Scott Benner 8/30/24 Scott Benner 8/30/24

#1293 The Fighter

Sandy has had type one diabetes for 63 years.

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

Scott Benner 0:00
Hello friends and welcome back to the juicebox podcast.

Boy, I love this episode. Sandy is 70 years old. She's had type one diabetes for 63 years, and she and I had a fabulous conversation. Nothing you hear on the juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. Lots of people with autoimmune seem to have trouble with their thyroid, and that's why I've made the defining thyroid series, juicebox podcast.com click on defining thyroid the menu to find out more. A diabetes diagnosis comes with a lot of new terms, and you're not going to understand most of them. That's why we made defining diabetes. Go to juicebox podcast.com up into the menu and click on defining diabetes to find the series that will tell you what all of those words mean. Short, fun and informative that's defining diabetes. When you place your first order for AG, one, with my link, you'll get five free travel packs and a free year supply of vitamin D drink. AG, one.com/juicebox, one.com/juice box.

This episode of the juice box podcast is sponsored by Dexcom. Dexcom.com/juice box. Get the brand new Dexcom g7 with my link and get started today. This show is sponsored today by the glucagon that my daughter carries, gvoke hypo pen. Find out more at gvoke glucagon com, forward slash juice box.

Sandy Schwartz 1:53
Hi. This is Sandy Schwartz, excited to be invited to do a juicebox podcast with Scott and tell you all about my 63 years with diabetes.

Scott Benner 2:09
Sandy, seriously, 63 Yeah,

Sandy Schwartz 2:12
I was seven and I'm 70 now. So you can do the math? Well,

Scott Benner 2:16
I you assume I could do the math, but yeah, that's amazing. Seven years old, 60 through your 70 today. Wow, yeah, it

Sandy Schwartz 2:23
was Barb barbaric back in the day. By

Scott Benner 2:26
the way, I have a feeling I don't know you, but just from your intake form, I feel like you're a little you might be a little salty. I like that. I think we're gonna have a nice time together. So tell me, what do you mean barbaric?

Sandy Schwartz 2:41
Well, my father used to sharpen my steel needles in his wood chop, and I would help

Scott Benner 2:46
him, like, on a stone and or and Sam, like, literally take a steel needle and make it sharper for you, exactly. And

Sandy Schwartz 2:58
you know, there was one walking shot of insulin a day. There was no carb counting, although, after a couple of years, I went to Barnes Children's Hospital in St Louis, and they taught us something called the tag system. Have you ever heard of that? You're the first person to ever say that I have the book somewhere so the everything had a tag. And rather than explain it, we came home from the hospital to Memphis, and I rode my bicycle to the local Five and Dime, which is all that we had in the 60s and aka 711 now, and I bought two Snickers bars, and I came home and my mother made dinner, and I brought the Snicker bars to the table, and she asked me, What are you doing? And I said, Well, I added up your dinner and it's equal to these two Snickers.

Scott Benner 3:57
So I'm skipping dinner, and we're going like this today,

Sandy Schwartz 4:01
right? So I guess that was the beginning of carbohydrate counting.

Scott Benner 4:05
When do you think that was? Now, let me make sure I'm right. You're born in 54 353, and you're diagnosed, what? 60 Yes. Okay, so at what point do you think someone brought this tag system up to you? Probably 1963 64 Okay,

Sandy Schwartz 4:25
I have it somewhere. I'm going to send it to you. I'm

Scott Benner 4:29
googling it right now. Hold on a second. See if I know bacon

Sandy Schwartz 4:32
had a tag. Everything had a tag. So it wasn't just carbs, but it was the beginning of thinking that you could exchange more than green beans for broccoli.

Speaker 1 4:45
Sandy tab T, A, B, T, a G, G. Tab system, diabetes, T,

Sandy Schwartz 4:53
a G,

Scott Benner 4:54
yeah, I'm not seeing it. I mean, I guess it's just something that nobody ever talked about on the internet. I guess I. And that's okay.

Sandy Schwartz 5:00
Look up Barnes Children's Hospital. I'll try. They developed it. I'll find it and send it to you. It was very interesting. Thank

Scott Benner 5:08
you. I wonder too You're you talking about sharpening the needles? How frequently do you remember that happening? I don't remember. Would they get would they get sharpened after they started to hurt because they weren't because they were kind of like pushing instead of piercing.

Sandy Schwartz 5:26
I was seven. I don't remember. I just remember going into my dad's wood shop and helping him sharpen these needles that I was going to be using to take insulin. I very quickly learned to take care of myself as much as possible. I came home from the hospital. I've written about this on juicebox and how it changed my relationship with my mother, but I saw how much pain it caused her. And so at seven years old, I said, Give me that thing. I'll do it. Of course, she drew up the insulin. I'm the one who injected it.

Scott Benner 6:05
You took over your own care to save your mom.

Sandy Schwartz 6:07
You should be shrink. That was a very good statement. I'll have to discuss that one in therapy. Okay,

Scott Benner 6:15
by the way, I've had a couple of episodes. When it got done, I was like, I might be a good therapist one day, but, yeah, but I'll

Sandy Schwartz 6:21
be your sponsor. Oh,

Scott Benner 6:25
okay, well, keep your mind, this podcast thing falls apart. I'll put it on my list of ways I might be able to make a living.

Sandy Schwartz 6:31
I don't think the podcast is going to fall apart. I think it's the best thing that happened to diabetes sensors.

Scott Benner 6:39
Oh, do you really?

Sandy Schwartz 6:40
I did. I really do. I think that the way you run it, the way anybody can say anything, and, you know, I read something, I'm like, Really, they said that, but nobody jumps on them. I think it's very polite and informative and and supportive for so many people.

Scott Benner 7:02
Yeah, I tried very hard to set that Facebook group up so that it operates the way an adult with common sense should live. Yeah, and not. I can't believe you said this, or it hurt my feelings, or that made me upset, like I don't want people hurting people's feelings on purpose, right? But you know, and we certainly don't let that happen. But you know, there's, there's just listen, there's a good example. The other day, this, this person who I like a lot, and who's been a guest on the podcast, put up a post about something, and one of the responses felt a little harsh, but it was still on point, and it wasn't harsh towards the person. It was just, I'm trying not to give away details, but it was, maybe it would have been upsetting, almost being, like, kind of slapped in the face with a with an honest truth about about something. And, you know, I got, hey, this, you know, this should come down. And I responded back, and I said, I don't see it that way, like, I'm sorry you're upset, but there's nothing attacking about this. It's factual and it's valuable, and we're gonna leave it there. So, you know, that's just sort of how I do it.

Sandy Schwartz 8:04
I think it's a giant diabetes support group for the world.

Scott Benner 8:08
It is really, Yeah, no kidding. 47,000 people right now in it. And by the time someone hears this, it'll be six months from when we record this till somebody hears it. And I can tell you, as crazy as it sounds, yeah, there'll be 4000 more people in there by the time this airs, wow. Yeah. So there'll be more, like 52,000 probably by the time this comes out.

Sandy Schwartz 8:30
Well, good for them. It's good for them. Yeah,

Scott Benner 8:33
it adds 150 new members, like every few days. Wow. Yeah. I'm very proud that you said that because, because you're 70 years old and you've had diabetes for 63 years, like to say that this thing I made feels valuable only second to CGM is really touching to me. So I appreciate that if you take insulin or so final ureas, you are at risk for your blood sugar going too low, you need a safety net when it matters most, be ready with G, VO hypo pen. My daughter carries GE, voc, hypo pen everywhere she goes, because it's a ready to use rescue pen for treating very low blood sugar in people with diabetes ages two and above that. I trust low blood sugar. Emergencies can happen unexpectedly and they demand quick action. Luckily, jivo kypo pen can be administered in two simple steps, even by yourself in certain situations. Show those around you where you store GEVO kypo pen and how to use it. They need to know how to use jivo kypo pen before an emergency situation happens. Learn more about why G VO, kypo Pen is in Arden's diabetes toolkit at G VO, glucagon.com/juicebox, gvoke shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma, or if you have a tumor in your pancreas called an. Visit gvoke, glucagon, com, slash risk for safety information. Today's episode of the podcast is sponsored by Dexcom, and I'd like to take this opportunity to tell you a little bit about the continuous glucose monitor that my daughter wears, the Dexcom g7 the Dexcom g7 is small, it is accurate and it is easy to use and wear. Arden has been wearing a Dexcom g7 since almost day one of when they came out, and she's having a fantastic experience with it. We love the g6 but man, is the g7 small, the profile so much closer to your body, the weight. You can't really feel it, and that's coming from me. And I've worn one, I've worn a g6 I've worn a g7 I found both of the experiences to be lovely, but my gosh, is that g7 tiny? And the accuracy has been fantastic. Arden's a one. C's are right where we expect them to be. And we actually use the Dexcom clarity app to keep track of those things. That app is built right in to Arden's Dexcom g7 app on her iPhone. Oh, did you not know about that? You can use an iPhone or an Android device to see your Dexcom data. If you have a compatible phone, your Dexcom goes right to the Dexcom app. You don't have to carry the receiver. But if you don't want to use the phone, that's fine. Use the Dexcom receiver. It's up to you. Choice is yours with Dexcom, dexcom.com/juicebox,

Sandy Schwartz 11:30
well, I will tell you that I've worked in the industry for a long time, and you know, I thought, I thought that I knew a lot about diabetes, I find that I not only learn things, but it has inspired me, maybe where I've gotten lots of days a call, it has inspired me to bump up my game, bump and nudge my game. You bumped

Scott Benner 11:58
and nudged your game. Can you tell me a little bit about what being connected to other people does for motivation? For

Sandy Schwartz 12:06
me, the podcast and Facebook groups have inspired me to like I said, bump up my diabetes game a little and and also to help motivate other people, like I I chime in when I think that I can be helpful. Sometimes I grit my teeth with what I read, but I try to be polite and couch what I say like I have, like I just said about my mother, that you know that we came home from the hospital and she felt guilty, and I felt sad that I quote, unquote, lost my mother. And so when I see these parents who you know are are not accepting the illness, it's I personally have a terrible reaction to it. I just want to get in there and say, look what you're doing to your child. But I know that diabetes treatment today is different than it was when I was seven years old. So if my mother had had this podcast, I would be have been treated differently.

Scott Benner 13:21
Are you saying that a parent that can't accept the diabetes and fold it into life is projecting rejection to the child,

Sandy Schwartz 13:31
rejection to the of the child. No guilt, grief,

Scott Benner 13:39
fear. This is from the child's perspective. If the parent doesn't seem like they've got it and they're not burdened by it, what do you give me the bigger picture?

Sandy Schwartz 13:49
I think the parent feels guilt, fear, sadness, anger, goes through all the grief responses and let me not generalize to me, I felt like, hey, where did my mother go? But I didn't know that at the time I have through thinking and feeling and watching the relationship with my mother, which deteriorated from the day I got diabetes, I think that I wish she had accepted it as well as I have. I think as a kid, you go through it. I mean, you go through whatever you're going through, and you don't know better, you just do what you have to do. And then when you see your parents change so much, or let me personalize it, when I saw my mother change so much, it created a rift,

Scott Benner 14:41
and she never got over that, or was it just set and set in motion, and that's how it felt to you.

Sandy Schwartz 14:48
Then it feels kind of sad to say that. I think I never got over it. I tried really hard. I didn't. I couldn't have said all this. If I'd known all this while she was alive, I would have. I processed it with her, but I think it set in motion that mother daughter stuff times 10,

Scott Benner 15:09
so she had all those feelings that you described you feel like she disappeared from the scenario. Maybe she came back and got it together, but by then you were hurt and you couldn't get past it.

Sandy Schwartz 15:22
I think she saw, I mean, she was always very proud of all the steps I made. And I was giving a talk one time at the Diabetes Research Institute at the University of Miami to a bunch of fellows. And she was in town, and I brought her, and I think that was very healing for both of us. I tried really hard to get through the resentment I felt as a child. And of course, I'm putting adult words to childhood feelings, so I don't know that's the word I would have felt. Then I think I felt sad. I felt like I lost my mother, like, where did my mother go? Who is this lady who's always sad and and scared and and not unlike she used to be?

Scott Benner 16:11
And you can connect that to yourself, because even if you don't realize that the timing is, I got diabetes and then this happened, and then you can put that onto yourself, like you caused it almost by having diabetes. I

Sandy Schwartz 16:24
don't know if that's my personality, but maybe like I didn't feel guilty, I felt sad and angry.

Scott Benner 16:31
Yeah, tell me. Tell me. Tell everybody what you do for a living. Well,

Sandy Schwartz 16:35
I'm a psychotherapist, but I also kind of fell into working with some of the big companies writing physician and patient education materials for a long time. So I see patients professionally, and I have had a personal experience in the diabetes space, manufacturing and that kind of thing.

Scott Benner 17:01
I just wanted people. I just wanted people to know because you answer questions like a psychotherapist. That's why should I change that? No, not at all. I actually Sandy, if Can I be honest? I thought because you're thoughtful when you answer, you're like Erica. You listen to me when I talk to Erica. Okay? So you're you're thoughtful and you're pausing. And I didn't want people to think, Oh, I feel bad saying this. I didn't want people to think it was your age. Ah, you're actually, you're, you're, you're considering your words very carefully,

Sandy Schwartz 17:31
okay, yeah, I'm sorry. It's funny when you say my age, because if you ask anyone who knows me, I do not act my age. I mean, I just came back from a Keith Urban concert where I was in the pit, so get out of here, really. Yeah, six feet from the stage, that's fantastic. I could be up close and personal, dancing and hollering and having a great time.

Scott Benner 17:57
Let me tell you something. I spoke at an orthodox event this week. It's this weekend. It's the second time I've done their event. Really lovely group. And when I walk from my room to the where I have to go speak in the morning, or when I'm done at the end of the day, and I walk back, I have my headphones in, and I'm listening to like Metallica while I'm doing that, and I wore my headphones all the way back into a room, and I sat down, and people were already waiting for me. I was early, but they were already waiting for me. I sat down, and as I took out my my headphones, they all looked at me, and I went, I'm not listening to metallic, if that's what you were thinking. And I watched all their faces, and I think most of them didn't know what I was talking about. And I was like, okay, and I put my just put my headphones on. I was like, hey, so we're here to talk about and I thought, why don't we get going early? But I don't think people would look over at me at 52 years old, driving in my car and and imagine that I'm listening to freight ends of sanity. So, so good for you.

Sandy Schwartz 18:56
I drive a Bronco with the top off, and I Blair, Jimmy Buffet, God damn, I used to work on a scuba diving boat. Scott, oh,

Speaker 1 19:06
you're Sandy, you're a party. I see what's going on here. All right,

Sandy Schwartz 19:11
I was 20. I left Tennessee, I moved to Miami, and I quit school and worked on a scuba diving boat for three years before I decided to grow up and

Scott Benner 19:24
you went back to school after that, I did about that. So, okay, so barbaric in the beginning with these needles. But what are the shifts that you remember? Like, what's the first shift in care that you recall, so

Sandy Schwartz 19:36
short acting and so on? That's I was a teenager, and my if there were endocrinologists, neither my mother or nor I knew about them, I was at my pediatrician's office. Maybe I was no I was older than that. I was maybe 15, and because I was drinking beer. So that's how I know this. But. He said to me, Sandy, how come all my other patients go into DKA and you net, you have never been in DKA. And I said, you know that short acting insulin you give me when I'm sick? Well, I decided that I can take it when I eat pizza and drink beer. So I was bumping and nudging you were. I also, even younger than that, I used to take as much one shot of long acting insulin a day, as much as it took to get low and then back up a unit or two. Oh, so I kind of saved myself without knowing your

Scott Benner 20:39
Yeah, you and I have a lot in common. So you you pressed the the boundaries of what they gave you, and because you didn't have a measurement system, you were like, I'm gonna keep trying this till I get dizzy, and then I'll back it up a little bit

Sandy Schwartz 20:50
Exactly. And the same thing with the short acting insulin, if you can give me this, well, here's another thing. I have asthma, and I take steroids. So if you can give me this short acting insulin when I take steroids, and I can take it for pizza and beer. Yep,

Scott Benner 21:06
yeah. So you figured out what to do with that medication before they knew what to tell you to do with it. Yeah, in the 60s, I feel like that right now with glps, by the way, yeah, like so Arden is taking a GLP, and it's decreased her insulin needs pretty significantly. And she just, she's in the middle of her finals, like today and tomorrow, her last finals day for this for this quarter. And she and I were talking this morning, she was calling to tell me, here's what she called to tell me, she goes, Hey, I almost killed an old lady. And I was like, Wait, what happened? And she goes, she goes, it wasn't my fault. And I go, what happened? So she said, I got in my car to leave class, and she's like, and I've got to go to the printer. I gotta print this out. I gotta go home. I gotta change my CGM. Then I've gotta get back to class and I gotta turn in this other final. And if the printer is not like, she's kind of going online, she's like, but I get my car, I sit I you know, I put my stuff down, I get settled. And cars now, you know, they have cameras, and kids drive them, like video games. Like kids don't look over their shoulders. They like, they access cameras, you know. So she's like, I don't know what made me look forward, even though I was backing up, but I'm so glad that I checked my cameras. Then I looked forward and I said, why she goes? This very old woman was leaning on my car. Oh my god. And she had just been walking through the lot after Arden got in the car, and she's leaning on the car, and doesn't realize Arden is in the car, but she's using it for support. And Arden said, If I would have backed up, she absolutely would have tumbled over, slammed her head on the car and just went right to the ground. And she said, Oh my god, I'm just so happy that I saw her. And I was like, no, no, that that's great. And then, you know, I'm glad everything's okay. She's okay, yeah, she she's like, I let her lean till she was done, and then walk away. And I was like, okay, but, but then I was like, hey, you know your CGM is about done. You got to go home and do your CGM. And she's like, Yeah. She's like, that's on my to do list this morning. And I don't think there was a enough GLP in the pen when I shot it. And I was like, What do you mean? She goes, I'm supposed to shoot a half of this ozempic. We're moving her from ozempic to something else, but there's a transition period. And she goes, but I shot it, and I don't even think there was a quarter. And I said that that's not going to be enough. You know, you're going to need to go to the next pen that I gave you and do it again. She goes, will that be too much. And I said, well, the alternative is, your blood sugar is going to be crazy until we get back to the next injection. So just, just do it. That's a thing like her doctor prescribed it for. But, like, our insurance won't cover that. And if you go to any endocrinologist right now and tell them, like, you know, we're like, shooting, like, half you half milligrams of this and that and Arden's, they'd be like, You can't do that. It's not it's not okay for that. But I'll tell you right now, and you might be listening to this right now and be like, You can't do that, Scott, but five years from now, you're gonna look back on this recording and go, That guy was ahead of the curve, and

Sandy Schwartz 23:55
so that's where you were. So do I? I don't Do I seem like the kind of person that would say you can't do that, Scott, I'm gonna say, give me some Yeah,

Scott Benner 24:04
no, I think you're all in I love that example, because you literally took something that they gave you, and they were just like, look for steroid problems if you're sick, like this kind of stuff. And you're like, Well, wait, all that this is doing is I'm having a high blood sugar, and this is bringing it down quickly. I'll apply this to anything. You know what I mean exactly when you say you think that might have changed the course of your health. What has your health been like all this time?

