see the low, you see the arrows, maybe starting to go diagonally down, you might start to feel the low symptom. And you're hyper vigilant to that. And then you start to experience the anxiety and the fear around oh my gosh, am I going to have a seizure? That also contributes to your decisions traces? Can you be alone? Can you go out in a car? Can you go to public places? Do you let yourself go below a certain number because you are near that number?
Scott Benner 8:46
I interviewed a woman the other day, who's had diabetes for like nine years. As soon as she was diagnosed as an adult, they just gave her insulin. Roy didn't tell her what she was doing with it. And this one time, she's sort of alone in our house or husbands with their kids somewhere else. She starts getting a low, you know, goes in the kitchen, eats a bunch of stuff sits on the floor is panicking sitting on the floor. She talks about it like it happened yesterday. It was like eight years ago, and she still won't try an insulin pump because what she told me was I figured out how to control this now I don't want to change anything. But what I felt like I was hearing from her was I was slightly anxious person before diabetes, but then I got it. And then this low happen, and now I am scared for anything to happen. That is not something that I feel like I'm in control of. She's in therapy trying to figure it out like consciously she understands it, but she can't make good decisions for herself. Anyway, like that seems like what you're talking about here to me. That contour next gen blood glucose meter is the meter that we use here. Arden has one with her at all times. I have one downstairs in the kitchen just in case I want to check my blood sugar and or Arden has them at school, they're everywhere that she is contour next one.com/juicebox test strips. And the meters themselves may be less expensive for you in cash out of your pocket than you're paying currently through your insurance for another meter, you can find out about that and much more my link contour next one.com/juicebox Contour makes a number of fantastic and accurate meters. And their second chance test strips are absolutely my favorite part. What does that mean? If you go to get some blood, and maybe you touch it and I don't know, stumble with your hand and like slip off and go back, it doesn't impact the quality or accuracy of the test so you can hit the blood not good enough, come back, get the rest without impacting the accuracy of the test. That's right, you can touch the blood, come back and get the rest. And you're gonna get an absolutely accurate test. I think that's important because we all stumble and fumble at times. That's not a good reason to have to waste a test trip. And with a contour. Next Gen. You won't have to contour next one.com forward slash juicebox. You're gonna get a great reading without having to be perfect. How many times have you thought it's time to change my CGM? I just changed it. And then you look and realize I got it's been 14 days already a week, week and a half. Feels like I just did this. Well, you'll never feel like that with the Eversense CGM. Because ever since is the only long term CGM with six months of real time glucose readings giving you more convenience, confidence and flexibility. So if you're one of those people who has that thought that I just did this, didn't I? Why? Well, I don't have to do this again right now. If you don't like that feeling, give Eversense a try. Because we've ever since you'll replace the sensor just once every six months via a simple in office visit. Ever since cgm.com/juice box to learn more and get started today. Would you like to take a break? Take a shower you can with ever since without wasting a sensor. don't want anybody to know for your big day. Take it off. No one asked to know have your sensor has been failing before 10 or 14 days. That won't happen with ever since? Have you ever had a sensor get torn off while you're pulling off your shirt? That won't happen with ever since. So no sensor to get knocked off. It's as discreet as you want it to be. It's incredibly accurate. And you only have to change it once every six months. Ever since cgm.com/juicebox.
Erika Forsyth, MFT, LMFT 12:37
Podcast? Yes, it's the hyper vigilance, the hyper arousal that the mood shifts the cognition around like I know, I know why I'm doing this or choosing to not do the certain thing. But the fear is keeping them paralyzed. Because you're trying to do anything you can to avoid that trauma.
Scott Benner 12:57
Oh, she told me that her husband will text during the day and ask how her blood sugar is. But he doesn't really care about her blood sugar. He cares about her mood. He attaches to how her blood sugar's doing. And it's not because if she's high, she's cloudy or if she's low, she's shaky. It's because Oh, I didn't you're actually tying together that conversation for me when this Okay, all right, I got it.
Erika Forsyth, MFT, LMFT 13:21
Right. So do I feel safe and secure? Because I'm I'm going to make up a number 150 or 200 and stable? Or am I feeling really nervous? Because I'm below a certain number, right? Yeah, those numbers are arbitrary. People who have this experience that it is really common when they have a traumatic incident around insulin and particularly low blood sugar seizures. They can't figure out why it happened. So then you're going to be super vigilant to try and protect and prevent it from happening again. The
Scott Benner 13:52
other thing she talked about, is that something Wow, where were you yesterday when I was talking to her? She was talking about the she needs to know why it's happening. It's very important to her to know why what's happening is happening. Oh, that's interesting. Okay, okay, cool. Wow, look at me. I'm learning. Yes. Yes. Go ahead.
Erika Forsyth, MFT, LMFT 14:11
What else? Okay, so, in the case of what we're calling the, or how Dr. Edmondson says, the medically caused PTSD, we're considering in terms of an ESP model avoidance not only precludes emotional integration of the trauma, so this that means like, okay, so avoiding the emotional integration meaning, okay, you starting at diagnosis, like what is this mean? I don't know, and wanting to maybe even deny what this actually means. And this is, you know, any kind of chronic illness diagnosis applies to this, to then the actual dealing with it. Right, you might go through a period of shock, denial, not quite sure what to do, how to manage Who do you tell, do you keep it to yourself? Are you including people in this journey? And also, the actual treatment, right, like you might start avoiding, because of this traumatic experience that you have, you're avoiding the doctor's appointments. You're avoiding treating, you know, kind of insulin management or any kind of medication management for the illness. Yeah. So it has this, you know, replica, we've talked about this again, but really try I'm trying to do it from this ESP model, how this can into effect your experience with your diagnosis. Okay.
Scott Benner 15:27
Yeah, I'm so interested, are you going to? Is there I don't want to read ahead. Are we going to find out that there are big things like, big T, little T in this scenario to like, Are there going to be because what I'm sitting here thinking is, I had a recent conversation with an endocrinologist and we talked a lot about how some people just don't get it, or they're not motivated, or they don't try or whatever. And I'm sitting here thinking, is that just maybe their situation did they have or upbringing? Did they have an alcoholic parent? Like, did they did they have, you know, two or three things off the ACES list? That is it a money thing is that they live in a dirty house, and they don't know where to put their stuff down? Like you don't? I mean, like, is it more? It's got to be more entailed than just I don't know, I met a guy today, two o'clock, and he don't seem to care. Like nobody doesn't care about staying alive, right? You don't I mean, okay, okay. Okay. All right. Good. Yes. I'm sorry. So
Erika Forsyth, MFT, LMFT 16:23
I think that the challenge, like let's say, if you were the end, Joe, and you were presented with the case, such as someone who was avoiding, treating, managing their diabetes in the way that it's expected, or, you know, kind of doing the bare minimum, to stay alive and be healthy. There's, there's always more to it. So I think the challenge is when you let's say you had this case in front of you, is it is that person in a season of diabetes distress. Are they in a season of diabetes, burnout? Do they has their distress manifested itself becoming depression? Is it because right, everyone, most everyone in their lifetime is going to experience either diabetes, distress or burnout, if you're living our caregiving, it just is natural and normal? Yeah. But with the difference that we've talked about before is if you are still functioning pretty well, in your relationships in your job, and other aspects and areas of your life, then that is diabetes distress, we know that it evolves and becomes presents itself depression when your impairment, your functioning, is impaired across multiple areas of your life. Okay. So then or is it you are experiencing medical induced PTSD? Is this the way that you are interacting and experiencing your chronic illness? Is that because of your experience of previous aces of previous trauma? Is it you grew up in a very stable household, but over time, for whatever reason, the genetics of your brain, the genetic, the generational history, other things that are going on your life, you get this diagnosis, and you are experiencing it and living with it? As if you had PTSD? And to his case, saying, yes, you might have with this enduring somatic threat model? Yeah, to answer your question. Yes, it could be all of these things. It's usually layered. And it's called and that's why it's complicated to to help people when they are struggling with their diabetes,
Scott Benner 18:30
and may be difficult to talk about. Because when people it seems to me, when I see a group of people together, often the people who have awareness about what they're struggling with, look weak to other people. Does that make sense to you? When I'm saying like, when somebody's like, you know, I had this happen to me. And I know that's why I feel this way and I'm trying to get past it. And then people are like snowflake. Meanwhile, the person saying snowflake, they had stuff happening to them, too. They're just keeping it down and not talking about it. You're not obviously a weak person to understand what's happening to you. But I think that when they try to talk about it in a world where everyone's not on the same page, they come off as like a hippie or complaining or like that, do you know what I mean by that? Like so it does that make it difficult to like voice this like, where do you find a safe? Oh my god, am I gonna say safe space? Yes, you are Jesus, cliquish? Look what you've done to me. Where are you going to find a safe space to open up about that so that you can get some support and get yourself through the next piece? All right, there's no question in there. I just want to say that out loud. That
Erika Forsyth, MFT, LMFT 19:35
was that was yes. Yeah. Yes. Because there there is. And I think what you were kind of looking around in the area of like, are you using this to justify or even make excuses for why you act a certain way and for pull this out in a bigger perspective? Yeah, go ahead.
Scott Benner 19:52
Are you just onto something here and you're figuring out what's going on with you? You know what I mean? Yes,
Erika Forsyth, MFT, LMFT 19:56
yes. And so there's there's a difference and that's depends on where you are. in that journey, right of, of understanding,
Scott Benner 20:02
I'm gonna say right here in case you ever listen to this, I have this struggle with my wife, because I have you see it with me like I Aha, sometimes I'm like, oh my god, like, right? And I start like understanding something. If I say that to Kelly, sometimes she'll go, don't make up an excuse. And I'm like, Oh, she wants me to apologize here for something or she wants me to admit something or something like that. And I'm in the middle of going, Hey, I used to be here, but I think I'm here now with my understanding. And oh, and she's like, No, no, we haven't gotten Oh, I see what's happening. Okay, like, so she, she and I are having some sort of a thing doesn't matter what it is. And I kind of get my thinking together and elevate past it. But she's still back there where she might have been, like, I told you this as what was happening, and you said it wasn't. And so she wants to finish this. And so if I try to just jump past it, she kind of goes, like, don't make up an excuse. And I'm like, oh, no, this is not an excuse. Like, I've had like a real revelation just now. And oh, okay. I'm sorry, that was probably too personal. Sorry.
Erika Forsyth, MFT, LMFT 21:07
No, it's good. I think you're giving shedding light into the Yep. The process of understanding and then integration of that understanding, and then how it impacts your communication, your relationships, all of that, because
Scott Benner 21:19
what we're going to talk about next to me feels like this is where it starts. So I'm sorry, I'm putting the cart ahead of the horse a little bit. But yes, yeah, go ahead.
Erika Forsyth, MFT, LMFT 21:27
Yes. So I think, and we can we can skip, do you want to move into the resilience piece?
Speaker 1 21:33
Sure. Yeah, that's fine. Okay. Because I think I think we've we've
Erika Forsyth, MFT, LMFT 21:37
understood and highlighted the connection between peace to PTSD, chronic illness and vice versa. And in the world of diabetes in general. There's also tons of research around adversity, and trauma and how that connects to diabetes diagnoses in general. Okay. So
Scott Benner 21:56
so we've talked to all about this. Now we know what it is, and we know how it's hurting us. What do we what do we do about oh,
Erika Forsyth, MFT, LMFT 22:01
what yeah, now what? How do we become more resilient in the face of this understanding of how trauma impacts us? Okay. So one of the biggest things that we want to spend a lot of time on is connection. And one of all of the research says that one of the biggest protective measures and things to address and identify is your connection. Who is your support system? Where do you feel seen, validated and that you matter? Where do you feel safe? Who are you connected to in a way that feels like it's a reciprocal relationship? So those things I encourage you to think about? If you're feeling if you're struggling and feeling like, Okay, I'm stuck, I understand I have this trauma. And now you're telling me to connect to people? What do I how do I do that? Yeah. Okay. So when in one of Brene, Brown's books, the Gifts of Imperfection, where she focused, she's done 20 years of research, and out of this research, she picks up themes, and she identified five things that are the most common factors of resilient people. Okay, so I'm gonna list these and then we're gonna gonna go into like, Okay, how do I, what do I do with this? How do I get into these, how to become more support, okay, I'll just go, they are resourceful and have good problem solving skills. Number two, they are more likely to seek help. Number three, they hold the belief that they can do something that will help them to manage their feelings and to cope. Number four, they have social support available to them. Number five, they are connected with others, such as family and friends. Okay, so one of the themes, there are connection, resourcefulness hope. Now, that's really hard to do. If you are living in a place of stuckness, right, because of your trauma because of maybe depressive thoughts and feelings, maybe because of anxiety. So it's, it's hard to make the sleep. So I'm hoping that through our conversation, we can kind of shed some light into how to get to that place. Okay, so duct. So going back to Dr. Perry, who I've referenced a ton he also agrees with that the best predictor of your current functioning is your current connection. And he says independent of how bad things were in the past, how bad your trauma was adversity, how bad things are right now. If you are in connection, you are in an environment where you will have many opportunities for healing. He talks about how you might you might see the best therapist in the world once a week, and that will help you process some of your past pain and trauma. But if you aren't in connection and seeing other people in really in a reciprocal relationship, it's really challenging to get better. Okay. So with that,
Scott Benner 24:57
I'm sorry. Yes. If you don't see me People are in a reciprocal relationship where you don't have one, or both. Both. Okay, because
Erika Forsyth, MFT, LMFT 25:04
that gets into loneliness. Oftentimes, when people have experienced, will pretty much I'd say all the time, when people experienced trauma, they experience a sadness that can lead to a sense of loneliness. And oftentimes when people and we and we, that's why, you know, there's people find support and connection and Facebook groups, and we're so hungry for that, because people are lonely, there's a risk to that, which we'll get into, right. But people experienced loneliness as a result of a diagnosis of a chronic illness because nobody understands it initially. And when people so loneliness, what you just got into what you just reflected, Scott was really interesting, because loneliness is a feeling of sadness, due to perceived lack of companionship, friendship, or any social bond or relationship. So it's, it's a perceived lack of reciprocal relationship, right? So if you enter in to a conversation with someone, and you're anticipating to get something back from them that you didn't, you're gonna you feel lonely. Yeah. Right. Like, like, Oh, I feel I feel really close to this, even the checker at the grocery store. But maybe the checker is having a hard day, and they keep their head down. Like, oh, I don't I don't, I didn't feel like I had that connection that we used to do. That's a really minor example. Okay, so because when you're lonely, you're in self preservation mode, which prevents healthy social interactions. So you're in that it's like this vicious cycle, right? Where if you're feeling like, no one understands me, I'm suffering. I'm going to preserve my myself. So I'm not going to engage in conversation or connection with people. And then that perpetuates that that perceived lack of friendship and connection.
