Scott Benner 9/10/24 Scott Benner 9/10/24

#1299 Blue Book Part I

Tim is a 30 year type one. His son, daughter, grandfather and uncle have type 1 as well. Two Part episode. Part 2 is episode 1301.

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

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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.

COMING SOON

#1298 Miss Iowa, Alysa Goethe

Alysa Goethe is the 2023 Miss Iowa and a type 1

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Scott Benner 0:00
OmniPod, Hello friends, and welcome to another episode of The juicebox Podcast. Today,

we're going to speak with Alyssa. She's Miss Iowa 2023 and she has type one diabetes, what a terrific conversation with just an intelligent, thoughtful person you're going to see in just a minute what I'm talking about. 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. If you have type one diabetes, or you are the caregiver of someone with type one and you're a US resident, you can help with type one diabetes research by going to T 1d exchange.org, forward slash juice box, joining the registry and completing the survey. This should take you about 10 minutes. You're going to be asked questions that you definitely know the answer to. It's not a big pressure situation. They collect that data, and with that data, they help make better decisions in research. T 1d, exchange.org/juicebox, please do check it out. Don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juicebox at checkout. That's juicebox at checkout to save 40 percent@cozyearth.com 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 screened for type one.com for more info. This episode of The juicebox podcast is sponsored by the Eversense CGM, an implantable six month sensor. Is what you get with Eversense, 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. Today's episode of The juicebox podcast is sponsored by the contour next gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at contour next.com/juice box.

Alyssa 2:31
My name is Alyssa gothi, and I have lived with type one diabetes for about 13 years now. I was diagnosed at 11 years old, and I'm also the first diabetic. Miss Iowa. Miss

Scott Benner 2:41
Iowa.

Alyssa 2:42
How does that happen? Lot of hard work, but really, I started competing, gosh, at 10 years old, so before I was even diagnosed, and there's a big performance element, I've always loved to sing, and that's what initially got me hooked. My mom actually was very against it, because she didn't want me to be Toddlers and Tiaras, if you remember that show, oh yeah, and I basically wore her down until she said, Fine, you'll lose and you'll get it out of your system. Then I won. So I've been doing it for 14 years, but I became really involved after I was diagnosed because of the community service element. It kind of helped me work through that grief of being diagnosed and being the only person in a graduating class of 400 people to be living with diabetes. And so getting to represent in an area where not a lot of representation is there or visible, was a really big deal to me, and to win the title of Miss Iowa being the first type one diabetic to do so is just the biggest honor. Oh, congratulations,

Scott Benner 3:42
thank you. Yeah, I'd like to pick through it a little more, if you don't mind, like, I don't get to hear about stuff like this. So you're saying that when you were 10 years old, you were singing and enjoying singing, and you were looking for a place for for an outlet for that. Is that right?

Alyssa 3:58
Yes, yeah, I actually saw my cousin compete. I was invited to watch her in a competition, and I just was enamored by the talent portion, and I turned to my mom in the audience, and I was like, Hey, Mom, I want to do that. I want to sing for people. And that's when she initially said, No. Now also you have to keep in mind I was actually very much a tomboy, believe it or not, and hated wearing shoes, hated wearing dresses, hated my hair done, hated makeup. So of course, my mom was like, Why on earth are you the girl that's wanting to do this? But now, if you look at me, you definitely wouldn't see the tomboy in me at all. But I just I wanted to sing for people, and I've always loved doing it. I sang in church growing up. I did voice lessons. I did talent shows anytime I could be on stage, I was doing it, and pageants were a great

Scott Benner 4:44
outlet for that. Wow. And then you have to work your way through it. So what's the first thing you won? I

Alyssa 4:49
won my local county title. So we have different age divisions. We have little miss Junior, Miss Teen, and then miss, so depending on your age, I was 10, so I was. The Junior Miss and I competed for Junior Miss Scott County in my hometown auditorium, and had no idea what I was doing. Was just trying to have fun. I kind of forgot that you could actually win. And when they called my name, I was like, oh yeah, this is a part of it. And then got, got crowned. So after the local level, you advanced to the state. So I competed for Junior Miss Iowa. Did not win, which is totally fine. And after state, then you go to the national competition. So this past January, after I won this Iowa, I actually went to Miss America, which was so surreal.

Scott Benner 5:35
Wow. Okay, hold on, I'm gonna get back that. I want to know. Do you play any sports?

Alyssa 5:39
I used to be in softball, but I quit after Middle School. Okay,

Scott Benner 5:44
you have to have a killer instinct a little bit right to compete and stuff like this. Like, do you want to win? Or is it, do you know what I'm saying, or is it, you just go out there, you do your best, and whatever happens, happens, and you feel good about it. Like, you know what I mean? Like that feeling when you, like, lose a softball game, you're like, Oh, I put all this effort and we didn't win. Does that feel like that?

Alyssa 6:03
Yeah, it's a little bit of both, to be honest. But for me, the winning was not OmniPod. I want to be Miss Iowa. It was I want to be Miss Iowa because of what it would mean for the diabetes community, and that was really my guiding light throughout the whole thing. Because, yes, it's cool to say I miss Iowa, but seeing the reaction of people who see my CGM and then show me their devices, seeing people who reach out to me or comment on my posts saying they now feel okay with having diabetes because they've seen someone, either in their state or in a space that maybe they're a part of where they don't feel represented, actually be seen invisible, that's always been my my biggest urge to win, and so in my little speech after I won, I made sure to say, you know, this is a win for not just me, but for the diabetes community. But the nice thing about about competing is also you meet so many amazing and accomplished women that are all deserving of winning, and it's both very humbling but also very inspiring, because they are so kind. It's not at all like, you know, Toddlers and Tiaras. It's a little bit more like Miss Congeniality, where you actually get along and you make lifelong friends. I mean, in my crowning video, you can find it on YouTube, one of my best friends is behind me, literally off the floor, in her full length dress and heels, jumping up and down because she was so excited for me so it doesn't feel as competitive as maybe a sports arena or event, because you're all rooting each other on and knowing that your own capabilities are deserving to win as well. Yeah, it's

Scott Benner 7:33
not like, then when my daughter was playing softball and we would just get real close and be like, don't forget why we're here to make those other girls cry. Get out there and kick their ass. Nothing like that, right? Okay, hey, by the way, um, may seem off topic to you, but Michael Caine, who is in miscon Miss Congeniality, the actor, picks his roles. He's very old now I probably is not acting anymore, but he was picking his roles by the weather. So if, if it was cold where he lived, he'd pick a warm weather shoot. And that's how he would pick a script. And if it was warm where he lived, he'd pick a cooler weather shoot to get away from the honestly kind of smart he was using acting like a second home. It's fantastic. And I don't know you said, Miss Congeniality. And I thought, Oh, Michael Caine was in that. I don't know why I thought any of that. So, okay, so you go to you do these little things, and you keep moving up and, I mean, the truth is, is it's such a, I mean, from my perspective, it's such a an interesting mix of things that they're judging right, like, so obviously, you're, you're a little kid. They're not judging your body or but they are judging looks, though, to some degree, are they not, or is it just, how is it weighted? I guess is my question. What's

Alyssa 8:43
really cool about the Miss America organization and Miss Iowa program is it's not based on who the prettiest is on stage by any means. It's a lot about scholarship and service. So I won about $12,000 in scholarship just by winning Miss Iowa that I'm able to put towards student loans and a master's degree, which is life changing, because I had to pay my way through college. And as an educator, it's really hard to pay back student loans, and so it's really nice to have that scholarship opportunity. So they really emphasize furthering your education and also your intellect, as well as your service, which again, is a huge part of my guiding force and guiding factor of even competing, because it helped me so much to realize that I could help other people, and seeing how you can do that on the state level and even the national level. I mean, is just so rewarding and so life changing. So focusing on those two elements. I mean, if you look up our Miss America, she is incredible. She's honestly overqualified. She has her own nonprofit for pancreatic cancer. She's the first active duty military officer to win Miss America. I mean, she and she's so kind as well. So it's really about you know who you are and your dedication to service and furthering your education. It's

Scott Benner 9:57
interesting. I like that. It seems more modern than. I recall it growing up, yes, because, like, I'm not gonna listen. I'm 52 How old are you? You're, wait, I'm 24 Yeah, you were diagnosed in 11. Yeah, I got it. I mean, it was a bikini contest when I was growing up. It really was like, you know, it's nice to see how it's grown. I guess is what I'm getting at. Because it used to feel like, I don't know the prettiest girl from a state picked up a flute and was like, there, it's my that's what. I'm good. I played a flute and you're like, you don't play the flute. So people who are older, like me, who remember it like that, wouldn't recognize this. This is almost, I was almost gonna say, like, the Cub Scouts, but maybe it is a little bit about, like, learning, doing, helping, being a leader. Kind of that idea from the very beginning, your kids mean everything to you. That means you do anything for them, especially if they're at risk. So when it comes to type one diabetes screen, it like you mean it now up to 90% of type one diagnosis, have no family history, but if you have a family history, you are up to 15 times more likely to develop type one screen it like you mean it, because type one diabetes can develop at any age, and once you get results, you can get prepared for your child's future. So screen it like you mean it type one starts long before there are symptoms, but one blood test could help you spot it early before they need insulin, and could lower the risk of serious complications like diabetic ketoacidosis or DKA. Talk to your doctor about how to screen for type one diabetes, because the more you know, the more you can do. So don't wait, tap now or visit screened for type one.com to learn more. Again, that's screened for type one.com and screen it like you mean it,

Alyssa 11:56
yes. What's really cool that I appreciate is in I think it was 2018 Miss America actually got rid of the swimsuit portion entirely, and recently they added health and fitness, which is much less about how you look in active wear, but rather what your definition of healthy is and being confident in who you are. And I really love that I was not the thinnest person on stage, by any means, but I was showing how confident I was with all the hard work I put into managing my diabetes, and I got to talk about that on stage. And so honestly, for me, it's a really cool outlet to share even more of a glimpse into my diabetes journey and show that healthy might look different for certain people, and that just because I have diabetes. It's actually a joke. My dad and I have he also has type one. We always say, you know, despite our diabetes, we're the healthiest people we know, and so getting to showcase that is something I think is really neat.

Scott Benner 12:51
How old was your dad when he's diagnosed?

Alyssa 12:53
He was 13, so he's lived with it for, gosh, 43 years now.

Scott Benner 12:59
Did you guys talk about his diabetes prior to your diagnosis, or was it a thing that wasn't really or you might not remember, you're only 10, probably. But like, do you remember knowing a lot about his type one before you had it yourself?

Alyssa 13:11
I didn't know a whole lot, to be honest, because I was so young that I don't think my parents understood that I would understand it, you know, but I at least saw him doing it, but in my mind, I was like, Oh yeah, my dad just has to take shots at dinner. It wasn't ever Oh, this is because of his diabetes. And I also remember there were times growing up he would have really bad low reactions because he couldn't feel his low blood sugars. Now, this was before CGMS were really a thing or even marketed to the mass public. So there'd be times where he'd be, you know, almost seeming intoxicated, or like he was on drugs, because his blood sugar was so low that I grew up having to know to call 911, and how to get people there so my mom could try to get him juice or get him something, or glucagon. So those things were part of my life, but I didn't understand that was because of diabetes. I just thought, that's how dad is me being naive and and thinking, Oh, this is my dad. But then once I was diagnosed, the dots kind of connected for me. And my dad actually felt really guilty for a really long time about thinking it was his fault that I got diabetes, and actually, my brother was just diagnosed last year. He's older than me, so he had that same emotion when my brother was just diagnosed, that he felt like he did it to us. Oh, it always makes me emotional to talk about, but really, it's kind of nice to have someone else in my family that I can relate to and ask for guidance from, because he takes care of his diabetes so well, especially knowing that my brother and I have it, and he's just been a great role model throughout the whole thing. So if anything, I'm actually really grateful that we both are kind of in it together. I say we're DIA buddies.

Scott Benner 14:52
Your brother was just diagnosed. How old is he?

Alyssa 14:54
He was 26 when he was diagnosed, so he was significantly

Scott Benner 14:58
older. And do you have any other brothers or sisters? Nope. It's

Alyssa 15:02
just us, too.

Scott Benner 15:03
And is there any other autoimmune happening, like celiac, thyroid, anything like that? No.

Alyssa 15:09
I mean, knock on wood, not yet. I was tested for celiac, but I don't have it. We're very fortunate, but it's interesting, because also my grandmother, on my mom's side, has type one. So there are four people in my family that have it, and I'm getting it from both sides. So honestly, yeah, to happen?

Scott Benner 15:27
Alyssa, colloquially, that's known as screwed. So your dad has type one on so in your father's side, on your mother's side, your mom's mom, yes, oh, is that sort of how maybe your mom and dad got together,

Alyssa 15:42
actually, no, no. Their story, okay, this is a this is a tangent, but their love story is kind of insane. So my parents worked at a grocery store together, and they dated for approximately a month before my dad proposed, and they were engaged for only a year and a half, which sounds long, but they were long distance for all of it. And then they didn't live together, really, until they got married, and they're still together 30 some years later.

Scott Benner 16:11
Yo, your mom hot or something. What's going on there? Your dad tried real hard there. You know what I mean?

Alyssa 16:15
Listen, I asked if it was like a shotgun wedding or something. And they say, No,

Scott Benner 16:20
I'm telling you right now, one generation later, if a guy liked you that much, you'd call the cops and tell him to keep him away from you. Feel like, Oh, this guy's a little too into it. You know what I mean, it's become a fun story to share with people. Yeah, no, it's nice. But my thought was, is that when they when your mom was younger, she wasn't put off by diabetes in a mate because her mom had it. Maybe, you know what I mean, like, it was something she was accustomed to. Yes, do you have any idea it's so interesting. So what kind of gear does your dad use now, diabetes stuff? He

Alyssa 16:53
uses a Dexcom g6 and an OmniPod. He just got the OmniPod not even a year ago, I think, and he really loves it. He never had a pump before. He's a very active person. I mean, in the summer, he does the JDRF bike ride. He is always outside, either building something or gardening. He's always out and about. So he always thought the pumps that had the tubing would be in the way. So he's very adamant about doing MDI, and then he would have the OmniPod, and he really loves that. Now I have the FreeStyle Libre, so I'm still waiting to get that connected to an OmniPod, and then I'll definitely be on that. But he really loves that. But he always talks about how different it is compared to when he was first diagnosed. I mean, he started out taking one shot a day, peeing on a stick to see if he had ketones, and eating a very structured diet every single day. To now being so flexible with a pump and a CGM, which weren't even a thing when he was diagnosed, your dad

Scott Benner 17:55
may have started on beef and pork insulin. That might be how long ago he did this and animal insulin, then maybe it moved to mph and regular at some point, but he would have been on those structured eating plans. Is he a fit person today? Still? Yes, very. The reason I ask is because I do a lot of management series with a woman named Jenny Smith, and she's a CDE, but also her she was diagnosed years and years ago to some kind of more Midwestern parents who put her on a very, like, structured eating schedule, and she's a fit, good eater to this day. It's interesting, but it's interesting because I think you have to have the personality for it. Like, I think there are some people who could, if they were intersected with that, like, Hey, we're gonna eat like this. Now they might rebel against it, but some people like it. So it makes me think that maybe your dad either didn't have a choice or was okay with the program, and then it actually built up a lifestyle for him.

Alyssa 18:53
I think it did. I mean, he definitely had his rebellious years, as he's told me, where he didn't necessarily want to take care of his diabetes, which we now know is, I mean diabetes burnout, and yeah, I had my own experience with that as well in high school, but especially when he was first diagnosed, he was the only one in his family that had it, and also he's adopted, so he didn't know anything about his family history. So it really was a big surprise for them. I think his blood sugar was in the seven hundreds when he was diagnosed. I mean, the fact that he was able to lead a healthy life and still be, you know, a picture of health today is just

Scott Benner 19:31
amazing. That's wonderful. Did it carry over to you? Do you kind of eat and take care of yourself the way he does?