Sandy Schwartz 24:29
My health is excellent. Sometimes I have survivor's guilt because I've lost so many friends to diabetes. But for people listening to this, they have to realize that we took one walking shot of insulin a day. We had no we had no way to bump and nudge. And luckily, that rarely happens like it used to. But my health, I don't have any of the other medical. Colic syndrome, conditions, so I don't have any high blood pressure, I don't have any high cholesterol, no neuropathy, none of the things that make diabetes hard to treat, except I take steroids on a regular basis. But just like you're doing with the ozempic, you just get to know how much insulin you need for how many Miller grams of steroids, and you do what you have to do. I mean, it's it's a balancing act, but it's not impossible.

Scott Benner 25:33
Sandy, tell everyone listening, if you would have listened to doctors and waited for them to help you, where would you be right now? Do

Sandy Schwartz 25:38
you think Dad?

Scott Benner 25:39
You think you would be dead. I

Sandy Schwartz 25:41
know I would be. So when I was had had diabetes 19 years I went to the University of Florida for graduate school, and right before I went, I went to the ophthalmologist and found out that I had background retinopathy in one eye. And so when I got to Gainesville, I immediately looked up their diabetes program, and I was it was 1979 it was 1978 when I went to Gainesville, but in 1979 I joined a research trial there, and I wore the big blue brick that the first insulin pump that looked like it was, it looked was the size of a brick, okay? And we also did the research on home blood glucose monitoring. We would take our we would stick our finger and put it on a strip that looked like the old test strip. It would turn a color. We we would take our own venous blood with an insulin syringe and put it in a tiny test tube, and right on the test tube, what we thought our blood sugar was, and keep those in the refrigerator, and then we would turn those in weekly. And so I was one of the first six adults to wear a pump, and also to do home blood glucose monitoring. So I went to the ophthalmologist in Gainesville after six months. And I think you can finish the sentence. Yeah, everything. No, no retinopathy. It was gone.

Scott Benner 27:15
Yeah. How about that? Hey, I'm actually looking at a picture of the big blue brick. And in case anyone thinks that Sandy is gilding the lily, here it's about 10 inches long. Looks like it's maybe four or five inches wide, maybe two inches thick. It's got like, almost like tubes coming out of the ends, and it almost feels like pipes coming out of the top. And it hangs on the belt, but the person's belt that it's on in the photo is like pulled down like three inches by the weight of it. And it's really something, but it worked, huh?

Sandy Schwartz 27:46
We set the basal rate with a screwdriver in one unit increments. No

Scott Benner 27:51
kidding. I want everybody to did ever complain that my pump doesn't go down to point? Oh, five. You should. You should. You should stop complaining. That's amazing with a screw, like a little set screw, because, yeah, you were restricting the flow, like a like, like, plumbing, yes,

Sandy Schwartz 28:10
yes, it was on. It was an insulin syringe that fit a glass insulin syringe on the outside of the pump. I put a picture of it on your Facebook page. If you look up my name, you'll see it okay. It was pretty amazing. Wow. And then one time, I rode my bicycle to a party, and my doctor was there, and I kept telling him I didn't feel well. And he's like, Well, what do you feel? And I'm like, I don't know. Just not well. He's like, Do you have a fever? I'm like, No. And he's like, Well, what do you feel? I said, kind of shaky, but not like my blood sugar is low. He's like, Sandy. How far did you ride? I said, I don't know, 20 miles. He's like, Have you had lunch? I'm like, No, I don't have to eat lunch anymore. I'm on a pump. I was hungry, but for 21 years, I never knew what hunger felt

Scott Benner 29:01
like, because you were always eating on a schedule, because

Sandy Schwartz 29:05
long acting insulin you have, you know you're feeding it, it peaks. Yeah, I was feeding my insulin instead of my insulin, feeding me so I was hungry, but I didn't know what hunger felt like. No

Speaker 1 29:18
kidding, did the brand of management that was necessary while you were growing up? Did it have any more impacts on your relationship with food? Hell yeah,

Sandy Schwartz 29:30
yeah. I mean, I have had to change my views on food and lose weight, because as soon as I could eat what I wanted. I ate what I wanted, and I still love carbs and sugar and but I have lost about 50 pounds. I'd love to be on the GLP. I need to lose about 10 or 15 more, but, yeah, my relationship to food was, was altered. But, you know, we can check. Change Anything we want to change, if we try hard enough. Well, I'm

Scott Benner 30:03
but I mean, if you think back to very young Sandy, you know, hearing about the tag method, she's like, I'm having two snicker spars for dinner tonight. So like, you know, I did wonder, and I can't imagine being that restricted and having such a specific regimen for so long, and then somebody telling you this part's over now, and you're not going a little crazy in the other direction, you know, like, just makes sense to me, honestly, yeah, one on the lines of, I don't know, every Catholic girl I knew when, when they graduated from Catholic school, cut their hair or did something very drastic to take ownership of themselves. Does that make sense? Right? Yeah, yeah, that to me seems like the same thing. Honestly, just like, you're like, Oh, I'm finally in control. Let me do something big, you know, right? And then before you know it, those that sugar hits you in those carbs, and they're so good, you know, and and you're on your way. Well, can I ask what made you want to come on the podcast at

Sandy Schwartz 31:04
once? I found you guys on Facebook and started listening to the podcast. I just wanted to be involved. I wrote to you and said, I want to be involved. And you wrote back and said, Come on the podcast. I just, I miss working in diabetes. I think, honestly, I think I don't get the jobs I used to get in diabetes because of my age, which I mean, I still have a brain, and I I like to be helpful, if I can be to other people who live with this disease. I see mostly, most of my caseload is chronic illness and disability. And acceptance, not just of chronic illness or disability, but of life in general, but specifically when you're hit with a lifelong issue, is so hard for so many, and if I can help them get through that resistance and to acceptance, then their life is going to be so much richer. So

Scott Benner 32:12
is that the key? In your opinion, acceptance moving forward?

Sandy Schwartz 32:16
I think acceptance is the key to moving forward in life in general, yeah,

Scott Benner 32:22
I do too, changing, being able to change your expectations, not being so cemented on an idea, and being able to accept that things shift that have nothing to do with your decisions. I think all that's really important. Yeah, yeah, to your point, too. Not just about diabetes, really,

Sandy Schwartz 32:43
yeah, life and life in general,

Scott Benner 32:45
when people have trouble accepting things as you've worked professionally through the years, how do you help them get past that?

Sandy Schwartz 32:52
I think it has to do with expectations, and looking at their expectations, grieving what they've lost and moving through the grief process to acceptance,

Scott Benner 33:03
and that's through talk therapy that you can accomplish that. Mostly,

Sandy Schwartz 33:07
yeah, yeah. If not, I have a hammer I can hit them over that.

Scott Benner 33:12
You just whack them like Bugs Bunny. If they after four times they visit, it doesn't get together.

Sandy Schwartz 33:17
I don't know where that came from. I have never said that I'm like,

Scott Benner 33:22
so this episode, heard my titles already that I have written down big blue brick, which I don't think I'm gonna do. There's a Keith Urban song called the fighter. I thought I might call it and but now I'm thinking I just might call it the hammer, because for the first 35 minutes, people will be like, Why is this called the hammer?

Sandy Schwartz 33:43
I love it. I love the fighter. Tia. It's a great song. Yeah,

Scott Benner 33:46
well, maybe that's the one I'm gonna go with. Actually, is there a certain personality that has more difficulty moving forward than other types of personalities?

Sandy Schwartz 33:55
I have to think about that one, and I'll tell you on the next podcast. Okay,

Scott Benner 33:58
how about this? When people come into the office, can you assess them in an hour and know with reasonability how this is going to go? Yes, yes, and that that's about their build and their makeup, right? It's about

Sandy Schwartz 34:11
their ability to have insight and to be willing to let down their resistance and their fears and look inside themselves.

Scott Benner 34:22
Is any of that contingent on intelligence? I

Sandy Schwartz 34:26
don't think so. I mean, I'm going over clients in my mind, and I'm thinking of a couple that surprised the hell out of me, their ability to have insight. So I would say that you would suppose that it's the it's intelligence, but I think it has to do with emotion too,

Scott Benner 34:50
okay, maybe a less measurable part of who they are. So like, I know people, people love to say emotional intelligence nowadays, like a. A buzz word that people like is emotional intelligence, just you understanding the big picture and then not getting in your own way.

Sandy Schwartz 35:07
My goal is equal parts of head, heart and gut. And so a lot of people are stuck in their head and in their left brain, like the thinking part, not the feeling part. And some people are are angry and frustrated and stuck in their gut, and some people are very emotional and stuck in their heart. And I think if we can somehow rearrange and even to some degree, then we can give up some of the baggage. We can stop obsessing so much. We can stop being so depressed, if we can look at all at the parts that make us operate, as far as our emotions. Does that makes

Scott Benner 35:57
it does? Is there anything about it that's gender specific? Or is it people's experiences and that lead to during their growth times?

Sandy Schwartz 36:07
I think that men are more self protective initially than women, but breaking through that resistance, I think we're all pretty equal.

Scott Benner 36:16
Everybody can get through it,

Sandy Schwartz 36:18
no, and not everybody can. But equally well, yes,

the opportunities there and the opportunity. Thank you. Okay, thank

you. Yes.

Scott Benner 36:27
Is there truth to that idea that people can get stuck at a chronological maturity depending on where they're kind of like traumas come from, like, if something terrible happens to me when I'm 14, am I kind of stuck at 14 till I worked through it, or is that just kind of pop psychology?

Sandy Schwartz 36:44
No, I think it's true for trauma or drug use. I think my mom got stuck when I was diagnosed with diabetes. Yeah, it took her a long time to accept the fact that I wasn't going to die. And I mean, she never uttered those words, but yeah, I we call it fixated. Yeah, fixated. I just want to

Scott Benner 37:07
say for people listening emotional intelligence is the ability to understand, use and manage your own emotions and positive ways to relieve stress, communicate effectively, empathize with others, overcome challenges and diffuse conflict. That's from help guide.org if I have a lower emotional intelligence, but I have a good therapist, they can get me there if I want to get there, right? If

Sandy Schwartz 37:31
you're open to getting there, yeah, if you're not too resistant, if you're not holding on to the past that or or maybe you don't even know it. Maybe you're just too repressed to open up. Well, I was gonna

Scott Benner 37:45
say, Are there people who express that they want to get past something, but then their actions keep them there?

Sandy Schwartz 37:52
No, no. I think once you once it comes from your sub or pre conscious, to your conscious, you've broken the you know, you've broken the jar open. I think once you express it, you're on the other side of the hill, the good side. Yeah, yeah. So

Scott Benner 38:12
people who want change can change.

Sandy Schwartz 38:15
I believe so, yeah, don't you? Do you believe that?

Scott Benner 38:18
Oh, absolutely. I also think that it correlates right with diabetes to that thing I say to people like you get what you expect, like if you expect high blood sugars, as crazy as it sounds, there's these tiny variables in your thinking and your actions that you'll never even notice that are pushing you towards high blood sugars. Right? If you expect to be more in control, you make these little micro movements and decisions that get you there. And it's not a thing you'll see happening, but it's about attitude. It's about who wants it more, you know, who can stick with it long enough do the work not give up that kind of stuff. Eventually, one day, you pop your head up and you're like, Wow, I'm good at this, you know, and but you don't see it happen like that. Yeah, no, I really believe that. I just think that it's funny because I took a very technical thing and then had an emotional reckoning from it. Then the technical thing was I started to see wherever I set Arden's high alarm is where I could keep her blood sugar, which didn't make any sense. If the alarm was at 250 then her blood sugar was frequently 250 I made it 200 then her blood sugar frequently didn't go over 200 so I was like, Ooh, 181 50. Once I was just I was off to the races then. And then I eventually pushed it down to 120 and then I get what I expect, like I saw the technical side of it, which just really is, if I'm being clear, once you have your settings right and you know what you're doing a little bit, you react to those alarms. Your reaction requires less insulin, because it's happening at a lower number. If you use less insulin, you have less of a chance. Below, so you have less of a chance of a rebound high, and that's what keeps your stability there. But the truth is, is that once I saw the technical aspect of it, I realized that there's a bigger picture of unseen forces. And the way it came out of my mouth one day was, I think I'm getting what I expect. So I think you get what you expect, and that's it like, if you say to yourself, I'm going to get up every day and do 10 sit ups and you actually do them, your stomach will get harder, like it's just, you'll get what you expect. You just have to do it.

Sandy Schwartz 40:29
I love that. And probably the best thing I've gotten personally from juicebox is setting those, those high alarms. I mean, I never put it in the term. She just put it in. But I've been lowering them and lowering them. And my a 1c has come down and down. It's never been high. But I'm like, What the I mean, he's right.

Scott Benner 40:56
That's fantastic. What were target a one CS through your lifetime. I mean, I'm imagining the ADA has moved them a number of times through your life, right? Well, there was no

Sandy Schwartz 41:05
a 1c when I went to Gainesville, there was something called a glycosylated hemoglobin. The norm for that was around eight instead of six. And my first glycosylated hemoglobin after 19 years of diabetes, pumping and nudging and using short acting insulin for steroids and food and everything I tried to do was 18, really, and the norm was eight, and I had to get used to hypoglycemia, shaking, sweating, anxiety at 120 then 110 then 100 once I went on that pump, because you get what you expect, and the other way too. Scott,

Scott Benner 41:52
yeah, your body expects high blood sugar, so it makes adjustments to blood vessels and and a lot of different things trying to keep you alive longer at that higher blood sugar, and then suddenly you bring that blood glucose down, and then you have low signs and symptoms at numbers that are not actually low,

Sandy Schwartz 42:10
exactly. Yeah. It's amazing, if you think about it scientifically. I mean an 18 glycosylated hemoglobin is like, A, 15, A, 1c, yeah, no. I mean, I made good grades. I was in graduate school, you know, there was no 504 plans, and I never even thought about my mother, never thought about not sending me to school, but she didn't know what my blood sugar was. So you get what you expect. I mean, I expected to make good grades, and I did. So went out

Scott Benner 42:42
there and found a way to do it. And also, once you felt low at 120 you didn't say, Oh, I better make my blood sugar higher. You said, I better get through this, because I have to keep bringing my blood sugars down.

Sandy Schwartz 42:53
Well, the doctors told me that I was like, I can't handle this. And they were, yes, you can. So it wasn't all me. I had a little help from my friend,

Scott Benner 43:04
wonderful. Yeah, you get by with a little help from your friends. Exactly. Hey, the ADA is telling us right now that less than 7% for many adults. However, a 1c is individualized, and your doctor may give you a higher or lower a 1c goal, depending on your needs. Way to not say anything. Ada, congratulations. Lot of words, lot of words, lot of words. No guidance, yeah,

Sandy Schwartz 43:28
yeah. But listen to me, I think it's dangerous for people to try to have lower like, sugars when, when they don't know what they're doing like I have a friend who died because she got sent home from the hospital, not with type one, with type two, and was on hospice, but her daughter kept giving her her short acting insulin, but she couldn't eat. I mean, so with you know, it works the other way too. What you don't know can hurt you.

Scott Benner 44:01
Yeah, I am not a fan of just saying one thing my thought here is that we don't want to do least common denominator education. So the way I always think of it is, you know, in a class of 20 kids, there's, you know, two or three exceptional kids. There's a handful of above average kids, there's average kids, there's below average kids. There's a couple of kids who are really struggling. And I understand the desire to not want to leave the ones at the bottom of the line like behind, but at what cost is it to the rest of them who could take in more information? And isn't there a way to give everybody what they need, instead of just saying the safest thing, which is, hey, you know what? As long as everyone sees below seven, you're fine, because then people are going to come along and say, well, the ADA says, under seven, I'm fine, you know? And I say, well, the person standing over there doesn't have diabetes. There anyone sees like, 4.8 4.9 right now? So. That's pretty significant difference from seven to 4.9 and they say, well, can show me studies that say that seven is bad. And I'm like, I don't know if there's studies about that, but, you know, show me studies that say it isn't and they're gonna say, Oh, it's fine, because, you know, we've done studies, and people are okay, but you don't know what they're accepting is okay. You know what I mean, like, I don't know the answer to this question. Like, is a seven, okay, six, okay. Is five? Okay? I don't I honestly don't know. All I can tell you is that I try as hard as I can to put my daughter as a 1c as close to normal as I can without putting her in danger. That's what I'm doing. And you know, like, if they got explained to me that way, then I think that everybody on the spectrum of desire and understanding could make their own decision. That's how I feel about it. But makes sense? Yeah, they say seven is okay. So that's what they say. Family growing up, did you were you ever been married? Have children, anything like that? I

Sandy Schwartz 46:00
never got married. I had a son when I was 40, after 33 years of diabetes on my own by choice. I'm not gay. It wouldn't matter if I was, but I'm way too independent. I'm working on that now. Never Say Never Scott I think you might still get hitched if someone can handle me.