Scott Benner 26:57
You can feel lonely, but still be around people, right?
Erika Forsyth, MFT, LMFT 27:00
It's different from alone, right? Like you can, you can be, you know, the common example is like the billionaire, and everyone wants to be their friend, and he's talking to people, or she's talking to people all day long. But she can go home and feel lonely. Yeah. Right.
Scott Benner 27:17
So I'm having just so you know, before we move forward, I'm, I feel very sad right now, because there's a person that I'm connected to who I've seen in crisis, like two years ago, now, they're doing much better now. But I was there during their crisis. And he kept saying that people don't care about him. But he was full. He was in a room full of people who were trying to help him. And I think I realized, over the last couple of years that he had put himself in such a position with all these people, that they all had some trouble with him to the point where he felt like they didn't care about him anymore. Like, and I think he knew he put himself in that position. But yet he didn't do it willfully. If I look at that aces list, he's got five of those contributing factors. He was on this collision course probably since he was five years old. And to watch it as an adult, happened to him. Like as you're talking, I'm thinking about him, I feel I almost cried a minute ago, just like having a memory about him. Because I thought, Jesus, this is all about how he grew up. He's a good person, he loves these people like you don't he mean? Like he didn't, he didn't do any of these things maliciously. And it's really, really something and I'm watching him work out of it. Now. I'm proud of him. But it's taken a long time, to interesting to, to reflect back on it just now. Also, I can't cry in the middle of this. I did tell you
Erika Forsyth, MFT, LMFT 28:42
know, I saw you going you were in a place of reflection, I could tell
Scott Benner 28:46
I needed to let it out so that I could keep listening to you. And talking so sorry. But no,
Erika Forsyth, MFT, LMFT 28:52
that's good. But yeah, and I have to bring up this I wasn't going to this is from a quote from Brene Brown that I wasn't going to talk about today. But I have it up that I have to just quote right now because it summarizes exactly what you were just describing with your friend she says out of our woundedness we protect ourselves by being as unlikable as possible. So we beat people to the punch from hurting us. And then we ensure our demise because the thing that we need to overcome our woundedness is relationship, but the risk of hurt and the risk of having the old tapes reactivated is too great. So that is how loneliness is this kind of vicious cycle, right? Where you're trying, you're preserving yourself. You're gonna end up because you're you're acting out of your woundedness your trauma, all the things that you were have been exposed to in life. You ensure the demise because you're just gonna be like, nope, nope, I'm not gonna engage and I don't want to get hurt. Just
Scott Benner 29:51
simply said, I'm gonna make sure you break up with me before I break up with you before you break up with me. That kind of thing. Yeah, yeah, yeah, that can For sure, yeah, you see that happen a lot. But, but that's the same idea. So I, oh, that's so horrible. She's okay. Or do you know where that quote is from
Erika Forsyth, MFT, LMFT 30:11
that is from it's probably from the Gifts of Imperfection, okay? That she in one of her? Yes, I'll have to look exactly or it's from her podcasts talking about her book. But it was around, you know, the theme of, of loneliness. And she also, she also quotes John Cacioppo who I can't remember if we referenced this in the beginning, who did a bunch of work and research on loneliness. And he says, loneliness is like an iceberg. It goes deeper than we, then we can see. And loneliness is a better predictor of early death, and smoking, obesity, cancer, it just is another reflection of all the things we've been talking about that everything matters, and everything is connected. And so if we've experienced trauma, we can feel lonely, it can become the self perpetuating the vicious cycle, where you feel like nobody understands you don't have any kind of reciprocal relationship. And that is really hard to then hear me say, I just want to spend, you know, it's why I'm spending some time here, I understand the challenge or cycle, all you have to do is just get connected to people to become more resilient. So it's really important to understand if you're kind of feeling connected, or an agreement with some of these things that you are lonely to understand how, what is the source of the loneliness? And has that manifested itself into depression? Or is it a response to trauma? Is it a response to a loss, which we talked about diabetes, there is a loss, right? Yeah. Did you have a move? Did you change jobs, it can be something that we owe a major stressor, like a change in relationship, a change in Job, a change in your environment, we all have moments of loneliness in our lives. But if we don't pause and look around and note that that's happening, it can very quickly develop into a prolonged issue and challenge. Okay, do
Scott Benner 32:13
you think there's a spectrum of this? Like, we're talking about these kind of big examples of people having like big problems, but could people be going through this oil, high on a smaller scales and not seeing big problems? So they're not aware of it? Like, do you think that some variation of this happens to all of us?
Erika Forsyth, MFT, LMFT 32:33
Yes, okay. Yes. So we all we are human, we are, we are created and built to be in connection and relationship. That's kind of an understanding. Consequently, we also because we have this human need to connect and relate, because of life, and stress and change, we are going to experience moments of loneliness. It's not abnormal to have that. But if we continue, I'm thinking like you, there's a move, you move cities, states, and you're going to experience some loneliness initially, but maybe because of other factors going on in your life, it's hard to start reaching out connect, or
Scott Benner 33:14
you don't even notice it right away. Maybe that's right. Yeah. Feels like Oh, I'm so busy. I can't meet anybody or something like that. And you're lonely, but you don't I call was I know, Cole was lonely when he went to Atlanta. And I asked him about it constantly. And he always said, No, but I don't believe that he wasn't honestly. So you know? Yes.
Erika Forsyth, MFT, LMFT 33:33
And it takes, it takes time. Like if it if it's one of those external, you know, changes, it takes time to adjust. But even in that space, to get connected with people is hard. And that's where that the vulnerability piece comes in. So what do you do? If you think, okay, gosh, I'm lonely. Oftentimes, they say, you know, a lot of people will say, well just go out and meet people go to the group things meet, join groups online, those things can help. But it really, if it's become a struggle for a long period of time, the duration of your experience of feeling lonely has been so long, and it's impacting all your functioning. That's when it's time to say when did why did I start to become lonely? What was the kind of the circumstance that triggered this experience? And kind of start to unpack that, and then you start to kind of relearn how to connect, trust, relate and be vulnerable with people. And it's a journey. It's a process, it's hard
Scott Benner 34:35
to find people even jive with sometimes, you know, like sometimes finding people is not the problem finding the right people's the problem. And how do you do that? Even especially as an adult once you're working and everything it's, you know, I'm sorry? You're painting a hopeless picture.
Erika Forsyth, MFT, LMFT 34:52
Okay, okay, but we're gonna come we're gonna Yes, great work. Okay. So how can you support We now know Okay, those are the factors of resilient people. Now, how do you develop those factors? How do you develop resilience? Now, one of the things that Brene Brown, and I know I've mentioned it a ton is the vulnerability piece. And she defines vulnerability as experiencing uncertainty, risk and emotional exposure. Now, if you're operating from a place of grieving trauma, you're like, Heck no, am I going to go and be vulnerable? Because I don't feel safe. That and that, again, perpetuates itself. Yeah. So understanding that I love this, this quote that she says, if we are brave enough, often enough, we are going to fail. And this is the physics of vulnerability. So if you're in this place of like loneliness, and you're like, I can't risk anything, I don't want to be winded. I'm not going to be vulnerable, you stay there. But if we lean into as a society as a culture, that we are going to make mistakes, we are going to fail. But we have to take this risk to be to expose ourselves,
Scott Benner 36:12
because you're failing now. So you might as well fail moving forward and see if something doesn't work out. Yeah, if I stand here, and I don't move, this is always going to be like this. If I move forward, it might still be like this, but at least I can keep moving forward. And then one day, oh, my God, this work this time, but it's never going to work. Sitting on your sofa, I guess is the way to put it. Right. Like you gotta get up and go. Yes,
Erika Forsyth, MFT, LMFT 36:35
yeah, yes. So how do you how do you do that? How do you get up and go? Okay, so these four things, according to Brene, brown, is the first thing is to develop hope. Now, if you're if you have depression, it's one of the key symptoms and experiences is despair. So again, we're holding these things in like, Okay, if you are experiencing depressive anxiety, traumatic symptoms and behaviors, there needs to be a component of treatment of, you know, real, professional help in conjunction with these other things. Okay. So developing hope. And oftentimes, when you've talked about this, you've had, you've always had hope and positive mindset. Is that because of your genes, maybe, but it's also a choice, I think we often think of like, it's a feeling like, Oh, I feel really hopeful today, but it's a joy. Yeah. And psychologist, Dr. Schneider says, There are three steps to that you got to set goals that are realistic, you have to plan towards those goals, and then have the knowledge and the understanding that you're going to achieve them. But with the caveat that you're going to fail, there's going to be moments of disappointment, and increasing that tolerance, to the disappointment is part of that journey. So I think so often, we when we're feeling stuck, and hopeless, it's hard to say, Okay, today, I'm gonna get out of bed and brush my teeth. Like, what's the point? Right? And, and some days, you might, you might not get out of bed and brush your teeth. But setting that first goal of like, I'm gonna get out of bed, I'm going to brush my teeth, and I'm going to change out of the shirt I was wearing yesterday to shirt I'm wearing today. Yeah, that's, that's a goal. That's a plan. And know you're going to do it with with the understanding that you might fail. And that's okay. Some of the days,
Scott Benner 38:25
my son's been having these conversations with me about time and memory. And I was talking to him the other day, and I said, you know, everything you're telling me really makes me think over and over again, that life is just now it's a super simple thing to say. But like, if I'm not actually remembering my memories, exactly right to begin with, right? You don't mean that that means that in its best moment, that memory is when it was happening. And so that means that right now is my bet is my new best moment, I'm going to continue to have new best moments, I can't live in the future. Although I can I can set up hope for the future. I definitely can't live in the past, because the past isn't even exactly how you remember it to begin with. So now is life. That idea of like, what's gonna get me up and get me moving to me is I don't want my life to be sitting here. I would just much rather die trying. I guess. Like that's sort of I know, it seems like too heavy handed. But it's I mean, it's right. It's a it's a common saying, like, I just want to get moving and then see what happens. If it doesn't go well. It's no worse than sitting here not trying, in my mind. And you're saying that there are going to be some people in that in a situation that is so maybe dire. They're going to need professional help to get back to that idea.
Erika Forsyth, MFT, LMFT 39:39
Yes, yes. And sometimes even that's when made them medication could be beneficial to antidepressants and I you know, anxiety medication to get you back to that baseline, right. Oftentimes, I think we think about medication is like, Oh no, it's gonna be this lifetime thing that I need, but most Often when psychologists psychiatrists prescribe medication, it's to help people get back to that place of being able to have hope to get up and brush their teeth and get out of bed. Yeah, okay, right. Yep. Okay, so having hope, which is the choice, it's a way of thinking. The second thing. This is, again, these are ways to help, how to become more resilient. Number two, use critical awareness to combat societal pressures. So societal pressures, this means evaluating the media that you observe, you read you intake and consume, and the expectation is that it communicates. So this is really a critical piece, because from the moment you're born, and now to present day social media, TV, back in the day was like commercials right? magazine covers, right. Yeah, right. Yeah. Yeah. When I grew up, it was like, Yeah, you're you're not the magazine cover. But it's all of this input. And messaging, that you are not good enough, unless you look this way, buy this thing, do this exercise. Eat this way. Yeah. It's really easy, though, when you're lonely or feeling hopeless, or in despair, to scroll to be influenced, and be influenced by the societal pressures. So this is where, you know, we we talked about the pros and cons of any kind of diabetes online community, it could really help decrease that feeling of isolation. Yeah, and find support. But you also if you're finding that you're looking at this and scrolling and saying, Well, I can't become it, I can't get a 6.2. And I am not a good enough caregiver. I'm not good enough diabetic, I'm not a good enough Pre-Bolus. Or that messaging becomes really easily ingrained. If you are not aware of how that is influencing your mindset. Okay, the
Scott Benner 42:02
scrolling ruins everything. By the way access to access, I can't believe I'm saying this. Yeah. Some access ruins. Yeah. Like, look how my examples are not going to be palatable for some people. But this social media has ruined boobs for me. Like it was used to be so exciting to see a lady and now it's just not anymore. You're like, oh, yeah, look, this one's breastfeeding in the Walmart, like, hit like, you know, like, okay, and movies to access to like entertainment. Everyone has sat in their living room for 90 minutes, scrolling through choices and not ended up watching something. Because you're like, I can't pick anything back when you were like, hey, guess what? Indiana Jones is out. You want to watch a movie? That's the one we're watching. There is no other one. Well, what about Star Wars? That's not the theater anymore. You can watch that again in 10 years, when that used to exist you You took advantage of what was there? Now there's so much there, it overwhelms you, you get frozen. And so I think you're talking about something similar, honestly, it's like, there's so much access to so many images and ideas that your brain just goes I'm not those things. And then you can't move you know, and meanwhile, I know this is over stated, but everybody's not beautiful. A lot of beautiful people put themselves on social media, but there are far more people like me, and you know, and like you listening and we're like, Look, I'm not perfect, but I don't need to be perfect. I can't be perfect. But back in the day in the 70s. It was like, Well, I don't look like Cheryl Tiegs. But she was also the only one you knew who looked like that. I mean, Erica, you know, right? You go on Instagram. Every person looks like a model. You're like, oh my god, is the whole world. Beautiful. No. But Instagram is that going where those people are and then judging yourself against them. It just, it's so funny. Like, we don't do it with anything else. I don't watch a baseball game and go, I can't believe I can't hit a 420 foot homerun. I just think those are special people who can do that thing. I'll watch it. But when it happens in these other spaces, it really does make you feel terrible. Sometimes you're like, Oh, God, I'm never gonna get to this. You were never trying to get to that. But all of a sudden now you're now you're in a race. You didn't even mean to be running anyway. Yes.