Alyssa 19:37
Yes, but it is very different living with diabetes now versus when I was diagnosed versus when he was diagnosed. So they started me on a very structured, specific carb count. So I took the same insulin every time, and my a, 1c when I went back, was like 5.8 I was killing it. And then once they put me on the flexible, you know, ratio. So that's when it was a little more challenging with puberty. Yeah, puberty with diabetes is not for the faint of heart. It is not fun, as I'm sure you know. But

Scott Benner 20:11
yeah, I know, don't worry. I know

Alyssa 20:14
it was, it was rough, especially for me, because I was, I was almost 12 when I was diagnosed. It was my first week of Middle School, which is so much fun anyway, adding diabetes on top of that is even more fun. And my honeymoon phase actually ended as my puberty kind of really ramped up. So that mixed together was just chaos, yeah. So once I got into college and I got a CGM for the first time. I mean, my ANC was just so much better, and I was eating better, and so now I'm a lot more like my dad, where there's some flexibility, but I'm really able to take care of myself, which is great.

Scott Benner 20:52
Yeah, when I jump back, you said that you experienced some burnout in high school. What did that look like

Alyssa 20:56
for me? It was not always taking insulin for snacks. I always took insulin for meals, but if I was hungry, I would just eat, because that's what other people my age were doing. And from the time I was diagnosed until I graduated high school, I was the only person with diabetes in my graduating class of about 400 people, and I was bullied because of it, especially that first week when I went back to school, people just didn't understand what I was going through. They thought it was unfair that I got to leave class sometimes, even though it was to deal with a low blood sugar, which is one of the worst feelings in the world. They thought it was unfair that I got to be in the front of the lunch line, but they didn't see myself giving injections before lunch, and that's why I had to leave early. I mean, I just felt so misunderstood, and I longed to be quote, unquote normal and like my peers, that I wanted to hide my diabetes and I didn't want anyone to address it. So if we were out to eat for a field trip, I would wait to take my insulin until my blood sugar was already too high, or I didn't take insulin for snacks, I didn't always check my blood sugars as often as I should have, and when I got to about my senior year, I realized one I needed to take care of myself, especially if I was going off to college, because I did not want to have to be dependent on my family if something were to happen. But also, I just started to really embrace it. I got a friend group that asked great questions and were there to really uplift me through it, and I started realizing that if people didn't like my diabetes and that was their problem, and not mine. Yeah,

Scott Benner 22:31
I'm gonna ask some questions, you're not gonna understand why I'm asking for a minute. But okay, what do your parents do for a living?

Alyssa 22:38
My mom is a kindergarten teacher, and my dad works for the government. Okay, do

Scott Benner 22:43
you know your IQ?

Alyssa 22:44
I do not. I probably should, though,

Scott Benner 22:47
here's why I'm asking you are so agile. Conversationally, I got your IQ in the 130s maybe. Oh, so I know I've talked to a lot of people. I want to know you. Please go take an IQ test and get back to me. Okay, yeah. So at first I thought, oh, Alyssa is just a practice speaker because of the pageant system, right? I truly think if I said to you, maple trees or oak trees, which do you prefer? I think you and I could have, like, a thoughtful conversation about it. Oh, absolutely, I'm already thinking of an answer? And I know, I think it comes from, like, that kind of agility comes from intelligence. And so you're really, like, You're a wonderful speaker, and thank you. No no, no, please. And you've got that, like, middle of the country, I can't tell where you're from, no accent, accent, which is fantastic. Like, you enunciate all your words. You complete your thoughts. I tried to take you into a circle and then ask you a question, and you still answered it. And I was like, she's really good at this, but, but seriously, like you're a teacher now,

Alyssa 23:50
yes, I'm a music teacher. Oh, I

Scott Benner 23:52
was gonna ask, What are you teaching? Because those kids are gonna really know it when it's over.

Alyssa 23:56
Well, I love music theory, which is basically a sudoku puzzle for music, so I'm hoping they can understand that complicated topic when I teach it. Well, some

Scott Benner 24:07
of them aren't. Some are gonna be little dummies, but that's not your fault. But seriously, like I feel like you could have done anything you wanted to do. The contour next gen blood glucose meter is sponsoring this episode of The juicebox podcast, and it's entirely possible that it is less expensive in cash than you're paying right now for your meter through your insurance company. That's right. If you go to my link, contour, next.com/juicebox, you're going to find links to Walmart, Amazon, Walgreens, CVS, Rite, aid, Kroger and Meyer, you could be paying more right now through your insurance for your test strips in meter than you would pay through my link for the contour next gen and contour next test strips in cash. What am I saying? My link may be cheaper out of your pocket than you're paying right now, even with. Your insurance, and I don't know what meter you have right now, I can't say that, but what I can say for sure is that the contour next gen meter is accurate. It is reliable, and it is the meter that we've been using for years. Contour next.com/juicebox and if you already have a contour meter and you're buying test strips, doing so through the juicebox podcast link will help to support the show. This episode of The juicebox podcast is sponsored by Eversense, and Eversense is the implantable CGM that lasts six months. Eversense 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 Eversense. 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 Eversense CGM has a silicon based adhesive forge 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 Eversense, 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 Eversense. Eversense, cgm.com, dot com, slash juicebox, links in the show notes. Links at juicebox podcast.com.

Alyssa 26:49
Oh, well, thank you. Did

Scott Benner 26:50
you have that feeling? No, no, no, you don't have to be too nice to me. Did you have that feeling in college? Did were you like I have endless possibilities here?

Alyssa 26:58
I don't know. Actually, all I knew is so I'm very type A and I'm also someone that is very stubborn and determined. So growing up with my mom as a kindergarten teacher, I would see the chaos that happens in the kindergarten room, and I said, I'm never, ever being a teacher. And she was very aware of that. I was so vocal about it, but I knew I wanted to do something with music, and that does limit some of your possibilities, because you do have to pay the bills, and music doesn't always do that. So I went to school with just a music major, knowing this is what I really love to do, and I want to find some sort of outlet where I can use music. I mean, just like how I got into pageants, it was music was a big part of my life. Yeah. And then when I was in college, I started tutoring people, and, you know, at the top of my classes, and I just realized, Oh, I I really have an affinity for teaching and explaining things for people, and a talent for that. Why don't I? Well, no, just

Scott Benner 27:56
Yeah, it's because you see things clearly and quickly. I think that's

Alyssa 28:00
what it is. And I do really understand music I mean, I loved music theory, not to brag, but I got a five on the AP exam, which was a big deal. Alyssa, listen, I mean,

Scott Benner 28:10
I've known you for 25 minutes, and I'd adopt you a few stuff that happened to your parents right now. Because I think you're I think you're a winner. You see what I'm saying. I think we can make some money off you. I'm not talking like that, but No, but seriously, like, do you play instruments? I

Alyssa 28:23
do I actually play eight instruments? Well, that's what I was

Scott Benner 28:26
gonna say. You probably play multiple instruments, which is a clear indication of intelligence.

Unknown Speaker 28:31
Well,

Scott Benner 28:33
no stop. Have your parents never bumped pumped you up like this? I

Alyssa 28:38
really did. But also I I just think I have a lot of intrinsic motivation. And, yeah, the things that I excel at are things I really love to do. So I don't feel like I'm working for it.

Scott Benner 28:48
Try having that, that motivation with a 90 IQ, it ain't gonna go the same, okay, right? So, like, and not, by the way, 90 is a fantastic IQ. Like, if you're, if your IQ is out there is 90, like, you're killing it. Like, but I'm saying that those extra points, I think we're getting into a spot a list of where I'm now talking about stuff that you I don't usually say on the podcast, but I just say privately, those last 20 IQ points is where, is where you see something like that. Like, you know, like, there's an average IQ where lovely people exist, and there's a slightly higher one. You can see people a little more agile, meaning they can kind of think into layers. This is the way I think about it anyway, like the way thoughts layer on top of each other, and one thing supports the next and and you start getting perspective from a 360 instead of from a singular perspective. So some people look at the world through their eyes. They see that perspective, and some people say in the middle of the sphere, and can see all around them. I think the amount that you can see around you in that 360 at some point becomes about just computing power. And we can say it's intelligence, but it's, it's like, RAM, you know what I mean? Like, you can, you know, it's so funny we talk. Talked about this before we started. The kids don't know how computers work, but your computer has memory in it, right? And it's this, it's this place where it does its processing. It's how much space it has to think. And I think of IQ points sort of the same way, like the more space you have to think, the more things you can consider at the same time. And when you really see a clear person, I think they're clear because they can hold a lot of different ideas at the same time and juxtapose them against each other. And I realize just now that my son heard me say that he'd be like, Why did you have to say juxtaposed? Trying to say smart, but no, because that's really the word I want to use there. And so I should have just said out loud, I know you play multiple instruments. How many do you play? Because I had it in my heart already that you could play a lot of instruments. You might be undervaluing yourself. I

Alyssa 30:47
feel like I'm very humble, and that's probably the most humble thing I could say, that I'm very humble. No,

Scott Benner 30:52
no, I think it's possible I find you in 20 years and you're doing something that's a lot bigger than not that what you're doing now isn't lovely, but I think it's possible that you continue to grow as a person and find bigger and bigger things to do, because I think you can handle them. I

Alyssa 31:08
mean, that is the goal. That is the goal I want to I want to keep whether I stay in teaching or not. I do want to continue diabetes advocacy, whether it's professionally or, you know, just out of,

Scott Benner 31:23
ooh, Alyssa, you're gone. Hold on a second in this community. Hey, Alyssa, you disappeared. Go back to advocacy for me.

Alyssa 31:29
Can you hear me? Okay, yeah, you came back. Okay, perfect. So sorry, no, it's

Scott Benner 31:35
you live in Iowa, right?

Alyssa 31:38
Don't you have an Iowa

Scott Benner 31:39
right now? Like, aren't you grinding corn to make fuel to run the generator so your internet works or something like

Alyssa 31:45
that? No, no. I live in the Des Moines area, which is our state capital. Okay, this is a side story in

Scott Benner 31:51
the city. Go ahead.

Alyssa 31:52
I'm sorry. Yes, I live in a city, but when I lived in Chicago for one year for my freshman year of college, before I moved back to Des Moines, it was a little too big for me, for the Iowa gal, but when I met someone, they first of all thought I was in Ohio, because we always get confused for Ohio or Idaho. And their first thought was, So, what's it like living on a farm?

Scott Benner 32:16
Well, it's my first thought. But yeah, go ahead,

Alyssa 32:20
exactly. And so I turned him and I said, Well, my dad has a garden, but that's, I mean, that's about it, like, I don't know what you mean. So it's just, it's funny to me when people think that's all of Iowa. We do have cities. They're not huge, but we do have them. I walked

Scott Benner 32:35
into, I did a speaking thing in Kansas City one time, and they picked me up at the airport, and to say it was an airport, I mean, I have a McDonald's bigger than that airport at my house. They're like, Oh, the guy said, I'm to take you into the city. And I was like, okay, it actually felt like, if anybody's ever played SimCity, the city building game on a computer, like, you know, when you put down your first three buildings next to each other, like, that's what the city felt like to me. I was like, Oh, they put five buildings here, over three stories tall, and they think, and this is the city they call it. I'm like, oh, it's fascinating. Like, if I took them to Chicago or to New York or something, their head may explode if they, you know, had so what was that like when you went to Chicago for the first time? You like, oh, hell. Okay, I see it now.

Alyssa 33:17
For me, I grew up going to Chicago. I have family that lives there, and so every year I would go, and I loved to visit, yeah, but it's very different living there than it is just visiting, okay? Because I was right downtown. I had classes on Michigan Avenue. I was in the South Loop. I was, you know, walking everywhere, taking the L train at, you know, 18 years old, as someone who had never lived anywhere other than Iowa. So it was very different living there than visiting. And I just realized it was a little too fast paced for me with how much was changing in my life already, like moving going off to college for the first time. I was just a music major. I didn't have a specific end point or end goal like I did with teaching, yeah, so there's just a lot of change and figuring out for my life that I had to do. And I just realized that Chicago wasn't, wasn't the vibe for me, but it did make me realize how much I love Iowa, so to be able to represent Iowa is just that much more special. Do

Scott Benner 34:20
you have trouble dating or you? But by me, I didn't. I do not. Okay. You met somebody you like and all that.

Alyssa 34:27
Yes, I do have a boyfriend. It's been about three years. Oh, okay,

Scott Benner 34:30
so what were you looking for in a boyfriend?

Alyssa 34:35
I really love a singer with a deep voice, which is very specific. We met in college because we were in the same program. We were both studying music education, and he's an amazing singer. So that initially attracted me, but ultimately, someone who is patient and kind was kind of my which is very vague, but that's something I was really looking for, because I've just heard too many horror stories. Friends who went on dates with guys who were not very nice. Yeah, and I didn't want that to be me, but also I needed someone who would be patient and ready to learn about diabetes, because, again, that's such a big part of my family that it was important for him to know that. And he's been, I mean, he's been great. We keep emergency low snacks by the bed. I mean, he's always wondering how my blood sugar's doing. There was a time where, you know, he came home for Christmas with me, and my dad had a really bad reaction that his CGM didn't catch, and I had to call 911, and he was there to comfort me and help me through it. So, I mean, that's a big thing for me too, yeah. Plus,

Scott Benner 35:38
he's got a deep voice, so that doesn't hurt anything exactly, Hey, your dad. Is he using OmniPod dash or five, five? Okay. Is that helping him? Like, is his life changed pretty significantly because of that. Do you think

Alyssa 35:53
he was actually really, really good with injections? He was always really on top of it, but it has made his life a lot easier. Yeah,

Scott Benner 36:01
let me, let me stop you from it like, but he got low a lot though, right? Yeah. So you know what I mean, not that he wasn't doing well, but he was probably doing well, like, lower a one C's, because his, he was really keeping his blood sugar low, but he was having, I think, too many like, it sounds to me like a lot of excursions were, like, we had to call 911 like, is he having fewer of those on pumping?

Alyssa 36:23
I'd say so. I think he stopped having so many when he got the CGM too the CGM was honestly more life saving, in my opinion, for him, just because he's never been able to feel his low blood sugars ever. Yeah, and being able to hear that and do damage control before it gets too low. Is is really amazing, because a lot of times it'll happen in the night and he can't wake up. So then my mom has to, you know, wake up in the middle of the night and take care of him, or he, you know, ends up collapsing or something. So having the CGM really helped. And then there were probably only two in between the CGM and getting the OmniPod, yeah, that he had that were, unfortunately just undetected by the CGM. But

Scott Benner 37:09
I'm glad for him that he has that stuff. You know, where he keeps his a 1c

Alyssa 37:13
he's around six, he he does really, really, well, yeah,

Scott Benner 37:17
I would imagine, like now having had type one for as long as you have, which is what, like, 13 years. She said, Right,

Alyssa 37:24
yep.