Scott Benner 46:24
Well, you didn't like being tied down to another person. I

Sandy Schwartz 46:28
didn't know how to be. I dated, I had long relationships. I had a lot of fun. I'm working on learning to be I'll tell you when I get there.

Scott Benner 46:42
What are you working on being? What are you trying to get to, where I

Sandy Schwartz 46:46
can share more, where I can trust more, where I can let go more, where I can I mean, I have great friendship with men and women, and I've had great, quote, unquote, more than just friends with men. I've just never shared my space for very long.

Scott Benner 47:07
Can you self analyze and tell me why that's hard for you? Yeah, but that belongs on another podcast. Okay, can I guess or do you not want to talk about it?

Sandy Schwartz 47:17
No, you can guess. I just it's go ahead,

Scott Benner 47:20
you get and you don't have to answer, but I've done a lot of these. Did you have any sexual abuse in your past? No, never, nothing like that. Okay, nothing, nothing. Was your dad a problem?

Sandy Schwartz 47:31
My dad was a problem and that he was so loving and so kind and so attentive

Scott Benner 47:38
that you can't meet a guy as good as your dad? Consciously,

Sandy Schwartz 47:41
I would not say that, okay. Subconsciously, maybe Okay,

Scott Benner 47:45
all right. Well, that makes sense. Have I ruined Arden by being an attentive father? I guess we'll find out. Is that what you're

Sandy Schwartz 47:52
saying? No, I think it was more than that for me. But I What did she say? Ask her. I

Scott Benner 48:01
mean, she's got a boyfriend, she seems to be okay, so Okay, well,

Sandy Schwartz 48:04
then I guess the answer is, right, there, people are different. We're all different. Yeah,

Scott Benner 48:09
so you dated plenty, you had plenty of relationships. Some were even long term. You just Were you ever with somebody that you thought that I am going to marry this one

Sandy Schwartz 48:16
if they had gotten their act together?

Scott Benner 48:20
Oh, okay, you're not type A though, right? No, no, not at all. So you're not expecting other people to be perfect,

Sandy Schwartz 48:27
no, but I had very co dependent relationships where it was, I mean, you know, it can be 6040, but it shouldn't be 9010, so Okay, all right, couple

Scott Benner 48:38
people. So there are a couple people on the way, if they would have pulled it together, you would have done it. But would have done it, but you didn't you when you said you purposely had a baby, did you meet a guy and say, Hey, I don't want you involved, but I need, I need some help. Or did you get a donation? How did you do that? Okay,

Sandy Schwartz 48:53
now you have to put me on the after hours.

Scott Benner 48:58
Okay, go ahead.

Sandy Schwartz 49:00
This is not about diabetes. Do you want me to tell you?

Scott Benner 49:03
I mean, if you want to tell me, I want to know. If you don't want to tell me, You shouldn't say,

Sandy Schwartz 49:07
oh, yeah, I first I tried with friends, both having sex and the turkey baster method, and then I went to the doctor, and the doctor said that I needed to take some medicine because I was too old. Here we go to that age. To me again, I was 40, and so I started taking the medicine, and my turkey baster wasn't working. And then the doctor said to me, why don't you change doctors? And I was working at the University of Miami, and I said, because this one's free. And she said, Do you want free or to have a baby? So I changed doctors, and the doctor said to me, why are you doing this with friends? And I said, because, oh, he said something else to me that I haven't thought about till just now. You're a good therapist. And he said, Well, I want, I want. You to look at these sperm bank donors. And I'm like, but I want to know the person. And he said, Well, that's going to be a problem for you later on, or it could be, why don't you look at these? But he also said to me, when I first met him, he said he was sitting behind his big mahogany desk and in this luscious office, and he says to me so you're 40 years old, or you're going to be 40 years old, you're single, you've had diabetes for 33 years, and you work on a university income. Tell me why I should help you. And I said, you know that lady that was sitting in the waiting room with me, and came in before me. He's like, what does she have to do about it? I said, she lives in a big house, she has a husband, she has no chronic illnesses, and I don't know why my life should be any different than hers. And so he said, Okay, when do we start? Oh, wow,

Scott Benner 50:58
very nice. When you said Turkey based you, did you mean that euphemistically? Or?

Sandy Schwartz 51:03
No, it worked. I mean, it didn't work for me, but you can look that up. Oh,

Scott Benner 51:07
I don't need to look it up. Sandy, you're not the first person that said that to me. I've made a lot of podcasts, so, like, I just didn't know if you were just euphemistically talking about in vitro fertilization, or if you were actually at home using a collection from a friend and doing it on your own that, yeah, yeah, we had a whole conversation about that. One of the other episodes, you can cut that part out. Why would I cut that part out? Sandy, that's fantastic. You misunderstand me. If you think I'm cutting that out, that's really what happened in your life. I don't think these conversations are valuable if people are stilted, so you need to be open to say what actually happened to you and what you've done, and you know what's helped and what hasn't

Sandy Schwartz 51:49
I think my life is a person that has diabetes, and I think too many people identify as and this is not a used word anymore. It used to be, but as diabetic, I would never identify as diabetic. I am a person. I have a lot. I wanted to have a baby. I wanted to work on a scuba boat. I wanted to be a therapist. And I happened to have diabetes, and it's important to me to take care of it the best I can. So I it's probably my number one goal, because if I didn't take care of my diabetes, I couldn't have a job. If I didn't have a job, I couldn't have a baby, I couldn't have a house, I couldn't have a car. So taking care of diabetes is number one, but I do not identify as a diabetic. I understand

Scott Benner 52:43
the distinction. I do. Yeah, it's funny. It's and it's not the word as much as it is. The connotation is that, right? Yeah,

Sandy Schwartz 52:51
I'm a person with diabetes. It's not the first thing. Like, I don't go to a job interview and say, Hi, I'm Sandy Schwartz. I have diabetes. But sometime after I get the job, I say, we need to talk about this, or before I get the job, when it's offered to me, I'm like, if you want to use me to get money, you can say I'm disabled because I have diabetes, but it's not the first thing that comes out of my mouth.

Scott Benner 53:16
In Arden's day to day life, she is always aware of her diabetes and always taking care of it, and yet, and I say this frequently when I do speaking events, if I brought her up on the stage in front of a bunch of people and said, Hey, tell everybody about yourself, I think she'd talk for a half an hour and never mentioned that she has diabetes,

Sandy Schwartz 53:36
then you've done a good job. Oh,

Scott Benner 53:38
I appreciate that. Thank you. I think that's a goal for everybody too. You don't ignore it, but you don't bask in it, either, if that makes sense. And

Sandy Schwartz 53:47
since most people who get type one diabetes have parents that are helping them, then it's important for them to make their children's lives important in addition to taking care of their diabetes. Yeah, no, 1,000,000%

Scott Benner 54:05
Sandy, is there anything we didn't talk about that we should have?

Sandy Schwartz 54:08
I don't think so. Do you think so? I

Scott Benner 54:10
think this was terrific. This is one of my favorite interviews I've done recently. Actually,

Sandy Schwartz 54:15
I think you're terrific.

Scott Benner 54:16
Oh, thank you. Do you know you cursed in the middle of it?

Sandy Schwartz 54:19
I cursed a few times

Scott Benner 54:22
you surprised me with the one. I don't know why you're you're just like, you're like, a fucking and I was like, Oh, you caught me by surprise. I love saying, by the way, fucking mother, they're all my favorites, but I you took me by surprise. I wasn't expecting it. So we're gonna call this one, the fighter. Is that good? I love it. Excellent. I do too. What's the next concert you're going to? Well,

Sandy Schwartz 54:45
I'm in mourning for Jimmy Buffet, and when he died, my feelings of immortality died a little bit with him. So there's a big, a big event in Hollywood. Bull. I don't know if I can get a ticket. I don't know what my Knox concert is. I'm, like I said, I'm I I've been to like, 40 buffet concert, so no kidding. You're a paradigm big time. I mean, I lived in South Florida. I worked on a dive boat. I saw him first in 76 at the Orange Bowl opening for the Eagles, and fell in love. I've been to political rallies with him. I followed him around the country. I'm a huge carrier.

Scott Benner 55:30
No kidding. See you say the Eagles, and then I know I'm gonna get in the car and put the eagles on and listen to them for a month. Well, I

Sandy Schwartz 55:36
saw buffet when I was I mean, I saw the Beatles when I was 13. Did you really wear in Memphis, Tennessee, at the Coliseum? It was the first time my mother let me go anywhere with a friend. She dropped me off and picked me up. Do

Scott Benner 55:50
you still remember it? I remember it? Yeah, the Beatles changed the whole world. Huh? That's wonderful. What else have you done that that everybody would be like, Oh my god, I can't believe you were there for that. Do you remember the moon shot? Of course, Kennedy. You remember Kennedy being shot?

Sandy Schwartz 56:06
Oh my gosh, we had to line up outside the whole school, the elementary school, and the principal came out with a big megaphone and told us we were going home because it was a sad day in our country. MLK,

I live in Memphis,

Scott Benner 56:21
yeah, so I was gonna say, what was that like?

Sandy Schwartz 56:24
We were sequestered in our homes. My father took home the cleaning lady with a gun. He carried it. I was the first time I knew we had guns, and he took drove her home. My uncle's store was Ramsay. I mean, you know, yeah, yeah, it's

Scott Benner 56:44
crazy. Wow. My gosh, you've seen like everything. Can I Can I ask a quote? Wait, you have can I ask a question? Has nothing to do with anything? Sure, go for it. How long into your life before you realized that everything's repeating, like politics, entertainment, fashion. You hear a kid talk about politics, and they're like, you know, I think these people are all out for themselves. And you go, Oh, you figured that out, did you when's the first time you realize? Because it happened for me in my 30s. And I was like, Oh, we're just on a cycle, and new people are born and they think they're discovering something, but it's something the rest of us and history have known forever and ever. It's the first time they're seeing it like, do you? Do you agree with what I'm saying?

Sandy Schwartz 57:30
Oh, yeah. I mean, you know, I should have saved my bell bottom Pana worm a

Scott Benner 57:37
couple more times, a number of different in a number of different decades, right?

Sandy Schwartz 57:42
But think about what you're saying. I mean, I don't want to get into politics, but, I mean, you know, there was a time not too long before I was born, it seems to be where there was so much division and anger, and that seems to be repeating, and that's pretty darn scary. Yeah,

Scott Benner 58:00
I think there's, like, more than one cyclical thing happening at the same time, right? Like, so there's a place where, like, I don't know, communities cycle. There's places where states cycle, where the country cycles, where the world cycles, like, it's all like, but in the end, it's, it's only powered by by humans and their responses to things. So they're going to be very similar over and over again. What changes is, you know, the materials the cars are made out of, and the technology we have and stuff like that, so it looks a little different, but it's really the same. And that's why, when people get to a point where, like, I'm so scared, like, it's, you know, this is it. It's the end. I'm like, this isn't the end. Like, it's just gonna happen again and again and again, it's going to keep happening like this. I find it fascinating. I find it fascinating because if you can see that you can live a happier life, and if you can see the repetition in diabetes and learn to accept it and be ready for it and not shocked by it, you can lead a better life. So like nothing should be surprising to you after you've seen it a couple of times, I guess is what I'm saying. That's an interesting analogy to diabetes. Everything is the same. I don't care how different it looks. People, ideas, processes, they're they're all, everything's the same, right? Well, if you stop and listen to this podcast, the parts of it. When I'm not talking about diabetes, I'm still talking about diabetes, right? You know,

Sandy Schwartz 59:24
I get that.

Scott Benner 59:27
How about new music? Do you know who Gary Clark, Jr is? I'm sorry. I don't Don't be sorry. How hard is it to discover new music when you're when you're not around friends as much as you used to be and out in clubs and going to places. Excuse me, speak for yourself. No, you know what I mean. It's harder for me to discover new music. I'm contingent on my son, like my daughter telling me about newer music, and I try to keep up. And there is plenty of new music that I hear that I like. I don't do that thing like. It doesn't sound like what I grew up with, so I don't like it. It's hard to be introduced to it like I'm. Working. I get up in the morning, I take a shower, I eat something, I make this podcast. I do a bunch of work. I eat something again. I do more work. Like, I'm not, like, in my car at high school, I'm not bumping into 500 people. Or, like, have you heard this? Like, you know, interesting. Yeah, I agree. Yeah. All right, my last question for you, I promise, did covid scare the Holy hell out of you? No, Did

Sandy Schwartz 20:00:21
it scare you? No,

Scott Benner 20:00:22
I'm asking, because of diabetes and age, did you think it's going to get me? Or what would you even if you thought that, would it scare you?

Sandy Schwartz 20:00:30
No, I'm more like, go with the flow. Take care of it when it happens. I mean, not that I wasn't careful and didn't get my, you know, vaccine still now, but not much scares me.

Scott Benner 20:00:44
Is there a time in life and maybe you haven't hit it yet where you just say to yourself, what happens? Happens like whatever, like, I can't live forever. So if this is it, this is it, or is that a freeing feeling? Or do you not think of it that way? That is my life the whole time. Oh, yeah, did you think you weren't going to live this long at some point? At some point, well, my

Sandy Schwartz 20:01:09
parents I wouldn't live past 40, which is why I had a baby when I was 40. I mean, no, I ironically, you're calling this episode The fighter. I never thought I would it. Would I that's what I said. A little bit of my mortality died when buffet died, but I still got a lot. I mean, the day Jimmy Buffett died, I probably had 200 texts when

Scott Benner 20:01:36
I woke up. Tell me Jimmy Buffet's death, because he's a contemporary makes you feel mortal, no,

Sandy Schwartz 20:01:41
because what he stood for,

Scott Benner 20:01:46
oh, I see, hey,

Sandy Schwartz 20:01:49
go ahead, tell me what just his free and easy lifestyle is, is me 100%

Scott Benner 20:01:57
Yeah, and he was Still, he still died. Yeah. Hey, did we just figure out why you didn't marry anybody? Because I wanted to marry Jimmy Buffet, well, no, because do you think you didn't have children until you were 40, or get married because you thought you were going to die and you didn't want to start a family and then leave your family. And I'll go a little further, the way you felt like your mom left you.

Sandy Schwartz 20:02:21
I don't know about the mom part, but after I was diagnosed with diabetes for years, I had a repetitive dream. I was this child sitting on the front steps of our house, and this boy would come up to me and sit on the steps and say, you want to get married? And I would say, Well, I have to tell you I have diabetes, and he would run away.

Speaker 1 20:02:46
Okay, so you're afraid of rejection. Maybe. Did it ever happen? Sandy, did a boy ever say no because of diabetes? No,

Sandy Schwartz 20:02:54
no, no, never. I mean, it was part of who I am. Yeah, love me, love my

Scott Benner 20:03:00
fool, and men have loved you despite diabetes, with

Sandy Schwartz 20:03:04
diabetes, not despite Okay, okay,

Scott Benner 20:03:07
yeah, okay, all right, that's all. I just wondered, like, you just said that all of a sudden, and I was like, Oh, I wonder if that's what happened to her. If she just didn't is your child? I forget do. Is it a son or daughter? I don't know. My

Sandy Schwartz 20:03:19
son was in the trial net. He has no markers. Every now and then. He's 30 years old. Every now and then I test him, because I see him drink two Gatorades in a row. And

Scott Benner 20:03:33
so I'm never gonna stop. I'm never gonna stop being a parent. Is that what you're telling me?

Sandy Schwartz 20:03:36
Well, you can't help but notice it, right? Yeah, any other

Speaker 1 20:03:40
autoimmune for you? Celiac, thyroid, anything like that?

Sandy Schwartz 20:03:45
No, I have probably intrinsic autoimmune asthma. I have that's the only other autoimmune because of the long term steroid use. I have osteoporosis, the worst you can have but no, I'm lucky. I'm very unluck. I'm lucky. I mean, part of it is trying to control my diabetes, but like I said, I didn't have any control for 19 years. I think most of it is genetics. And I'm just at the jackpot

Scott Benner 20:04:18
genetics. And you pushed insulin hard. When you were younger,

Sandy Schwartz 20:04:21
I did push insulin hard. I was not afraid of it. Yeah,

Scott Benner 20:04:25
about that? Okay, let's leave it at Lucky. Then I like that as an ending. Thank you so much for doing this. I really, genuinely appreciate it. You can absolutely come back whenever you want to. This

Sandy Schwartz 20:04:34
is fantastic, once things change, I'll come back. Okay, all right,

Scott Benner 20:04:38
hold on for me one second. Okay. Okay,

a huge thanks to Dexcom for supporting the podcast and for sponsoring this episode. Dexcom.com/juicebox go get yourself a Dexcom g7 right now using my link. A huge thank you to. One of today's sponsors, gevok, glucagon. Find out more about G vo hypo pen at G VOQ, glucagon.com. Forward slash juice box. You spell that, G, V, O, k, e, g, l, U, C, A, G, o, n.com, forward slash juice juicebox, Hey kids, listen up. You've made it to the end of the podcast. You must have enjoyed it. You know what else you might enjoy? The private Facebook group for the juicebox podcast. I know you're thinking, uh, Facebook, Scott, please. But no. Beautiful group, wonderful people, a fantastic community. Juicebox podcast, type one diabetes on Facebook, of course, if you have type two, are you touched by diabetes in any way? You're absolutely welcome. It's a private group, so you'll have to answer a couple of questions before you come in, but make sure you're not a bot or an evildoer. Then you're on your way. You'll be part of the family. I want to thank you so much for listening and remind you please subscribe and follow to the podcast wherever you're listening right now, if it's YouTube, Apple podcast, Spotify, or any other audio app, go hit follow or subscribe, whichever your app allows for, and set up those downloads so you never miss an episode, especially in Apple podcasts, go into your settings and choose download all new episodes. The episode you just heard was professionally edited by wrong way recording, wrong way recording.com, do.