Erika Forsyth, MFT, LMFT 44:15
Because Because that tape that's being so easily triggered and replayed over and over again, I'm not good enough. You it's really it's hard to come out of that and say, Well, I'm gonna go build hope and follow my goals that I just set for myself. Right? So just having and I know it's Thankfully we're talking about it more and more. But just having that awareness around how much it's influencing your mindset, your choices, your thoughts about yourself and others is really, really important. You can
Scott Benner 44:45
start feeling like if I can't be that, then nothing's worthwhile being which is ridiculous, cuz there's four of those people. Yeah, yeah. You know what I mean? Right. And
Erika Forsyth, MFT, LMFT 44:55
and it could say, you can kind of catastrophize it To end globalize it, right like, oh, I can't, I didn't nail my my Pre-Bolus or my a one C, I must be a really terrible mother, or my whatever it is.
Scott Benner 45:11
And other things. Yeah, yeah. If I can't do this, I must not be good at that either. Yes.
Erika Forsyth, MFT, LMFT 45:16
As opposed to, oh, you know what, Gosh, I really I kind of goofed today. But I'm still really, I'm still doing the best I can. And I'm a great person, you know, if
Scott Benner 45:26
you can't figure out a way to stop looking at it, I would go from the aspect of somebody is sitting in a room right now, who knows, you're gonna feel like that. If they tune their algorithm the right way. And they're doing that to make you feel that way to keep you in that algorithm longer. Be mad at them and just leave. Like, for that reason. It's like, it's almost like smoking to me. I know, I've told you this before, but I told my brother one time when he was a little kid, I was like, there are 10 really rich people sitting in a boardroom right now laughing that you bought those cigarettes. Now and so you know, go ahead and make them rich if you want to. But yeah,
Erika Forsyth, MFT, LMFT 45:57
power, power and money. Yep. Okay, I'm
Scott Benner 46:00
sorry. Okay. Okay. Can I read one? Yeah, I never get to read anything. Well, yeah, read the next one. Read number three. Number three, refuse to numb your negative emotions. Avoiding feeling negative emotions such as sadness, disappointment, shame, anger, via alcohol, drugs, shopping, scrolling, it may eventually look like avoiding looking at numbers avoiding Pre-Bolus saying avoiding calculating or even guessing the, the best you can about your diabetes. So wait a minute, how does that do that? Go ahead and refuse
Erika Forsyth, MFT, LMFT 46:31
to numb your negative emotions. This is a really big one, okay? Because when you're trying to build resilience, which is right, like overcoming adversity, having the hope that you can achieve your goals. Once you start to feel like from going from number two, you starting to feel I'm not good enough. And you're starting to feel that sadness or disappointment or shame. We are a society that numbs those hard to have feelings. So you're numbing often with alcohol drugs, going back to the scrolling, which is perpetuating that I'm not good enough feeling or thought. And then you're starting to numb everything. And avoiding, right so I can even play out to like, what's the point? I'm going to numb and avoid taking care of my diabetes through that is a you don't even want to feel it right. So you're going to avoid looking at the numbers. And this happened. It's easier. It was easier to do when you didn't have your, you know, your apps with your numbers all the time. But it was like I'm not going to take my blood sugar. But now people might not look at the number on the app, right? I'm just going to avoid it. I'm going to not engage, because I don't want to feel, yeah, that feeling that I've associated with. If I have a disappointing or shameful feeling corresponding to a number, I'm going to avoid it. Does that make sense? I had a
Scott Benner 47:56
woman telling me that she couldn't say the number out loud when her parents asked her she'd like throw the meter at them so they could see it. But even if the number was good, bad or indifferent, she couldn't bring herself to like utter the words. She didn't want to say it out loud. And this, again, is rolling back into this conversation I had with a doctor recently. Because she goes, I had this one patient, I'd look at their clarity report, they were 400 for like days, which just indicated to her, they didn't even look at their CGM. And that's what you just said like so like, even though the data is right in front of their face, they'll just willfully ignore it through this numbing process. This is interesting, right?
Erika Forsyth, MFT, LMFT 48:35
Because you because you don't want to feel that. And that's if you have that association of shame connected to the numbers, right? So you're going to, and I'm kind of loosely connecting numbing to avoiding Yeah, but you're trying to avoid feeling those negative feelings. And so I'm saying you're kind of numbing, but really you're avoiding management. But does that make sense? Does
Scott Benner 48:59
I want to roll backwards for half a second, back to number two, the critical awareness like about those societal pressures? So there's a difference for people. If someone goes online, it's like, hey, look, here's my one. See, it's five, eight. Here's how I did it. I just you know, you guys should try it if you want. There are people who will see that and go, Oh, I'm gonna try that. That's fantastic. And there are people we're going to try that we're going to fall into this trap here, or we're already in this trap. Right? Then that becomes an argument because this is a place where I had to make a decision a long time ago, like who am I going to be in this space? Am I going to be the woe is me person who just goes up to people who don't feel well and go, Oh, I know. It's terrible, you know, or am I going to be the person who goes I think this is possible, like here, look, someone's doing it like a spider. Because you kind of can't be all things to all people, but being one or the other. No matter how you present your information in this in this diabetes specific situation. Some of the people are going to be pissed at you because they're going to say you're making me feel bad or they're going To say, God, you knew the answer to this and you didn't share it to me like, like, right? Like no matter what I do, someone's gonna hate me for it. And so I decided to go with hope, because that's just kind of how I'm wired. And I thought I'll bring people along with me. And hopefully, we won't hurt too many people along the way. But I don't think shifting this to me for a second, it gets us off track. But that's not my responsibility. Right? Correct. Because like, how you how you're going to respond? Yes,
Erika Forsyth, MFT, LMFT 50:28
because we're only in control of our own thoughts and feelings, responses, we can't, you know, control other people's reactions. However we can we can be that's not an excuse to be a jerk when I know that's not what you're
Scott Benner 50:41
obviously not being a jerk about it. But so but my point is, if you're a person who's going to be triggered by that, it's incumbent upon you not to look at me, then is that right? You don't get to tell me I'm doing it wrong. Which
Erika Forsyth, MFT, LMFT 50:55
is right, well, it's like you could, but then you can also choose to, like, not engage with it. Yeah, just be
Scott Benner 51:00
done with it. Right. Like, yeah, like, that's what I would do normally, but but do people who end up doing that? Are they predisposed to doing that? Because they're so into this trap. Like they're already so far in this pit already, like maybe lashing outs, the only thing they have left?
Erika Forsyth, MFT, LMFT 51:15
Perhaps that's the way that you're trying to kind of make yourself feel better, make yourself feel better. But also, I think it's going back to the sense of like, where are you in your journey of resilience? To say, you know, what, in this example, okay, Scott is giving you the Pro Tip series, right? Or beginning series, one can look at that and digest that and say, well, good for him, I'm never going to be able to get that it's more like an all or nothing thinking, yeah. Or the alternative is to say, with some hope, there's so many things, I'm so overwhelmed. I'm going to start with trying to Pre-Bolus just for my breakfast meal. And I might forget every other day, but I'm going to try this one thing. And I'm going to expect that I'm going to do it and have hoped that I'm going to do it and have that mindset, but I'm also going to hold that I'm there's this tolerance for disappointment in it. So your question of when people are lashing out and saying, Why are you telling me
Scott Benner 52:22
Don't show me your great success? It makes me feel bad. Okay. Yeah.
Erika Forsyth, MFT, LMFT 52:27
Yes. And that is a hot topic in the Facebook group. I know.
Scott Benner 52:30
It's a hot topic and diabetes since the day I've been involved. Well, yeah,
Erika Forsyth, MFT, LMFT 52:34
diabetes. Yeah. So I think it goes back to the delivery. And we've talked a ton about this, the delivery of the information, to be mindful and compassionate. But also holding that you can't control other people's responses. And then if you are the digester, you're consuming that information, being mindful of Why am I being triggered in this way? Is it because it's is it triggering this old tape in my brain? That I am never going to get this? I am never going to be a good enough diabetic, right? So be mindful of like that those three things, the delivery, the tone? And then how how are you being? How are you consuming it? And is it triggering the tape? And for those of you Yeah, I don't know, tape is such an old
Scott Benner 53:18
thing. No, but no, you're making it listen, I asked the question, because I think that's the answer. And like, and this will sound pejorative for a second. But I don't mean it that way. Like, if you make nerfing the world my responsibility, I'm not going to have any time to help all the people that have been helped by the podcast, like there's got to be a point where I say, not everybody can, can accept this right now, some people are going to be in this position that we're talking about. But that's why if you hear this and you feel that way, the reason I brought it up right here is if you hear this and you feel that way, go back, develop hope, use your critical awareness, like do these four things that we're talking about here it because you're in that position right now, whether you know it or not, if you're busy telling me I'm the reason you feel bad, then or anybody doesn't have to be me, I put it on myself for this. But if you're busy telling yourself, they're the reason I'm not doing well, please hear me, you're probably trapped in a situation you might not even be completely aware that you're in. Yeah, that's how I feel. I don't know if you'll agree with me or not. But well, I
Erika Forsyth, MFT, LMFT 54:22
think it's a little bit different if we're sticking into this very specific example of you are very clear in your messaging and goal of helping people manage their diabetes, right? So maybe it becomes more confusing in that concept or that conversation when other people are saying this works for me or do it this way, or when
Scott Benner 54:45
it's more and more social media manipulative, or that kind of thing. Okay. All right. Like when they go they say stuff like do you feel like this? Oh, my God, I do. And you know, and then the next thing you know, you're three swipes over and the Instagram story and they're offering you Coaching for just $300 a month, you're like, Oh, yes. All right.
Erika Forsyth, MFT, LMFT 55:03
I mean, this, we're going into, you know, the boundaries conversation, which I think is a really fascinating one of how you are communicating with somebody else. How are you receiving someone else's communication? How is that impacting you? Is, is a whole other conversation around emotional physical boundaries? Let me
Scott Benner 55:23
drop that so you can finish and maybe we'll talk about later.
Erika Forsyth, MFT, LMFT 55:26
But yeah, yeah. Okay. So the fourth thing that Brene Brown had identified through her 20 years of research is embracing spirituality. And she is very clear, and that it's not about when she says spirituality, I know people might think of church or religion, but it's actually a really different concept. And so she defines spirituality, as recognizing and celebrating that we are all inextricably connected to each other by a power greater than all of us. And then our connection to that power into one another is grounded in love and compassion. practicing spirituality brings a sense of perspective, meaning and purpose to our lives. So again, she goes through all different examples that people talk about, you know, practicing their spirituality in houses of worship, like churches and mosques or at the fishing hole that most people do reference God, but it doesn't have to be. So it's this larger concept of interconnectedness that was identified as people who were resilient or working on becoming more resilient, which I think is a really important component, particularly as I think there's a reason why there's so much power in the diabetes community. Yeah. Because even in that essence, of whether it's online or in person, however it is, you feel that connection, right?
Scott Benner 56:47
No, I'd say it's like, when I can't do it, we can do it. That sort of feeling like you're not really with me, but I feel like you are. And whether that's a person on Facebook, or, or God doesn't really matter, as long as you have that feeling.
Erika Forsyth, MFT, LMFT 57:00
Yes. Yeah. And and wreck it Yeah, recognizing it, celebrating it. And I think it becomes, it is so painful when we see within the context of even just the diabetes community of people kind of going after each other. Because there's beauty in that, like, No, we're all here together. We're all in this together. Yeah, let's let's offer this compassion to one another, we all have different experiences of living with it. We all have different challenges because of our past because of how we function and because of how we process challenges. But to embrace that concept of like, we are connected, let's offer compassion to one another, breeds that sense of resilience. This is
Scott Benner 57:43
such a lovely ending, because I don't even know if Erica knows this or not. But I just got out of the shower one day and texted Eric and said, I'd like to talk about resilience on the podcast, then she weeks or months later sends me back this document. She's like, I think this is the outline for maybe a four part series about resilience. And we're here at the end. And I'm like, oh my god, it's the things that that are always important. You know what I mean? Like these always important things, I found them at the end of this path. And the part you may or might not be surprised by is I didn't read your document when you sent it to me. Like I wanted to experience it as we were talking about it. And so like, while you were building the, you know, building the story for people. I mean, I think it's pretty obvious how we do it, you build the story, I have realizations, we chat through them, etc. But I swear to you when we got the end here, and it was like I was like, oh, it's hope, critical awareness, not giving into pressure. Don't numb yourself find community. I was like, God damn, how about that? Like, I actually like at the end, I was like, I didn't think this was going to be how this ended. It makes a lot of sense that this is that this is the end of what we're talking about. Truly. Yes. Wow. Wow.