Scott Benner 37:25
How would you describe your management at this point? Like, are you down to, like, the nitty gritty? Are you looking at fat and protein in your meals to stop later rises? Are you, you know, manipulating it more with how you eat? Like, what is it you do day to day that leads to your successes in

Alyssa 37:42
health. Yeah, actually, this year as Miss Iowa, because I'm constantly on the road. I've traveled more than 40,000 miles this year, and which is a lot for those who don't realize that learning how to deal with flexibility, because when I'm just teaching your day is really structured, but when I'm traveling from county to county, or even to other parts of the country, that throws things off. So learning how to adapt to flexibility has been a really huge part of my year, and I feel like I've done it really well. I also have personal trainers this year, which has been really helpful, because I didn't realize, and this is where you might take back your comment about me being really smart. I didn't realize that protein was such an important part in stabilizing your blood sugar. No one ever told me about that, and I just didn't realize it. So I went from, I mean, I still had protein in my in my day to day life, but I've really been prioritizing that, especially in the morning, because I have a really bad Dawn effect, okay, where I wake up and it just starts to rise for no reason at all, which is really fun. So prioritizing protein has been a big part of my management, and that's really helped me level out my blood sugars a lot so I see fewer spikes, which has been great, but otherwise, I mean, it's kind of the things I've been doing that are second nature. I well,

Scott Benner 39:07
don't, don't confuse being young with not being intelligent, like you still have to have experiences to learn things. But yeah, so you're doing so you open your eyes, your blood sugar starts going up,

Alyssa 39:20
basically, I mean, it could be in the 80s all night, like perfect, and then I'll wake up, shower, look at my phone, and it rises to, like, 150 Yeah, so without eating anything,

Scott Benner 39:31
let me ask you this, you, you, I, you identified yourself earlier as a type A personality, yes. So do you wake up and start really thinking about what you have to do?

Alyssa 39:41
Oh, I think about it before I even wake up. I sometimes have dreams about what I have to do the next day. Yeah,

Scott Benner 39:48
that's probably why your blood sugar goes up in the morning. You might have what they call feet on the floor. And it might not. It might be less about a dawn phenomenon, and because, if you're you. Sleeping in the 80s, and your blood sugar's literally not going up until you you start your day. There's a little difference between Dawn phenomenon and feet on the floor. And it feet on the floor just kind of means like when I stand up and I and life hits me, that adrenaline and the cortisol pop gets you, and then you're suddenly the amount of insulin that was good to keep you stable overnight at 85 is not enough to stop what's happening. You're getting a an actual impact on your blood sugar from that. It's seriously, well, there's no way to think about it, because you'll just, you'll just think about it make your blood sugar. My easiest example is that my daughter is very specific about doing well in school, and I didn't really know that about her. I have two kids, but my daughter's a little bit of a blend of my wife and I in one specific way. So my wife's very like, type A, get it done. Do a good job. It's important to do a good job. And I'm more like, it'll be fine, right? So my daughter has an it'll be fine attitude with an underlying of, oh my god, I gotta get this right. And she'd go to school and need more insulin all day, like more basal, more aggressive insulin sensitivity, like everything throughout the day. But the minute school ended, her blood sugar would start to fall because the the release was there, like she wasn't worried or thinking about school anymore. And I do wonder if maybe that's not something that's happening to you. Interesting.

Alyssa 41:27
I would not be surprised actually, now that you say that when I'm in stressful situations, I mean, my blood sugar will shoot up to the three hundreds. I'm like, what happened? Yeah, you know,

Scott Benner 41:37
yeah, you're not as you're not as chill on the inside as you are on the outside right? Because on the on the outside, you seem really You seem chill, you seem chill and thoughtful, but your brain's racing. Maybe, is that possible?

Alyssa 41:50
I think that's what it is. I also do have anxiety, which just paired with diabetes already, is not very fun, because then you're anxious about your diabetes, and then you see your blood sugar go up, and you're like, Oh, wow. Now I'm more anxious, which will just make it higher and higher, which is so fun.

Scott Benner 42:06
Actual loop of of it just keeping itself spinning right, right?

Alyssa 42:10
But I've noticed my blood sugar also tends to hang out a little bit lower in the evening. I don't always necessarily drop low, but it tends to be a little lower in my range than throughout the day. So that's when you really consider, yeah,

Scott Benner 42:26
when you relax, right? Yeah, that's how you learn things exactly. Okay. Why did you want to come on the podcast?

Alyssa 42:37
I had heard about it through it was actually a post from beyond type one that said, here are some good diabetes podcasts to listen to. So I was listening to it. And I just love that you share people's stories, and it's really real, and that's something that I feel like the diabetes community needs, because you can see posts by nonprofits all the time, but until you really hear someone's story, that's when you start to feel less alone. And I just realized, oh my gosh, I would love to do that. And then I think someone had commented like tagged me on Facebook, when you made a post in the group saying, Oh, we're looking for people or whatever. And they said, Oh, Alyssa, would be great for this. And I was like, I never thought about putting myself up for it, but sure, Oh, that's great. That's why I'm

Scott Benner 43:25
here. I have to tell you, I'm having a lovely time talking to you. I wasn't kidding. I would happily adopt you, and especially now that you're not really financially like needing of me, I'm gonna make it an admission to you, right when you reached out, I was like, am I going to talk to miss Iowa? Like, what are we going to talk about? You know what I mean? Like, what are we going to like, what are we going to talk about? And is she going to tell me about picking dresses? And, you know, like, I'm like, because I don't know how long I can do that for exactly like, I can muster that up for my daughter, you know what I mean. But like, I don't do it a lot with a lot of other people. I just want people to realize that, like, this is the example of why you talk to so many different people, because you just really, until you get to know them, all you have is your supposition, and you're often incorrect, you know. Like, I'm not saying that I thought you were going to be ditzy. And like, you know, like, I didn't have that feeling I'm being serious. Like, I didn't think that, but I did wonder, like, would you come on here and just want to talk about pageants? Or, you know, when I hear you say, Miss Iowa, like 800,000 times, or something like that. Or would I joke with you? And you'd get stiff because you'd think like, I don't want anybody to hear me from the pageant community, but you are just absolutely lovely. Your parents should be very proud. Oh, you're welcome. Did they do this? Or is this you? Is this a nature, nurture thing, or what do we got here?

Alyssa 44:48
I think both. I mean, my parents are amazing. My mom was born to be a mom, and my dad has been a great role model for me, like I said with. Diabetes, he will. He's also so proud that anywhere he goes, he will say he will somehow find a way to bring up, oh, my daughter's Miss Iowa. I'm like, Dad, you're talking to a random person on the street, and it wasn't part of the conversation. He just brings it up. He's very proud, yeah. So yes, they are proud of me and my mom. It's funny. I went to her school for a school visit, because I like to do presentations on, you know, diabetes and, you know, accomplishing things despite your obstacles that you may face. And so I went to her kindergarten classroom. I said, Well, if I'm a princess, what does that make my mom like a queen? So now they always say hi queen, to her at school, and it's really cute.

Scott Benner 45:44
That's very nice. Do you bring the magic wand with you and the hat? When you talk to people? Definitely

Alyssa 45:50
the hat, my sparkly hat, but I don't have a magic wand. I do have a sash. And I tell kids, it's like a big name tag. It's to the point where if someone says, Miss Iowa, I will whip my head around and respond. So that's going to be really hard to get used to when I'm not miss

Scott Benner 46:04
Iowa anymore. I'm trying to figure out what Hermione Granger's wand was called, because, I think, because I imagined you with a scepter, if I'm being honest, where you touch people and Knight them. But I guess they don't give you that power, right?

Alyssa 46:15
No, unfortunately, not. So

Scott Benner 46:17
did you say that you so once you're Miss Iowa, then you then you go to Miss America. Yes. How was that so now I'm gonna completely sound like a hypocrite. What was that experience like? Did it feel like you went from like minor league baseball to like the pros or like or is it all about the same? It's just the names different on the on the show.

Alyssa 46:39
It did feel a little bit like stepping up to the big leagues. I mean, the production was next level. We had choreographers, flown in, we had a hair and makeup team. I mean, things that Iowa just we don't have. I competed against like 17 other women, which is still, I mean, 17 other women who are all accomplished and amazing and talented. I mean, that's still tough. But then you're also competing against girls who come from, like, my friend, she's amazing, she's Miss Texas. She compete against like 60 other girls. That's more than the amount of people that even compete at Miss America. So you're like, How can I compete with that? There's a lot of imposter syndrome going on for sure, just knowing I came from a smaller state, and seeing like how many girls I was surrounded by who are so qualified and so just accomplished. But then you also have to remember, well, I'm here for a reason, and Iowa is no less of a state than a Texas or California or Hawaii, we're just all very different. So I just kind of focused on making friends and making memories. Because for me, the dream was always miss Iowa. It was just honestly a cherry on top to go to Miss America and experience it. And I had a wonderful time. I did not win a single award, and I still am so proud of of what I did and what I accomplished?

Scott Benner 48:00
Were you referencing Avery Bishop. She was

Alyssa 48:05
Miss Texas last year. Texas is Ellie bro, and she was actually first Turner up to Miss America. She is the kindest human. I love her so much. Wow.

Scott Benner 48:14
And so you guys make kind of lifelong friends doing this too. Oh, absolutely.

Alyssa 48:17
I mean, it's kind of the really cool thing is you have friends in every state now, plus Washington DC. So if I travel, I know that I have a place to stay, which is really nice on a teacher salary. I

Scott Benner 48:31
have to tell you that you that you were thoughtful enough to include for people, that Washington DC is not a state. I think that's the core of who you are right there. That was fantastic. You were, like, so many states, plus Washington, DC, which, as you know, is not a state.

Alyssa 48:47
I can't forget my DC girl, she's great, no,

Scott Benner 48:51
but Alyssa, that you took the time to make sure that, like, if you just said, like, you know, all the states, it would be, you wouldn't have to, I don't know, you wouldn't have to qualify like that. That that was, I don't know if that's the teacher in you, or there's something specific about how you think. I can't tell, but that was what you're like, that's the District of Columbia. It's like, yes, it's not a state. I don't know if you guys knew that or not, and but you weren't. You weren't coming off as like, like showing that you had this information. You were just making sure everybody was aware. I love that that was really nice. Oh my god. I don't know why this is I was so amused by that. I gotta let that go. You have this boyfriend for a few years now, this guy that you've that you've obviously molded into the person you need him to be. And now he now he behaves, and he's, he's right. And you're 24 and you're who you are. You're thinking about getting married or no, yes, that's definitely on the radar. Oh yeah. I mean, I can smell it on you by the time you're 27 for sure, right?

Alyssa 49:47
Yeah. I think I've always said, now this is the type a in me to just lay out my life. I've always said, at 25 I'll consider an engagement, not even I'll get engaged. I'll consider an engagement at 25 and then at. 30, that's when I'll, you know, start thinking about kids. I don't know why I mapped out my life that way, but that's kind of the the general progression. So then by the time I'm 25 it'll been like three and a half, four years. And I think that's a great, a great timeline.

Scott Benner 50:12
Oh no, I got you that that kid doesn't know I you. He doesn't know you already have his life worked out pretty well. So he's just absolutely, yeah, you better be saving for a ring, is what I was thinking. But my question was, you identified your mom as somebody who you felt like was born to be a mother, and you seem like very nurturing, and now you're telling me you do want kids. My question is, do you think about that anguish you saw your father go through? Boy this is going to turn having watched his kids be diagnosed, and does that give you any pause about children, or does it just make you think about it differently? Yeah,

Alyssa 50:47
this has been honestly a big topic in my life that I've thought of, because when I was first diagnosed, I'd say when I was going through puberty and was really experiencing my burnout, I kind of swore off having kids. Totally I was like, I'm not having them. There'd be a higher, high risk pregnancy for me. I know I would feel the same way that my dad did, even though I don't blame him at all, I know I would feel the same way he did, because when when I was diagnosed, he had to drive separate to the hospital, which was about 40 minutes away, where they had an endocrinology unit for pediatrics, and he had to drive separate because he was crying the whole time. Yeah, and when my brother was diagnosed on the phone, my mom was talking to my brother when he was in the ER, and my dad said I did it to another one. That was his first reaction. I'm sorry. And even though I mean, and that just breaks my heart, because I would never, ever consider that my dad's fault. It's just, it's just our genetics. We can't control that, sure, and I know I would feel the same way. So I've actually thought about, especially with my dad, being adopted, I've actually thought about adoption, and that's something that honestly really early on my boyfriend and I had just kind of mentioned is, yeah, adoption is a great way to go, just because it for now, would still be a pretty high risk pregnancy for me, and I don't want to have to live with that guilt if I were to have a child with diabetes. Yes, I'd be a great mentor for them, and I would still love them just the same. It would not affect how I feel for them, but living with that get will be really hard. Well, Alyssa, I

Scott Benner 52:24
don't want to crush your your your plan there, but your dad's parents adopted him and got a kid with diabetes.

Alyssa 52:31
I know. I

Scott Benner 52:33
know. So what do you mean? Like, you imagine if you adopted a kid that got type one diabetes, you'd be like, Oh my god, don't you. So here, let me put you in that scenario. You have the thought you have you adopt a kid, the kid ends up getting type one diabetes. Do you ever think I could have just made a baby myself? And right? Isn't life weird? That is true. Listen, there's no planning, is what I'm trying to teach you. But I'm not sure if you're getting it or not. Yeah, you can't plan. What you could do is prepare yourself to believe what you said, which is that this is a genetic thing, and that I have no control over this whatsoever, that none of us have any control over anything, because I would be afraid for you that you would adopt a baby that one day, I don't know, couldn't poop, right? And you'd be like, Oh, see, this kid has a problem too. They're all gonna have a problem. Because I think a lot of people have medical issues. That's true. I think some people get it into their heads that like an illness is something that doesn't happen to other people. If it's happening to you, then you think it doesn't happen to other people, and if it doesn't happen to you, you just think, oh, that's something that happens to other people. You know what I mean? I think the truth is, the longer I do this podcast, the more people I talk to, the more you realize that everybody sort of has something that they're dealing with, you know? So I don't know, I've talked to you for a while now. I'd like to see more kids that think like you on the planet. So with a nice, deep voice, yes,

Unknown Speaker 54:03
yes,

Scott Benner 54:04
that's what I want.

Alyssa 54:05
I mean, I'm still that's the thing. I'm still young, and if I go by my plan, I still have about six years until I have kids, so I do have plenty of time to think about it, and who knows. I mean, by then, with how the landscape of diabetes has changed just the past five years. I can't imagine how much it will change throughout the next five years. Yeah, I just, I mean,

Scott Benner 54:27
I'm sorry. I just interviewed a woman yesterday whose son used the T Zeald. So his sister had type one. They got the family screen. The boy had three markers. He qualified for tz old took it, and now they're hoping that it holds off his type one for years, possibly. And you know, who knows where, like, even that drug will lead and what it'll come up with, or how much better these algorithms will get for insulin pumps and things like that. Like, there's so much stuff moving forward, it doesn't. Look anything like when your dad grew up? Honestly? Oh,

Alyssa 55:03
absolutely. And the screenings are so much more accurate. Now, what's interesting is my so my brother, when I was diagnosed, he was screened through the the trial net screenings, and he didn't have any of the markers for it at the time. And of course, I mean things change. He also so I always say, like, of course this would happen for me with certain, certain scenarios. So like, the adoption thing, when you said, What are the chances you would get, you know, a kid that ends up having diabetes anyway, I would say, well, that's just how my life is going to go. Because my brother, when he was diagnosed, he had just moved to Texas, like, four months prior. Like, of course, that happened. Of course, it was when you moved, you know, halfway across the country, of course. Because why wouldn't it? Well, that's things like that.