#1292 Keep Taking Showers

Jason, his sons, his sister and his father have type 1 diabetes. We talked about hospice care.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends. The hell was that? Hello friends, and welcome to another episode of The juicebox podcast. I gotta find out what that was. Hold on. I just listened back and realized that you couldn't hear that. So now you're wondering what's wrong with me. But trust me, there was a noise.

Unknown Speaker 0:22
You today

Scott Benner 0:24
I'm going to be speaking with Jason. Now. Jason has type one diabetes. He got it when he was 18. He's now 45 his son Wesley is 12, has type one diabetes since he was two. His son Cooper is 10, diagnosed 11 months old. And his daughter, who is six, well, she currently doesn't have type one diabetes, but there's other people, and we're gonna find out all about it. Please don't forget that nothing you hear on the juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin when you place your first order for AG, one, with my link, you'll get five free travel packs and a free year supply of vitamin D drink. AG, one.com/juice box. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's juicebox at checkout to save 40% at cozy earth.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 again. Did you know if just one person in your family has type one diabetes, you are up to 15 times more likely to get it too. So screen it like you mean it one blood test can spot type one diabetes early. Tap now talk to a doctor or visit screen for type one.com for more info. Having an easy to use an accurate blood glucose meter is just one click away. Contour next.com/juicebox That's right. Today's episode is sponsored by the contour next gen blood glucose meter. 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 last seven to 14 days, but the ever since, sensor is inserted completely under the skin, lasting six months, ever since, cgm.com/juicebox,

Speaker 1 2:35
I'm Jason. Live in the middle of Iowa, and I'm type one. I'm diabetic. I have two children that are also type one diabetic, and I believe today that Dave and I are going to be talking about my dad, who was also type one diabetic.

Scott Benner 2:50
You want to tell people why you called me, Dave,

Speaker 1 2:53
why I called you? Dave? Well, apparently there was some review of your podcast that referred to as Dave, which is telling you how much they pay attention to the actual content they're listening to.

Scott Benner 3:02
It was a really great review about how fantastic the podcast was and how great I was, and then called me Dave. And I was like, I love that. I it could have been a typo. It could be that this person believes My name is Dave. I don't care. You know, I am maybe one of the few smaller podcasters who don't come on and go, Hello everybody. I'm your host. You know what I mean? And then my name and like, I don't do that because I think, I mean, if you want to really know why, I think it makes you sound like you're small time, right? Yeah, I don't turn on the television and not know who somebody is I'm looking at. I don't need to be introduced to them. I know sometimes, like in older media, a host will come onto a TV show and be like, you know, Hello, welcome to the show. I'm David Letterman, like that kind of thing, but that's just, to me, an old idea. So like, moving forward, they're a huge podcast. I've never once turned one on and been like, hey everybody. My name's Billy, I'm the host today. And I'm like, Okay, if they don't know, they'll figure it out, and if they don't figure it out, they're not listening to you. So anyway, maybe I was wrong, just in case that guy's listening Hey everyone, this is the juicebox podcast, and I'm your host, Scott Benner, not Dave. Oh, hey, Scott. Hey. What's up? Dave, how many people right now do you think we're like, oh, Scott, or is it just him?

Unknown Speaker 4:26
I thought this was Dave, yeah.

Scott Benner 4:27
Well, now on the Facebook group, if you or a couple of other intrepid people call me Dave, then it causes then people are like, that's not Dave. And I'm like, Uh oh, this is gonna go on forever.

Speaker 1 4:37
It get it gets engagement though. It gets engagement though. So people ask them questions.

Scott Benner 4:41
We're feeding that algorithm. That's right, Jason, we're feeding the algorithm making it do something I actually that's a whole job that, yeah, I wouldn't want to take the time and to be boring and explain to people, but getting a Facebook group to serve the people who were in it well is a lot about making sure contour. Conversations are happening. And, you know, every once in a while somebody will ask a question, and it's kind of like a, maybe a, I don't know, a beginner question, and somebody will rush in and go, that question has been asked 50 times, and just search the group. And I every time I'm like, no, no, no, bad not don't just search the group ask the question, because if you start searching the group and shooting the group like it's an encyclopedia, the group will die like the algorithm needs to see people asking questions and answering questions, and it's more human, and I think leads to people understanding things a little quicker. So let's start with you. How old were you when you were diagnosed?

Speaker 1 5:40
I was 18. I just turned 18. It was in October, and actually voted for President for the very first time from my hospital bed.

Scott Benner 5:50
Who'd you vote for? You don't tell me that it was Bill Clinton at that time. Okay. How old are you now? 45 that's insane, isn't it? Yeah, time is terrible. Oh my god, okay, let's run through it. You have two kids.

Speaker 1 6:08
I have three kids total, three. Two of them have type one. How old are they? Our oldest is 12 years old, and he was diagnosed at two and a half years old. And our middle boy, who just turned 10, he was diagnosed at 11 months old. Wow. And our daughter, she is six years old,

Scott Benner 6:28
and you're worried because she hasn't reached 10 or 12

Speaker 1 6:32
yet? Yeah, yeah, she's, she's made it so far, so it's, uh, thankfully, she hasn't shown any signs yet. But we're, we're prepared, yeah? Well, I

Scott Benner 6:40
mean, you'd have to be this point. I mean, if you don't have enough experience to handle it, then who does right, you know?

Speaker 1 6:47
And then your father, type, yeah, yeah. You know, when he was diagnosed, he was diagnosed around three years old. Oh, wow, yeah. So that was back in the stone ages. So

Scott Benner 7:01
you're the one that really pushed the envelope, as far as you all go, making it to 18. Okay, so he was three, yeah,

Speaker 1 7:11
and, you know, just, just to tack on to that, my sister, who is a couple years younger than me, she's also type one. Oh, okay, yeah, how

Scott Benner 7:21
old when she was diagnosed? You remember she, I think was just 14 or 15. Okay, beat her easy. Okay, no, wow. Do you have other brothers and sisters? No, just one sister. Okay, how about other autoimmune stuff? No,

Speaker 1 7:39
I know you're gonna say, but you know, did you No, I don't think there is. You don't think

Scott Benner 7:44
there just is. It's just type one diabetes. You guys are what they call hyper focused. Yes, okay, wow, when you have type one and your sister has type one and your father has type one, when you are getting ready to have a family, what runs through your head about the possibility of diabetes in children? This episode of The juicebox podcast is sponsored by ever since, and ever since is the implantable CGM that lasts six months, ever since. Cgm.com/juicebox cgm.com/juicebox, have you ever been running out the door and knocked your CGM off, or had somewhere to be and realized that your adhesive was about to fall off? That won't happen with ever since, ever since. Won't get sweaty and slide off. It won't bang into a door jam, and it lasts six months, not just a couple days or a week. The ever since CGM has a silicon based adhesive forged transmitter, which you change every day. So it's not one of those super sticky things that's designed to stay on you forever and ever, even though we know they don't work sometimes, but that's not the point, because it's not that kind of adhesive. You shouldn't see any skin irritations. So if you've had skin irritations with other products, maybe you should try ever since, unique, implantable and accurate. So if you're tired of dealing with things falling off or being too sticky or not sticky enough, or not staying on for the life of the sensor you probably want to check out ever since, ever since, cgm.com/juice box. Links in the show notes. Links at juicebox podcast.com, contour, next.com/juice box. That's the link you'll use to find out more about the contour. Next Gen blood glucose meter. When you get there, there's a little bit at the top. You can click right on blood glucose monitoring. I'll do it with you. Go to meters, click on any of the meters. I'll click on the Next Gen, and you're going to get more information. It's easy to use and highly accurate. Smart light provides a simple understanding of your blood glucose levels. And of course, with Second Chance sampling technology, you can save money with. Fewer wasted test strips. As if all that wasn't enough, the contour next gen also has a compatible app for an easy way to share and see your blood glucose results. Contour next.com/juicebox and if you scroll down at that link, you're going to see things like a Buy Now button. You could register your meter after you purchase it. Or what is this? Download a coupon, oh, receive a free contour next gen blood glucose meter. Do tell contour next.com/juicebox head over there. Now get the same accurate and reliable meter that we use. Well at that point in time. You know, I

Speaker 1 10:42
mentioned it to my endocrinologist a few times, and they always said, you know, it's a very low percentage chance of that happening, so I really didn't give any thought to it. And I don't think it, I don't think it would have changed my mind at all. It wasn't a surprise when it happened, but it still hurt, you know, hurt a lot, yeah, I bet two years old, right? Yeah, two two years old, 11 months old. So, yeah,

Scott Benner 11:05
yeah. Arden was just two years old, and I recall it feeling like the promise of my life was revoked. If that makes right, you know what I mean? Because we were a young family, and things were, I mean, we weren't like, killing it or anything, but it was going well, and you could see that we were moving in the direction we intended. We had bought a very small house recently, and I was like, oh, you know, I grew up renting my whole life, and it's like, wow, we're like, we're doing it. You know what? I mean, like, we're getting out of the hole that somebody started us off in, and then that happened, and it felt like it felt like the hole we were in got thrown into a different hole, you know. So how about your wife? Do you think she ever even considered it?

Speaker 1 11:55
I don't think so. I don't think she thought about it at all like it wasn't on her radar. I think part of that's because I've been fairly well managed my entire life. So she only saw a few lows here and there, and didn't really, you know, partake in any of my care for it, because, you know, I'm an adult guy, and I can, I can do it myself. So

Scott Benner 12:13
do you have any hindsight on that? Should you have made her more aware of it?

Speaker 1 12:18
I think so. I think in general, people should do that more often. I think it's important for people to more understand, I think what's wrong with your significant other. You have any idea why you didn't? No, I talked to my mom about this recently and asked her about that, and she she said, I think it's just a guy thing, but I'm not even sure it's just a guy thing. I think it's people in general, because, you know, people are just worried about showing a weakness, yeah, and especially weakness like type one diabetes, where it's not visible most of the time,

Scott Benner 12:51
yeah, it's not, like, the it's sort of the invisible stuff, right? Like, yeah, like, that's why I think anxiety or mental illness is even harder to talk about, because you're like, there's an unseen thing that just tackles me, and I don't hear it coming, and I don't know how to get out of the way of it. And, you know, just once in a while, randomly, my blood sugar might get really low, and right, I could get into a situation where there's nothing I could do about it, and now I'm like, left open to hope that the world around me helps me and gets me back here again, exactly. Yeah, it's tough. Your father not share it with your mother. She

Speaker 1 13:27
did not really partake in any of his care, either, and he was very, very, very private about it. I would say so much so that my sister and I really had no clue or weren't very knowledgeable about how to treat him if he was low. We'd only seen it happen a few times, because he was fine most of the time. And I remember one time, you know, I got home from school probably early teens, you know, sitting on in my bedroom, Dorking around, and I hear my dad's truck pull up in the driveway, and I hear kind of a crash outside. I get up out of my bed, and then he comes stumbling through the door, you know, pale, sweating, shaking. I ran to the bathroom where the glucose tablets were at, and I grabbed one glucose tablet and took it out to him and made him eat it, and then like nothing was happening. So I poured him a glass of water and just dumped a bunch of sugar into it, and he drank that, and eventually he came around. But you know, that's all I knew how to do at that point in time. And it wasn't like somebody came to me and said, Hey, if he's low, do

Scott Benner 14:34
this right. It was more of just

Speaker 1 14:39
do what I thought was right, even though it wasn't enough at that point in time. And you were in your teens at that point, yeah, probably 12 or 13. It's a long time to live with somebody and not understand fundamentally what turns them back on. You

Scott Benner 14:52
know what I mean Exactly? Yeah, look at you, and you figured it out, though, right? Yeah,

Unknown Speaker 14:57
we figured it out. Yeah. Did

Scott Benner 14:58
that get you a puppy? An ambulance that day. Yeah, if you had a puppy out of that or anything, you remember,

Speaker 1 15:03
no, but, you know, I would say that my dad and I's relationship wasn't always incredibly close. And you know, he's not a a guy that's going to come out and say, Hey, I love you. He would say it in other ways, but after he kind of recovered from that low I had went back in my bedroom and I was like, crying, you know, sitting there because I was scared to death, yeah, and he actually came in and gave me a hug at that point in time. And that was, it's something that really sticks out in my mind. Like having a care when somebody needs you, kind of important. Well,

Scott Benner 15:36
you, I guess you learn that being there for somebody is a way to get life is the way to get love from them, right? Yeah, it's because. It's what other ways did you do? You think you were performing as a child that did not result in a hug?

Unknown Speaker 15:52
I don't quite understand what you're asking.

Scott Benner 15:54
I guess the question is, is like, did you do you? Can you look back and see that you tried other things? Did you try being good at sports and thought that that would make him say, I love you and give you a hug. Did you keep the house really clean? Did you like, were there other things you were doing that didn't result in a hug? Plenty, all of them. Yeah, all of them.

Speaker 1 16:12
No, it's, it's, I don't think I was a terrible kid, and I always kind of tried to take interest in things that he may have been doing, whether it be working on this truck out in the garage or working with him during summers. He owned his own business too, and would go work with them. My sister and I would he treated us well when we're out there, you know, paid us free lunch and gave us food and stuff that we wanted. But it wasn't like, oh, yeah, thanks. This is a enjoyable time. I really enjoyed spending time with you. It was on to the next job.

Scott Benner 16:42
Do you do that as a father? Do you tell your kids that you enjoyed spending time with them? I

Speaker 1 16:48
try not to do things that happened with my relationship with my dad, so I try to spend time with my kids. I try to instill that I love them all the time, give them hugs all the time, and I'm there, I'm the primary type one caregiver in our house, so we have a lot of connection that way. And our daughter, she takes advantage of all this and always wants to go to the grocery store with me, because she'll know that I'll buy her a candy when we check out. So

Scott Benner 17:20
buddy, isn't it? Like, I just realized that you're talking like my son full knows that I love and care about him, and so if I said to him, like, I'm doing, I have a project this weekend, I was like, Hey, I'm gonna be working on something this weekend I can use your hands for. And he goes, I'm probably busy. And he wasn't. It wasn't shitty. It was just like, No, I'm alright. And I realized now, like, if he, if he was, like, running around, going, I hope that guy loves me, he'd be like, Yeah, Dad, I'll help but instead, he's like, No, thank you. I mean, you do see people manipulate people that way. You know what I mean and that. But that's not what your dad was doing. Your dad was just closed off. Yeah,

Speaker 1 17:57
and I think you know he was, he was 69 when he died, so he grew up on a farm, so it's all about work. That's just kind of his life revolved around. Was working? Yeah,

Scott Benner 18:09
I hear you like, Get up, do the thing. I did the thing. It means I love you, because I'm working hard for you. I didn't leave you, I didn't quit my job. I don't drink during the day, like I'm doing the things I'm supposed to do. It's weird that people can't see the whole picture. They just, they get focused on one, like, aspect of it, and like, I'm doing a good job with this. So right? That means I love you. And you know it, come on the other day I my son's back. Like, he left, he finished college, and he went worked a job for a whole year in another city. He was, like, across the country and gone. And then he said to us, like, I've gotten as much out of this job as I can. If I want to move up, I'm going to have to take a different job, you know, I want to come home and reorient myself and look for work again. And so we said, Fine. And he had saved, actually, very proud of him. He'd saved a bunch of money while he was working. And He came home, and he's home now, and it's, it's the end of March, he's been here for three months, and every day I see him educating himself and applying for work, and, you know, talking to people and making connections, and he's doing all the things he should be doing. And I think every day, God, I hope this kid has some success here, like, I don't want this to drag on for him, because, you know, it might get a little, you know, might get a little bit of a bummer after a while. And then my next thought is, I hope he doesn't get a job, because he'll leave. I just took a second yesterday and I said, Hey, I want you to know that every day I see you, I think, Oh, I hope this works out for Cole today. He's doing a good job. It's going to work out for him. It's coming. I'm sorry if he feels badly about it, I said, but man, my next thought is always, I hope you don't leave right? And like, we didn't hug or cry after that, there was no commercial. And then we came back to the Hallmark Channel and, like, talk some more. Like it was just, like, that was it. And he didn't say much, and we moved on. But I know he knows, yeah, and if he doesn't, Jason, I don't know what to do. You know what I mean? Like, I wouldn't know how to. Adjust it like I wonder if your dad thought

Unknown Speaker 20:01
he knows, and then you

Scott Benner 20:05
were over there going, I wish someone would talk to me about this once in a while. It's interesting. Do you ever talk to him about it? No,

Speaker 1 20:13
not really. He wasn't much of a much of a talker. You know, I kind of see that coming from his side of the family too. It's like my grandma is the same way and his dad was the same way. Really didn't talk about it. It was it's rare on that side of the family for somebody to say, Hey, I love you, and hey, come give me a hug. It's kind of weird now with our kids, my wife and I's kids, when we go see great grandma, my grandma, they always insist on giving her a hug, you know, before we leave and say goodbye. And it's, it's heartwarming to see that, and I can kind of see that tear in my grandma's eye whenever that happens,

Scott Benner 20:50
yeah, I wonder if she's thinking, this is what we should have been doing, yeah, yeah. That's, feels like it's too late, but it's not for her, right? She's getting a

Unknown Speaker 20:58
little bit of it, yeah. Okay, so

Scott Benner 21:02
why were you so well managed? If your father wasn't and also wasn't teaching you about diabetes,

Speaker 1 21:11
I think it came down to seeing him not treat himself well. There was a few times, like growing up, where he would have lows in the middle of the night, and the ambulance would come, I would know nothing of it, like no one told me about it, until many years later that you know, the ambulance came. Paramedics came and took him away because he was low and my mom couldn't help him. And after hearing like those stories, that kind of made me want to do better, because I knew it could be avoided with a little bit of effort. Yeah, and also, when my sister was diagnosed, she was diagnosed me, like a year before I was she struggled really hard with it too. That also kind of made me say, this is a my mom. I can't rely on my dad to do this. This is this is me. I have to do

Scott Benner 21:59
it. So you did your sister figure it out? Uh, she wasn't

Speaker 1 22:05
nearly as bad as my dad was with it, but she definitely struggled. She struggled with burnout quite a bit, and she kind of saw the opposite of my dad, you know, she saw the lows or heard about the lows and didn't want to be low so she kind of rode, you know, 131 4150, a lot of the time.