Erika Forsyth, MFT, LMFT 58:55
Yeah, they're hot. They're like, as you said, kind of hallmarks hallmarks. And like, yes, of course, that makes so much sense. Yeah, and yet it's so it is hard to implement. But I think it's so important to end on this on this hopeful piece that this is what is identified and recognized in the in the research and the literature and can be implemented. And if you if you are feeling stuck, or challenged even through these last four notes of of hopefulness, awareness, refusing to numb for seeking spirituality that you're there's, you know, there's something greater than just yourself, yeah, to reach out for help, again, to whoever may be and if even that part is feeling challenging. Starting with, whether it's a therapist or an email to I was gonna say to you, don't
Scott Benner 59:48
don't email me I'm very busy. But listen, develop like, Be hopeful. Believe in yourself. Don't listen to other people. Believe in yourself. Don't put your head in the sand. Go and You find some community because you're going to need help. That's it. Yeah, that's fantastic. And
Erika Forsyth, MFT, LMFT 20:00:05
community again, the community doesn't have to be you don't have tons and tons of relationships if you're experiencing that loneliness, starting with one career person. Yeah. When? Yeah, when another person I
Scott Benner 20:00:17
see people in the Facebook group become friends all the time, like, I don't, I don't like pry into their business. But like, I know, I'm thinking of this one person right now. I did a live thing the other night. And I was like, Oh, I wish this person was here. And somebody goes, I'll text them. And I thought, how the hell do you know how to text them. And then I realized, as I called, they became friends to my little podcast. And that looks like you don't even like that. And even if it's just the two of them, and I'm sure it's not, but even if it was just the two of them. Now they've got the connections, the right word, but it seems lame to say but like, there's a synergy, like you can feel each other's energy this way. And when yours is waning, there's can kind of make up for you. Like being hooked to a lot of different batteries, almost and one starts to go down. And maybe, you know, you steal a little charge from the other one. Wow, this was great. Thank you that I'm gonna text you more when I'm in the shower. It's working out really well.
Unknown Speaker 20:01:10
You're welcome. Thank
Scott Benner 20:01:11
you, please did not go anywhere. Like I thought it was gonna go. I'm so pleasantly surprised by what you did here. Congratulations, and Bravo. Thank you. Oh, thank you while we're recording, so I never say nice things to you until we're done recording usually. I don't know what I thought was gonna happen. Yeah, I
Erika Forsyth, MFT, LMFT 20:01:29
was just going to ask you what, what did you anticipate?
Scott Benner 20:01:32
I mean, I don't know, I'm a boy. Like these things that I do naturally, I don't see them thoughtfully like this. Do you know what I mean? Like, I just figure, I don't give up. And that's why stuff works for me. And I'm thoughtful about stuff. And I pay attention. And I move away from things that don't make sense to me. I don't let people tell me no. But in the end, if you asked me to quantify that, I just be like, I don't know, man. I'm just hard headed. Like, that's pretty much how it feels to me. And it's not true. Because as you were going through all this, I was like, Oh, that is who I am. Or that is what happens to me or that is why I feel like that. And it's nice to have that feeling because it resolves tension, and makes me feel lighter when it's over. Like that's literally what I would hope people get out of these four episodes. If they listen through them. I hope when it's over, they're not gonna have an answer to their problem. But they might feel like it's more doable. And, or they can at least understand the reason why it's happening to them so they can stop blaming themselves, or somebody else. Yes. Oh, wow. Look at you. You're doing the Lord's work. Good. I kept you over. I'm so sorry. It's so good. Thank you hold on one second. Want to take another moment to thank Erica for all the hard work and preparation that she put into the resilience series. And I want to remind you that you can hire Erica to be your therapist at Erica foresight.com. Or if you're in California, you can see her in person. A huge thank you to ever since CGM for sponsoring this episode of the podcast. Are you tired of having to change your sensor every seven to 14 days with the ever since CGM, you just replace it once every six months via a simple in office visit. Learn more and get started today at ever since cgm.com/juicebox. Arden started using a contour meter because of its accuracy, but she continues to use it because it's adorable and trustworthy. If you have diabetes, you want the contour next gen blood glucose meter. There's already so many decisions. Let me take this one off your plate. Contour next one.com/juicebox Are you still here? Why are you not getting your tickets to the touch by type one event or at least checking them out on Facebook and Instagram touched by type one.org. If you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective, the bowl beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CDC es a registered dietitian and a type one for over 35 years. And in the bowl beginning series Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698 In your podcast player, or you can go to juicebox podcast.com. And click on bold beginnings in the menu. 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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#1249 Grand Rounds: Dr. Nader Kasim
Dr. Nader Kasim, a pediatric endocrinologist diagnosed with type 1 diabetes at 18, shares his personal and professional journey. They discuss managing diabetes as a student, the importance of understanding insulin use, and the challenges patients face.
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
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends and welcome to episode 1249 of the Juicebox Podcast.
Today on another episode of the Grand Rounds series, we talked to a Pediatric Endocrinologist, Dr. chasms gonna pull back the curtain and share his perspective on endocrinology. 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. T one D exchange.org/juice. box you want to help, you can go to that link, join the registry, complete the survey and just like that, you will have helped with type one diabetes research that's T one D exchange.org/juice. Box, do it do it as a favor of me please take you like 10 minutes. Let me pay back that favor. If you like comfortable and quality, you're going to love cozy earth.com Go there, buy whatever you want. Save 30% off of everything you get with the offer code juicebox. And don't forget the private Facebook group Juicebox Podcast type one diabetes on Facebook. It's the greatest community there is bar none. It's a private group. So you have to answer a couple of questions to get in. But after we know you're not an algorithm. We're a evildoer. We'll let you write in there and you can meet 51,000 Other people living with diabetes Juicebox Podcast type one diabetes, no evildoers allowed. Did you know if just one person in your family has type one diabetes, you're up to 15 times more likely to get it to screen it like you mean it. One blood test can spot type one diabetes early tap now talk to a doctor or visit screened for type one.com For more info. Today's episode is sponsored by screen for type one. And also us med is sponsoring this episode of The Juicebox Podcast and we've been getting our diabetes supplies from us med for years, you can as well us med.com/juice box or call it 888-721-1514 Use the link or the number get your free benefits check it get started today with us med The podcast is also sponsored today by Omni pod five that's on the pod.com/juice box get over your FOMO fear of missing out on Omni pod and get started today with the Omni pod five using my link links in the show notes links at juicebox podcast.com. to screen for type one.com us med Omni pod and all of the sponsors when you use my links, you're supporting the production of the podcast and helping to keep it free and plentiful. My
Dr. Nader Kasim 2:44
name is Nadia Kasam. I'm a person who has type one diabetes diagnosed when I was 18. But I'm also a pediatric endocrinologist. I just like diabetes a lot. From the sense of an academic perspective. I think it sucks as a disease. Yeah,
Scott Benner 2:59
let's pick through it a little bit. So you're 18 When you're diagnosed?
Dr. Nader Kasim 3:03
Yeah, so as at first semester of college, it was when I was getting ready to learn medicine. It kind of hit me like a brick wall presented in decay. In the hospital for like a week. I had all the symptoms I lost like 20 pounds. Yeah. Didn't know what was going on.
Scott Benner 3:21
Not in your family. Nothing you were expecting.
Dr. Nader Kasim 3:24
Not really a distant relative with presumably type one. But everyone else has type two,
Scott Benner 3:31
presumably type one means they don't know. But that's probably what they have. Yeah, yeah. Just so old. They don't talk about it that way. Yes, yes. Gotcha. I have diabetes, I can't drink soda, something like that. Ah,
Dr. Nader Kasim 3:45
more so, you know, several generations ago, so I really can't explain what was happening at the time. How
Scott Benner 3:53
about other autoimmune issues, anything like that in your family or for yourself?
Dr. Nader Kasim 3:58
Alright, no, actually, no thyroid, no celiac. No inflammatory bowel disease or anything like Pernicious anemia or anything like that. Nice.
Scott Benner 4:06
I'll knock on wood for you. That's very good. Keep that going for you. So you're diagnosed the date teen you're away at school or somewhere local to your family.
Dr. Nader Kasim 4:17
So I was kind of both I was actually at school. I was living alone, but my family lived in the area. They were there. I had support, but I didn't see them often enough to really get their input on how to deal with things.
Scott Benner 4:32
Okay. How long ago was this? How old are you now?
Dr. Nader Kasim 4:34
I guess is my question. Yeah, some 3719 years. Yeah, you can do the math. Yeah,
Scott Benner 4:41
look at me. It's pretty impressive. Yeah, you saw me, not her. I was like 38 would have been 20. I'll just take one off of it. And that's exactly how my brain did it just now.
Dr. Nader Kasim 4:53
I do the same. Yeah, of course.
Scott Benner 4:54
So okay, so you it's an interesting time, right? Because you're diagnosed people We'll know you're a kid still, but you're away at college. So there's not a lot of, you know, there's not a lot they can do. If you want to keep going to college, they're not going to know, you also start learning about diabetes, presumably, or hopefully, while the rest of your family is not brought up to speed. So is that was that you're finding like, there was no one to help you?
Dr. Nader Kasim 5:21
I don't know if I would say it that way. There are people there. It's just, even though symptoms happen relatively rapidly. Because it's progressive, it takes a while for someone to say something. So you know, even it took 20 pounds of weight loss, falling asleep in the middle of class, for someone to say something. And it really took someone who hadn't seen me for a bit to say, You don't look well.
Scott Benner 5:51
It's hard because not everybody, you know, I just had a personal experience. I've lost 40 pounds using GLP medications in the last year. Nice. And I I'm looking for 20 More, by the way. But then I'm done. I was out in public, I saw a person I hadn't seen in years. And we're talking back and forth forever. And at the end, I said something about that. And the relief that came over them was really something because she said, Oh, I didn't want to say anything. I thought maybe you had cancer. Like it was that I looked that different to somebody but still, she wouldn't mention it. So like, it's it's interesting that it did a it takes a person who hasn't seen you in a while to notice enough of a change, but they also have to make the leap to say to you not are you okay? You know, it's really it's really something from your perspective. Did you notice the weight loss?
Dr. Nader Kasim 6:41
Yes. I mean, you do notice it, it's just you don't you find other explanations for it. And I mean, we've all heard this, right. Like, it's, you know, I, I thought I was getting sick with something else or had a stomach virus or, you know, so it's you play mental games with yourself. And because it's, although it's rapid, it's progressive. It's really hard to draw a line in the sand to be like, alright, nothing's right. I need to go seek care, especially as an adult,
Scott Benner 7:10
then how was your care? What did it look like for you 20 years ago is that I mean, that's faster acting insulin time, right? You were, you were doing I would imagine you started with MDI with something like love Amir Lantis.
Dr. Nader Kasim 7:23
So I was in DKA. So I was basically taken to the emergency room
Scott Benner 7:29
by a family friend. And, you know, I
Dr. Nader Kasim 7:34
started out in Saundra, and I was in the ICU for several days. And then when my dk or my diabetic ketoacidosis resolved, they switched me to injections. At that time, it was Lantus by vial, if I remember correctly, and rapid acting insulin was also by vial. Pens came out. It became more prominent shortly thereafter, so I switched relatively soon.
Scott Benner 8:04
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Dr. Nader Kasim 10:30
I was a carb exchange guy. The hospital I was diagnosed at was effectively a community hospital. So from my diabetes education perspective, you know, I got everything that I needed, but I wasn't really given the whole picture. You know, I was basically told, this is how you dose insulin. You know, you're supposed to, you know, one, one carb exchange equals this, you know, the multiple carb exchanges, you take this amount of insulin. It's given a sliding scale. I remember on the discharge summary, the sliding scale wasn't complete, it was all handwritten, and it wasn't completed. So remember, I had a high blood sugar. I was like, Oh, snap, I don't know what to do next.
Scott Benner 11:10
But, uh, yeah, how long? How long did you manage that way.
Dr. Nader Kasim 11:14
So the way it worked, then was they would actually refer you to your primary care provider, and then your primary care provider would refer you to an endocrinologist. So I'd say it took me about half a year to connect between the two. So I don't know if I really got any formal education or you know, kind of like a, like a medical home for a bit. Okay. It's really unfortunate. Yeah,
Scott Benner 11:41
so the healthcare provider just turns into the person who gives you like, here's needles, and you need a prescription for this and that kind of stuff. Yeah, yeah. And I,
Dr. Nader Kasim 11:51
I think from a medical perspective, like I was, I was given enough to, to kind of deal with the circumstance at the time. But you don't you don't get any of the nuanced stuff that you know, you kind of wish that someone told you later, like, this is how insurance works. You know, like, half your supplies might not come through the pharmacy. This thing costs a bazillion dollars.