Scott Benner 55:49
Yeah. That's just how it goes. You ever noticed how many people are diagnosed on like, vacation or on Halloween, yeah, or you have breaks in school? Like, what I really think is, is what happens, is the diagnosis has happened when people's lives slow down enough that they can see what's going on around them, they have time to think about it. That's why they catch it on vacation, because on vacation, they're not thinking about a million other things like they are during the that that's been my, my assumption from from hearing so many people's stories. I think you'll, uh, I don't know. I think you'll do what you'll do. I think planning for it is tough. My wife told me that before she met me, she wanted to move to New York City, buy an apartment, put all white furniture in it, and never let anybody in there. So it stayed nice and clean. And I was like, Okay. And then I

Alyssa 56:36
wrote a little like, American Psycho. Well, she's

Scott Benner 56:39
a little weird, but no, no, no, she just, she's like, I just had this picture of, like, I think she grew up in a very chaotic house, and I think she, like, was looking for it not to be like that, if that makes sense. Yeah, that's my guess a little bit. I think the the white furniture is more of an allegory for, um, she wanted, like, some calm. But anyway, then we, you know, got married. She didn't expect that to happen. We got pregnant. Nobody expected that to happen. And, like, now I think I've been married, like, 27 years, or something like that, so I should probably buy her a white sofa at some point. You know what I mean, actually, that's a good idea.

Alyssa 57:18
Write it down so you don't forget. No, I'm

Scott Benner 57:20
definitely gonna forget. I want to understand you said you had a libre and you hoped what to so you like libre, but where you need it because of your insurance, you what's your situation there?

Alyssa 57:33
I really love the libre. Personally, I have the libre three. So it's really small. It's a lot like the Dexcom g7 in college, I used the Dexcom g6 and personally, this is nothing against Dexcom. I just had a lot of troubles with it. I know they replace it if you have issues, but it was getting to the point where every sensor I was getting was either faulty or there was one time it still makes me like, shiver. I put it on and the applicator wouldn't detach, so I had to rip the whole thing off. Oh, it was so painful,

Scott Benner 58:09
actually. Um, Alyssa, wait, the g6 wouldn't attach. Yeah, yeah. Do you know what you could have done? This is gonna sound crazy. Oh, no, you could have whacked it with a wooden kitchen spoon once, and it would have released. I can't believe I know that no, because it was like, it was a hack. It was a hack that was going around on the internet. So the applicator, sometimes the applicator got stuck. It didn't happen a lot, but it got stuck. And then if you whacked it, like just I gave it a good thump with a wood spoon, it would I'd like to say the Dexcom to sponsor dexcom.com/juicebox I don't notice anybody talking about it online anymore, like, I think it's a thing that maybe happened, and they figured it out and took care of it, but,

Alyssa 58:52
and I'm sure they they have because my dad loves his Dexcom. My brother has the g7 and he really loves

Scott Benner 58:57
that. That's what my daughter uses. Yeah, it was just, I

Alyssa 59:01
was, I think I was a sophomore in college. I did not have a wooden spoon in my dorm room, unfortunately, a wooden kitchen spoon, yeah. But it was just, you know, trying it over and over again. I was just getting frustrated. And, you know, being a college student, my sophomore year, I had transferred, so I was in a new environment, a new school. So that was also a big change for me. And that's when I was just kind of like, I need something different to try, just to see if I like it. And so I got on the libre too, and I really loved at the time, because they were very different designs. I loved how flat it was, yeah, and kind of how sleek it looked. So I ended up just really loving the libre two, and have stuck with it. But I'm not against using a Dexcom, g7 by any means. Libre

Scott Benner 59:49
three. Libre is great, like but you, but you. What pump are you using? Are

Alyssa 59:54
you not? I'm still an MDI. MDI. So

Scott Benner 59:56
do you want a pump but you're waiting for the libre. To work with the pump.

Alyssa 1:00:00
So like I said earlier, I'm really stubborn, and I have just I have lived my whole life with MDI, and change is hard for me, so I keep convincing myself I need to wait until the perfect moment, I guess, or the perfect pump comes along. This is turning into a therapy session. And honestly, I was just in, actually, Washington, DC, which may be why I mentioned it earlier, right? And I was working with the American Diabetes Association for their call to Congress event, and I was hearing from some diabetes educators about different CGMS they have now and different pumps. And I was like, that seems really cool and also really nice to have in my life. Yeah. So I'm, I'm really considering, at my next endo appointment, saying, Hey, can I, can I get a training session on some of these pumps?

Scott Benner 1:00:56
Is it a control thing? Do you think that's why you like the FBI? Yeah,

Alyssa 1:01:01
I think so. And also with kind of the same sentiment my dad had, where I don't want anything to feel like it's weighing me down, because I'm very active, I'm always thinking about the next step, always doing something. If I sit still too long, I will go crazy. So having something that doesn't feel like I'm attached to too many things, or something could get caught or in the way. But at the same time, I know I'm a very adaptable person because of my diabetes, and I know I would be able to adapt my life to fit what I needed to do, especially if it's for my health, yeah. Oh, I

Scott Benner 1:01:34
think you'd really enjoy it actually. What's your a 1c right now? Mask.

Alyssa 1:01:38
It's, oh, gosh. What was it like? Six point something,

Scott Benner 1:01:43
6.0 gosh, on the high side of 6.5 or the low side of 6.5

Alyssa 1:01:50
it might have been 6.5 okay, exactly. Yeah.

Scott Benner 1:01:52
I mean, in the middle, first of all, you're doing well, like nobody you know would say otherwise. But I mean, just the sleeping on an algorithm is amazing. I mean, nothing that can compare to how I sleep now versus how I slept before. My daughter used an algorithm pump and for her as well. So if for no other reason, look at it for that reason. And if you go with OmniPod five, and I'm this is going to sound like a plug, but it's not. I have two small series, two, three part series, at least. Listen to the the OmniPod five Pro Tip series before you set it up, because the way you set it up dictates how it goes, and you want to have settings right on on day one. It makes it much easier and a much more enjoyable experience in the beginning, you know what I mean, and you're gonna sleep so much better. That's the other thing.

Alyssa 1:02:44
Yeah, and I think it'll help with the I guess, if it's feet on the floor, Dawn phenomenon, whatever it is that happens in the morning, for me, I think it would be really helpful. Yeah,

Scott Benner 1:02:54
when your blood sugar starts to rise, it'll start to move insulin to try to meet that. And you won't have to do anything about it, like right now, you'd literally have to get out of bed and give yourself an injection to stop that, right? Yeah. When do you shoot your basal in the morning or at night? I do

Alyssa 1:03:11
it in the morning. Yeah, I used to do it at night, and then I would get lows every night. This was probably my senior year of high school. I would do my Lantis, and then I would wake up every night in the middle of the night with a low and so I had to start doing it in the morning. Alyssa, are you still using Atlantis? Well, I'm on the generic one basal Glar, because that's what insurance made me do. But yes, I use, I use that for my basal. Because what

Scott Benner 1:03:37
I was going to say was, even if you could get to traceba, I've heard great things about it. Yeah, that might give you better 24 hour coverage. Because that might, because that's the other thing is that if you're shooting your basal in the morning, your basal is pretty much shot in the morning, so you have nothing to combat that, that rise. So you might even so you let's think about what was happening. You were shooting at night and getting low overnight, so you moved your basal to the morning, huh? Yes. I wonder if you could move your basal to earlier in the day, and that way have it in long enough where you don't get low overnight, but it's not gone in the morning. Like, does that make sense to what I'm saying?

Alyssa 1:04:21
Yeah, yeah. I've also heard from some people that they have some of their patients do half in the morning, half at night, split it, yeah, but that's something I'm I plan on asking my my endocrinologist in my upcoming appointment is, you know, what are some other methods to do the basal because I am tired of if I can help it, you know, the higher blood sugars throughout the day and then lower at night.

Scott Benner 1:04:48
You did a very nice thing coming on the podcast today and helped me. I'm going to help you now. Okay, okay, episode 1000 through. Episode 1026 is the diabetes Pro Tip series for. The podcast, I'm going to tell you that a lot of these things that I hear you wondering about are going to be covered in there, and that most people who listen to this podcast series tell me they're going to they get an A 1c of six or lower. You should try it. I just, just give it a shot. Okay, so, yeah, it'll take you, I don't know, take you, like, a week to listen through it, but I guarantee you that a lot of those little questions about, see, you're not thinking about the timing of the insulin the way, the way I would, and I don't have, like, if I try to explain it all to you now, like you're just gonna be, like, he could have just sent me to this series. So this year, it's absolutely free, obviously, but give it a try, because I think that it might help you a lot, and I think that it's possible you could find a way to help your father and your brother with it too. I don't we didn't talk about your brother's management, but let me just say this at my funeral, I hope somebody brings up this series, because I think that that's how many people it's helped. So I think it would be a valuable use of your time, plus you're traveling a lot, so you had nothing else to do but listen to but listen to podcast.

Alyssa 1:06:03
Anyway. That is true. That is true. I'll definitely I wrote it down. Oh,

Scott Benner 1:06:07
good. Well, look at you. I didn't think you wouldn't, by the way, and my last question then I'm gonna let you go. Then being Miss Iowa has responsibilities, right? Yes, but you're also teaching. So how do you balance that? Is it like having two jobs? For me, I

Alyssa 1:06:27
have taken a break from teaching to be Miss Iowa full time, okay, but I still teach private lessons, so I do work two jobs, but not in the classroom or the traditional sense of teaching,

Scott Benner 1:06:40
I guess, to be Miss Iowa, or miss anything. Like, it's a full time job for a year, or is it a full time job to try to, like, get into the pageant? Like, give me the like, that idea of like, what is it you're able? Like, how much time does it take to accomplish what you did? I guess there's

Alyssa 1:06:57
definitely some nuance. So you win the local title, and that advances you to the state level. Being a local title holder is by no means a full time job. It's kind of up to you to decide what commitment you want to give to that title. So I represented the, you know, the county that I been now. So Polk County. I was Miss Polk County. I was crowned in October of 2022 and I did about 60 different events throughout my time, from October through June, and I was also balancing teaching full time in the classroom, doing community service, diabetes work, etc, and also preparing for the different phases of competition. So practicing the modeling, the song, the interview portion, all those sorts of things. And then come June, school years already ended, I actually accepted a different position at a different school. So I already was thinking about, you know, moving into a new classroom and all those things. And then, lo and behold, I win Miss Iowa in June of 2023 right? So I had to call up my school district, because it is in my Miss Iowa contract that, if it's possible, this becomes my full time job. So I had to call my school. And also with teaching, I realized that if I were trying to do both of these things, I would not be able to give Miss Iowa, and, you know, the diabetes community 100% and I also would not able to give my students 100% and that would have really broken my heart. So I knew that letting them have a teacher that could give them 100% would have been really soothing for me to know going into this job. So being Miss Iowa is definitely a commitment, because I'm booking all my own gigs. I am traveling to all of our 99 counties because, of course, we can't have 100 we have to have 99 and I've, yeah, I've traveled 40,000 miles. I've been to 63 of the county so far. And I still have two more months, and then I'll go back to teaching in the classroom. Wow, look

Scott Benner 1:09:00
at you. That's wonderful. Well, a ton of effort too. So good for you. Yeah, no, the follow through is big. Easy to say, I want to do something, but when all these steps come up and all the obstacles and the things you have to conquer or or fight through, a lot of people back up and go, Oh, it's a lot of work, you know. But you know, you didn't do that and, and so, you know, so you're Miss Iowa. I didn't know I was talking to miss Polk County too, my goodness,

Alyssa 1:09:28
well, not anymore, because then I got the, you know, the promotion, yes, Iowa. So it's

Scott Benner 1:09:32
really lovely. I it's just been really nice to meet you and to talk. And I appreciate you taking the time to do this with me. Thank you very much.

Alyssa 1:09:39
Well, thank you for having me. It's been a lot of fun. Thank you.

Scott Benner 1:09:42
You did have fun. I was so afraid you were gonna hate me. Oh, when this started, I was like, This is gonna be one where at the end I'm like, Oh, she doesn't like me at all. But you did have a good time. You have a your really lovely way about you. I appreciated it well. Thank

Alyssa 1:09:53
you. Of course, I did have fun. I can reassure you. I did have a good time. Excellent,

Scott Benner 1:09:57
excellent. Hold on one second for me. Okay. Bye.

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 screened for type one.com for more info, I want to thank the ever since CGM for sponsoring this episode of The juicebox podcast and invite you to go to Eversense 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 Eversense feels right for you. Eversense cgm.com/juicebox, a huge thanks to the contour next gen blood glucose meter for sponsoring this episode of The juicebox podcast. Learn more and get started today at contour next.com/juicebox thank you so much for listening. I'll be back very soon with another episode of The juicebox podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple podcast and set it up so that it downloads all new episodes, I'll be your best friend, and if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card if you have type two or pre diabetes, the type two diabetes Pro Tip series from the juicebox podcast is exactly what you're looking for. Do you have a friend or a family member who is struggling to understand their type two and how to manage it? This series is for them seven episodes to get you on track and up to speed. Episode 860, series intro, 864 guilt and shame. Episode 869, medical team. 874, fueling plan. Episode 880, diabetes technology. Episode 885, GLP ones, metformin and insulin. And in episode 889, we talk about movement. This episode is with me and Jenny Smith, of course, you know, Jenny is a Certified Diabetes Care and Education Specialist. She's a registered and licensed dietitian, and Jenny has had type one diabetes for over 30 years. Too many people don't understand their type two diabetes, and this series aims to fix that. Share it with a friend, or get started today. 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, wrongwayrecording.com, you got a podcast. You want somebody to edit it. You want rob you.

#1297 Kamikaze Raccoon

Sarah has Type 1 and Addison's.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
OmniPod, Hello friends and welcome back to another episode of The juicebox Podcast.

Today, we'll be speaking with Sarah. She has type one diabetes and Addison's. Her father had type one and Addison's as well. He's passed on now from a heart issue that Sarah is concerned she might also have. We're going to talk about type one today as well as Addison's, and how it adds to dealing with type one diabetes. 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. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juicebox at checkout. That's juicebox at checkout to save 40% at cozy earth.com, 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. The Diabetes variable series from the juicebox podcast goes over all the little things that affect your diabetes that you might not think about, travel and exercise, dehydration and even trampolines. Juicebox podcast.com go up in the menu and click on diabetes variables. This episode of The juicebox podcast is sponsored by Eversense. The Eversense CGM is more convenient, requiring only one sensor every six months. It offers more flexibility with its easy on, easy off, smart transmitter, and allows you to take a break when needed. Ever since cgm.com/juicebox, today's show is sponsored by OmniPod five. Do you have fear of missing out on OmniPod? If you do, you have fomu, but I can get rid of it for you at omnipod.com/juice, box. OmniPod five is no longer just a great option for people with type one diabetes. It's also now FDA approved for people living with type two. This episode of The juicebox podcast is sponsored by cozy Earth. Use the offer code juice box at checkout at cozy earth.com and you will save 40% off of your entire order. I

Sarah 2:29
am Sarah, or on Facebook, you'll know me as Sarah vel and the reason I'm giving away my identity right out the gate is because not even my mom calls me Sarah, because there were so many Sarah's born in the like five year time span that I was that it just really didn't make sense to answer to it for most of my youth.

Scott Benner 2:49
What does your mom call you?

Sarah 2:52
Val? Pretty much everyone calls me Val. You

Scott Benner 2:55
want me to call you that I

Sarah 2:56
am. I'm not upset. You can call me Sarah or Belle. I know that you think of me as Sarah. And obviously, people that encounter me online think logically, well, she's got a first name, so I should use it, so

Scott Benner 3:09
at least there's not 1000 Sarah's when somebody's tech, you know, messaging you Sarah Exactly, exactly. Okay, well, I'm gonna see what it comes out of my mouth. What do you think about we'll figure it out. That sounds

Sarah 3:19
great. Maybe it'll be none of these things, or I'll just be known as the April Fool from here on out.