Scott Benner 22:27
Is she having any trouble now?

Speaker 1 22:31
No, she's she's pretty healthy. I don't think she has any any side effects from type one at all. So when

Scott Benner 22:38
you were figuring it out for yourself. Did you ever go to her and say, like, did you try to trade war stories or tips and tricks, or did that not, was that not a thing you guys did together? That

Speaker 1 22:51
really wasn't a thing. I think the one thing I do remember she got moved over to Humalog before I did, you know before that, it was regular, NPH, and when she got moving over to human log, she told me, Oh, this is, this is great. Like, you know, you can actually take it at 15 minutes before you eat. And so then that was, like, the one thing, that tip that she gave me that I actually followed and moved on and enjoyed it, you know, I liked that part. But other than that, we didn't, we didn't

Scott Benner 23:20
really talk about it. Were you close in other ways or not particularly,

Unknown Speaker 23:24
not particularly, yeah,

Scott Benner 23:26
just the girl boy thing, yeah, I

Unknown Speaker 23:28
think so yeah.

Scott Benner 23:29
Did that change as you were adults?

Speaker 1 23:31
I'd say it did not change much until our two boys were diagnosed. Okay,

Scott Benner 23:38
then she fell and then comp, then

Unknown Speaker 23:41
it changed. Yeah,

Scott Benner 23:42
does she have children?

Unknown Speaker 23:45
No, she doesn't. Okay, not biological.

Scott Benner 23:48
Do you so what do you think happened inside of her when she saw your children get diagnosed? I

Speaker 1 23:53
think she saw, you know they were so young when it happened. And you know she loves them dearly. So when she sees something that she struggles with, happened to them. I think it kind of opened up that door. Do

Scott Benner 24:05
you think people realize that when their siblings show affection to your children, like when your siblings show affection to your children, that it's probably the affection they have for you, but it doesn't come out because you grow up together,

Speaker 1 24:20
you would agree with that, yeah, for sure. Really something.

Scott Benner 24:24
And if you are very affectionate, you don't feel like you have to get it out some other way. So interesting, right? Hey, cultural, religious, not cold this. But where does the way that your family interacted? Where does that come from? Do you

Speaker 1 24:40
think? I don't think it's cultural, I don't think it's religious. Why it happens that way? I really kind of attribute it to just our family histories. Like neither side of the family is very, very much out there saying things like, you know, hey, I really appreciate you. I love you. It's more on my. Mom's side. It was a lot of getting people, joking around with people, and my dad's side was very, very, don't say I love you. Get the work done. What were their backgrounds? What do you mean by background?

Scott Benner 25:15
Irish, German.

Speaker 1 25:16
There's a bit of Irish in there. Last name is wierman, so you know, it's about as German as you get. I think that's Irish, and German is incredibly interesting.

Scott Benner 25:26
My mom's parents were German, and you're describing them, you know what I mean? Right? It's interesting. Okay, all right, I got it. Well, how do you manage today? And is that different than how you manage before your kids got type one?

Speaker 1 25:43
It definitely is. Today I am using loop. Both boys are using loop, and we're using human logging those in those pods, using Dexcom g6 that all happened because of the boys when Wesley was first diagnosed. He's our oldest boy. I was still MDI and using human log. And Atlantis, the human log was in a pen, of course. And when Wesley was first diagnosed, 10 years ago,

Scott Benner 26:15
yep, you know, I don't think Dexcom was really a thing. Then, was it a thing 10 years ago? 10 years ago. Arden is 10. She had one then, yeah, you just didn't know about it yet. She

Unknown Speaker 26:28
four, maybe. Yeah, I

Scott Benner 26:30
don't that. I don't remember which one it was, but it existed, yeah, and you were MDI till you were 35 Yep. Okay. And doing well, or just, okay,

Speaker 1 26:42
um, a one Cs were right around six most of my life. Yeah, that's good. And I don't think a lot of that was, there was definitely a roller coasters, like it was, it was probably a roller coaster ride up until I got the Dexcom. Okay,

Scott Benner 26:58
you were always like, chopping down highs and stopping lows. Yeah, so your standard deviation probably was off, but you weren't tracking that right. Yeah, couldn't see it, yeah. How do you see it? Interesting, and doctors told you you were doing great. There was no ever

Speaker 1 27:13
a one. Cs were always good. And blood sugars, you know, on paper, when you tested four times a day, looked good. Yeah,

Scott Benner 27:24
if you test at the right time, everybody, you just have to, just have to catch your blood sugar in the right spot. They have a right before, right before you eat, yeah, yeah, yeah. When you're when your blood sugar is falling because you're hungry and and you've used too much insulin at the last meal, and you test and you're like, Oh, I'm 89 I'm really doing great at this, not really thinking if I didn't eat now, I'd be 60 soon. Yeah. What a flawed system. Okay, so what happens, man, when they're diagnosed, do you just go, this isn't good enough for them, or, like, what makes you dive in and and get the rest of it?

Speaker 1 27:57
That's a really good question. I don't remember the exact epiphany moment, but it probably centered around seeing something on social media, and when we dove in, like with Wesley, like we dove in, it was as soon as I kind of figured out what the Dexcom was like, our doctor had mentioned it to us, but, you know, I had done many, many years MDI and just a tester and did fine stuff like, well, what is this technology like? Is it? It's nothing, right? But after seeing online, on social media, you know, seeing what the Dexcom could do, and then what I really saw was the Dexcom g4 attached to a cell phone and night scout and being able to see numbers remotely, I think that's what kind of made me dive in. Yeah. And then after that, it was like hardcore diving in.

Scott Benner 28:56
And so what does he start with? A pump, a CGM or how long was he MDI?

Speaker 1 29:02
He was MDI for maybe a year or so, year or two, okay? And a lot of that had to do with because he was using such little insulin, like none of the pumps OmniPod could not deliver, uh, insulin in small enough amounts at that point in time, right?

Scott Benner 29:19
And that's the same thing that happens to a lot of people. They're like, well, just do shots. Because meanwhile, the shots are, they do a unit at a time. And, you know, if you have half unit noodles and your kids small enough, that's still not enough or small enough. So it's interesting how we were

Speaker 1 29:34
doing, we're doing like you were doing, you know, seeing how much you could, like, pull back a quarter of a unit. Yeah, we did that for a long time. Had syringes that could do half units, and then ends that could do half units, okay,

Scott Benner 29:46
and then probably about the time you're figuring out a pump for Wesley, then your next son is diagnosed. Yeah,

Speaker 1 29:53
we had moved across the state, and I was still doing business, you know, in our Old Town. It's about two hour drive away. I was over there for a meeting. Wife had called me and said, uh, she had checked Cooper's uh finger, because he had went through his diaper the past couple of days, and that morning it was super heavy. And she said, Well, I checked his finger, and it was like, you know, 450 you know, at that point in time, my heart just dropped, and I said, you know, why don't you guys? I'll call my mom and I'll have her come over and pick you guys up and drive over to where I was at, because that's where our other boy had gone to, the endocrinologist at over university of Iowa Hospitals and Clinics, which is, you know, our best hospital in the state for type one. And said, Hey, drive over here. While you're driving over here, give him, like, a quarter a unit of insulin to bring him down. And that's what happened. He came over, and family came over, and we went through that hell all over again, yeah,

Scott Benner 30:56
so soon after the last time too. The thing is, Jason, that's not why you're on the show. I just wanted to get I just wanted to get your background so for everybody, so they knew who you were and what you're living through. But you really wanted to come on today to talk about something completely different. So why don't you express to everyone why you're here? Well, last year, which would be

Unknown Speaker 31:23
January, ish, 2023 my dad and mom. Type

Scott Benner 31:28
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 too. So 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.

Speaker 1 31:58
Both got covid. My mom was able to, you know, to kind of maintain she didn't have very bad symptoms. But my dad, because of his type one diabetes and his health history, because of type one diabetes, we should probably talk about that slightly here. I think most of his life, his a one Cs were, you know, 1011, 12, just because of poor management, yeah, and that had a significant impact on his his health. Like he was a healthy guy. If you looked at him, he's tough guy, skinny guy. He had quadruple bypass. And then probably 10 or 15 years after that, he had like four mini strokes, and everything kind of went downhill after that. And after the strokes, he kind of felt worthless, but didn't get around much, didn't try to rehab much, because, you know what? What good was he if he couldn't do work type of thing? What kind of work did he do? He was an electrician. He had his own electrical business, and then he also worked at a company that makes gigantic industrial valves. Okay? He was a hands on person that got down and dirty, right? And you describe him as robust,

Scott Benner 33:16
but with a one sees in double digits, exactly. Yeah. So it's funny as you're trying to talk about his physical characteristics and his health, what I really thought was, I wonder if he would have told you he loved you, if his blood sugar was lower, that very well could be, yeah, I wonder if he would have had more mental clarity and and and seen things differently.

Speaker 1 33:37
Very well could be. You know, kind of mention that, like, after he kind of switched from MDI the majority of his life over to OmniPod five, he seemed to take a lot more interest in type one, and he seemed to soften up a bit, and as a 1c, had dropped down to like, seven, yeah, plus

Scott Benner 33:58
he had something to focus on again, and a thing that he needed to be good at and learn and, you know, right work at. Yeah, it's interesting. Listen, there's a chameleon sitting behind me in a cage right now, because my kids grew up and I don't have anything to take care of. So I got very like, stir crazy very quickly, just trying to take care of all you guys wasn't quite enough for me. I was like, I needed something alive in front of me to, like, work on and study and and, you know, figure out what it needed. So, oh, all right, well, did that give you some time with him? I'm gonna say no. You know, my dad's

Speaker 1 34:35
the type of guy that would if you needed work done. He was there immediately. So we had an old house at that point in time, and he would come over frequently to kind of help me with things around the house and share His love with me that way. And even after he had a stroke, his first stroke, like we had a huge windstorm roll through town, and it like knocked over trees all over town, and our big tree and our. Backyard. It fell over, and he came over even, you know, suffering the consequences of a stroke where he can't move half his body very well with chainsaw. And we're, you know, chopping the tree apart and taking it down. And he was just trying to do his part, you know, trying to help me and the family. Yeah, wow. Well,

Scott Benner 35:21
I mean, listen, clearly he loved you. He just didn't, yeah, yeah. He just didn't say it the way you were hoping for, right? But look, look what it did for you. You're really open with your children and your family, I bet, with your wife too. And you know, don't worry, that'll slingshot the other way, and your boys will be quiet, strong men who won't say anything to anybody. You'll just bounce back and forth through all of eternity getting back to your dad's health. And really the reason you wanted to be here, you know, your note to me is very simple, just that, you know, talking about hospice care and type one diabetes and being older with type one was something you want to talk about, and I know we don't talk about it enough. So I'm very interested, what, what was the, you know, what was the course, what, what happened? So after, after, my

Speaker 1 36:11
dad was in the hospital with covid, he was there for the probably a week or so, and just was not getting better, and we didn't go see him. So I was just talking with my mom over the phone, because I didn't want to get covid. Yeah, my mom had said, you know, this is not looking good. You know, I'd call him every day, talk to my mom every day. And my dad really wasn't able to talk while he was in the hospital doing this. He had his OmniPod five on. He's working great. And my mom said, you know, he's not eating much, and he's got a super flat line, and it's like at 100 all day long, all night like, well, that's great, but we need him to eat. You know, kept saying we as soon as you can, you gotta probably get over here and after his, after his 10 days of being quarantined, my wife and kids and I went over there and saw him, and he's just kind of laying there, kind of comatose, not really knowing what's happening. He'd look at us every now and then, but quickly, you know, close his eyes and just go back to sleep.

Scott Benner 37:10
The hospital staff, because

Speaker 1 37:11
he was on his OmniPod five, they would not deal with that like they wouldn't touch it or interact with it. So my mom had to do all the, all the stuff on it, whenever something would happen, she had to change the pods, enter carbs, if he was eating anything, or do any corrections. So she was left in charge of that because the hospital staff refused to be involved, refused to be involved with it. And they also wanted to know, you like, how much insulin he was getting for different things, you know, whatever. If he feed some crackers or whatnot, they wouldn't know how many, how much insulin he was getting for those crackers. You know, it's kind of hard to say to my mom, you know, you can't really tell him how much insulin he's getting because the algorithm is algorithming. It's doing its thing, right? So they had no clue or idea on how to deal with a pump in that setting, probably

Scott Benner 38:03
Jason. They probably don't understand how to deal with it out of that setting, either. But yeah, yeah, we'll learn about that here shortly. Yeah, and they, and they weren't interested. The bigger, the bigger point is, is that they're not interested. They're going to chart what they need to chart, but like, they're not going to touch it. They're not going to learn about it. That's not going to be a focus for them. When you said he was kind of comatose, like, this is after 10 days with covid, after his quarantine period, yeah.

Speaker 1 38:30
Like there towards the end of the his covid stay for 10 days, like he just would not recover and kept sleeping more, just laying down more, not sitting up much, not opening his eyes, not talking.

Scott Benner 38:43
What did you think was happening at that point?

Speaker 1 38:46
Part of me, you know, was hoping that he would make it through and be able to, you know, return to somewhat normal life where it was at that point in time. But the other side of me knew that this is probably his last, last little bit of life that he's going to be spending in this hospital. Yeah.

Unknown Speaker 39:04
How long ago was this?

Unknown Speaker 39:05
Just last year, January, okay,

Scott Benner 39:07
did you cognitively understand that his heart attack and his strokes were from from high blood sugar support management? Yes, okay,

Unknown Speaker 39:15
like 100% All right. So

Scott Benner 39:17
you know, there's still other things happening inside of him that are also being impacted by that, and have been for decades, and now, exactly I know this comes along, and it's stressing every system, right? You know, what did you mean by? I'll find out more. What happened next

Speaker 1 39:32
after his 10 days, it kind of deciding shortly after that that they're going to call in hospice care, because, you know, he's struggling to breathe, he's not eating, he's he's not he's not trying to live. The hospital staff decided to move over to hospice care, and my mom said, Yes, that's, it's, it's his time, like it's going to happen. So let's go ahead and do that. And once they moved him over to hospice care, you. They, you know, stopped all medications besides morphine and that unfortunately included insulin. Stopped giving him insulin after his last pot expired, and really didn't take any care or concern about his blood sugars. At that point in time, they would check his blood sugars, but you know, it'd be every three four hours, and there's no response to the high blood sugar until I showed up at the hospital.

Scott Benner 40:33
So I've watched a hospital manage my mom to the end of her life. So if once they decide you're not coming back from this, they start removing all the things that keep your body going. And it's interesting when you're when you're older and you've been sick for a long time, you don't think of it that way while you're alive, and you're going like this, pills for my blood pressure, this pills for my you know this, and you know my lipids and this is happening, and what you really, like, begin to understand in that time is that you have been artificially kept alive for so long. Like you weren't gonna die, like, if you stop taking all your medication and doing all the things you're doing, you weren't gonna, like, just shut off, but the end of your life was going to be sped up without your heart medication or etc, whatever else you're taking. And then it's such a weird feeling when someone says we're going to discontinue those things. And you think, but those are the things that are keeping her healthy, right? And then you're like, oh, even though I knew this is what we were doing, I didn't know this is what we were doing, right? Like, we're gonna take away all the things that are keeping, keeping this person alive, and to to to hasten the end of their life. You're trying to get to it faster, because it's just seems cruel to, you know, if, if the end is the end, and they're struggling, or, you know, why? Why would you keep that going any longer than you had to? Right? So you get to that situation, but the taking away the insulin, and you not live with it like, what is that about there in

Speaker 1 42:11
my eyes, from, you know, being type one myself, from my, from my point of view, like a high blood sugar is insanely uncomfortable, especially when you get up to like, 400 or 500 you know, you get that, that thirst sensation that's unquenchable, like you have to drink something. In my eyes, when he was in hospice, you know, they wanted him to be comfortable. You know, they're shooting him full of morphine to make him comfortable, a little bit of insulin to bring him down to a normal, somewhat normal level would make him more comfortable. I don't think it's like a blood pressure medicine or something like that, that you know you don't feel it when you take it. You don't feel the results of it. You're not going to be uncomfortable if you don't take that medication for a day or two days or three days, but if you're doing multiple days or multiple hours without insulin, and that blood sugar is, you know, 400 500 600 that's incredibly uncomfortable, yeah, and I don't think anybody really thinks about that. I don't think the hospital staff thinks about that. I'm not even sure if his doctors thought about that. And I would be curious as to, like an endocrinologist thought on that, like, Is that comfortable? Is it something that should be dealt with? Yeah,

Scott Benner 43:29
but he was on morphine, right? Yep. So do you not think that they were just trying to hasten things by removing the insulin? I don't think

Speaker 1 43:39
that crossed their mind, like them, thinking of DKA wasn't on their radar.

Scott Benner 43:45
And did you speak to them about that, or was that just your feeling? I

Speaker 1 43:48
spoke to them about that adamantly, and that kind of explained my point of view, and we finally got them to come in and just give some small correction, small corrections throughout this last few days and kind of get them down to a moderately okay level. But it was hard. It was really, really difficult to get them to do anything. And when they decided, you know, hey, we're going to do something, well, we agree to giving him insulin. You know, it took him two, three hours to come back in with the insulin to give it to them. It was really slow.