Scott Benner 12:12
Yeah, Pre-Bolus. But now, I'm always high. If it doesn't come back down. It does, then it's fine. Yeah, that's the extent. So do you know what your outcomes were? Like? Like, say through your undergrad, for example? Yeah, so
Dr. Nader Kasim 12:31
I was pretty well controlled. So I honeymooned. So that helped a lot. And I kind of honeymoon for a bit, probably say, close to two years. I think it didn't take me long to figure out the impact of nutrition and activity and whatnot on blood sugar control. It did take me a while to understand what the big picture
Scott Benner 12:55
would be, as far as you know, what
Dr. Nader Kasim 12:57
the point of treating diabetes is. I'd say I lived a big portion of my life. genuinely having the goal of not being back in the hospital in the UK, when in all reality, that really isn't your primary driver. Right. You know, it's not not to have a heart attack or stroke or so, but I think for the most part, I did well, I did a lot of self learning. You know, I I wish that there were podcasts at the time that, you know, that would effectively you know, supplement. Whenever care, I did not get or supplement the care that I actually got their books. You know, I was I was in college, I was able to read medical literature. I I fared
Scott Benner 13:40
Yeah. Okay. It's interesting that you would say no, I mean, not interesting. Like, oh, I can't believe it. I hear people say it all the time, but that you didn't even have a goal in mind. Is is kind of fascinating, right? I mean, they 20 years later, doesn't that throw you off as a pediatric endo that, that people would that an 18 year old kid would be out in the world at college and not know why he was doing what he was doing?
Dr. Nader Kasim 14:05
Yeah, yeah. i And honestly, I still see this all the time. You know, in between transfers of care that we read, and people who've had diabetes for years, I asked, I asked that question. I'm like, what's going to come see us every three months? What's the point?
Scott Benner 14:21
And if I could tell you
Dr. Nader Kasim 14:24
how many I don't know how I was or, you know, I don't want to be in DKA. Or that again, no one really talks about the long term outlook.
Scott Benner 14:35
It's really common. Is it so common that it's not upsetting?
Dr. Nader Kasim 14:42
It really bothers me because you know, as an it's tough because I'm a pretender. So it's, it's hard. It's hard to expect a child to you know, to say this, especially if they're younger. But especially with like the older kiddos, just get them not knowing
Scott Benner 15:00
feels like, feels like feels like a big, big
Dr. Nader Kasim 15:06
gap in knowledge. And it's, you know, that's it's a place where emphasis should be placed, I think, do
Scott Benner 15:12
their parents know, generally speaking, where are you dealing with an entire family of people who just they're taking the steps, but they don't know why?
Dr. Nader Kasim 15:20
I would say, Yeah, I would say families as well. I think parents know, they just don't confidently know. So they're, they're aware that they're at risk for long term complications, you know, but it's, it's typically along the lines of I'm afraid of getting nephropathy or retinopathy. So like kidney disease and eye disease, because it happened to another family member, or it's because of, you know, to happen to someone that they knew,
Scott Benner 15:48
or I thought on a television show or something like that. Yeah.
Dr. Nader Kasim 15:52
Well, and just because it's, you know, you're talking mostly diabetes is type two. So, a lot of a lot of people who have type two, they can even get those complications early on, it doesn't take a long time, per se. Yeah,
Scott Benner 16:06
it's, um, I don't know, like, it just seems to me that, even while we're talking about it now, it wouldn't take me that long to explain type one diabetes to a person and why what they need to do is important, and then what those things are, you see it happen? I mean, you're in a position to do something about it, obviously, like, what's the, what's the thing that stops it from happening?
Dr. Nader Kasim 16:28
I think it's, it's partly because of our taught, like, as medical providers. But I also think it's part of human nature in the sense of how we think about things. So when we compartmentalize the two types of diabetes, so making generalizations here, but you know, we think of type two as the,
Scott Benner 16:50
you know, diabetes that's,
Dr. Nader Kasim 16:54
you know, heavily impacted by lifestyle choice and whatnot, when in all reality, that's really not what type two is, you know, for type one diabetes, we effectively remove the life style choice component of it. And we kind of put it in this box of, you know, we take insulin, and insulin normalizes our blood sugar. And that's how we treat it. That's correct, to an extent, because, you know, the most impactful thing you can do to reduce your risk of heart disease and whatnot, is to normalize your blood sugars, but there are many other aspects in life that impact your risk of developing these problems. I think if we can't convey this, then we're doing a huge disservice to, you know, people who are generally trying to lead healthy lives with diabetes, and they're not going to realize the impact of lifestyle choices until later in life. So it's going to be one of those too late circumstances. Um, but I think, on the medical side of things, we do the same thing. So when we're taught, you know, we, we oftentimes put a lot of emphasis on making lifestyle changes, or type two diabetes when you know, and then for type one, diabetes, there's a tremendous amount of focus on dosing changes, and, you know, the technology aspect of things. And when we kind of put the other things, I guess, to the side,
Scott Benner 18:25
it feels like, what you're telling me is that physicians are going to say, lifestyle, lifestyle lifestyle, and that's the last thing that patients are going to focus on.
Dr. Nader Kasim 18:36
That's also true, I think, I think it's, it's a harder thing to, it's a harder to harder sell. So if you have a short duration of time to meet with a patient, it's going to be very difficult to put a lot of focus on diet and exercise. And mental health is very similar to that, you know, and they're, they're very hand in hand, right?
Scott Benner 18:56
So the way I think about it, and the I guess the footing that I started off on with the podcast was I thought, well, I know about how to use insulin, and I know the good outcomes that come from it. And I'm pretty good at communicating those things. But here are the things that I can't control like I can I can put that information into people's minds into their ears and let them hear it. I can't control what they eat. I can't control if they exercise, I can't control if they're mentally healthy. Like there's so many things that I can't impact. What could I give these people? And I thought, I'll give them the knowledge of how insulin works, and they can apply it to their lifestyle, and at least have the healthiest outcome possible. No matter what their lifestyle is, like. I think that the things I talked about on the podcast would work as well for you if you had 20 carbs a day is if you had 200 carbs a day, then But moreover, the idea that you can tell somebody just eat differently, that'll help and that you should expect them to go Go home and do that is kind of insane to me. Like I know they should. I know we all should. But I don't think that's what happens. So I started with Well, let me give them something that's rock, solid and concrete. And then they can do what they're adults or they're the parents of children like they can do what they want to do with that information. And hopefully, they'll see the benefit of it, and make these adjustments along the way. I very steadfastly do not tell people how to eat, it is not in my purview. I do not care how you eat it, it's not up to me. But privately in my mind, if you don't think that I don't hope that you Bolus for a cheeseburger and fries with ice cream later, and then see what that's like. And then maybe the next day have you know, something a little more low carb, something a little more, a little less processed less oil, stuff like that and see the difference. I do hope you see that. But I don't think it's up to me to help you do it. That's sort of how I think about it. But you're in a different position. Like, you get the end of the stick if people don't have good outcomes, right, because they're gonna blame you at some point. 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 g7. They accept Medicare nationwide, over 800 private insurers. And all you have to do to get started is called 888-721-1514. Or go to my link us med.com/juicebox. Using that number, or my link helps to support the production of the Juicebox Podcast, even though they're the one having the fries and the ice cream.
Dr. Nader Kasim 22:33
Well, so I think you're spot on. And I it's really the intention is not to necessarily dictate or tell people how they should be eating. But in all reality, it's it's to educate. It's you know, and even even when you look at the diabetes guidelines, like the recommendations, just a regular general pediatric diet, yeah. So but if I can tell you how many people are not aware of just aspects of eating. So like the differences between food types, you consider the processed food versus a whole food, the impact of protein, the quality of the protein, same with fats, you know, the quality of your fat and how that's actually really relevant. None of that is very well known among I'd say most, most people who have diabetes, as a medical provider, I think that's really how we should approach it is to teach people, I think, similar to many other things that involve behavior, you kind of need to gauge where people are at and whether that that advice is welcomed or not welcomed. But I think as a medical provider, it's important to at least broach the subject and at least get a feel as to where people are at just because of how relevant it is to
Scott Benner 23:47
know everything delve into that idea of welcome or not welcome for a second because I think if I can stand away cold and calculated off to the side, third person, it's your job to tell me whether I'm gonna listen to you or not. But you're dancing, a different dance, because if you lose the group, what is that going to have? It's going to put it that's like, it's like you're a head coach. If you lose the team, if you lose the locker room, you'll lose the team. So like, so if you come at somebody the wrong way, and build a wall between the two of you, you might never get that wall down again. But if you don't broach the subject, they're going to end up having trouble. And so you're left to decide how to deal with that. And I want to ask you your opinion, but it's been my, you know, my experience so far. A lot of times the brain that makes a good doctor is not the same brain that makes a great communicator. Is that fair? I think that's I think that's true. Okay.
Dr. Nader Kasim 24:42
But I mean, it's, it's someone walks in to the office, right? You
Scott Benner 24:47
have half an hour with them.
Dr. Nader Kasim 24:51
Entire half an hour is not going to be about eating or activity or you're not going to know exactly where they're at in life. You don't know what their stressors are. or you can certainly get a vibe for it. It's kind of part of your mission, you kind of need to figure out, Is this the right time? What's the level of interest? Someone willing to actually share their knowledge about that particular subject? And then really give them what they're, what they're ready for what they're asking, if they're receptive to feedback. You know, we see this oftentimes in kids that are active, that are involved in sports, you know, they're coming to you with questions, that becomes the theme of the visit, because the next time they come around, something else might be happening might not be a priority. So I think that's a really good way to
Scott Benner 25:37
kind of attack it from, you know, from that perspective, is it possible that the medium that I have to speak to people is just better suited to disseminate this information than an office visit? Or a doctor patient relationship?
Dr. Nader Kasim 25:53
Yeah, hands down on the table. I mean, it's just like what I told you about myself earlier, like, I needed to fill knowledge gaps, you know, when I got diagnosed, so I went ahead and sought out information, I was ready for that information I wanted to learn. So I think that's one of the pros of, you know, a podcast or a book or, you know, an online article, whatever is that you can seek it out when you're ready. Yeah, you know, but I think, you know, but even as a provider, we can still get a vibe, as to where someone's at in this conversation and potentially provide these resources. So I think there's a difference between going and seeking it out yourself versus, you know, being able to provide information when someone is actually ready for that, or if they're interested in it, is
Scott Benner 26:39
it possible that that may be should be communicated to a person, the the kind of idea that, look, there's this information here, you need it, if you have it and understand it, your life is going to be happier and healthier, and probably easier. But there is no way for me to rush you to the place that you need to be to absorb all this to want to absorb all this, I need you to know that it's here. I need you to know what it is. And I'm willing, as your physician to sit back and wait for you to be ready to take it up. Because that's the truth. Right? Like, that's how me You've described it. I've seen it here for 1100 episodes, and all the conversations I've had, this is exactly right. People do not take care of themselves until they're damn good and ready to. And often they won't do it unless it's for someone else. Like I'm getting married, I want to be healthier because or I'm pregnant, or I want to have a baby, or I want to be around for my family or I saw this thing happen. And I don't want that to happen to me. Like that's generally speaking how most people make the leap. Maybe it's important for them to know that this is a very human reaction they're having right now, I know, you don't want to hear about Pre-Bolus I know you don't want to learn that, you know, the French fries have fat in it, it slows down your digestion, and therefore, you know, you're gonna spike like 90 minutes after you eat them like, and you're gonna think I don't know what happened, I already covered the carbs. And you know, they need to know all that stuff. But is it not? Maybe incumbent upon us to tell them because as far as humanity goes, I don't know that we know a lot about ourselves. Like, you can stand back as a physician and say, I know how this is going. As a matter of fact, I bet if I said to you, right now, think of a patient that you don't believe is going to do well. These people start popping into your heads, you know what I mean? And then there's probably people who think, Oh, if they just make this one leap, I know they're going to do better. I bet this person figures it out when they're in college or when they become I'm sure these people all present you like different parts of this path. And but we don't know that about ourselves. Like, you know what I mean? Like, you always need somebody to tell you who you are, it's hard to figure it out for yourself.
Dr. Nader Kasim 28:51
Yeah, I I agree. And I think I think it's more so it's almost like a reminder, just like how you get spam, emails, advertisements that pop up, like they stuff like that just triggers you mentally. So I think I think if you engage in conversations repeatedly, your interest kind of shifts, and it's part of that is based on life circumstance, what your personal goals are, but also, if it's on top of mind more frequently, I think it's more likely to change. It's very similar to smoking. So if you think about people who smoke, you know, the more you ask them about quitting, you know, engaging where they're at better than they typically do. So I think it's kind of similar. I don't think it's remotely close, but kind of the same. Well, it's
Scott Benner 29:40
actually fascinating that you brought that up, because as you were talking, I thought, if the conversation keeps going the way I think it's going to, I'm gonna make a joke that we should get those PR people from the 50s who sold cigarettes to everybody and retask them with teaching people to Pre-Bolus or pay attention to like their foods or I I actually thought that Oh, like, let's get great marketing people to tell us good things that we need instead of the bad things. Maybe that would work. You don't mean like, there's something to that. I mean, there really is, like you said, you have to hear it over and over and over again, I've learned from making the podcast and even just getting someone to click on a link is an excruciating task. Like you have to first tell them that the link exists and explain to them what it is. And then sometimes you have to do that sometimes up to 10 times before they remember the link, and then think, okay, maybe I'll check it out. And that's just how we work. And so it makes sense. You know, it's interesting, because I'm doing these two series at the same time. And you and I spoke about this before we started to record because we weren't 100% Sure, and maybe still aren't. Which app which series this episode belongs into, but I'm doing this grand rounds thing, which is, it's aimed at doctors to tell them look, this is what people who have type one diabetes want to know, it's what they told us they wish somebody would have said or how they would have said it, etc. Here's the reasons why. You know, and Jenny and I are going through and discussing all of them. And at the same time, I'm doing another series called cold wind, where people are coming on health care providers, other professionals, completely anonymously. And they're basically blowing the whistle on what they see at their jobs. And, as I'm recording these episodes, I am stuck in this paradox where I both find myself vehemently defending the doctors, because they seem like they're in an impossible situation. And at the same time defending the patients, because these doctors are the only thing that they have. And it's just it's just a it's a situation that I don't like, the more more conversations I have about it, the less answers I say the fewer answers I say my wife would be so upset if she heard me say less answers, the fewer answers I see. But you know what I mean? Like you're in a, it's you. You're the one they're counting on. But you're in a human situation that that's almost unfair to ask, have you because it's probably not going to go well, unless they're in the right place to receive the information and then put it into practice? Yeah. So what do we do?