Scott Benner 3:24
So always at the first

Sarah 3:26
it is, Oh, interesting. I was so excited to try and organically get you to say that something in my life happened in the alley behind a Dunkin Donuts, because it cracks me up every time you say that. And today, I got an alert from Dunkin Donuts that they're now being called donuts only, which I feel has to be an April Fool's thing, but I just don't know

Scott Benner 3:50
what's gonna happen. Do people not dunk their donuts anymore?

Sarah 3:55
I mean, if they were going to drop one or other parts of their name, I would think they would go the KFC route and drop the donuts, since they have other things like Dunkin, yeah. Like, I think my app says Dunkin. I don't

Scott Benner 4:10
wanna go too far down this. But donuts didn't used to be like soaked in sugar. They were more like cake. So I get dunking like a cakey donut into coffee, maybe. But I mean, if your donut is pink and purple and has 33 like, sugary things stuck to the top, it probably just melts in your coffee,

Sarah 4:32
yeah, which, I mean, could be, like, a sneaky way to add, I don't know. It was the the OG fancy latte, I don't know, like, listen,

Scott Benner 4:42
I think we're overthinking. I think what actually happened is a over blown group of PR people in a room decided that they needed to do something or they weren't going to be able to keep their job. That's normally what I find happens. No disrespect, I work with a lot of good PR. People with the companies that, you know, the advertising comes through. But there are times that I get on calls and I just, I'm like, why are there seven people here? I'm like, we're talking about an ad for a podcast. There's like, I don't think this many people signed the Declaration of Independence on the first day. Like, what are we doing? Exactly, you know, I think they had to come in slowly to sign it, you know what I mean. And I'm sitting in front of seven people, and they all have like, like, five of them have thoughts, and one of them's clearly the alpha, but not in charge. Then there's the one that's in charge that's more quiet. Then there's two people who don't say goddamn word through the entire thing. And I'm like, what are they even here for? And all I can think is, if you fired four of them, you could give me their money anyway, I don't know what they're doing much, yeah, not nevertheless. So Sarah, you and I live near each other. Is that right? Like, reasonably speaking,

Sarah 5:52
we do? Yeah.

Scott Benner 5:53
Do you think that might be why you like me? Do I remind you of people that you grew up with? No,

Sarah 5:59
because I did not grow up here. I only moved here, like, two and a half years ago.

Scott Benner 6:04
Oh, that goes my whole theory about you online. I just figured that you were like a Philly girl, and I made sense to you. No,

Sarah 6:09
although I think that that my energy very much works on the East Coast like I love it, I love it on the east coast. So I came to college on the East Coast in North Carolina, then I moved back to Denver. I'm from Colorado, like I've lived there a good chunk of my life, but moved out here two and a half years ago, and it's been fantastic, cool.

Scott Benner 6:33
I like you about four inches closer to that microphone. In case you're wondering, you sat back when the dog you sat back when the dog came?

Sarah 6:39
Yes, I actually will also move the mic further back so

Scott Benner 6:42
that, yeah, all right, so how old are you when you're diagnosed three

Sarah 6:46
and a half? Oh, really. And I know, I know that. I think I just heard you talking about, like, how it doesn't really matter if you were the day before three or the day after three, but we all know that toddlers are very into if they're three and a half, or

Scott Benner 7:02
things like that. So at that time, were you very into being three and a half? Probably,

Sarah 7:06
I was. I was probably a pretty textbook three major. So

Scott Benner 7:09
I, by the way, don't care. It's just for the course of storytelling. But when people get lost and, you know, I, you know, it's 1986 and they're like, or was it might have been 87 five, you know, it's because my uncle, he had that haircut. And I'm like, Oh my God, no one cares. Stop. No one's gonna remember. We need a frame of time. It was in the 80s. Keep going,

Sarah 7:35
yes, yeah. So at some point in the mid 80s, I was at some point in the early 80s. So it was March of 81 when I was diagnosed. Nice.

Scott Benner 7:45
So 91 2001 2011 8121 hold on. But I'm counting 91 2001 2011 2021 that's 40. And then three more years. 40? Are you 46 almost 47

Sarah 8:03
I am 46 Yes. Sarah, you

Scott Benner 8:06
look like you're 15. That's why I was thrown off by the counting.

Sarah 8:09
Thank you this. This makes life even better. Wait, you're, you're

Scott Benner 8:13
46 Yeah. Holy crap, good for you. Congratulations. Diabetes keeps you young, doesn't it look at that, something like that? Probably not how that

Sarah 8:24
works. Yeah, I think my body would disagree, but at least my face is is holding up the ruse. So

Scott Benner 8:29
let's give people just a tiny bit of understanding. Are you regular mph when you're diagnosed as a baby? No, I was pork. Oh, wow, you make it that, which

Sarah 8:38
I was highly allergic to good but, but was told this will be a recurring theme in today. But was told, Well, some people just get hives and bumps, and that's what we get, well and obviously, like, it's better than the alternative of like, eat as little as possible and keep moving until you die. Anyway. So well,

Scott Benner 9:01
so Sarah, tell me about this like so even as a baby you got your first injection, you broke out. Or did it not start right away? My daughter is 20 years old. I can't even believe it. She was diagnosed with type one diabetes when she was two, and she put her first insulin pump on when she was four. That insulin pump was an OmniPod, and it's been an OmniPod every day since then. That's 16 straight years of wearing OmniPod. It's been a friend to us, and I believe it could be a friend to you. Omnipod.com/juicebox, whether you get the OmniPod dash or the automation that's available with the OmniPod five, you are going to enjoy tubeless insulin pumping. You're going to be able to jump into a shower or a pool or a bathtub without taking off your pump. That's right, you will not have to disconnect to bathe with an OmniPod. You also won't have to disconnect to play a sport or to do anything where a regular tube pump has to come off. Arden has been wearing an OmniPod for six. 18 years. She knows other people that wear different pumps, and she has never once asked the question, should I be trying a different pump? Never once omnipod.com/juicebox, get a pump that you'll be happy with forever. This is from a listener. Thank you for introducing me to cozy Earth for my birthday, I bought stuff to update my bed, sheets, comforter and a blanket. It honestly made our lives better. My husband and I used to have a conversation in quotes every single morning about who pulled the covers so far to their side, or how we were too hot or too cold. That never happens. Now, both of us sleep better and more comfortably. And don't get me started on the clothes you all should just try one piece. Use the offer code juicebox at checkout@cozyearth.com and you will, in fact, save 40% off of everything you put in that cart. Cozyearth.com use the offer code juice box at checkout. Yep, nope, right away. And they were like, well, at least she's not dead. Keep doing this. Basically,

Sarah 11:04
yeah.

Scott Benner 11:05
How long did that go on for?

Sarah 11:06
It went on until I got on regular NPH, and things were less bad then, but we'll jump way forward, and then we can go back to the 80s if you want, but I figured

Scott Benner 11:22
out, huh, what's less bad? Oh, well. I

Sarah 11:25
mean, like, less aggressive hives and things like that, like a tall I mean, it's all relatively tolerable. But I figured out last year, with the help like this is how I found the podcast that I am still allergic to now an additive that they put into every single sub subcutaneous insulin. It's just like on an allergy scale, if they go from one to five on probably like a three. We had to rule out a lot of other reasons why insulin never really seemed to work in my body the way it was supposed to, and I was very relieved to figure out that it's not something wrong with my body, but just my body reacting the way a lot of people do to this specific additive. Do

Scott Benner 12:10
you know what the additive is? It's called metacrisal.

Sarah 12:12
Okay, M E T, A C R, E, S, o, l,

Scott Benner 12:17
oh, I wasn't ready to Google. M E T, A C, R, E, S, o, l, I got it organic compound with formula. I'm not going to read you the formula. It's colorless, viscous liquid that is used as an intermediate in the production of other chemicals. It is a derivative of phenyl and is an isomer of p cresol and o cresol Interesting.

Sarah 12:46
I my best understanding is it's either a preservative or an antibiotic. So obviously I understand the need for it, but it is problematic. I found a I'm like, a huge science nerd, but I found a journal article and a study from 2015 where they tested four different insulins of varying metacrisal ingredient strengths or whatever, and within five minutes of exposure, even To the insulins, the cells that touched it were either dead or toxic. This is, I think this is why they really encourage it's not the insulin losing efficacy that they tell you to switch out pod site or pump sites every two or three days. I think it's because everybody's system, like those sites being constantly saturated as a reaction. Yeah, that makes sense. It just is much more aggressive.

Scott Benner 13:49
And did you learn about that? Because I did those episodes with people who had insulin allergies.

Sarah 13:54
It's how, it's how I found it. Oh, okay, so I started. We'd been wondering for a few years. I got on a pump first in 2000 end of well, basically 15, and it worked pretty well for a few years. And then the summer of 19, it like I would change sites and get an almost instant occlusion, or it would last, like, a few hours, and then I do a big bolus and occlusion. I mean, tandem sent me three different pumps just in case it was a hardware issue kept happening like it would happen with a brand new pump. So I just gave up on pumping in the summer of 19 but really wanted to try it again, because it helped my control so much. So I was trying to get back on it, and kept having, like the sites would last, like maybe 12 hours, but I would just keep throwing so much insulin at I mean, when I found the group and the podcast, I think. Like, a year ago or 11 months ago, my average daily was, like, in the 250s

Scott Benner 15:07
Okay, yeah, I was

Sarah 15:09
waiting for your eyebrows to fly off your head. So it's, you know, obviously, like, I'm throwing a ton of insulin at things, just to be like, come down, and then even, like, I found the podcast and heard about Prussian catch it, and I was like, Okay, I'm going to try this. Like, let's see what happens. And would just throw insulin, throw insulin, throw insulin. And it either, well, usually, like, the site would be dead within like, 12 to 14 hours, Max. So I think when I came into the group, I think I'd asked in a tandem group about, like, Is this, like, does this kind of thing happen to anybody, or is it possible to be allergic to insulin? Like, we're starting to see some of the symptoms that I have always had on my face, where we started to realize we're kind of like lesser versions of my reaction to known drug allergies. So we know I'm allergic to pork based drugs. Found out again the hard way in 21 in the ICU when they gave me heparin. It's a, I think, a blood thinner to prevent clots when you're lying in a hospital bed. Nobody checked that it is pork based. So I had, like, a terrible allergic reaction to that, and it's very similar to my sulfa based drug allergy reactions. It's just it's lesser. So we're kind of like, wait a minute, like this is kind of, maybe this inflammation is not based on something I'm eating or some other thing, but between the inflammation and, like, my face gets, like, really red and it burns almost from underneath. It's like a sunburn, but from underneath my skin, okay, which I'm now finding out may or may not also be kind of mast cell issue or a histamine issue. I've met some people that have some similar responses that know that they have MCAS. I don't, but I mean, it's possibility. I suppose anyone with an immune system as active as mine might have something along those lines.

Scott Benner 17:20
Has anyone talked to you about, like, one of the injectables for your immune response? No,

Sarah 17:28
like the kind of things that they do for what is the as the anchoving, like the biologics? Yeah, the biological injectable.

Scott Benner 17:37
No, no. Have you thought about it? I

Sarah 17:41
mean, I guess now I have. It had not it had not previously occurred to me trying

Scott Benner 17:47
to think of the name of them right now,

Sarah 17:49
there's, I know, it's like, Humira, and there's, there's, I think four or five of them,

Scott Benner 17:55
yeah, Zoller, zolar, I think is one they use for like, a lot of things like, like, spontaneous eutic area, which is just hives, and right, idiopathic as well. By the way, idiopathic means they don't know how it happens. That's fun, yeah? Like, when they give it a big name to say, I

Sarah 18:12
don't know what's happening, I know, just to make it even more mysterious, yeah? I

Scott Benner 18:16
mean, I just wonder. I don't know if you want to be injecting more things with your luck, it's probably made with pork, but, well,

Sarah 18:22
yeah, who cares? I mean, I kind of, I've taken the stance of, I have, like, I'm open to using my body as a science project, because I know nobody else, liability wise, is going to and they won't do with the same urgency that I want to get to the bottom of things. No,

Scott Benner 18:41
no. If we waited for everybody's timetable, we'd all be dead by the time something happened. Yeah, tell me what is the real world implications of all this like day to day. So

Sarah 18:52
I figured out last year that it is possible to be allergic to insulin. So and I found four studies, and I think at least one. I think Sasha Sacha the first guest on your allergic insulin, like the one with a really bad allergy, the girl from Canada, thank yeah, thank goodness. My allergy is not anything like that, because I can't imagine, yeah, like mine is tolerable. It just like, things don't work the way that they're expected to. I figured out that it seemed to be better for my body to do kind of a slow drip, basal only for that. I figured out this is earlier than I expected we'd talk about this, but like, Thank goodness for the podcast, because the pre bolusing episode was instrumental for me, not in the same sense as it is for everybody else, but because when I was first like, okay, like, I want to see how long it takes the arrow to start moving, I realized with Novolog in my pump, it. Takes between 90 and 120 minutes, like an hour and a half to two hours. So i i inflame so quickly at pump sites or injection sites even that I just don't absorb. And for as long as I can remember, I've been told like, well, you just have really bad absorption, like you're just going to have to deal with it. Nobody ever talked to me about the timing of the absorption, like, what a wrench that was throwing into the works. And they also told me, you know, diabetics scar badly. We expect to see that, but you scar worse than any diabetic I've ever seen, just as far as our tissue building up and injection sites, things like that. So it was, it was funny. I was telling a friend I did something the other day where they were like, measuring every part of me. And the lady was like, you know, it's kind of funny. She was like, one of your arms is, like, remarkably bigger around than the other. And I was like, I bet it's my left and she's like, it is. How did you know? And I was like, I am allergic to insulin, and I'm right hand. Well, not even allergic, but I'm right handed. Any injections I did in my arm could only be left. Like I wasn't going to experiment with being a lefty to give myself a shot. I'm

Scott Benner 21:17
trying to figure out if I could do with my right arm into my right my right hand and my right arm.

Sarah 21:21
Anyone who can't see what's happening right now, Scott is trying, I look

Scott Benner 21:25
like a bird trying to fly for the first time. Yeah, yeah. And you don't think you could have injected left handed Well,

Sarah 21:33
I mean, you could. I started doing my own shots when I was five. I wasn't really gonna, like, No,

Scott Benner 21:39
I'm saying there's a way you could do it, but you might just have been trained. To do it the way you were doing at that point. Well,

Sarah 21:45
yeah. And I think it didn't really occur to me that, like it wasn't that big of a deal to me, yeah, so, but I haven't done an arm injection. Can

Scott Benner 21:53
you imagine if everybody had to think about

Sarah 21:55
that? Yeah.

Scott Benner 21:58
So you basically have, like bowlers arm you like, you have just or like a pitcher you have, like, stronger. Even my son played baseball the right side of his body was stronger than left side of his body.