Scott Benner 44:25
Can you describe your state of mind during this time?

Speaker 1 44:28
I was extremely pissed off, because I'm used to, you know, I'm used to dealing with type one diabetes like now, like you deal with it now. You don't let us sit you don't, you don't do that. And just seeing how slow the process worked, there it was infuriating.

Scott Benner 44:47
You think you were mad because you couldn't help your dad, and you were looking for a way to help him. Yes, yeah. Did they ever say to you were mad? Edging the end of his life. Now we're not going to give him insulin.

Unknown Speaker 45:02
Yeah, that was their their perspective on it.

Scott Benner 45:06
What was yours though? Like, you knew that was happening. Were you okay with this? The what, what was being done?

Speaker 1 45:11
I wasn't okay with it at all. Like, I just can't, like, even, even if he was on morphine and out of it, not really aware of what was going on around him. I can't imagine your body not saying to you, hey, you're really thirsty, your mouth is really dry right now, and you might have a headache, you might feel like you gotta puke, you might feel all of these things, but you can't do anything about it, because you're you're locked in this bed, and you're locked inside your body, right, just sitting there, and you can't do anything about it.

Scott Benner 45:43
Were you okay with the idea that he was dying like, like, and that the plan was he was in hospice now to get to the end of his life, or did you think he should be fighting

Speaker 1 45:53
after seeing him in the hospital, after he kind of had his quarantine from covid, like, I knew that it was coming, like I could see it coming. I think kind of, I made it a little bit easier to deal with, but I still didn't want him go through that process and suffer from type one diabetes still.

Scott Benner 46:12
Yeah, okay, so that's really the aspect of it. Like, not that you're okay with his passing, but you're okay with what we're doing. I know what we're doing. He's he's gonna pass away. We're managing towards that. But just like emotionally, psychologically, you couldn't stop taking care of his diabetes,

Unknown Speaker 46:29
right? Yeah,

Scott Benner 46:32
you know. Why do you have any thoughts about it? You go to a therapist. Anything? No,

Speaker 1 46:37
no therapy. I just listened to that episode of the podcast with the therapist on it. So that's mine. Oh, yeah, sure. I'm

Scott Benner 46:43
sure she'd be thrilled that that's your therapy.

Speaker 1 46:47
Hey, the ground, the grounding method helped me tremendously. So thank you for recording that episode. Oh, did

Scott Benner 46:52
it really? Oh, that's fantastic. Yeah, good. I'm glad. Oh, you're stuck in this conundrum where the plan is we're going to take away my dad's stuff. He's going to pass away, but I can't let it be as his insulin. So did you, you talk them into giving it to him eventually?

Speaker 1 47:06
Yeah, we, we talked to him. I really had to push like my mom was, you know, out of it. She had just recovered from covid and dealing with, you know, her husband passing away, or in the process of passing away, she was just kind of there, nodding her head, agreeing with everything, and not necessarily always remembering what she agreed to. But I finally convinced her to say, we really need to do something about this. Can you please ask, you know, the hospice care people and the doctor or nurse whoever to come in and let's talk about this. You know, I kind of, when they came in, you know, I kind of put my foot down. I said, you know, having a blood sugar this high is not comfortable, um, and you guys want them to be comfortable, so we're going to do something about it. And, uh, eventually, you know, that, they said, okay, and then, you know, three hours later, they come in and do something about it.

Scott Benner 47:59
Yeah, it's tough, because they don't get very assertive. But, like, they could have made the argument that DKA could could help him pass away, right? It's such a weird thing, like you're turning the body off, you know what? I mean? Like it the person's dying to begin with, and you have all these artificial things in place to keep that from happening. So they take them away. It's interesting. They must have seen you must have been really pissed, I guess, is what I'm saying. Yeah, you must have scared them into doing it. And they probably thought he's going to die one way or the other if we give him this insulin or not. So let's just make the family happy and do this. Yeah?

Speaker 1 48:32
And that's kind of like my point of view on hospice, is that, yeah, make make the patient, the person dying, happy or comfortable, and you gotta make the family comfortable. Also, they gotta be comfortable with the process. Him suffering from high blood sugar along with dying wasn't something that I was willing to really compromise too much on,

Scott Benner 48:55
yeah, well, and you didn't. So after you got the insulin, what happened afterwards? They keep managing the insulin he wasn't obviously eating where they and they took his intravenous or his IVs away as well, right?

Speaker 1 49:09
Yep, yeah. They took all that away so they would just come in, you know, every however many hours in between, checking his blood sugar, coming back, you know, 3040, minutes later, to give him a small correction dose. And of course, you know, I agree with, agreed with them, that we shouldn't try to bring him down to a normal level, because he can't eat or drink anything at this point in time. So it's just try. Hey, let's use them close to 200 so they they'd come in quite a bit, quite a bit, quite frequently after that, and just give him small correction doses.

Scott Benner 49:43
How long did he? Did he last after that?

Speaker 1 49:48
So he was in the hospital like a total 25 days. 10 of those were heavy covid stuff, and then 15 of those were two. Kind of all downhill from there, type of thing. Yeah, and I think it was in hospice care for probably just shy of a week.

Scott Benner 50:07
How were you there all the time? Or how did you guys manage the that?

Speaker 1 50:12
No, we weren't there all the time. We went over there. That's a like an hour drive from our house to where there the hospital was at so we drive over every day and see him, because we know we have three kids that are still in school at that point in time, yeah. So we had to kind of maintain a somewhat normal life. And you know, my dad being the workaholic guy, he would have agreed with that. He would have been okay with that, okay

Scott Benner 50:38
with it. He would have been like, what are you doing here? Staring at me. Yeah,

Speaker 1 50:42
that's that. That's exactly what he would say, yeah,

Scott Benner 50:46
make some money. Help somebody. Yeah.

Unknown Speaker 50:48
Help somebody. Do

Scott Benner 50:49
something. How they're going to know that you love them if you're not working exactly? Oh my gosh. I have nothing but sympathy and and respect for the the process. I can tell you that in my mom's hospital room, at one point, I sort of just went to a corner where I wasn't in her sight, even though I don't know that she could have seen me to begin with, and I don't know how to explain that, I silently screamed and gritted my teeth so hard I thought they were gonna break, because I was had come to the realization that there was nothing left to do, right, you know, and that was a terrible feeling for a person like myself, you know, who you know seems to be minded towards caring for people to begin with. And you know, just as her son and, you know, and my brothers were there and I, I had grown up in a very hybrid situation where I was parenting my brothers and their brother at the same time. So now we're, you know, now we're there, and I'm in my 50s, and my brothers are, you know, in their 40s, and I still feel like, on some level, those are, they're my like they need me to say something or do something, or be something, and at the same time, I'm having my own very personal, you know, experience. And it was, it

Unknown Speaker 52:08
was very

Scott Benner 52:10
upsetting. Is not the right word, but I thought I was going to break my teeth while I was silently screaming it through my chest, is what was happening. Yeah, you know, it's just maybe, I mean, I don't see how anything's worse than this, you know,

Speaker 1 52:25
yeah, it's a it's a weird trip to uh, lose a parent. It's uh, it's just something you don't, you can't know about until it happens, right?

Scott Benner 52:35
It's not something you can prepare yourself for. So if it happens to you too early in life, I can see where it would really just get to you in a different way. And even though I was 50 and had lived through my kid getting diabetes and all the other things that had happened, I do think I was more prepared for it because of that, but I'd say that when it's over, your perspective levels up again. And I thought I had some pretty high perspective from living through type one diabetes, and, you know, every day realizing that a little too much of this at the wrong time. And you know, that could be it like, even last night, I'm still trying to adjust Arden's insulin back properly, because she's using that. GLP, yeah, and she got into the mid 50s last night at like, 130 in the morning, and I let it go for a couple minutes, and like, she's not seeing this, I texted her, and she didn't answer me. So I got out of bed and I walked into another room so I wouldn't wake up my wife. And I called her just to arouse her and get her awake. And she texted me, and I said, Hey, just like, drink a half of juice. But in those couple of minutes, like the couple of minutes where you're like, she'll be okay, she's low, but she'll be okay, okay, she's not taking care of it, like, she's not waking up. I'll wake her up. I woke her up. That's good. She drank something. I see her blood sugar coming back up. That whole time is only like, 10 or 12 minutes, you know. And in that time, like, standing there with my phone in my hand, I thought everything in my house looks so normal right now, like everything looks like every other day I walked downstairs and let the dogs out while I was doing this, like, but is Arden gonna die right now? Like, you know what I mean, like, and I don't think about it that way, day to day, but last night, I was probably just the right mixture of woozy, a little asleep, a little awake, where I didn't, you know, manage myself that way. And I thought, wouldn't it be weird if, like, everything was so normal in the world, and she just disappeared, and you know what I mean? And and then i She's like, texting me. She's like, I drank it. I'm like, Okay. And then I was like, Yeah, she'll be fine. But a lot of people don't live in that space, you know, and so I thought I had some pretty massive perspective about what's important in life and what were to focus and those sorts of things. Then my mom died, and I thought, Wow. I didn't think I was going to be able to level up. But here it is, I hope. Nothing else terrible happens, because I'm good with where I'm at now, as far as perspective, I don't need any more, you know, but I don't know. Maybe more will come. Still, Jason, I'm not sure. Yeah,

Speaker 1 55:10
something that similar thing happened to me too. Like, you know, the past year my dad's health, it's just been terrible, and watching him kind of start falling down that ladder ramped up my anxiety. You know what really kind of got my anxiety really wound up is thinking, what, what if I get low and I die? Or, what if I get low and crash the car and die? Who's going to take care of my family, like, who's going to be there for them? And that's a it's a hard, it's a hard thing to think about. Do you think you're

Scott Benner 55:42
examining your mortality in that, or do you think you're reacting to the idea that your father's gone? Because you know before that, if you would have died, he would have taken care of your family.

Speaker 1 55:52
I think it was just it's amplified by him having these health issues and seeing him being the guy that if you needed something done, you call him at that point in time. You know, I wasn't able to call him anymore because he couldn't, couldn't do these things for us anymore. So it's kind of like I'm stepping up into that role.

Scott Benner 56:12
Yeah, it's me now. There's nobody behind me anymore, right? Yeah, the way that happens to me is I imagine everybody I've ever been related to, standing in a line at a cliff. They fall off the cliff as they die. And then my mom, my mom went off, and I was like, Oh, I'm next. Like, there's no one in front of me in this line anymore, right? You know, that was the thing that got me. I was like, there, you know, it's my dad and my uncle and my aunt and like all these people, even though I wasn't even that close to them, like all these like all these people, like, I felt like if they were alive, I was going to be alive, because age and chronology, you know, etc, even though that's completely ridiculous, I'm sure the guy standing on that bridge in Baltimore didn't think they were going to die right before that, yeah, but um, but in my mind, that's always what comforted me. I'm like, there's more people to go before it gets to me. And then my mom, my mom passes away. And I'm like, there's no one left standing between me and the edge of this cliff. And, yeah, that's when you start doing things like, you know, trying to put away more money, and talking to your kids about stuff that you're like, they're probably like, Why the hell are they explaining this to me, like, that kind of stuff, you know? Yeah. And actually, it's funny, my dad left my mom, and I can look back and see that he was planning it for a while. And the one way that I really like, like, this kind of touch point for me is I was like, I don't know, I was 12, and he drugged me into the basement one day to explain how the fuse box worked. And, like, I remember the time thinking, like, this is cool. My dad and I are doing something together, you know what I mean? And like, trying to understand the fuse box. And I felt like I did understand it. And I was like, Oh, cool. Look at me. Like, there's they were the old screw and glass ones, you know. And, well, you know, your dad's electrician, like, and I was like, Oh, wow. And then I look back some years later, and I think, oh, he was just explaining to me how to take care of the house because he was going to leave. And I don't know that it's any different with dying, except maybe you don't plan to die, you know what? I mean? Yeah, yeah. So, yeah, I've

Speaker 1 58:16
been, I've been slowly doing that, like, ever since I started really feeling that anxiety, like slowly dropping those little hints or knowledge on my wife, like, you know, if you need to take care of this with loop, this is where you should go and look at it. You want to look at it? And she'd say, No, of course, but,

Scott Benner 58:34
but you're thinking, look at it, in case my body explodes and I'm not, unexpectedly, that's right, yeah. Now that's, uh, how are you making out getting through that anxiety?

Speaker 1 58:45
Well, you know, after learning about the grounding method from the juicebox podcast, subscribe, turn downloads on that stuff. I that that episode on grounding, I probably have listened to that 10 times. No No kidding, I've kind of picked out things within that, those grounding methods that kind of really helped me, and I've gotten pretty good at making it happen quick when I start to feel that anxiety, come on. So, you know, I can usually just look at something, and I kind of start describing it in my head. I would feel how it would touch, how it would feel when I touch it, what it smells like. And it kind of calms me down to a point to where I can let my mind move on to something else.

Scott Benner 59:29
It's episode 913 it's called the 54321, method. And it's just Erica, who's the a licensed marriage and family therapist who she has type one diabetes for like forever, like over 30 years, and I have her on to talk about this kind of stuff. It's where I like, where we pick a topic, and then normally it devolves into me talking about how I feel. She and I did this, this grounding method. What is it? It's five things. You can see

Speaker 1 59:59
we're. Things You Can that's, it's like, see, touch, you know, feel them, something, those five things, just to get your mind to focus on something else. And they and I really, I just kind of picked out of those methods, just like, What things would feel like if I were to touch them, just the general shape of things and things like that. That kept that really helped me.

Scott Benner 20:00:21
Yeah, the 54321, method involves identifying five things. You can see, four things, you can touch, three things you can hear, two things you can smell, one thing you can taste. And by doing so, it shifts your focus from anxiety provoking thoughts to a present moment.

Speaker 1 20:00:36
And it works for you, huh? It most definitely works for me. That's very cool. Well, it's

Scott Benner 20:00:40
a shame you're not gonna have any more kids, because I think we could have got a Scott out of you, for sure, but I

Unknown Speaker 20:00:49
would have named him Dave, go with it. Yeah, you

Scott Benner 20:00:51
know what, honestly, would have been the way to go. Well, I'm grateful that that it helped you. I wish you knew. I wish you guys all knew that most of what the podcast is is the thoughts that I have standing in the shower in the morning. And I think I bet you people would want to know about this. There's no production meeting or anything like that. Nobody's telling me what the like do or say. I just one day I got it in my head. I was like, I heard about this method. I watch people do it. I thought, boy, that makes sense. And then I listened to some people online talk about it. I was like, Wow, this helps a lot of people. I'm going to ask Eric if she knows about this, and like, really was the extent of it, and to hear that it made it all the way to Iowa and to you, and that it was valuable for you while your father is passing away and and you know, afterwards, it's very heartwarming for me. So I appreciate you sharing that with me, because, you know, day to day, it just feels like I sit in this room and click on things and, you know, and talk and make sure this thing's in front of my face when I do it. That's right, yeah, but to know that it actually works out, like I'm working on something now for the podcast, for like, later, it's a lot of work. Like, I'm not gonna lie to you. It's like a lot of me sitting here and talking to myself, I'm not gonna tell you what I'm planning yet, and it's hard. It's hard to get the energy up for it. It's hard to have an engaging conversation by yourself in a room, one of those things, like, anybody that can do that. I have a lot of respect for stand up comedians like even get feedback, you know, from a crowd. But even though you can make the argument that they're on their own up there, but I am not getting any feedback, so I have to kind of imagine how you feel while I'm doing it. And I slowed down on that project because it's just such a slog. Yeah, you know, you saying this to me, honestly, will help me get energy up to to finish it up and get it out to you guys. It's a ton of I almost curse, but it's a ton of I'm gonna curse anyway. It's a ton of work, and I don't get any like, nobody at the end of the day is like, you're doing a good job, or try harder, or do this differently. I just, I'm like, on my own to figure out what it is anyway. I appreciate it very much, and it'll be helpful to me. So thank

Speaker 1 20:02:59
you. Yeah, well, keep, keep taking showers, Scott, and keep coming up with good ideas. Well,

Scott Benner 20:03:03
hell if I stop taking showers. We have bigger problems than the podcast falling apart, right?

Unknown Speaker 20:03:09
Keep taking showers.

Scott Benner 20:03:12
Oh, my God, Jason, you just named the episode. Yeah, there you go. Well,

Speaker 1 20:03:17
we need you to keep coming up with good ideas. And I'll, I'll keep, I'll keep posting in the Facebook group. Try and help people and help you come up with ideas. You're definitely doing, like a real job. You gotta think of like all those like podcasters, YouTubers, these jobs didn't exist 10 years ago. Yeah. So it's hard to, I think it's hard for some people to say that what you're doing is a job, and you deserve compensation for it. You definitely do, and I think you're doing a fine job of it. And thank you. You know, top of the game, type of type of job, and I think you deserve to be paid. And however you get that money? You get that money?

Scott Benner 20:03:54
Well, I'm not human trafficking people like P Diddy, allegedly. So Right?