Dr. Nader Kasim 32:14
It's one of those things where I think
Scott Benner 32:17
you just you keep, keep pressing, you don't want to press too hard. You want to give them
Dr. Nader Kasim 32:26
you know, information that's relevant to them at that moment in time. I think that's all you can do. I mean, really, the the other thing that I've personally seen, that helps a lot is, and I think this goes to human nature, is that we learn from each other. So there's a big difference between telling someone to do something, or even effectively planting an idea, versus having someone learn from an experience or like a role model. Yeah. So as an example, like I do, diabetes can. And I can tell you, how often things change when, you know, children interact with other children who have diabetes. And it's not just from a dosing perspective, it's all the other behaviors that go into diabetes, it's all the other coping mechanisms that you have to basically feel normal in your skin. That's, that's not from anyone telling you anything, it's from seeing other people do the exact same thing, see them succeed, see them fail, see them get mad. So I think that's really valuable, too. Unfortunately, in the office, we can offer that. So I think that's where, you know, being engaged in diabetes outside of an office becomes really, really important. And I think it's eerily similar to things like your podcast, because it really does give a sense of community. And I think that's, that's a way that we learn as humans is to kind of emulate and, you know, mimic other human beings.
Scott Benner 33:55
You know, I've said this a number of times in the podcast, but I feel like it fits here as well. There's times when I think there should be mass appointments that are management specific, like not every time you come in, but what if twice a year or three times a year there, you know, there was a you guys did seminars instead of you know, and I know it turns into a billing issue and an insurance issue and like all this stuff, like it's the doctors don't have time to do it. But I've given talks, like to hundreds of people at a time, and then received back emails from a large portion of them, saying, Hey, I did better the week after I heard you speak. I don't even know why. I couldn't even begin to tell you what I did. But we talked about diabetes for two hours and my blood sugar's were better than next day. I think that's important. And I don't think people like it's nice to say that you went out and found the information, but you're who you are, and there are plenty of people who aren't going to go they're going to hear, count my carbs, shoot the insulin. drink a juice if I get low Don't be high for too long, because I don't want to be in DKA. That's it. And they'll do that every day, they will not change, they won't wonder about if there's more, they'll think that's the whole game. If their health gets bad, they'll say things like, well, that's just diabetes, or you know, it's my lot in life, it happened to me, never thinking like, this is a thing I could impact. And not not like, with information that's so hard to get or tools that, you know, I can never find like just understanding how insulin works, you can make a significant dent, like I say it on the podcast, because I want people to hear it and believe it, but just Pre-Bolus in your meals could bring your agency down a full point. But just that without even understanding the rest of it. And yet, people won't wonder about that. And it isn't until they get into a terrible situation, and go out to find a thing, that they even hear some of these ideas, but you have no idea how many notes I get from grown adults who have had diabetes for 20 or 30 years. Who will, they're praising me in this email, on and on and on. And when I get to the end, what are they praising me for? I taught him to Pre-Bolus their meal, they have 30 bad years, because they didn't know that, like, that's insane. Yeah, yeah, I'll say it again, I'm not sharing any special knowledge that I have, that the rest of the world doesn't have. I just found a way to communicate it in a, in a form that people can take up easily. And I've scaled it, which, uh, you know, if you're looking for things I'm proud of just scaling the podcast is a big deal. Like I was back, I'm like, Oh, I'm helping 10 people, that's really amazing. Like, you know, this, but a lot of people don't know the feeling of helping 10 people. It's amazing. 100 people, it's amazing. It doesn't really change the good feeling, whether you help one person, 10 people or 100 people, it's exactly the same. But once you realize that you have this knowledge that changed someone's life for the better. I almost get into a panic. I'm like, Well, how do I reach all the people who need to know this? And so I put a bunch of effort into scaling. And all it did was prove out over and over again, that this basic kind of baseline information, communicated well helps people on on a mass scale. How do we get that to them? In a doctor's office? Because most of them, believe it or not, are never going to find the podcast. Listen, here's what I'm Yes. My question is, you're diagnosed when you're 18, you're already on your way to becoming a doctor, did you become an endocrinologist? Because of your diagnosis? Yes,
Dr. Nader Kasim 37:28
basically. So I was going into as going into medicine at the time, so I did kind of like, you know, I'm going into med school, knowing, knowing freshman year of college, I didn't know what type of physician I was going to be. And then, you know, it's kind of threw me in the door.
Scott Benner 37:42
Can I ask you a cultural question that everyone's not gonna understand, but you will, and some people will? Sure. Did you want to be a doctor?
Dr. Nader Kasim 37:52
Oh, yeah, you did. And hence, hands down on the table. This
Scott Benner 37:54
was a family thing where you're gonna go be a doctor? No, okay.
Dr. Nader Kasim 37:59
No, both of my parents are like, math people and statisticians. And you
Scott Benner 38:03
know why I'm asking, though, right? Just because most physicians have family members that are? Well, I was actually thinking culturally, I see a lot of you're going to go be in medicine. Like, that's a good paying job. It's, it's a respectable job, go be in that job. And I just I know, a lot of kids who are currently trying to be nurses and doctors who don't want to be but their parents pushed them in that direction. I was just wondering if you were pushed by parents, or if it was the thing you actually really wanted to do? No,
Dr. Nader Kasim 38:35
I wasn't pushed by anyone. And actually, it's kind of funny, I was given advice not to go into medicine, because of the effectively the commitment and the debt burden and the high risk of not making it through the entire pathway and getting stuck with that. But I think, at least for me, just mentally, I'm a very
Scott Benner 38:57
sciency you know, type of person,
Dr. Nader Kasim 39:01
I geek out on technology. So just by by nature, I, I needed to be in a science field. And I was originally planning on doing computer science. And I actually did web design for a short bit and quickly realized I did not like it. When it wasn't for fun. So then, you know, that's how I basically landed.
Scott Benner 39:24
Okay. Oh, that's amazing. Are you more of a people person doctor or a medicine? Or do you try to straddle the middle? To be honest, I don't know what that is. So I think some doctors can be can lack people skills, and but still very passionately feel about what they're doing because they love the medicine of it. And I think there are some people who just want to help people, and they've learned the medicine so they could help the people. Does that make sense? Yeah.
Dr. Nader Kasim 39:51
I don't know. I don't necessarily think I do well, with people like in other words, I probably not well said but it's it's More so that, in general, I'm typically laid back. And I think, you know, through a care perspective, that also shows like, I am pretty conversational, really, my intention is to walk in, you know, get to know you as a person, that type of thing and troubleshoot things that are meaningful to you. So that's, that's how I roll. I've just taken my experiences from past medical providers, and I basically figured out that that's how I vibed well, with others, so I tried
Scott Benner 40:30
to try to do that. Yeah, I think if I was, if I was an endocrinologist, I've never thought about this before, but just now it started running through my head. I think if I was an endocrinologist, I would be like, of the camp of like, listen, we're all gonna, like, talk and be nice and have be friendly and everything. But by the time a year goes by, you're gonna know how to handle how to handle your insulin and your meals. And then we'll branch out from there, you know, if you want to go talk to a therapist about how you feel you should do that, you know, if you want to talk to a nutritionist, you should definitely do that. Here are all your other options of things that you could be doing. But in this office, we're going to talk about how to functionally use insulin so that you have outcomes that are repeatable and desirable. Because I think it's like teaching somebody to throw a baseball. You know, like, when you when you show up? You're pretty young. Still? I don't know. Do you have any kids? Yeah, yeah, two girls, oh, two girls, okay. So they're awesome. Excellent. So you go out there the first time you try to get those girls to throw something to you, and their elbow flies the wrong way, and the ball goes eight feet to the right and everything. And it's demoralizing. You can see it on children's faces, like, Oh, my God, I can't even get this done. You know what I mean? And then you teach them technically how to do it, whether they love softball or baseball, when it's over or not, who cares? What you can see is the confidence that comes from picking that ball up not thinking and putting it where you want it to be. And I kind of think about the diabetes like that, like, I want you to be able to no matter what your situation is to be able to pick up that ball, throw it, it goes where you want. And then you have a tool, that you have an actual skill and a tool, and you can go put it to work wherever you want. And it comes with confidence. And I think that once you have that, then the next meal, it's a little more difficult, or the high blood sugar that you know doesn't come down and and at first, you're like, there's no reason for this, you can actually step back, apply your knowledge and your tools to it and come up with a reason why fix it and move on. And I don't know, I just think that that would be the way I would roll. I've seen it happen. I've seen people send graphs and they're out of their minds like you can you can sometimes read in an email a person who's about to like, just flip out, you know what I mean? Like I've they've done that they've beat their head against the same wall over and over again, nothing's changing. Their diabetes is not where they want it to be. They feel like apps use emojis. Oh my god, they just they're just like, I need help. Like, and by the way, you know that a person needs help when they're writing to a stranger that they heard on a podcast. Like that's when you know, somebody's in trouble. Me because there's a lot of like, leaps in there to make you know, and then I don't know them. I don't know their trials or tribulations. I don't know their IQ. I don't know their financial situation. I just go you got a pump or no pump. What insulin are you using? You have a CGM. You do Can you show me a graph? Great. I see a 24 hour graph. Great. This looks like you don't have enough basil. This looks like you have too much bass. It looks like you're not Pre-Bolus In your meals. Are you Pre-Bolus In your meals? You're not you should try that. Have your basil tested now? Well, I see. You seem real stable, but your stable 180. Let's get your basil right. And it doesn't take. I just did it with a lady. I don't know her. She just sent me a graph like she panicked, sent me a graph, like through a direct message. I think I message back and forth with her for four days. And like five days later, her doctor was like, my god, how did you fix all this? And she's like, I messaged the guy on the internet. Like, that's awesome. Yeah. But I didn't tell her what to do. Keep in mind, I asked her questions. And I let the answers that she had informed what she thought she should do next. Then if she wasn't sure I'm like, What are you thinking? And she's like, I think it might be basil. And I'd say I tend to agree with you here. And she said, How much should I move it? And I said, I can't tell you that. But I can tell you that based on your kids weight. I think he needs about 22 units of Basal insulin a day. But she was at like 16 I was like don't just like crank it up to 22 Just know that I'm thinking that the high end of the possibility is 22. But let's go slow. It took her like three days to fix it. Once she had the basil right? Boom, everything was like magic. And then she went back looked at her carb ratios. She started having these thoughts about like, Oh, I was covering for my basil with the Bolus is for the meals. And because I so I said to her now that your basil is right. Be really careful at meals and corrections because the way you do it is probably now Oh, maybe a little heavy handed. So let's be careful that. And if that ends up being so then let's reevaluate those things too. But I'm telling you, they're back and forth and a DM with a person I don't know. And they it's not maybe more than 15 times back and forth, and everything's fine now. So like, when that's possible, can you see why people are upset? And why they say my endo doesn't help me? Yeah,
Dr. Nader Kasim 45:25
I think that's a struggle, in general, and it's hard. I oftentimes feel that's because a lot of people are also overwhelmed with everything that goes into diabetes, just in general. And when that happens, there's oftentimes no conductor. So good example is, you know, patient, you know, is newly diagnosed at the point where they want to start pursuing tack, you know, the reading about CGM and insulin pump therapy and automated insulin delivery. And you know, 90% of their time is going into figuring out how to obtain these doing all the necessary trainings and education. And finally, they have everything in hand. And they're like, oh, wow, I have like, two apps I need to look through. I don't even know which one I need to look and people can be overwhelmed. Yeah, like one doesn't go to my so a lot of a lot of the same kind of behaviors that would go into injection, kind of the simplistic, you know, Basal testing and whatnot, people are hesitant to, to kind of rediscover that. I don't know if that's the word. But so there's a lot of hand holding, at least what we do in our clinic. And I think it works relatively well say that it doesn't work for some, but we typically have, we put strong emphasis on gauging where they're at, like glycemic control. Yeah. And then we teach pattern recognition. So we basically tell people, all right, you know, remember, you know, you're, you're effectively have a Bolus and a Basal dose, and you're running high post meal that's oftentimes reflective of your Bolus, etc. And then we effectively try to connect dots so that if they understand that they're not in range, they can go and see where they're running high, to effectively understand what dose change needs to be made. And I say it this way, because some people are not, they will never feel comfortable changing their own dose. Although we are huge proponents of doing that, like literally, the last diabetes ed class that we talked about, is to effectively empower people to change their doses, to whatever comfort they have. I think that works really, really well, because it effectively tells people Alright, this is the goal, this is where we want you to be this is what's going to minimize, you know, your risk of complications long term, this is how you go and look for highs. And then this is how you're gonna identify for those change needs to happen. And then they reach out to us. And then eventually, once they start reaching out to us, regardless of the degree of help they need,
Scott Benner 47:58
that's when we can
Dr. Nader Kasim 48:01
basically, layer on top of that we can talk about, you know, bolusing strategies, split Bolus, you know, timing of insulin impact of certain food choices, how to, you know, cover proteins and fats. And yeah,
Scott Benner 48:15
when they know how to keep adjusting their settings for these things actually have a shot at working, right? Because a lot of times they know the tools, but their settings are so off, they still have bad outcomes. And then they're like, it doesn't work. Yeah, like, yeah, I tried to do a Temp Basal, but it didn't work. Well. Yeah, what your Basal is point five, and ours should be point nine and our, you know, tamping it up 10% isn't gonna change anything. It's, you know, it's 40% Too weak to begin with. So for me, again, I think it's, you teach them how to get their settings, right? You teach them how to make adjustments. And I know this is gonna sound silly, but I think most people listen to this podcast know how to adjust their insulin because I say, if your blood sugar is too high, you don't have enough insulin. And if it's too low, you might have too much insulin. It's just, it's just that that kind of stuff that's so simple, that a doctor wouldn't say because there's, you know, 8000 caveats that go along with that, and you don't have time to explain them all are you know, but the truth is, that's about right. If you're high all the time, you don't have enough insulin. Like it's not like turning it into something that sounds like, oh, you know, the problem is your insulin to carb ratio might be off like, great. You just lost people. You know, you know, your insulin sensitivity. By the way, when you start telling people insulin sensitivity, and then turning the number down, makes it stronger, and turning the number up makes it weaker. I think you lose people there too.