Sarah 22:08
Well, I'm sure, yeah, so it's not even, it's not even strength for me, it's, it's my left arm. I haven't done an arm injection in probably 10 years. It is still one inch more in circumference, like around than my right. Do

Scott Benner 22:24
you think you're just inflamed in general? This episode of The juicebox podcast is sponsored by Eversense, and Eversense is the implantable CGM that lasts six months ever since cgm.com/juicebox, have you ever been running out the door and knocked your C jam off, or had somewhere to be and realized that your adhesive was about to fall off? That won't happen with Eversense 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 Eversense CGM has a silicon based adhesive forge 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 Eversense, 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/juicebox links in the show notes. Links at juicebox podcast.com, I mean, yes, do you have trouble losing weight when you want to

Sarah 23:55
Yes, let me say my thing, and then you say your thing, because I can't wait to hear what you have to say. Okay, good. I started thinking last night, like I've put on a ton of weight in the last eight or nine months, 2000

Scott Benner 24:08
pounds. I'm just kidding. No,

Sarah 24:11
not an actual thumb. I'm carrying like 50 extra pounds right now, and probably 30 of them came in the last eight to 10 months, which lines up with when I started pumping again. And I am starting to wonder if this full body inflammation is my body's response to the basal insulin, like that constant supply. So I'm starting to think as much as I like love and really feel like I depend on being able to manipulate basal. Now that I understand how to do that, I might try a traceba, just to see how that works. If like any of this will move the other reason I. Feel like I have a lot of trouble losing weight and come up now or later, but it's, it's related to my Addison's. So okay, and not the steroids or not directly, the steroids

Scott Benner 25:10
and not the doctor from Grey's Anatomy, either. No Addison Montgomery, never mind. I only,

Sarah 25:16
I only think of her as Addy. So

Scott Benner 25:21
tell me about the Addison's now, Addison's,

Sarah 25:24
I think, well, maybe the easiest way to get into Addison's, well, Addison's was diagnosed finally in 2011 I've been severely symptomatic for two to three years leading into that which was extra frustrating because I'd been in a study for like, a decade, like they knew I would get Addison's. It was a when and not an if, or a most likely when. And they were, you know, every time I went to clinic, they would draw an extra vial to send upstairs to the doctor who was doing this study to test for Addison's related things. So they missed that coming on somehow, really, really awful for two and a half to three years in looking back at it now,

Scott Benner 26:18
oh, go ahead. Val context, really awful. What? What was awful?

Sarah 26:21
So exhausted, like fatigue, does not begin to describe I call it soul level exhausted, like would sleep for 16 hours a day, sleep as late as I possibly could in the morning before, like peeling myself out of bed to get to work, but then leaving myself enough time on the way to work to pull over in this park that was about five minutes away from my office, and it's only a 12 minute commute, so it should not have been this difficult, but to pull over in this little park and to vomit three to five mornings a Week every day for two plus years, and like, so dizzy that I didn't know what to do with myself, and then I would come home from work and fall asleep and peel myself up off my futon like at least once to let my dog outside, and then, like, fall back into bed and repeat the whole thing the next Day. For me, those were the most noticeable symptoms. Now, knowing what all Addison's and low cortisol symptoms are like, I suspect that a lot of the freakishly low blood sugar events that I had during those times were much more cortisol related than insulin or diabetes related.

Scott Benner 27:40
Yeah, tell me what you what do you notice between cortisol and blood sugar?

Unknown Speaker 27:44
So

Sarah 27:45
cortisol first. Anyone who's listening to this like, please listen to episode 649, cuatro immune with Christina. It like, literally saved my life when I found it. Christina does a spectacular job explaining the relationship between cortisol and blood sugar, but really, cortisol and insulin are the body's system for managing blood sugar. It's not cortisol or it's not insulin and glucose. Cortisol helps our bodies know when to release glucose. It triggers the liver to release glucagon, to release stored glucose. It also helps to metabolize carbs or anything else to achieve blood sugar, to be able to get into your systems when there's too much insulin on board, either as a non diabetic human, or as someone who's taken too much insulin, or not eaten enough, or whatever set of variables may line up. I have gotten my diabetes now in the last year to the point where insulin is incredibly predictable. Yay. For the first time in my life, insulin and diabetes are predictable. So I now know that if my blood sugar is low, it is a cortisol low. Took me a little bit to realize that, but I didn't know until a year ago that the reason sometimes I would drink what felt like a whole liter of juice and my blood sugar wouldn't get above 50 is because my body didn't have the green light to be able to process it. So

Scott Benner 29:28
it's crazy bomb. Why would you be vomiting in the morning? Do you like, functionally understand that that's

Sarah 29:34
an that's an adrenal crisis. Okay, so and I basically, I've started calling it a muted crisis. Basically, my thyroid was so absentee during this time that it like slowed down everything enough that I didn't wind up in the hospital or dead. That's how most, most people are diagnosed, kind of like Christina was or in the hospital. Yeah. With Addison's, like, it's very rare for people to catch it without some kind of catastrophic event, which is so

Scott Benner 30:07
frustrating. Yeah, and to button this up for context, once you find out you have Addison's, how does it, how is it managed?

Sarah 30:15
So I take steroids daily to replace the cortisol. It is not the nightmare that most diabetics think of when they think of steroids, because when you're at the proper replacement dose, it just keeps your blood sugar level. It doesn't shoot you sky high. So the reason that that diabetics get high blood sugars when they take steroids is because the steroids are called glucocorticoids, like the people forget about the glucose part of that. Its purpose is to create blood sugar and to create insulin resistance, because in fight or flight days, it would not help you to have a bunch of insulin being super sensitive in your body and to not have enough blood sugar or actual energy to run from a bear or a saber tooth tiger or whatever thing was happening. So the reason that either, if I'm over replaced, my blood sugars will get high, regular diabetics without adrenal issues will have that is because that's their whole job is to create blood sugar and insulin resistance. I

Scott Benner 31:24
would run from a raccoon with the same ferocity as a bear. I just want everybody to know that you don't have to go to saber tooth tiger to get me upset and get me running the other direction. I'd be like, That thing,

Sarah 31:33
trash pandas. The trash pandas strike fear into your heart. I

Scott Benner 31:36
gotta go like, for sure. Oh my god. So Sarah, Have I ever told the story of the raccoon that jumped on Arden's car? You

Sarah 31:44
have not or not in, not in any episodes that I've heard, at least, just

Scott Benner 31:48
coming down the road we live on, and it gets a little windy at one point, a big curve, a lot of trees, you kind of have to slow down, you know? You can't go through it too quickly. So she was driving my wife's car, and she's coming through there. There was a raccoon on a trash can. And she looked over and she's like, Oh my God, there's a raccoon. And as she thought that the raccoon jumped onto the moving cars hood. That's all. That's the whole story. I just love it.

Sarah 32:14
Omnipodsi Raccoon would maybe, like, maybe there's a greater were you like, would you have run from a raccoon before this,

Scott Benner 32:21
I don't know, but you might have just named the episode kamikaze raccoon. Yes, good job. Because before I was like, metacryl allergy, that's boring,

Sarah 32:32
super boring. I'm way more fun than that. Like, please,

Scott Benner 32:39
fantastic. What do you do for a living?

Sarah 32:41
My main job is I am a tax attorney. Which I make sound or I make way more fun than it sounds. I for a long well, maybe this will tie back into the Addison's a little bit, at least. So Addison's is, you don't make cortisol your body physically cannot handle stress, physical, emotional, mental, any of the things my job at the time I was in onset and diagnosed, was negotiating against the IRS or the state or city taxing people or businesses or people that fall behind with their taxes, not like Surgery, where a bad day means that somebody dies. But a bad day could mean somebody's bank account gets cleaned out and they can't pay their employees or keep the lights on, or any of the things and love like love, love, love, the work I still do things in that vein, just not as much anymore. But the worst part of it was the industry of tax resolution is completely based on make these people that owe the scariest people on the planet, aside from the mob, make them pay our company for you to work for them, and if they won't, you threaten them with withdrawing your power of attorney and, like, leaving them hanging in the wind and given monthly quotas to like, like, twist the arms of these people who I then get to know on the phone every day, see their financial statements, but management's just like, just hit Your number

Scott Benner 34:18
so you're the heavy in this scenario, pushing people? No,

Sarah 34:23
no, no, I was not in management. I'm the one being told, like, get them to pay you,

Scott Benner 34:29
but how do you get them to pay you? It's collections. No, no,

Sarah 34:32
it's not collections. Because I'm not the IRS, okay? I'm effectively the private defense attorney to the IRS being the prosecutor. Okay,

Scott Benner 34:42
hey, you said the scariest people are the mob. Who the next scariest people? Well,

Sarah 34:47
I mean, I think a lot of people are pretty scared of the IRS, or, like, the state tax people or whatnot. Yeah, wow.

Scott Benner 34:54
So, so anyway, you've got this job with, like, a lot of right? Like, a lot

Sarah 34:58
of stress well, and I literally. Would go in every day and not know if I would still have a job at lunch or at the end of the day, like they fired people willy nilly for not making quotas, or just because it was a day that ended in why? Like, yes, gotcha, but especially for not making quotas. And my personality was, I'm going to do the like, I'm not going to be a jukebox for these people. Like, if the money runs out, I'm not just going to stop helping them. Like I I am a helper. Like, lots of write ups and screaming sessions and screaming voicemails left on my work phone from owners about, like, Get your together, or get out, or, you know, Quit letting these people free ride. And

Scott Benner 35:45
does the Addison's make that job more or less difficult?

Sarah 35:48
Put me in the ICU four times after

Scott Benner 35:52
I was diagnosed. What's the process that that happened when

Sarah 35:56
your body can't handle that much stress? Basically, your organs start to shut down. For me, I know when I'm going into adrenal crisis, when the vomiting isn't just once, like I was vomiting just once on the way to work, maybe twice, like in a row, if I start vomiting now I know that it doesn't stop until I'm in the hospital with IV steroids and IV Zofran. So I mean, basically your your organs start shutting down. There's also, like some really intense electrolyte imbalances involved with Addison's, and I seem to have an even more aggressive form of it. So I trend to super high potassium levels when I'm in crisis? Yes,

Scott Benner 36:41
Sarah, does anyone in your family have these issues?

Sarah 36:45
Here we are where I thought we'd be at the beginning of the podcast.

Scott Benner 36:49
Now John Travolta is alive again. He's on the toilet, that's all

Sarah 36:53
so I am the Medical carbon copy of my dad. He was type one diagnosed when he was 13, he diagnosed me, well, I guess, unofficially, but and then Addison's when he was 18, hypothyroid at some point in there, he is why I was in that study to see when Addison's what happened, because they knew I had the antibodies, and they knew that I was his carbon copy, basically, yeah,

Scott Benner 37:21
wow. I hate that for everybody, because it feels like, once you know, once you see it somewhere, you think it's probably coming, you know, and you just gotta Yes, yes

Sarah 37:33
and no, I think I never really, I think the study didn't start like, they never told me, like, Addison's will, for sure be a thing until I was probably in my must have been when I was in my 20s. Okay, my dad died when I was 18. How old was he? Then? He was about to turn 51 so he was 50. He died of a heart attack, massive. Well, we thought so. Okay, I actually got my mom to send me his autopsy last night, because I've had a theory for a while now that it wasn't actually a traditional heart attack or a heart attack because of severely blocked arteries, like kind of what we think of as the heart attack, but the the autopsy says that there was no definite evidence of an infarction. So the the myocardial infarction is the like, that's what Bailey had on Grey's like, that's, that's the heart attack, right? But instead that it was, gosh, I don't remember all of the words right now, but basically it was an issue with cardiac insufficiency, so his muscles, his heart, wasn't pumping enough blood, right? Are you ready for me to make it like real full circle, right? Now, go ahead. So when I am having an Addisonian issue, not always in crisis, but most of these have been in crisis. My potassium gets super high. Like, I think the normal, like, top edge of normal on most labs is 5.1 or 5.2 I have found out several times when I am above seven, my legs become temporarily paralyzed, like they become so weak that I can, like, flex in your chair right now, if you were going to stand up, I feel how, like you flex your quads. Yeah, you can feel everything flex, and then you stand up, right, right? So I can flex, but I don't, like, I'm physically unable. You don't go,

Scott Benner 39:43
how long does that last for?

Sarah 39:45
It lasts until I get to the ER and they pump me full of insulin. Helps to reduce potassium, because potassium and the blood attaches to blood sugar. So when insulin moves blood sugar. Sugar into the cells. It takes potassium in with it, lets sodium back out of the cells. I don't think anybody really understands how important electrolyte balance is, because it is normal for most people, steroids, one of my steroids, helps to suppress potassium, and I recently found out that also thyroxins can help to suppress potassium. So I don't really know what my levels would be like if I didn't take all three of those peds daily. Oh

Scott Benner 40:30
yeah, yeah. And what's the relationship between your heart and the potassium? Potassium

Sarah 40:35
is what helps your muscles to be able to flex or not flex, I think. And have thought for a little what like within the last year, since I started figuring out all of this potassium stuff, for me, I have been thinking that my dad's death was he had, like, just a flood of potassium in a system, and it was so much that it also paralyzed or severely weakened his heart. Okay, so the first time I went to the hospital for the leg paralysis thing, because it happened at least once before that, when I was in the airport. And thank goodness, I don't know, like, I think I just had figured out, like, oh, when this happens, I just have to chug a bunch of water. It's usually when my blood sugar's really high. Okay, so in the airport, it resolved itself enough that I could get on the plane. The next time it happened, my friends were able I was, like, meeting with a bunch of friends. They were able to, like, slide me into a wheelchair at the building where we were meeting that happened to be there, get me out to a car, get me to the ER, they are, like, freaking out in the ER, I think it's just like, I didn't really know I'm, like, cracking pasta puns. And they are, they are transferring me to the ICU, which I figure, I mean, it's standard, because if you have to get admitted as a diabetic, they put you in the ICU, right? Like, that's, that's just what has always happened for me, I think, because of the insulin drip, right? So they're like, Yeah, we're putting you in the ICU. And I'm like, You guys always do this, like, can you just, like, my legs are better now. Can I just go? And they're like, No, you're going to the ICU. And they told me when I was ready to get out of the ICU and be discharged, buddy, you can't be this close to the mic. Everybody's going to think both of us are heavy breathers. They were like, We have been in the hallway with the crash cart this entire time waiting for your heart to stop, because that's what happens when potassium gets this high. So I learned that night that potassium is the lethal part of lethal injection. Oh, really, because it stops, stops your heart.

Scott Benner 42:48
We're killing people with banana extract.

Sarah 42:50
Is that crazy? Yep, too much or too little, potassium will stop your heart.

Scott Benner 42:55
I'll tell you what. You're a party, calling your mom and asking for your dad's autopsy. Yeah, she must have been like, Hi, honey, what's up? You're like, Oh, no. I

Sarah 43:03
mean, she like, I don't know, March is the anniversary of when he died, so we tend to, like, all think of talk about him a little more, yeah, yeah. So, and it's been 28 years now, so it's a little bit more removed. And leading up to this obviously, like, I've been peppering her with questions about all sorts of things, just because I'm like, oh, like, I mean, when you're three, when you're diagnosed with diabetes, like you don't really remember any of it. Well,

Scott Benner 43:32
I don't, I don't know how much our parents remember either, because I don't know how much I remember at this point. By the way, potassium chloride to potassium salt, which increases the blood and cardiac concentration of potassium to stop the heart be an abnormal heartbeat, and thus cause death by cardiac arrest. That's the the lethal injection definition about that. All right,

Sarah 43:53
so since then, I think I've been to the ER, five or six times with potassium issues. The worst was in 21 it got so bad that my legs were gone, but then also my arms were starting to go, and it was getting really like and then my neck and it was getting really hard to breathe. So I think now being further removed from it, it was probably my diaphragm was starting to go,

Scott Benner 44:25
Yeah, no kidding. That's where the pasta joke comes from, right? Like, you can't, that's what you were saying.

Sarah 44:30
No, that was like, that was way, way before then you meant like your limbs were like, noodles. No, I mean it just like I my, my policy when I'm in the ER, especially, or in the hospital at all, is to just be like, the nice, funny patient that people want to come back and check on if they have, like, a gap in therapy.