Unknown Speaker 20:04:00
So you're just taking money from OmniPod and Dexcom and cozy Earth. And

Scott Benner 20:04:05
I'm older, so I'm still slightly embarrassed to be a podcaster, not embarrassed, but like, there's a little piece inside of me that's, like, you don't really that's not a real job. Like your dad, it's your dad would think I'm doing a weird a real job. Yeah, yeah. And my dad, you know, it's funny, my father, while not an electrician, did all the electrical work at the rubber molding plant that he worked at, like so your dad and my dad were pretty similar people as far as what they did for a living. He worked in an industrial situation, big, heavy machines that it was his job to take care of and keep them running. And then when that, when nothing broke, they would just point him to the floor, and he'd go work on the floor. And, you know, like he was the maintenance supervisor. But I also, there were days he came home where he just, you know, he did the grind too, like he, you know, they put him in front of a machine and said, you know, make 10,000 of these things come out of here by the. End of the day. I think if I would have told my dad, you know, that I'm gonna do this, I think he'd be like, What do you mean? Like, you know, like, go do something. Like, go work on something. My mom never understood exactly what I was doing. Like, she was older by the time I was really at it, and she's just like, she knows I talk to people, like, through the internet. Like, that's basically what she understood about it. And I think my kids make fun of me because I feel like I have a 12 year olds job. Like, you know, like, it's funny. Like, to older people, you're not really working, and to younger people, they're like, oh my god, are you and are you on tick tock right now? Like, I get notes all the time. Please stop doing this. Like, or they'll send me, they'll send me links of myself, like, trying to get people to listen to the podcast. Like, don't do this ever again. I'm like, and I'm like, look like, if you can get people to listen a different way, like, let me know what it is. But right now, this is how the world works. And you know, I'm stuck standing in front of a light, talking into my phone, telling you that episode, whatever came out today, and you should check it out. Yeah, anyway, I appreciate you very much. Is there anything we didn't talk about that we

Unknown Speaker 20:06:07
should have? I don't think so. I think we, we hit the hits all the bases. Aaron got him. Yeah,

Scott Benner 20:06:12
well, I'm so glad you said keep taking showers, because I was like, I was down to, like, using the word hospice in the title. And I was like, Oh

Unknown Speaker 20:06:19
God, no one's gonna listen to that.

Scott Benner 20:06:23
Just gonna be like, No thank you. Not on a Tuesday, but it's just very important conversation. Jenny said to me the other day, we were doing a just a pump. I think we did, like a pump and CGM overview. I think we did, that's how much I do this. And during that, she said, Are we going to talk about, you know, older type ones and how these, none of this technology is made for their fingers or their eyes, you know, or their ability to work on stuff? And we, you know, we talked about it for a minute, but like, there's not much to talk about. Like, because what are you saying to a pump company like, go make something for a person at the end of their life, and they're gonna say, oh, they'll get somebody to help them with it. Like, we can't just make a product for that small number of people, but it's still a big deal. Like, you know what I mean? Like, you're gonna get older one day and your fingers are gonna shake, and, you know, if you're lucky, they're just gonna shake. And how are your eyes gonna be? And how are you gonna understand that? Could you understand? Do you think you could have taught loop to your father, absolutely not, yeah. So you know, when that becomes the standard of care and algorithm, like, how do you, I mean, he made out okay on OmniPod five, though, right?

Speaker 1 20:07:32
Yeah, he, he did. But I think a lot of that had to do with my mom helping him his like, I think a lot of that comes down to his mobility, too. Like him being an electrician for the majority of his life, his hands were beat the shit, yeah, so they could hardly register when he touched a touch screen. You know? That thought he was dead already, and so she had to do some of the button pushing for him when it wouldn't work for him, and he didn't have the dexterity in his hands to put pods on. So she had to do that for him. Yeah. So it kind of, you know, shows that some of these things are need to be taken into consideration with an aging population, or a population that doesn't have the that mobility or ability anymore. Listen,

Scott Benner 20:08:20
I worked in sheet metal from the time I was 16 until I was in my 20s, and you know, it wasn't even that long, and the skin on my hands is still like, it's hard to put into words, like I haven't done a real job in a long time, and my fingers are still very dry all the time. Stuff slips out of my hands a lot, if that makes sense or not, but whatever Spider Man has, I have the opposite, you know, and it's I was always touching, you know, this is back before people paid attention to things. My hands were like, we used to wash our hands and paint thinner.

Unknown Speaker 20:08:53
Great, yeah, my dad did that, yeah,

Scott Benner 20:08:55
you know, of course. Like, how do I get this grease off me quickly so I can go eat lunch? Paint thinner, yeah, you know. And then they finally came out with that soap that scrubbed it off. And, you know, you're like, oh, wow, look at the advancement here in my life. I'm not using paint thinner anymore to clean my hands. There are still days I think I'm just gonna wake up with lung cancer one day and I don't smoke or bleed, an unhealthy life at all. But I worked in that place long enough I'm like, hopefully it's not going to get me. But, you know, I don't know that it can. I mean, I worked in the industrial situation before people were like, you know, wear your personal protective gear.

Unknown Speaker 20:09:33
They were right, yeah,

Scott Benner 20:09:35
I made $5 an hour.

Speaker 1 20:09:38
Well, maybe that's why, man, that's why you have your good podcast voices from breathing in all that you shouldn't be breathing in.

Scott Benner 20:09:43
Wouldn't that be great? The thing that propelled me at the end also got him. We'll need somebody to write that on my tombstone. Anyway, Jason, nothing like talking about death with a with somebody at 9am this was great. It was Yeah. I really did appreciate though, and I appreciate you. I imagine you know that, but thanks very much

Unknown Speaker 20:10:04
for doing this. Yeah, no problem. It was a pleasure.

Scott Benner 20:10:07
Hold on one second.

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 too. So screen it like you mean it, one blood test can spot type one diabetes early. Tap now talk to a doctor or visit screen for type one.com for more info. Arden started using a contour meter because of its accuracy, but she continues to use it because it's durable 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.com/juicebox a huge thank you to ever sense 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 Eversense cgm.com/juicebox, hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. 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, wrongway recording.com

#1291 IDU: How do GLP meds work

I don't understand… Why the type 1 guest from episode 1230 doesn't need insulin anymore. What did the GLP do?

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome back to the juicebox podcast. Ready to have some fun?

Jenny's back for another episode of I don't understand. Did you like the last one? I hope you did, because there's gonna be more of Jenny and me and other people not understanding things and us figuring it out. Nothing you hear on the juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. This episode of The juicebox podcast is sponsored by the Eversense CGM, an implantable six month sensor. Is what you get with ever since, but you get so much more exceptional and consistent accuracy over six months and distinct on body vibe alerts when you're high or low on body vibe alerts. You don't even know what that means. Do you ever sense cgm.com/juicebox, go find out this episode of The juicebox podcast is sponsored by us med. US med.com/juice box, or call 888-721-1514, US med is where my daughter gets her diabetes supplies from, and you could too use the link or number to get your free benefits check and get started today with us. Med

Today's episode is sponsored by Medtronic diabetes, a company that's bringing together people who are redefining what it means to live with diabetes. Later in this episode, I'll be speaking with Mark. He was diagnosed with type one diabetes at 28 he's 47 now he's going to tell you a little bit about his story, and then at the very end of the episode, you can hear my entire mini interview with Mark. To hear more stories from the Medtronic champion community, or to share your own story, visit Medtronic diabetes.com/juicebox and check out the Medtronic champion hashtag on social media. We're gonna do something here today. We're gonna try to figure this out together. Because I don't understand this, and I don't know if you do either. Okay. Now this is actually coming from a listener, so I'm gonna read, I'm gonna read their their question. But okay, truth be told, I don't understand this the way I should. I don't think you do either, and let's see if we can figure it out together. Did you hear episode 1230 with the gentleman who had type one diabetes diagnosed at age 50, and now at age 58 on Manjaro is not taking any insulin at all

Jennifer Smith, CDE 2:40
I did. I listened actually. I did listen to that episode. That's perfect, because

Scott Benner 2:44
this gentleman says, with regard to podcast number 1230 where the T 1d guest says he has been completely off of insulin for two years due to being on a GLP one medication. How does his body get nutrients without insulin? Does insulin only Shepherd glucose to muscles and cells. So now this person right here, their confusion is where my I don't understand, comes in, because what they think is, well, that guy's not making insulin anymore, because that's what I was told about. Type one. Type one means don't make insulin, which we all agree about. But then, if this guy was type one, how is he not taking man made insulin, and if he's not, how come all this stuff isn't happening to him? So my question is, Jenny, I don't understand how this happened to that guest on that episode. Do you understand why he doesn't need insulin anymore,

Jennifer Smith, CDE 3:33
not at an in depth way, but I think one, his diagnosis was at age 50, correct. So he was diagnosed as an adult. So Lata, what we do know about diagnosis as adults, and it differs adult to adult, is that they have a tendency to actually have more beta cell reserve. And the expectation is that, and if I remember correctly, he still wears a CGM, even though he just uses the GLP one right now, right? So he did say that he can see excursions in his blood sugar, but his body fixes those excursions like his blood sugar might go up to 171 80. It does it on its own and brings it back down to the goal, target for the most part. Again, generalizing people without type one that have fully functioning beta cells, their blood sugar is not going to go up to 180 it is not it takes a lot of excessive, really simple carb to get it to nudge above target, yes, right? So he's having excursions. He doesn't technically have to take insulin, but I also expect that most of the time he's not eating, you know, six plates of sushi. He's probably eating a really well balanced diet. He exercises, if I remember correctly, from the episode and. So his beta cells that were in reserve, along with the impact of the monjaro, which is the only dual hormone, right? It's a GLP one and it's a GI P, yes, so it's the one on the market that has the heaviest impact on insulin sensitivity and weight loss and glucose management. So when we consider the kind of GLP one he's on, the fact that he was diagnosed as an adult, likely has a beta cell reserve, that would be my again, tip of the iceberg, understanding as to why he's not having to inject or pump insulin at this point. Yeah,

Scott Benner 5:41
okay. So that that is exactly my expectation, that, in truth, the poor guy might very well need his insulin again at some at some point. Yeah, right, but it is not so the so the story gets confusing, like it's confusing to this person, because, you know, I'm confused as to why this guy isn't starving because he's not taking insulin. He's on a GLP medication that suppresses appetite. Everything about it is confusing. It's exciting to see someone needing only one dose a week of GLP and that he's off insulin. I just want to understand how this works. So this guy is being very reasonable. I've seen people not be reasonable around this conversation, right? I

Jennifer Smith, CDE 6:21
have seen that as well. And I also think, in terms of the gentleman's question, the idea that type one totally and completely destroys every single little, teeny, tiny beta cell that you have in your body. It's not really the case, right? I mean, the only true measure of that would be a C peptide. And I don't know that he commented on his C peptides. I don't remember in the conversation if he did or not, but I would expect that with this down shift in delay in digestion, the body's ability to not have these major excursions in blood sugar, I would expect that again, those betas that are in reserve for him. He probably has still diagnostic of type one, but he probably has more C peptide visible than other people. Again, his time of type one has been very short, comparative to other people as well. So he it's not that he's not getting insulin. He is his betas that are there are still making it. And so to answer the guy's question about, How is he getting nutrients, his body is shuttling it in because his insulin receptors are working better. His cells are responding better to glucose and metabolizing the glucose better with this GLP one assisting with all of that, right? Right now

Scott Benner 7:44
we're going to hear from a member of the Medtronic champion community. This episode of The juicebox podcast is sponsored by Medtronic diabetes, and this is Mark.

David 7:53
I use injections for about six months, and then my endocrinologist in the Navy recommended a pump.

Scott Benner 7:59
How long had you been in the Navy eight years up to that point, I've interviewed a number of people who have been diagnosed during service, and most of the time they're discharged. What happened to you? I

David 8:09
was medically discharged, yeah, six months after my diagnosis, was it

Scott Benner 8:13
your goal to stay in the Navy for your whole life, your career? It was, yeah,

David 8:16
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'd made the decision despite all the hardships and time away from home. That was what we

Scott Benner 8:30
loved the most, was the Navy like a lifetime goal of yours. Lifetime goal.

David 8:34
I mean, as my earliest childhood memories were flying, being a fighter pilot,

Scott Benner 8:39
how did your diagnosis impact your lifelong dream.

David 8:42
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, the Medtronic champions community, you know, all those resources that are out there and help guide the way, but then help keep abreast on you know, the new things that are coming down the pipe, and to give you hope for eventually, that we can find a cure.

Scott Benner 9:07
You've probably heard me talk about us Med and how simple it is to reorder with us med using their email system. But did you know that if you don't see the email and you're set up for this, you have to set it up. They don't just randomly call you, but I'm set up to be called if I don't respond to the email, because I don't trust myself 100% so one time I didn't respond to the email, and the phone rings the house. It's like, ring. You know how it works? And I picked it up. I was like, hello, and it was just the recording was like, US med doesn't actually sound like that, but you know what I'm saying? It said, Hey, you're I don't remember exactly what it says, but it's basically like, Hey, your order's ready. Order's ready. You want us to send it? Push this button if you want us to send it, or if you'd like to wait. I think it lets you put it off, like, a couple of weeks, or push this button for that. That's pretty much it. I push the button to send it, and a few days later, box right at my door. That's it. Us, med.com/juice, box. Or call 888-721-1514, get your free benefits checked now and get started with us. Med, Dexcom, OmniPod, tandem freestyle, they've got all your favorites, even that new islet pump. Check them out now at us. Med.com/juice, box. Or by calling 888-721-1514, there are links in the show notes of your podcast player and links at juicebox podcast.com to us, med and all the sponsors. Right? So my, my kind of layman's expectation is he's lotta. So latas typically develops in individuals over 30, often between the ages of 30 and 50 symptoms, initial symptoms of lot of may resemble those of type two diabetes, and include, you know, everything, etc, but diagnosis, lot of can be challenging to diagnose and listen. We've had people on the podcast talking about this forever. There's always people diagnosed type two and there are lot of lot of meaning a very slow onset of type one diabetes. Wasted diagnosis. Auto antibodies, presence of auto antibodies, such as the GAD go, God ready, glutamic acid, Jesus, can you say that mic acid? What's the decarbolus thing?

Unknown Speaker 11:15
That's pretty good

Scott Benner 11:18
antibodies. These are typically found in type ones and indicate an auto immune response. That's really what I think most people stick to. If you have auto antibodies. This is auto immune. Your type one like it gets into the

Jennifer Smith, CDE 11:32
and then there are several more. I think there are four or five that are typically they this is a insulin antibody or auto antibody. There's a zinc transport there. There are a couple of them that have specifics to type one, not only the GAD, yeah. So again, regardless, he clearly was diagnosed with type one. At least one of these was positive, right, right? And

Scott Benner 11:56
your C peptide level is an indicator of your insulin production. Is that? Right? Right,

Jennifer Smith, CDE 12:01
correct. So when insulin is made in the beta cells, sort of the there's a piece of protein that's attached to, kind of move it out, and it's shaped, kind of like a C shape, is my understanding. So when it gets cleaved off and it enters circulation, that C shape remains there as an indicator of your own pancreatic insulin production, which is why, when you start injecting insulin, you can still get a C peptide level tested, because the insulin that you take via injection or pump doesn't ever put that C peptide into your body,

Scott Benner 12:33
right? And that can lower and decline over time. And that's our expectation when somebody comes with Yes, with Lada, because that's exactly what you know. What I'm looking at here is over time, individuals with LADA will typically require insulin therapy as their beta cells are gradually now, this says destroyed and and their ability to produce insulin decreases. I do. I believe in the destroyed word there, because there are definitely people you could, you know, they could drink GLP in their ears, and they're not. They're still going to need all their insulin, right, correct, like, so. So for the guy in episode, in the episode that we're talking about, I guess I should have it here, 1230 he was diagnosed at 50. He was using all the insulin by six years in like, he was really he was using a lot of insulin, which indicated to him and to his physician, I have type one diabetes, like I just do, they end up putting him on Manjaro for weight, and he suddenly doesn't need insulin. But he's also, to Jenny's point earlier, having excursions at meals that are higher than a person without diabetes would have, right

Jennifer Smith, CDE 13:40
and higher than somebody who was taking insulin to cover or clear some of that carbohydrate or food, right? That his betas are clearly not doing everything, but enough to clear it so that he's not sitting high for eight hours, right? I'm assuming that his excursions, along with his endocrine they look okay, if

Scott Benner 14:04
I remember, possibly it's only over an hour, an hour and a half, he pops 180 and comes right back, doesn't get low. And that's that. So what he's saying is, is that for however long this is going to work for me, this is magical, you know, and everyone would type one, and who's listening to this, I would assume would trade one shot a week for that situation over, over what they're in right now. Agreed, the confusion becomes, and you can tell by this gentleman's question is that, what is it? It's the um, it's older type ones, really, who think of it this way, right? Like, because, what is it? Do you think it's that argument between type one and you're old enough to know this. You're not old Jenny, but you're old enough to know this, like, okay, old head type, type ones, they don't want to be thought of as type twos,

Jennifer Smith, CDE 14:51
right? I guess in in general, yeah,

Scott Benner 14:53
because back in the day, if you have type two diabetes, you don't control yourself. You're overweight. That's your fault, right? That was the narrative. And type one defense of that was, I can't help this. This is auto immune. This just happened to me, and Don't lump me in with people who aren't taking good care of themselves, right? When that gets into the zeitgeist, and that's how people think my concern has been, and I'm using this episode to clear it up. I hope is that now that we're in the future and we're learning new things, we don't want to jump on this poor guy and say, because I saw him take it after the episode, you know, you're not a type one prove to me that you had auto antibodies. Blah, blah, blah. I'm like, just listen to the guy's story and like, I don't understand how nobody listens to type to episode 1230 and thinks, wow, there's a lot to learn about this. GLP, well,

Jennifer Smith, CDE 15:43
and I think to go right along with it, while it wasn't a complete loss of insulin use, I know that you've It was either an episode or you've talked to somebody who has a teenager whose insulin needs have come down like 90% of what this person was using now, being on a GLP one, so again, not completely off of insulin. But you can see, even in this person with, I don't know if she has longer diabetes than this gentleman or whatever, but diagnosed as a as a child, she probably had more B to cell initial destruction, and so has enough left to assist, along with what the GLP one is contributing, but still needs some insulin. And if

Scott Benner 16:31
she gets years like that, then good for her, then good for her, yeah, not just good for her, like her happiness, but her health and her longevity. It's going to help a lot of different things. So let's go into this gentleman's question a little deeper. The guy we're talking about needs insulin. He's taking a basal insulin and a meal time insulin. He's got type one diabetes. Obviously, it's going to be a very slow onset, like, probably what he was taking six years in, wouldn't have managed him well, 10 years from now, even you know, as possibly as his possibly as his beta cells continue to degrade,