Dr. Nader Kasim 49:39
Yeah. And then the next sentence, you said correction factor, and they're like, why?
Scott Benner 49:43
Yeah, what are we? I don't know what we're talking about. And, and that's why I don't talk about it that way. Yeah, no, you're you're 100%
Dr. Nader Kasim 49:50
Correct. I mean, like, exercise is probably the best example of what you're saying. Like if I can tell you how many people walk in and they're like, oh, All right. You know, I keep going low during activity, my doses are off my, you know, and then I tell them, the reason you go low is because of insulin. You know that right? Yeah. And they're like, Oh, yeah. And then they finally it clicks. They're like, Oh, snap. But you know, I took I took in like, you know, six units of insulin an hour ago for lunch. Yeah, that didn't even cross my mind that I had insulin on board. Yeah, but perfect example of, you know, people just need to be told that this is what
Scott Benner 50:29
you want to exercise. Don't have active insulin going. And you're probably going to be okay. Yeah, if your settings are right, by the way, if you're, by the way over basil, because is that a thing? Will you admit to do endos over basil people because they're afraid they're not going to cover the food? Well?
Dr. Nader Kasim 50:45
Oh, yeah, absolutely. And I think I mean, we see that less, because most people are on AI D now. Yep. And you know, with a significant portion of AI D, you kind of lose control of that, even. But yeah, we still see it.
Scott Benner 50:58
Do you think automatic devices, and you know, like, something paired with the CGM that's making the insulin decision for you? Do you think the greater the prevalence is with them? Do you think the less people are going to know fundamentally about their diabetes? Do you think they're just going to lean on it and say, I'll just let this thing do it?
Dr. Nader Kasim 51:17
I don't think so. And medically, there's evidence to suggest that that's really not the case. So they've put insulin pumps on newly diagnosed patients, even before learning how to do injections. And they were effectively taught injections kind of like after the fact, um, kind of as an on an as needed basis. And those people do well. And they they do, you know, arguably better, and not necessarily the right choice for everyone. But the point that I'm making is that you might be losing a skill, you might not be taught a particular skill that could potentially be valuable, but getting it taught later. Might be a reasonable idea. Yeah.
Scott Benner 51:55
So I don't I don't think so I'm
Dr. Nader Kasim 51:56
glad that I kind of superiority of the devices are really evident. So taking it away from someone with the intention of, you know, quote, unquote, teaching them how to drive a manual car, I think it's kind of silly,
Scott Benner 52:08
I find it to be an old idea as well. Yeah, I'm just worried that if something becomes so automated, that if you took it off them, they wouldn't know how to help themselves. I do think that's true. I mean, you know, I look at my daughter's Basal insulin, you know, overnight last night, even, you know, just absolutely, like, you know, the, the algorithm took her basil away for an hour and a half, and then it gave it back, and then it almost immediately was like, well, I shouldn't have done that and took it away again. Right. So like, that's not a thing that if you just go back to shooting love Amir for example, or Lantos, or CB, even, that's never going to happen. And they're not going to know, because they're going to think Well, when I was on a pump, everything worked. And now I'm injecting it doesn't work anymore, because they don't see the impacts of the insulin. And that's again, why I'm gonna go back over and over again, I'm gonna sound old. At some point, if people don't know that basil is first, and without a good Basal insulin, you're lost. And they don't know about the ratios, they don't know how to attack different foods, because they those foods have different needs. They're never going to understand what they're doing. And it's going to be a problem, even on an automatic system. Because if you don't know how to Bolus for something, if you look at Chinese food and say, Oh, this is 50 carbs, and think it's going to be the same as bolusing. For you know, another thing that's not deep fried, doesn't have sugar on it, and isn't like breaded. But it's also 50 carbs, you're going to be confused forever, because you're gonna say 50 carbs, 50 carbs, why didn't it work the same? Because of all these different impacts on your digestion, and, and all these other things that no one talks about? But it's not that hard to talk about, in a way. You know, what these conversations are, they depress me, and they get me excited at the same time, because the part of what I feel like we're saying is, if you get lucky enough to find a doctor who understands and can communicate it, you're probably going to be okay. Yeah, but what if I don't get that? Yeah,
Dr. Nader Kasim 54:03
I am going to add to that, because I feel like part of the benefits to these types of conversations is that it's empowering, right? So like, you know, if you go and you slam Chinese food, and you run a high blood sugar, you're going to feel defeated, and you're going to feel like your your treatment isn't working and you're failing and, and all that. So if you can give people pieces of knowledge, to effectively really take the reins and take control over their diabetes, then I think that makes it very empowering. So if you're able to make decisions about how you eat and how you dose and have a good outcome after that, you're gonna want to do it again. Yes. Because you know, you're not going to wake up in the middle of the night treating a low, you're not good exam. That's actually a great example, right? Like, for example, if you're gonna go go into eating Chinese food at like 10pm with like a bazillion units of insulin because you inflated the dose knowing that your blood sugars are gonna get demolished, but then you deal with a low you know, if you chose Maybe a Thai Chinese food a little bit earlier in the day. So you didn't have like a morning, I mean, an evening low, you're gonna feel awesome about that. Because you made the choice you thought it through, you know? So I think that's the value of talking to people about insulin as well, is that it really changes attitudes around. Really what's what's happening? versus you know, here's a machine, I hope you fare well on it. And if you know, if you keep typing numbers in it, you should do okay. I mean, that's, that's, that's really what would happen if you didn't have these conversations, right? Yeah.
Scott Benner 55:36
Now, yeah, I would tell you that one of the bigger surprises for me when I start, I mean, this podcast is I'm in my 10th year right now. So I've been doing it a long time. But when I first started doing it, I thought, Well, I'm really good at insulin, I'll explain it on the podcast. And that's what the podcast will be. And it has been very beneficial. I think anybody who's heard the Pro Tip series, or the, you know, the ball beginning series for really newly diagnosed, people would probably agree with that about the value of it. But it's the conversations that really just, I don't know, supercharge it. And I did not expect that. I really didn't, until I started having them, and listening and thinking, there's a ton of value here. Like they're, you know, I'm talking to a 24 year old person, thinking of a conversation I had recently this 24 year old girl, and she struggles, you know, it just it doesn't go her way. And she's real active during the day because of her job. And she's got a little vacillation, or you can hear in her voice, that she's beaten up. You don't I mean, like, she's just she's fought one too many wars, and they haven't gone her way. But at the end of the conversation, she's invigorated again. And that's great for her. But that's not really the way I think about it. While I'm talking to her, like, I'm happy to have a conversation with her, and I am speaking directly to her and about her. But in the back of my mind, I'm thinking 10s of 1000s of people are going to hear this, and they're going to think, oh, that's what's happening to me. And then they don't feel as alone. And then it feels more possible. That's the kind of stuff that we we can't value that enough. And it's almost impossible to explain to a person, the value of it. You know what I mean? Like, I've tried to tell somebody, you don't know, go listen to this, like, just go listen to somebody talk about what went right for them, or what went wrong for them. It'll help you earn ritual. And some people look you a lot of people look at you cross, like, you know, hearing someone's story is not going to fix my low blood sugar. But it is, it actually will. It's it's not a thing I expected, I didn't realize it when I started doing this. I also don't know how you're supposed to do that as a physician, either.
Dr. Nader Kasim 57:48
I think I think this goes full circle, right? We were just talking about, you know, experiences in terms of, you know, counseling, you know, people have diabetes, you know, it's, it's just like camp, right? Like, that's how we learn as humans, it's, there's a difference between being told something, and experiencing it with someone or learning it from someone in the sense of hearing a story. Like I think I think that's the value of those types of things. So I think it's just, we're, we're back to where we started.
Scott Benner 58:17
And you can do that purposefully. And I'm gonna pull the curtain back a little bit. It's almost an hour, you and I have been talking. We didn't come full circle by mistake. You understand? Yeah, yeah, I do this for a living. But doctors, you do it for a living to you do your thing to like, be purposeful about it. I had a real honest conversation for the last hour. But at the same time, I had half a mind on not just having the conversation, but leaving it behind for other people to follow as a roadmap. And I, you know, I think that's it, I think you can do that. I'm gonna just come out and say, and I hope the doctors don't take this the wrong way. I'd be a terrific endocrinologist about diabetes, I'm sure I don't know anything about anything else. Although I'm not bad with thyroid stuff. I have a lot of thoughts about anemia that I think are valuable. Also, I think I'm undecided. GRPs, by the way, and what they're going to do in the next 10 years for people, that aside, I think I could do your job. I actually think I do it every day. I do it in small chunks in personal conversations. And I do it in bigger chunks by teaching myself from other people, and learning how to talk to the next person because of that, and you have to make some generalizations when you do that. That's not a bad thing all the time. Like you don't want to generalize, put somebody in a box and be wrong about them, obviously, because that's a disservice. That's pretty infuriating. But I mean, bigger generalizations like, people forget to Pre-Bolus or people forget that they have diabetes where they don't want to be bothered by this. Some people don't want to think about it. Some people like so talk to that person that way. Like here's how you can tell I tell my daughter, I'm like, you don't want to think about this, do these things. And then you won't have to think about this otherwise because my daughter is not one of those like, like you guys, like her Jenny talking Jenny is a healthy person. She eats healthy on purpose. I once asked her when you go on a road trip with your family and like, where do you stop to eat? And she goes, we don't stop to eat on a road trip. I was like, What the hell? How do you eat? You know what she said? She brings food with her. I was like, God, damn, I never thought of that. Like,
Dr. Nader Kasim 20:00:24
I was like, why would you do that?