Scott Benner 44:53
Remember me. Please, please remember me. Or just like, Hey,

Sarah 44:57
she's funny, or like, she's really nice, and like, Thank. Thanks us when we go in there, rather than yelling us at you know about things, like, I just am and plus, like, I know that they get so much of that otherwise, I'm like, I'm here regardless, I might as well be a good human about it. Like, you're

Scott Benner 45:12
like, you wanted them out in the hallway, thinking, let's save this Val check. Like, if there's two people to save and we only have enough time for one, let's go get her. There's two code blues, like, let's be here. That girl was funny. Let's go this way. Okay, yeah. I don't know if that works or

Sarah 45:28
not, but it might. I'm gonna be like, No, they were mostly just like, you are, like, we're literally waiting for your heart to stop and to restart it, and you're in here, like, making jokes, like nothing is happening. Yeah? Wow, yeah. So my potassium when, like, everything was going was at 9.2 and in talking to any medical professional, it's usually kind of entertaining to see their faces when that happens. Because, I mean, eyebrows gone, yeah? Because they're all like I have never spoken to anyone who has been at that level and is still alive. So I I don't know why I keep surviving this outside of in the last year, I've gotten really involved in type one communities, Addison's communities, and then there's a condition called either it's basically potassium related periodic paralysis. Most of like the primary version of that, is all genetic. It's a genetic condition. So I know that I don't have that. I have some version of secondary periodic paralysis, but being able to make connections between all of those, like the people in the too high potassium paralysis group, are told, like, eat a high carb diet, and it's I was able to connect the dots for them. This is why, when your blood sugar goes up, your body releases insulin, and that moves the carbs, blood sugar and the potassium back out of your blood, and they're like, Oh my gosh. Like, see, nobody ever understood why this was a thing. We just did it because it works. I

Scott Benner 47:11
was getting ready to say, I wonder if a GLP wouldn't help you with weight, and then have you using less insulin too, and then you wouldn't have so much with the allergic reaction with the insulin. But every

Sarah 47:23
time I hear your zebound or we go via weight loss diaries, I'm so tempted. I think the issues are twofold for me, the biggest being because, as I understand it, part of the job is to change or to slow down metabolism in the stomach, right? It slows digestion. So I think that that will mess with my steroids, because they're pills. I mean, it is possible to pump cortisol, I just am not ready to wear two pumps.

Scott Benner 47:55
So it's a little pill, right?

Sarah 47:59
I mean, it's a little pill, but it's my day supply of this life giving substance.

Scott Benner 48:04
So is it down there being digested very slowly?

Sarah 48:08
I mean, not currently, you know. I mean,

Scott Benner 48:10
like, does it go and it's just absorbed and then you have it for the day? I think I would check on that, because I listen, let's be clear about two things. I'm a fcking idiot, and I don't know what I'm talking about. Okay, I don't think that a GLP would slow down the absorption of your steroid pill, but if I'm wrong, I'm wrong, but I would ask,

Sarah 48:27
I know that people with like I know that Christina from that episode 649, she also has Addison's a type one. She also has gastroparesis, which I know is an aggressive like, it would be an aggressive side effect of a GLP, if she has had to start pumping cortisol because she, like, was not absorbing her her oral meds anymore. Yeah, so I just don't know. The other reason I'm concerned about it is because Addison's causes low appetite. Like, I just, I don't really have an appetite right now. I also was recently diagnosed with ADHD, which the diagnosis was a blessing, because, like, every system in my body that might have an effect on emotional regulation kind of exploded at the end of last year, beginning of this year, leading to, like, a bunch of mental health health crises and like all sorts of things, like, almost check myself into a facility one weekend. So, like, the diagnosis is so helpful, because I know what's happening, but right now I need to be on meds, and it is a massive appetite suppressant, so I'm, like, having to force myself to eat anyway, yeah, most of the time, yes. So

Scott Benner 49:42
GLP agonists may slow down the absorption of certain orally administered medications. So you got to figure out if that's one of them that's going to be touched by it. But the hunger thing is different, because I had like a project around the house this weekend. Yesterday was Easter, so I had. Yeah, I'm gonna tell you everything I ate yesterday because I was really busy. I had four Marshmallow Peeps. I had them in the microwave. No, I like them stale, so the person who left them out for me opened the plastic the night before. So then you're

Sarah 50:13
gonna go HAM at the stores on the 50% off sales today. I

Scott Benner 50:16
love you. Just open the package and let the air get to it for 24 hours before you eat them. I had four Swedish fish before I said to my wife, I don't think Swedish Fish are a thing I can eat anymore on GLP meds, because they make it feels kind of heavy, interesting. I had a glass of water, and then I worked like all day. I just didn't eat. And then at like, six o'clock, my son's like, can I eat something? And I was like, Oh, I see what he's saying. He's saying, will you make me food? So I had a baked potato and a steak, like a, I think it was a New York strip steak for dinner. I couldn't finish the potato. I ate most of the steak, and that's all I ate yesterday. And I don't think I was ever hungry once yesterday. So that is what GLP will like, yeah, do now

Sarah 51:08
well, and I already have that two fold between the Addison's and the Yeah, I

Scott Benner 51:14
don't know what was happening. I mean, maybe it couldn't get worse, you know what? I mean, I'm not sure. Yeah, it's tough, because the the

Sarah 51:21
other interesting thing with Addison's is, annoyingly, that loss of appetite is a sign of low cortisol, and it is also fasting is a cortisol drain, like your body, like should be pumping out more blood sugar to give you literal energy To live when you haven't eaten in a long time. This is why we see Dawn phenomenon, because it's to break the fast, right? So,

Scott Benner 51:49
so maybe this would be counterintuitive to you. It's possible, it's possible, it wouldn't work at all. I

Sarah 51:56
don't know. I like, mull it over all the time, but especially every time you air a new episode, because I'm like, Oh, I'm so tempted every time I hear all

Scott Benner 52:04
I can tell you is, I was active this weekend and busy, so I ate less. I am two pounds lighter this morning than I was on Friday. Like, I mean, and I feel better and better every day, like, but it's just I'm not dealing with, obviously, all the other things that you're doing. Yeah,

Sarah 52:21
that's crazy. No, it's always interesting to think about.

Scott Benner 52:25
Let's talk about your diabetes here at the end. Okay, in your note, you said that you've, in the past, had upwards of a 14, A, 1c, how long ago was that? That was

Sarah 52:38
at some point in the 90s, I think it was like nine or 10 years after I was diagnosed. Okay, so, I mean, it wasn't like I was because I wasn't diagnosed in DKA, like my dad had noticed over a few days, like, I started wetting the bed again, which had not been a thing for a while. Super thirsty, super hungry, really extra, like, cranky all the time. And so they started like, lining up Little Dixie cups of urine and using the test strips, because that was the thing in 1981 like there was no at home blood meters for regular people, at least. And so that was what like he, I think he was taking me to preschool one day, and, like, I was extra feisty about something, and probably either, like, really wanting more water or something. And he like, turned the car around and was like, let's start, like, testing. Like, I think this is diabetes, yeah. So they figured that out. So I wasn't in DKA when I was diagnosed.

Scott Benner 53:44
How was his management? Do you think it

Sarah 53:46
was as good as it could have been at the time with the tools that that he had available? So he was diagnosed when he was 13, so that would have been sometime in 58 Wow. I mean, he was on either bovine or pork insulin up until, like, the same time that that he and I both

Scott Benner 54:06
switched. Did he have any of the allergic stuff with it, too? Not

Sarah 54:10
that I know of, okay, but I mean, my allergy, like, it's not aggressive enough that anybody would have ever, like, I didn't even know it would could be a thing. Like, it's, it's, it's not, it's not like immediate open sores at injection sites like the girl from Canada or things like that.

Scott Benner 54:27
So there would have been maybe no way for them to put that together back then when, yeah, if you had that problem. Okay, so through your life, let's break it up into sections. Do you know what your a one C's were like from three to 15 years old.

Sarah 54:40
I mean, I think I was just looking back as far as I could find records of and I think, like, more often than not, it was between like nine and 13 most of the time, some some eights. When I was in college, what do you attribute that to? Well, probably high school and college, I played volleyball, okay, all through like, from when I was 12, played year round, like club school, whatever I could do, from when I was 12 all the way through college. I see played for my college team. Don't remember testing my blood sugar, really ever during college, like, did a lot of treatment based on how I was feeling, which we all know is basically never accurate.

Scott Benner 55:30
If you're always 250 for example, and you or higher, and you throw in some exercise, you're not probably still getting low all that often. No, yeah,

Sarah 55:40
no, I don't think, but I I would feel like I was getting low, because at a normal, like, dropping so much so then I would still, like, chug up. Like, I would like, stop and practice occasionally, and like, chug a thing of juice, and then, like, get back in. But I was probably like, just to get me from 150 back to 250 where my body felt okay, yeah, that's what I

Scott Benner 56:00
was gonna say. Your body's so used to that higher blood sugar. You're probably you're probably treating a low feeling to get yourself from being at a number that I mean, at this point, you wouldn't be okay being at absolutely

Sarah 56:10
terrified of lows, because I had seen my dad have so many seizures through my childhood, and I'd had a few myself, like that, alternative was not an option. Yeah, I think also that probably a good chunk of my dad's seizures and lows were Addison's based, rather than diabetes. Okay, okay, but nobody, I mean, even, like, I learned about this cortisol blood sugar connection from the podcast and from Addison's groups on Facebook in 42 years at that point of being type one or 12 years of having Addison's no doctor has ever mentioned it to me.

Scott Benner 56:56
Wow. So you have genuine information that's helped you about Addison's and insulin allergies from the podcast. Yes, oh, well, I didn't realize that I

Sarah 57:09
will unabashedly credit the the podcast and the group and the like inspiration to join other communities on Facebook. I will unabashedly attribute that to saving my life? Oh, well. And I, like before, until last year, was just pretty sure that, because I'm the Medical carbon copy of my dad, right, that that my fate was also to die of a heart attack around age 50.

Scott Benner 57:37
Yeah, it's the only thing I haven't asked you yet that's on my list here, of as Yeah, you think, you think you're in at the end,

Sarah 57:43
you tell me your schedule is much more. No,

Scott Benner 57:47
not the end of the podcast, the end of your life. Not

Sarah 57:50
anymore so. But until, until, until last year, I was really, like, just kind of resigned to this is, I mean, it was, like, a very aggressive version of, well, that's just diabetes, right? Like nobody ever said, like my doctors would say, like, Okay, well, let's aim to get you into the single digits next time. But no concrete ideas about how to do that. Do

Scott Benner 58:17
you imagine if you went to a money manager and they were like, Hey, let's focus on making you a millionaire. Next time I see you, get out of here. Now, you silly kid? Yeah, going. How would I do that? Sir, anybody? No,

Sarah 58:31
like, a suggestion, at least, like, point me in a direction. You want to whisper a stock name right here, doing, like, the, the weird thing where you blindfold me and have me spin around a bat and then try to get, like, I

Scott Benner 58:42
just, I find that the most fascinating thing, like, Let's get your a 1c down. How are we gonna do that? No mention of that wall. Yeah, yeah. Well, what a great idea. I also should be taller, works,

Sarah 58:52
works, works for me. Like any, any ideas, like anything, it's fascinating. It's, well, I'm just, you know, constantly having the idea that it was all something wrong with me versus so it's really hopeful. Now I still am in touch with one of the nurse educators who's also type one at my old clinic, and I texted her in October when I got my first ever six Well, a 6.1 but like, first time in my life I'd been in the sixes nice for a one C's yay podcast. And told her about figuring out the allergy and that I was doing pump basal and then bolusing only with a Fresa because it does not have any additives. Nice so. And she was like, Oh my gosh, this is like, Can I share this with your Endo? And I was like, please. And she's like, we have a patient that we're pretty sure has a really, like, a pretty bad insulin allergy. And I like, want to see if this might be an option. And please, let this help somebody else. How

Scott Benner 59:55
come you don't do that? Are you just strictly a fresn and. Is an a basal. At this point

Sarah 1:00:01
I only bolus with a Fresa. So when I the podcast episode 530 is about tunneling and leaking. And so I was like, oh, like, maybe this is part of why. Like, maybe the tunneling is why my sights go bad so quickly. Then I started experimenting with, like, how big, I think, in the in the episode, it says, like, sometimes it can be, like, in the neighborhood of five units bolus, where people start to see problems with, like, putting in that much insulin at once, right? So I was like, okay, like, I'm gonna see what happens. And, you know, tried at five, tried at four, and it would still like, within five to 10 minutes, like the site would be pretty much done. So then the next time, so I got down to figuring out that my body can deal with a bolus of point eight units at a time, even if I go up to one unit, I can literally feel it itching underneath my skin. It's not like a skin, like I feel it underneath my skin. It's itching. And then not long after the site is gone.

Scott Benner 1:01:15
Did you ever try fiasper loomjev? I use loom

Sarah 1:01:19
JEV in my pump right now, okay, it takes, it's about a 45 minute delay, like, it takes me about 45 minutes to see the effects of a temp basal increase or a decrease, like, if it cuts it off or low. So I right now, I got really lucky, because I got my new basal IQ pump on the last day when basal IQ was an option from tandem. I did not know that at the time, but I knew that I needed to get back on basal IQ because control IQ, my delay with insulin is too much. Where even in like sleep mode, where it increases the basal to deal with highs, I would see that affect, like 45 minutes later, but I'd already bolus with the fressa, so then it would bottom me out and cutting off the insulin still only, like saves me with a cortisol low, because where I keep staying low, because it takes about 45 minutes for The absence of insulin to start showing our eyes. It's fascinating

Scott Benner 1:02:23
that you have multiple things trying to kill you, and those things are also fighting with each other. That's yeah,

Sarah 1:02:30
yeah. Well, and, and they're the things that keep me alive, right at the same time.

Scott Benner 1:02:36
Jesus, Are you tired from all this? I mean, mentally, yes, but I

Sarah 1:02:43
don't have an alternative. So

Scott Benner 1:02:45
just what it is, are you married? Do you have kids? Do you have any of that stuff going on?

Sarah 1:02:49
Not married? I would have loved to be a mom. I was told through my 20s and 30s, especially after the Addison's diagnosis, that getting pregnant would basically be a death sentence for me and or baby. I have, since in the last year, met multiple people online with both who have had numerous successful pregnancies. I think, really, my doctors didn't, they just didn't know what to do with me. Yeah, so it was easier, easier to say like, to scare me, to ever think about having a baby instead of being like, Okay, well, let's figure this out. You think

Scott Benner 1:03:27
having been told that about children stopped or changed the way you dated?

Sarah 1:03:31
No, although I like, am grateful that I don't have children with any of my exes from those points in my life, like it would be terrible to be tied to most of them for a period of years. It recently, it led to a breakup within the last couple of months because the guy I was dating, I think now, even if I did get pregnant, I don't know that I physically have the energy and steroid reserve, basically, to be able to to, like, raise an infant, much less a whole child. And although I don't feel like the end is within the next five years for me, I am still fairly confident that my end will be earlier than a lot of people's, unless we can figure out this potassium thing, because sometimes it happens outside of crisis, and I don't know why that is, I'm incredibly lucky to have made it through all of the times that I should have died. But I'm not really trying to test like, how many more that may be? Yeah,

Scott Benner 1:04:43
no kidding. So here's a question, do you feel like you have a medical team that's helping you get to this answer? Or, Yeah, are you literally just picking through the internet and listening to other people

Sarah 1:04:53
picking through the internet? My current endo is helpful only. And that he will write whatever prescriptions I tell him to write. But that also comes down to I am literally figuring out what my dosages should be on your own, completely like for for things like t4 and t3 meds, and when you have too much thyroid on board, and it burns through your cortisol super fast and puts you straight into crisis. Found that out in November when he medicated me into crisis. So I figure out my doses now, but I like, I should not be the one figuring out these kinds of things. Yeah, like, I feel like I've done an endocrine residency in the last four years, but I have zero certificates to put on the wall. Like nobody else should listen to me. But yeah, I don't really have a team right now. I am probably moving back to Denver, like, by the time this airs, we probably won't live near each other. Why? Well, because I moved out here for the guy,

Unknown Speaker 1:06:00
this boy, I know. No, no.