Jennifer Smith, CDE 17:04
especially considering he was already having a weight management issue, and that was the reason you said the mole jar was started given to

Scott Benner 17:13
him to begin with, right? So, so, so then my question is, what changed? What did the GLP do? Like, I know it increases insulin sensitivity, but, but how? Like, what does that mean? Do we even know that part, or do we just know it happens

Jennifer Smith, CDE 17:27
the insulin sensitivity part? Yeah. Like, how

Scott Benner 17:30
does the GLP, like, magically? Because it feels magic, like you need insulin and now you don't, or you need even when you need less. Like, forget this guy for a second, right? My daughter takes a GLP medication. She's using significantly less insulin than she was without it. Okay, right? Why? What

Jennifer Smith, CDE 17:47
happened? Well, I mean, the GLP ones work several ways. One is for those who do still have some beta cells, or essentially, you know, type twos who have beta cells, but it's really the use of insulin and whatnot. That's the problem. These GLP ones do help with release of insulin. So for him, if his insulin resistance was cleared up because his weight came down and he had enough beta cell response then that his body wasn't having to overcome the resistance, then that could be a piece of it, in terms of the GLP ones helping to trigger the insulin release actually, and maybe more in the correct way, and usability improves. Obviously, GLP ones obviously also block glucagon release from the liver, and so, you know our response, it's a big reason that we actually have the idea of pre bolusing and understanding insulin use around meal times, because we do have this release of like stored gluco so to speak, and output of the liver. And if we block that, we are going to have lower post meal blood sugars, which is, again, probably a piece of why. Maybe his blood sugar goes up, but he responds very well. And now that he's had enough insulin release and his body is sensitized to the insulin, we have to remember that these meds also slow gastric emptying or delayed digestion, so the slower the things kind of sneak into with somebody who may have better insulin sensitivity. Now it allows the insulin that their betas are producing to actually gain traction right to work. And then, of course, you know whether this is helping him or not, and I can't remember whether he spoke much about it, but obviously the satiety factor with all of the GLP ones, most people, that's a big thing they talk about is, gosh, I feel like my head is clear from not considering food all day long anymore, like I can eat when I want to eat, or I choose to eat, but I'm no longer. I. I no longer so hungry, so to speak. Yeah,

Scott Benner 20:04
the episode that went up today I told you about before we started recording, so it's not on here. It's called, I'm getting the name for it. But this one is with a mom of a young type one daughter, and it's called Ken, GLP, meds, impact mental health. Oh, episode 1254 because this little girl is bipolar, and a mixture of lithium and GLP medications took away so many of her issues, it's like it's almost insane. But during one of the during a part of the conversation, the mom said that you could not keep packaged food around the house, because she would just attack it and just eat it. And she's like, what the GLP med has done just specifically to that kid's desire for sugar is amazing. But I want to say this sincerely. It's going to sound like I'm joking. If I had a private plane when we got done recording it, I'd get on it. I'd fly to where you are. I drive to your house, I'd give you a big hug. I'd tell you you are a national treasure. Have lunch with you. Let you give me some of that weird food you eat. And then I would drive home and let me tell you why. Let me tell everyone why. While Jenny was just saying what she said, and she is looking at me in the camera, she is not reading. She right, you know. Okay,

Jennifer Smith, CDE 21:19
I have nothing because I know that podcasts get recorded. Well, when nothing else is open on the computer screen, I have learned so. Scott, thank you. Jen. Jay is

Scott Benner 21:29
like, it doesn't open anything because I don't want anything to crash. Well, while, while Jenny was doing that dummy over here, went to chat GPT, and I said this, how do GLP meds remove the need for man made insulin be technical, but at a fifth grade level, that was so that I could understand it. And it said, and I am not kidding everything, you just no more or no less. You just pulled that right out of your ass, okay? And it was exactly Jenny is as smart as chat GPT when it comes to diabetes. That's all I wanted to say, boosting insulin production, lowering other hormones like glucagon, slowing down digestion, helping you feel full. And the wrap up was, GLP, one meds help your body make more of its own insulin, lower extra sugar, slow down sugar spikes and reduce how much you can eat. Your blood sugar stays more stable because your own insulin and these other effects are working better. You might not need as much man made insulin to keep your blood sugar in check. God, damn, you're a fcking brilliant person. I love to

Jennifer Smith, CDE 22:30
know the medication, because it's I mean, thank you very much for

Scott Benner 22:34
Oh, seriously, Jenny, I could have lined up 1000 people and asked that question. I would have got no

Jennifer Smith, CDE 22:43
well, thanks. Seriously, it's such the new I mean, honestly, this

Scott Benner 22:48
episode of The juicebox podcast is sponsored by the only CGM you can take off to get into the shower the ever since CGM, ever since cgm.com/juice, box. Well, I mean, sure you could take the other ones off, but then you'd waste the sensor and have to start over again. But not with Eversense. Eversense is a six month wear implantable CGM. So if you want to take a shower without anything hanging on, you pop off the transmitter, jump in the shower. When you get back out, put it back on, and you're right back to where you started, come to think of it, you could do that whenever you wanted to. Maybe it was your prom night or your wedding day. Maybe you just don't want the thing on for a little while, but you don't want to go all through the hassle of taking it off and having to restart it and, you know, starting back over with, like, wonky numbers, and having, you know, all that that goes with it when you take off a CGM and put it back on. Oh, but you don't have to do that with the Eversense CGM, because Eversense is the only long term CGM with six months of real time glucose readings. This gives you more confidence, more convenience and flexibility. The Eversense CGM is there for you when you want discretion, a break, or maybe just a little adult time ever since cgm.com/juicebox, pop that transmitter off, pop it back on, you're right back where you started, without any wasted devices or time.

Jennifer Smith, CDE 24:13
I've also, you know, GOP ones have been on the market for a long time, despite them really gaining ground because of the new formulations that really do have a lot more power than the older versions had, but the older versions still worked. I mean, they were, they were what we had initially, that we, you know, the victos and the by durians and those types of things. They they did a good job, just not what our current day does.

Scott Benner 24:42
I was having this thought this morning because it became so popular for weight loss, we ended up and listen, there was a lot of bitching in the media and everywhere else about it. But in the end, it ended up being a good thing, because instead of target, using it for one thing and finding a lot of very similar. Are people. There are people with all different kinds of health implications across the world who needed to lose weight. So we basically spread it out over everybody. And that's why you're getting back these like, Hey, um, I'm getting pregnant on this. Or my again, more I'm hearing about people saying their airs danlers syndrome is, like, I know I never say that correctly, but like, like, they're having lessening facts. Now, I got a girl here that says that, you know, a significant amount of her bipolar issues are cleared up. I mean, come on, right and then, and the guy from the episode we're talking about, he's gonna listen, if you want my opinion about what happened to the gentleman episode 1230 which you should really listen to, is that he is going to get a much longer honeymoon than he was going to and need less insulin during it than he was doing fantastic right

Jennifer Smith, CDE 25:51
on so many fronts, you know, glucose, glucose management ties into so much in terms of long term health. It does a cardiovascular health, brain health, I mean, all the things that are now being studied and understand, understood about true glucose management, whether you have diabetes or not, it's tied into a lot of body function. So you know, if we can sensitize our bodies in multiple ways, this doesn't necessarily mean you throw out all of the good lifestyle habits that you've been trying to put into action keeping them. In fact, exercise, by far, is the top the tip of the pyramid of anything good that you can do for your body, for like an ongoing health into your later years, even as little as walking every single day, right? But if we keep those things in the picture, along with something that could help when those lifestyle things aren't doing enough for us, then great. Yeah.

Scott Benner 27:00
I mean, listen, you say lower your inflammation prior to GLP, if you tell somebody, you would tell them to eat low inflammatory foods and blah, blah, you can't eat enough of that goddamn food to help you if you have a real problem. I mean, come on, you know, use fermented. Okay, great. Like sauerkraut and myself. You think if I ate sauerkraut, I'd have lost 50 pounds? No, okay, you know, I don't have diabetes. I have no my doctor told me all the time, like I actually was told by my endocrinologist, I don't foresee you ever getting Type Two Diabetes, like at your age, where you're fasting glucose is and everything I see from you, you just don't present as somebody who's gonna end up with type two and I'm like, Oh, great. I'm still significantly overweight, unhealthy, etc, and so on. But I wasn't doing any of the things that classically people would say, oh, it's because he's doing this. Like, I really don't live a much different life right now than I did before. While we're looking for, like, spreading out over people who needed to lose weight and learning things. I was getting iron infusions yearly, maybe twice a year. Some years or I would fall apart and die. My ferritin level was going down into the single digits, right? That doesn't happen anymore. My body is absorbing iron now, and I'm fine. I haven't needed an infusion in a year and a half, and

Jennifer Smith, CDE 28:19
I wonder there, you know, just in in that small, little, narrow, I wonder if it has to do something with the way that these meds slow digestion. I wonder if it's your body now has enough time to completely absorb what it needs to and so you don't have to medically manage your irons, yours,

Scott Benner 28:39
yeah, and keep in mind that, prior to that, my fartin drops, and the doctor, so first of all, they think you have cancer right away, because if you're of a young enough age, and it looks like you're losing, you know, iron, they just so I gotta go through all that. I scope one way I get scope, the other way, well, Oh, you don't have cancer. Good, good. Congratulations, thanks. I'm still having all these problems, right? Maybe have celiac don't eat gluten for a month. A month later, nothing changes. I'm like, Look that that wasn't it. You know what they said after that, take an iron supplement with vitamin C. It helps it uptake it faster. So I did that. You know what? That did? Not a lot, nothing. Yeah, right. And so I was going to be one of those people that they were like, Hmm, don't understand. Bye, bye. Like, you know, like, that was it? Like, we did all the things that we understand. We go off and think I took the GLP because I went to when my kids, my second kid, went off to college. I went to my kids endocrinologist, and I said, Hey, yo, I did it. I raised those kids. They're good people. They're not going to murder anybody. Now, I

Jennifer Smith, CDE 29:42
have time for me. I

Scott Benner 29:42
need to stay alive, right, right, right, like and, and she looks at me. She knows me. She'd been helping me with things, right? And she didn't know what was happening still. And I said, I need to lose weight. And she looked at me and said, why? And we were standing face to face. See, and I said, and she goes, I said, you don't see. And she goes, No. She goes, Scott. She's like, you could lose weight, but you don't look like that's your problem. And I said, Well, that's very nice. And I stood up. I don't know if I've told this in the podcast, I stood up, I took off my sweatshirt, and I said, I'm gonna get on a scale in a minute. You guessed my weight? And she guessed my weight at about 175 pounds, which, by the way, is well under, yes, is eight pounds less than I weigh right now, and I've already lost 48 pounds like so when I told her my weight, she goes, Oh God, we'll get you a GLP medication. And the stuff that came after it, she didn't say, I'll get you the GLP medication. And, by the way, you won't need iron infusions anymore because this, she didn't know that was going to happen. No, yeah, right.

Jennifer Smith, CDE 30:42
I think that's, I mean, you bring up a good point there. I think that again, despite GLP ones having been around for a while, this new generation of them being so much more impactful, there are so many things being discovered and found that are, let's call them positives, yeah, or other health related things. Now, I do think that longer term, we need a lot of evaluation and study and everything, because you know, you're putting something in your body that technically, while, while it is a hormone that your body would normally make for whatever reason, environmental, food system, whatever's happening in our today's life, body, there's something that's not working the right way. Otherwise people wouldn't be responding. I think people like you, as an example, would it really be responding if your body was actually doing what it should be doing? That's my

Scott Benner 31:46
only point. Is that for me and for many other people, your body's not doing something, and this medication is is covering for it, somehow covering what do we care? Like, like, I Why do you like? Just listen, I know this isn't like. I'd spread it on everybody. I'd sprinkle it over top of us and be like, let's see what else it fixes. We're gonna figure that out. Like, it's the baseline stuff. Like, Oh, I lost weight so my knees don't hurt anymore, and I'm not gonna have to have a hip surgery or something. Like, that's nice and all. And don't get me wrong, it's amazing. But listen, this is new. Recent studies have highlighted the potential of GLP one agonists such as ozempic and reducing the risk of dementia, particularly Alzheimer's disease and people with type two diabetes. A large study involving 88,000 participants showed that those treated with GLP one agonists had a significantly lower risk of developing dementia compared to those using other diabetes medications like sulfonylureas and DPP four inhibitors, the reduction in risk was 30% compared to sulfonylureas at 23% compared to DPP four inhibitors. Come on. Like,

Unknown Speaker 32:53
yay. Like,

Scott Benner 32:55
you know what I mean? Like, you mean I don't have to be overweight, and when I'm 85 I'm not gonna be like, banging my head on a wall, like, you know what I mean? Like, this is wonderful. Jenny, for 20 years, I heard people say inflammation is the problem, but they didn't know what to do with it. After that, it feels like we know what to do. Now a little better, a little better. Yeah.

Jennifer Smith, CDE 33:18
I mean, they're only, I think the biggest thing that I'd like to see with these medications is the right kind of education in use of them. You know, in terms of prescribing, as a prescriber, you're a caregiver, and you should really be checking in with your patients. You should really be checking in and saying, How are things going? You know, you start them on this a weekend, there should be a follow up, even a quick message, right? They How are things going? Let's see, how are you feeling, etc, because some people may respond better to one than another, yeah, you know. And if there's not enough information given up front about how you might feel, is this normal? When should I call if it's not feeling back to normal or whatever? I think on the case of clinicians, they really need to do a lot of self educating about these to know what's appropriate and how to help people use them to their advantage. Yeah, they

Scott Benner 34:19
also have to understand what they're what they're actually doing for people. Because right one of the bigger problems with the glps right now, as it's being reported, is that the dropout rate is like around two years. So you know, my opinion of that is that this medication may be doing a lot more for you than you understand, and just because you didn't continue to lose weight or didn't get to your goal weight might it might

Jennifer Smith, CDE 34:41
not be, might not be. The only thing that it was helping Exactly, right? And doctors

Scott Benner 34:47
need to understand, like, Listen, if you are one of the people who takes it and you're nauseous and vomiting constantly, it's not for you, obviously, like, but I'm not talking about just force yourself through it. But right? I made it through some side effects, like. There was, there was a a fair amount of time in there where I was like, I'm never gonna have a solid bowel movement ever again in my entire life. And like, but I was losing weight to the point where I was like, You know what I actually thought? And this is nothing technical, obviously, this was my thought. I'll let you go. Yeah, it took me this many years to get this fat. I wonder what horrible things were happening inside of me then that I never, like, I never batted an eye against I didn't, I didn't go out and, you know, eat greasy food, because I used to eat greasy food, I don't anymore. I didn't go out eat greasy food, come home, have distress in the bathroom, and then go, Well, I'm never gonna eat greasy food again. Like, like, I'm like, I struggled through that to get to my next french fry. I better, like, I'll try this, you know what I mean, right? And I stuck with it. Now I don't have that problem anymore. But I mean, if you're really impacted by it in a way that you just can't function, I understand it's not for you that's fine, but for everyone else, like, we gotta keep paying attention to this, I think. Yeah, so, to answer the gentleman's initial question, I don't understand why this guy doesn't need insulin. He does need insulin, and his body is making it right now. Yes,

Jennifer Smith, CDE 36:03
that's it. That's the bottom line, without all the biochemistry and physiology and all the stuff, yes, that's the bottom line. I mean, we

Scott Benner 36:13
made a good podcast episode here. I'm

Speaker 1 36:14
gonna let you go. Thank you. Of course, you I

Scott Benner 36:23
want to thank the ever since CGM for sponsoring this episode of The juicebox podcast, and invite you to go to ever sense cgm.com/juicebox to learn more about this terrific device, you can head over now and just absorb everything that the website has to offer, and that way you'll know if ever since feels right for you, ever since cgm.com/juice box, Arden has been getting her diabetes supplies from us med for three years, you can As well us med.com/juice box, or call 888-721-1514, my thanks to us, med for sponsoring this episode and for being long time sponsors of the juicebox podcast. There are links in the show notes and links at juicebox podcast. Com to us, med and all of the sponsors. 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 define you, and that is what the Medtronic champion community is all about. Each of us is strong, and together, we're even stronger. To hear more stories from the Medtronic champion community or to share your own story, visit Medtronic diabetes.com/juicebox Once, there was a time when I just told people, if you want a low and stable a 1c just listen to the juicebox podcast. But as the years went on and the podcast episodes grew, it became more and more difficult for people to listen to everyone. So I made the diabetes Pro Tip series. This series is with me and Jenny Smith. Jenny is a Certified Diabetes Care and Education Specialist. She's also a registered and licensed dietitian and a type one herself for over 30 years. And I, of course, am the father of a child who was diagnosed at age two in 2006 head now to juicebox podcast com, go up in the menu at the top and click on diabetes pro tip. Or if you're in the private Facebook group, there's a list of these episodes right in the featured tab. Find out how I help keep my daughters A, 1c, between five, two and six, two for the last 10 years without diet restrictions. Juicebox podcast.com start listening today. It's absolutely free. Okay. Well, here we are at the end of the episode. You're still with me. Thank you. I really do appreciate that. What else could you do for me? Uh, why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribed in your podcast app, go to YouTube and follow me or Instagram. Tik, Tok. Oh gosh, here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page you don't want to miss. Please do not know about the private group. You have to join the private group. As of this recording, it has 51,000 members in it. They're active, talking about diabetes, whatever you need to know. There's a conversation happening in there right now, and I'm there all the time. Tag me. I'll say, hi, hey. What's up everybody? If you've noticed that the podcast sounds better, and you're thinking like, how does that happen? What you're hearing is Rob at wrong way recording, doing his magic to these files. So if you want him to do his magic to you, wrong way. Recording.com, you got a podcast? You want somebody to edit it? You want rob you?