Scott Benner 20:00:25
Oh my god, where you could get like a Milky Way bar at the store, like, like, you know, and I'm like, Oh, she's an actual healthy eater. Like, she would never stop at a gas station. Like they, she just wouldn't do that. So when you're talking to Jenny, you talk to Jenny about who she is. When I talked to my daughter, I talked to my daughter about who she is, right? My daughter is not a person who wants to be involved with diabetes, but she also wants to be healthy. If you ask her personally, and I say, Why do you do this, she'll go because I don't want to die. Like that's she's motivated by her own health, about the longevity of her of her existence and, and her ability to do the things that she wants to do while she's alive. She doesn't give a shit about diabetes. When I tried to explain something to her. She's like, I don't care. And I'm like, I know you don't. But this parts important and she knows if I go this parts important, she stops. She's like, he's gonna tell me something I actually really need to know if I started telling her something that's extraneous, or like, you know, like the geeky stuff that you enjoy. And actually, I guess, oddly enough, I enjoy by the way, how weird is it that we anyway, like, like, she gets lost. She's like, don't care, don't care, don't care. And I'm like, okay, so I don't bother her with that stuff. I gave her the tools she needs. I gave her the knowledge she needs. Could she have more? She could does she need them? Not right now. That's how I put her. I mean, my daughter has a one C, she just she just left. She just went back to college. She was home for like, seven weeks. In the seven weeks she was home or when she was 5.6. Right? And that's her managing herself completely by herself. And when she was this awesome. Oh my God, when she was in college, the first year as a freshman. I said just do the things you know how to do. And she struggled a bit because the food was crappy. Now when I say that, processed and fried, okay, just when you hear crappy here, processed and fried, not real ingredients, fried food. And she was using insane amounts of insulin. And like and I don't mean insane, like the number I mean, versus what she would have used at home eating the way we eat here, which is not like super clean or anything like that. It's just much better. But she stuck with it. She did not give up. And she came home with I think of a six five a one C after her freshman year. All I did when I saw how bad the food was and how it was impacting her as I told her look above all else Pre-Bolus. And don't stare at a high blood sugar. Do something about it. Those are the two things I told her and she came home her freshman year with a six, five. Now she left with a six one I think, but okay, bad food, different variable. We fix that she came home. I said what fixes this problem. She said if I had my own place with the kitchen, I could eat better. We petitioned the school, we got her a place to stay that had a kitchen. She came home the next time or he once he was six one. She got it back down to where it was before she left. Then we got her home. And I watched it come down a little bit. But she was fighting and I said Ah she's just like a longer story. But we think Arden probably has PCOS. Right. So she sees a little bit of insulin resistance, tough periods, acne, stuff like that. I don't sit back and go, Oh, well, that's her a lot in life. I get in the game. And I figure that out. So right now, and I think this is the first time I'm saying this on the podcast. Arden is shooting point two, five of ozempic a week, just that she's never going to titrate up, it's going to stay just like that. Her Basal went from 1.1 an hour to point seven an hour. She's using seven units less insulin a day in basil. And based on her total daily insulin, I think it's completely possible that in 2024, Arden will use 11,000 fewer units of insulin for point two, five of us Olympic once a week. And I don't know if that's right for everybody. I don't know if you can get your doctor to be on board with that kind of stuff, etc, and so on. I just tell the story to tell you that when I see a problem, I fix it. And I tried to explain to RT and what the ozempic did, and she went okay, I got it. And then I tried to get a little deeper into it. And she went, I don't care. And I was like Gotcha. So I didn't burden her with more. But if she sees it helping her, like she's seeing it, she'll keep doing it. So I don't know, and I don't know where you fall on that but I think GRPs are going to become as soon as insurance companies pull their head out of their formulary s you're gonna see GRPs for type ones pretty quickly. Yeah,
Dr. Nader Kasim 20:04:53
I've so I use it situationally and it's it's amazing like, you know, there are people that are just insulin resistant, and it's really evident. And, wow, just a whiff of with almost any GLP. One will, will help. It's
Scott Benner 20:05:09
insane. Yeah, like, I mean, honestly, I'm about to interview the mother of a little girl, I think she's like 12 or 13, who's had type one for three years, and is now not even using Basal insulin anymore. Because of this, she got put on we go V for weight. And they, her insulin is just kept dropping and dropping and dropping. Yeah, I'm not saying it, you understand kids got type one diabetes, I'm sure at some point. But it turns out this child might have been in like an extended kind of like lotto situation, that this was enough to help along the way. I mean, it's just, it's fascinating stuff. I mean, the reason we started Arden for was, you know, the really painful long and excessive periods, and the and the pain in the stomach. And we got on that my wife was on a Facebook group for for GRPs. And she said, Scott, I keep coming every time I come back as a new woman who hasn't been able to have a baby for 20 years is pregnant on a GLP medication. And I'm like, Get out of here, really. And she's been telling me about that for six months, I started Googling it. And there's already some testing going on that women are just like, who could not get pregnant before are seeing like pregnancies on GRPs. And that spurs more conversation that tells you like, Oh, I'm taking it for PCOS. And it's really helped with my PCOS symptoms. And I'm telling you Arden's acne cleared up 80% on it. It's an I don't think we're not sure where her her dose is going to be yet. So I'm not sure that we're there yet on where it's going to be. But her acne cleared up 80% her insulin needs went down the way I just explained. She lost 10 pounds. And she just generally looks better. I saw I don't know if he's this. Listen, this is a little weird, but I saw a thread on Reddit. And hey, read it. I appreciate how cool you guys are about the podcast. Thank you. I saw a thread on Reddit where people with I'm gonna mispronounce his ears. danlos? Can you tell it say that for me? Oh, yeah, there's downloads. Okay. There's a whole group of people that have that connective tissue disorder, who are saying that a lot of their symptoms went away on a GLP medication? Ah, yeah.
Dr. Nader Kasim 20:07:19
I don't know if I saw that. Just insane.
Scott Benner 20:07:21
I you know, I'm on the internet. And so like, I don't know, like, like, look, who knows, if that's a real thing. Maybe they have it. And they were heavier, and they lost weight. And it's easier on their joints. Like, I have no idea what it is. But like, that's the kind of like, thing where the community stuff really does help. Because like, someone hears that and goes, maybe I should look into that, like, maybe I should find out about this Pre-Bolus ng thing. You know what I mean? Like, and I don't know, to me, I appreciate this conversation greatly. But in the end, what I hear is, the model that set up right now works great for some things and doesn't work right for type one diabetes in a doctor's visit with with a physician, like there's not enough time, there's too many variables. There's doctors who aren't great communicators, there's doctors who don't have a lot of good information. There's patients who aren't good communication communicators, patients who are not interested in doing well for themselves and everywhere in between. And with all these different variables, how can this static system work? It'll work for some people, and it won't for others. And that's just what it's going to be your smart young person who has type one, I didn't hear you go, Oh, my God, I have a great idea. Let me tell you how we can fix this? Well,
Dr. Nader Kasim 20:08:36
I mean, the way I look at this is that we're effectively like cheerleaders. So I was, I was gonna disagree with you at one,
Scott Benner 20:08:43
at one point, please do. And that is, you know, we will never ever
Dr. Nader Kasim 20:08:49
know the person who has diabetes as well as they know themselves, we will never understand the child and the parent will eventually know more about their child's diabetes more than us. So we are effectively like cheerleaders, what makes us useful to most people who have diabetes, and I say us as in like, endos, and other diabetes care providers is that we see the gamut. So you know, we were a clinic have to close to 2000 Yeah, we see the stupid we see every walk of life, we can kind of get an idea of what would be average, what would be an outlier, what would be and we can kind of augment your, the person's expertise in their own diabetes. So I think as a medical care provider, that's how we become valuable. So I think you're right you can you can you know, diabetes, this as well as, you know, any endocrinologist just you probably don't see, you know, as as many different people as us well for you because they have a podcast maybe but I don't
Scott Benner 20:09:52
disagree with you, because I do find myself wondering because I do work in a room. I don't actually see any of the people I'm talking to. Am I just attracting? And I'm sure you can think this, am I just attracting a certain segment of the population who works well with what I'm doing. And that's completely possible. And if that's the case, and I'm happy to help those people, but, but I would share this is that if you've ever heard the Pro Tip series, at some point, the Pro Tip series, you'll hear me describe Pre-Bolus thing as a tug of war. I don't know if you've ever heard me say that before. And the explanation has been told back to me by clinicians and people the same, that it's the clearest explanation of bolusing insulin they've ever gotten in their life. And I came up with it on the fly, gees, a long time ago, maybe over 10 years ago, because I used to be this person who wrote a blog. And once in a while someone would get on Facebook and have a problem or somewhere online to have a problem. And someone would say, you should find this guy, he can help you. But back then what that meant was, is like, they'd call me on the phone. And I'd be like, Hey, what's going on, and we talk for 3040 minutes, and I hit, you know, what I think of is the most important pieces that would kind of get them going in the right direction, hopefully let them find their own path. But I was talking once this very young girl, she's in her early 20s. But she had had, she had a baby that was already four, four years old, I think. And it was clear to me she had dropped out of high school to have her baby, she was waiting tables. And you know, I don't think she was, you know, I hate to say this out loud. But she was not the brightest person I've ever spoken to in my entire life, I guess I'm just gonna come out and say, and I explained Basal insulin. I think she got that I explained bolusing. And she was, she was concerned enough for her child to stop me and say, I don't understand what you're saying. And in that moment, I recognized I was either going to tell her, I couldn't help her. And she was going to go struggle for her whole life. And that baby was going to live with anyone see in the eights and nines, where I was going to find another way to say it. And I said to her, have you ever been in a tug of war? And she said, Yes. I said, you can picture the rope with the flag in the middle. And she said, I can I sit? Okay, well, instead of like, one team on one side and one team on the other side. And the goal is for one team to pull that flag on their side. And when, let's imagine that on one side of the rope, it's carbs. And on the other side is insulin. And the new goal is for the flag never to move. And then I just explained it from there. And I got done. And she said, I got it. And I was like, oh, that's terrific. Thank you. And like months later, I get a message from her. She now has my phone number, right? So I get a text from her Can I call you? And I'm like, okay, so she calls me and when we say hello, she's crying. And I swear to you, my first thought was this a really long time ago, my first thought is God, did I say something to her that caused the problem? You know? I'm like, are you okay? What's wrong? And she just says, Thank you. I want to thank you through tears and choking and snot and crying. I want to thank you. Well, Mike, what are you thanking me for? And she says, My daughter, she's sitting on the floor playing for the last hour. And this is how I remember her from before the diabetes. And I was like that I'm crying. You know? Now I'm going to cry now, actually, if I'm being honest with you, and such a real memory for me. And I said, why I actually had to break it off because it was too much like actual emotion. I was like, Why are you calling me for call somebody else? She's like, No, she's like, You did this. And I stopped her. I said, I didn't do this. You did this. I just told you how insulin works. And she we talked, we chatted for a little while and we got off the phone. That was that. She said my daughter was sitting on the floor playing for an hour or more her blood sugar never got too high. Never got too low. She kept saying like, you should see how steady it is. And I was like, Yeah, I know. Like, it's, it's how it works when you have your stuff, right? And she's like, but everybody told me she was brittle. And I said, Yeah, that just means you aren't using insulin correctly. And I think older type ones would disagree with this. But I don't think brittle is even a real thing.
Dr. Nader Kasim 20:14:05
I hate I hate that word. Yeah, yeah, I
Scott Benner 20:14:07
think people don't know how to use insulin, and it makes you look like you're all over the place. And somebody says, and then some at some point, a doctor says Oh, uh, you know, you must be brutal. Nothing we can do. You know, and I get that back then no monitors, no, sometimes no meters and their CGM. So for sure. I can see how they might think that. But that's how I think of this job. So I think of that girl who's now in her 30s and her kids probably 15 years old. And I think that kid's life might be better, because I took 15 minutes to explain to her mom how like insulin works. You know, that's amazing. Yeah. So I it's what I hope for everybody. I hope everybody gets something out of these conversations and goes forward and does this. I mean, there's part of me that thinks that doctors are just going to be pissed at me for talking like this. And there's part of me that hopes that they'll listen, I don't know what's going to happen, but I'm just going to keep telling the story.
Dr. Nader Kasim 20:14:58
I think you should. Thank you is there's definitely a void. And I think, just like I started out, I mean, I, this is this is how we learn. So and you're, you're, you're contributing to that. So don't stop. No,
Scott Benner 20:15:10
no, no, please don't Don't worry, I'm, I love this job. I tell people all the time. I am 52 years old, when I was 16, my grandmother forced my uncle to give me a job in his sheetmetal shop. With the day I graduated from high school. When everybody else went out to a party after graduation, I went home and went to bed because I had to get up at six in the morning and go to my uncle's sheetmetal shop and work there full time. I'd already been working there for three years part time, and I honestly thought that was my whole life. And if you go find that kid and tell him one day, you're going to make a living, you're going to enjoy what you're doing, and you're going to help people, that kid would not have believed you. So um, I have no plans on not doing this. This is the maybe the greatest thing I've done outside of my family in my life. So you know, but I use that that girl, like she sits in my heart when I do this podcast, and her story about her kid, and everybody else's that I've ever bumped into. I just get sad when I hear. When I hear doctors say there's nothing I could do. They didn't understand. And I'm like I think everybody can understand. You just have to distill it enough that it works for everyone. I think that one of the biggest mistakes we make, I'll leave you with this. I think we teach to the least common denominator. And I think that's a bit of a mistake, right? I think you should just assume that everyone can absorb the information and wants it, you just have to find a way to say it. So that the least and the greatest of us, as far as our ability to understand that we can all hear it. And I think that I think that's what I've done here really is I've just found a common sense way to talk about diabetes in a plain spoken manner. And it doesn't matter if you've got a master's degree, or you had to drop out of high school to have your baby, I think you can understand it. And that's all I think the doctor should be striving for honestly. So anyway, that's said, I agree. Thank you. I appreciate it. I appreciate you doing this very much. So back to our original question at the beginning. No reason to make you anonymous and this right.
Dr. Nader Kasim 20:17:17
No, no, I don't mind at all. Good.
Scott Benner 20:17:20
Thank you. I really do appreciate it. Yeah, it was lovely of you to do this, especially on a late on a Friday afternoon. And I have to tell if you want to come back sometime. I'd love to have you back.
Dr. Nader Kasim 20:17:28
Hey, thank you. I appreciate it. Yeah, and I honestly, if you ever want to do anything speaking wise, I'm involved in camp here in Michigan, both kids and adults. So it'd be awesome to have you as a talk. I
Scott Benner 20:17:41
appreciate I would love to do that. I can't I can never wrap my head around. But you know what? Let's stop the recording. And we'll talk about it privately. Do you mind?
Yeah, by all means, thanks so much.
type one diabetes can happen at any age. Are you at risk, screen it like you mean it? Because if just one person in your family has type one, you're up to 15 times more likely to get it to screen it like you mean it. One blood test can help you spot it early. And the more you know, the more you can do so don't wait. Talk to your doctor about screening. Tap now or visit screen for type one.com To get more info and screen it like you mean it. 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 the sponsors. A huge thanks to Omni pod, not just my longest sponsor, but my first one Omni pod.com/juice box if you love the podcast, and you love tubeless insulin pumps, this link is for you. Omni pod.com/juice box. If you enjoyed today's episode, go check out the rest of the Grand Rounds series. There's links let's see where you can find them. Well, here's the easiest place go into the private Facebook group go up to the feature tab. There's links of all the series in there you'll see every episode of the Grand Rounds series, you'll be able to go back into your podcast app and listen until your heart's content. 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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