Sarah 1:06:02
I mean, I did the breakup. Scott, like, Please, please. No. I

Scott Benner 1:06:06
mean, the relationship, I know how they end. I'm just saying that guys cheat or women break up with you. That's how relationships well. And

Sarah 1:06:15
it's just, you know, he, he's a lot younger than me, and wants to have kids, and it's not fair for me to have him choose no kids to be with me, especially when I don't know how I feel about maybe signing a kid up to lose a parent early, like I did, because I know that pain. Do you ever

Scott Benner 1:06:38
think about not wanting a kid to maybe have Addison's or diabetes? Oh,

Sarah 1:06:43
I mean, obviously, yes, okay, I think right now, the the bigger thing for me, I think honestly, like, between, like, how the last year has been, and like, with the way that I know that things are going, and with tools like the podcast, like, let me keep the diabetes, like, I like whatever, and if, if a kid had diabetes, I would deal with it. Okay, Addison's is more of a challenge, but I'm figuring out a lot of that now. The bigger hesitation is getting through this thing in my head of like, not wanting to sign a kid up to lose a parent at a young age. Yeah.

Scott Benner 1:07:19
Well, let's finish a little bit with, um, with that, because you're, I mean, you're 46 and your dad passed when he was 50, but that's a number of years ago now, right, yeah, but it's still very effective, impactful to you. I can tell when you're talking about it, like, yeah, yeah. So you're still upset that that, that he's gone well, I mean, yeah, yeah. I mean, I don't know, like, I'm adopted, and my dad didn't live with me for a while, and he's been dead for a while, and I'm not that upset about it. So I think,

Sarah 1:07:49
like, in addition to being the medical, like, I'm very similar to my dad and personality, and like, he was, like, he was a lawyer, like, like, to help people didn't always accept, like, tangible money and as payment from them, like he found a way to make it work for like, a lot of those things carried through, right? And I was like, Absolutely, a daddy's girl, until I wasn't. So

Scott Benner 1:08:15
I see no. I mean, so how about your mom? Did she remarry? She

Sarah 1:08:18
has and it's sorry mom, like, I know she will listen to this. It's sometimes it's really sad, because even her current husband acknowledges, like, I will never be like Ken, like they all kind of know that he's, he's the the runner up.

Scott Benner 1:08:38
Your dad was a good guy, great guy, yeah? And that's not just you,

Sarah 1:08:42
like, no, like, universally acknowledged as a great guy, yeah.

Scott Benner 1:08:47
Well, I'm sorry that sucks. If he was a dick, you wouldn't even miss him. That'd be maybe, maybe, did you disservice by being such a good person? No,

Sarah 1:08:54
no, he was, yeah, probably not, probably not. But, you know, it's perspective is everything. So maybe I'll think about, like, oh, like, if only he hadn't been such a good guy. Damn it. Is

Scott Benner 1:09:05
there anything we haven't talked about that we should have? Because I have one more thing for you, but I want to make sure we get to all your stuff.

Sarah 1:09:11
I think the biggest thing for me is, man, there's so many things. No, I think for me, the biggest thing maybe stems off of of what I just said about perspective is everything. So if nothing else, if you are listening to this, there's a few podcast episodes that I feel like our perspective must listens for everyone. Go ahead and those are, I think Christina's so number 649, cuadmune, Mike, number 531, like at some point Scott to like that episode has had such a deep impact on I think everyone who's heard it, huh? Yeah,

Scott Benner 1:09:48
I just re, I just recorded again with Mike last week.

Sarah 1:09:51
Oh, I can't wait to hear that. He's really an incredible human I'm so grateful for him his episode, I think kind of really. Like, like, that was the one that made me be like, Okay, I'm going to figure this out. So, oh, gosh, I had a list of them, both of Nicole's episodes. Hold on. Oh, it's like 251

Scott Benner 1:10:10
maybe I'll help you, because two

Sarah 1:10:12
or 151 and 261

Scott Benner 1:10:15
Hold on, one second, 151 is complications are complicated. Yep, Nicole has multiple serious complications with and what was the other one? One?

Sarah 1:10:25
And then I think she's 262, 61 maybe is when she came back on pre owned pancreas. Yes, yeah, yes. And then Sheila, the space musician, I'll

Scott Benner 1:10:38
piss were you that she wasn't really a space musician. That's 940

Sarah 1:10:44
it, um, I think I was pissed about that. Sometimes, also your episode titles really catch me off guard, because there was a recent one DJ eight years. Yeah, and I've probably like my cadence in saying that is not how people would expect it to be. But because the podcast that I listen to, as often as new content comes out, are yours, and then I listen to a tax podcast from a like a woman who is very similar to me. So basically now I I teach mostly DJs and creatives and people in that space about how to do their taxes and to not be so scared of their taxes. Oh, that's funny. So I've been super involved in the DJ and music community for like, 25 years, and then the other podcast that I listen to regularly is about DJs. And so I 1,000% was like, Wait, does that say juicebox or DJ? Eight years I thought it was his, like, his stage name. And I

Scott Benner 1:11:48
Well, that's how I did it. So, yeah, I mean, that's why I made the title like that, because, yeah,

Sarah 1:11:53
I was like, this is a such a collision of universes. For me. It's

Scott Benner 1:11:57
so funny. It didn't end up that way, yeah. Now, by the way, your microphone changes colors. That's the thing you should mention to people, because I thought I was having a stroke for a while.

Sarah 1:12:06
No, no, it's, it's pretty entertaining.

Scott Benner 1:12:10
You said you do streaming.

Sarah 1:12:12
I do so I teach, I stream on Twitch, and I teach, I teach people about tax stuff, like I talk about tax and business stuff. Yeah,

Scott Benner 1:12:22
that's so cool. I think about going on Twitch once in a while, but then I, like, seems like a big commitment of my time.

Sarah 1:12:28
I had no idea what Twitch was pre pandemic. It Like It saved me during pandemic, because all the DJs in the world pretty much started streaming there when Instagram Live and Facebook Live would shut you down immediately. If you weren't like Jazzy Jeff or someone famous, they would stop you midstream. But Twitch will let you stream as long as you want to stream. They just mute it afterwards, so they're not breaking copyright laws. But so I connected with people all over the world in those Twitch streams just by like, getting to, like, be in music again, and like, it feel like you're going out and whatever, like, that's how I met the guy that brought me here. So, yeah, what's

Scott Benner 1:13:14
your handle on Twitch?

Sarah 1:13:16
It's Miss Vel, M, I

Scott Benner 1:13:18
s, s, all one word,

Sarah 1:13:21
yeah, I was cracking up when I was getting ready. Because I think when you were live on Insta the other day, somebody was talking about like, you're gonna do, like, when pretty girls go online and just work. And I do not put myself in the pretty girl category, but I haven't streamed in a while, and I need to, so I'm just probably going to do a like a co working stream today, where I will just be repping taxes, talking out loud

Scott Benner 1:13:46
what you're doing with your taxes. Well,

Sarah 1:13:47
not even, not even talking out loud, like I'll just be working. But then if people want to pop in the chat and ask questions, or, like, just chat, then we will.

Scott Benner 1:13:56
It's so funny because the the aspect of how Twitch works. I was on that a couple of years ago, and I thought this is really perfect for talking about diabetes, but so many of my people are in Facebook. I don't know how to get them anywhere else. It's hard to get anybody else to it

Sarah 1:14:11
was, it was a thing. I think a lot of us that fell in love and found so much community during pandemic were really frustrated by is like, trying to get our like, non Twitch friends to come, like, check it out, yeah, and so meant, like, probably 98% of them never would, and it's just like, well, then we're finding our new people now. So I mean, if you, if you used twitch or like CO, like, co strained then, or even like played a YouTube recording on a channel and just sat in the chat to answer questions or whatever. Like, you would find new community, but probably the Facebook community would not come with it for the most part. Like, also be there,

Scott Benner 1:14:55
yeah, no, I'm absolutely I know it's one of the things I keep in the back of my. It though, okay, I'm gonna go because I think we've done a good job here, but I want to just ask for a favor first. I just realized, while you and I are talking, because I don't do video all that often, that I've lost enough weight now that I think I can readjust my camera. So I'm gonna have you help me with that, right? Okay, so this is me looking to the bottom of my monitor, but this is me looking to the top of the monitor. Which 1am I more handsome in? Bottom, bottom, bottom, okay, because

Sarah 1:15:26
bottom is close. It's more eye contact adjacent. Okay, like it looks more like you might like, like you're looking at someone in that range. But it's at the same level as like, oh, you might look over to your right and see like where my camera is. Now,

Scott Benner 1:15:43
let's see this. I did not, I did not used to be able to handle straight on because my head was too wide, but now I think I can hold on a second. This is very exciting for me.

Sarah 1:15:51
This is like the eye doctor, like camera what? Or like camera one, Camera two. Like

Scott Benner 1:15:56
in my house, when I say things I used to say. So when I first started losing weight, I bought some shoes, and my daughter was like, you had like, one pair of shoes forever. And I was like, skinny. Scott likes shoes. I

Sarah 1:16:08
was mostly thinking like, new shoes is a strange like first purchase when you've dropped a bunch of weight, like, did your feet change

Scott Benner 1:16:15
significantly? Not about my weight, just about my willingness to let people look at me. I guess so. Then I went to more clothing, and I made a proclamation to Kelly. I'm like, I'm gonna wear nicer. Even when I'm wearing a t shirt, it's gonna be a little nicer. I'm gonna spend a little extra money on T shirts so I don't look like slovenly and and she's like, okay, then I changed, upgraded some other stuff, and then one day, Arden's what's going on. I'm like, skinny Scott loves fashion. Now I think skinny Scott might enjoy a head on camera angle. All of a sudden it works. It's better this way. I used to have to be like this. I don't know why. As well, I was more comfortable with myself, but now I'm okay like this, and you helped me realize that today by haranguing it with turning on your camera, just

Sarah 1:16:56
it feels I mean, I didn't expect you to keep it on. I just figured one way, like we're doing our pre interview things. No, once

Scott Benner 1:17:02
I liked how I looked, I didn't think to turn it off again.

Sarah 1:17:06
I just like, it feels a little strange to talk to someone about all of this stuff without at some point being able to, like, have eye contact. Yeah,

Scott Benner 1:17:15
I hear that. I don't feel it at all like I can. I know I'm so radio oriented with how I like things I listen to. I actually have a I have this thing in front of me that Kelly got me on. I'll show it to you. It's just this little cutout she bought. I like it. It says, Be bold, and it's sitting on top of some of my, um, my equipment that you guys won't see because it's behind the camera, and usually without the camera. I sit here like this and basically stare at one of the letters in that while I'm talking and making the podcast, it

Sarah 1:17:45
was my secret trick to make sure that you were mostly awake while we talked.

Scott Benner 1:17:50
Do you think I fall asleep? Have you ever thought? No, I'm just giving you a hard time. Oh, but one time,

Sarah 1:17:56
it's part of the reason why I was like, I'm just gonna let this dog, like, sleep on my lap, because I know I've heard you say, like, usually I'm like, feet on the desk, like, leaned way back, like, just relaxing while we have these conversations. One

Scott Benner 1:18:07
time it happened, one time I was back like this, like, way back, like this. And I thought, you got to sit up, man, or you're gonna fall asleep. And it was, it had nothing to do with the conversation. The conversation was, like, absolutely terrific. Just

Sarah 1:18:20
the comfort, yeah, I

Scott Benner 1:18:21
just thought it's like, that's too I sat way up, and I was like, God damn, don't do that again. Plus, you have to close the doors, so I lose my ventilation during it, like, so it gets a little stuffy while I'm talking, okay, so I can, like, like, this is me head on. I'm okay, yeah.

Sarah 1:18:35
So the one you're great.

Scott Benner 1:18:37
I hate that. When you're head on, you can't look away from the camera to see yourself, because then you don't actually see what you look like when you're head on. Does that all make sense? Or is that just like a fat person? No,

Sarah 1:18:46
it does. I know I usually have to like, in zoom settings, a like, I think everybody knows that. Like, occasionally you're going to see eyes move to like, Look at the camera or look at the the monitor. I also will usually try to, like, move the little thing where it shows the faces to somewhere, like at my eye level, and then, like, most of the time, like, when it's just the two of us, it's easy, obviously. And I know that my camera's, like, just up a little bit. You could also always get a little tripod for your camera.

Scott Benner 1:19:20
My camera, it's on an arm. It moves all over the place, yeah, okay, so do i So, I mean,

Sarah 1:19:25
you could always put the camera, like, right in front of our faces, like, what? Like, that's what I'm doing to the monitor, than where, then where my mic is, yeah, that's

Scott Benner 1:19:34
what I'm actually doing right now, because I'm because I have a listen, I have a pretty large monitor too. So, like, I'm trying to think about, like, Where do I sit, so that I'm looking at you. I don't want to stare at the camera. I want to I want to feel like I'm looking at you, but where it doesn't feel like I'm looking away from you. So like, then

Sarah 1:19:50
I would put the camera in front of the guests. It is the guest screen right now.

Scott Benner 1:19:56
The camera's here, and your face is right next to it. Okay? So. I look like I'm talking to you right now. Yeah, yeah. I think we figured it out. Okay, let's do lighting too, not too, too bright, right? Yeah, too, too damn or good.

Sarah 1:20:09
I think it's good. Okay, some people might like, I like, but I don't need

Scott Benner 1:20:14
a lot of I can go warmer and go cooler. Cooler makes me look very Caucasian, yeah,

Sarah 1:20:19
it makes you Yeah, and well, and a little bit ill. Okay, yeah, there's yellow,

Scott Benner 1:20:23
like, right there, maybe, what do you think there? I think that works. This has been very helpful. Thank you. I can't do this with Kelly. I've tried before. I'm like, hell, just jump on, Zoom real quick and tell me what this looks like. And she's like, Get the out of her doing that. She's like, go find one of your people for that. I'm like, You're my people. She goes, not for that. I

Sarah 1:20:45
love how your entire family refers to all of us as your people, people. Yeah, you're whether, whether or not we're gonna help you or or murder you. One like,

Scott Benner 1:20:54
good or bad. It doesn't matter. Hey, those people are gonna kill you. Are responsible for everything you want somebody to say something nice to you. Go talk to your people, and I'm like, okay, so although not here to affirm you husband, I listen. I'm we're gonna end on this. Okay, the thing I spent all weekend doing, I'm a little embarrassed, but I'm not so behind me right now. You can see, see the chameleon in the I also

Sarah 1:21:16
really enjoy that with the new head on the

Scott Benner 1:21:19
chameleon enclosure, what do we call it? I think it's an enclosure. Yeah,

Sarah 1:21:24
okay. Is like, just there, so that, like, it's a little bit of interest, slash, like a more interesting background then. So

Scott Benner 1:21:33
there's going to be another one, another chameleon, or this one's going to slide that way, and then there's going to be a one there that's actually going to be wider, so it's going to be it's that whole wall will almost look like two chameleon cages when I'm done. But I bought that one because I didn't know what I was doing. I've since then made one. This is very embarrassing. I spent my entire weekend building a chameleon enclosure out of quarter inch acrylic, impressive. So I spent a lot of time online, on YouTube, videos and podcasts, listening and learning you're a chameleon connoisseur. Now, I've had this very interesting experience over the last four months where I've come to realize, I know this is going to sound like something. People are like, yeah, no idiot, but the all the ups and downs, the ebbs and flows of the diabetes community that I've built, like, you know, where it works, where it doesn't, where people struggle, how they learn, that's mimicked across the world and everything. If you go into like a chameleon community, they have the same ups and downs and concerns. It's really it's all just people, right? And so it doesn't matter what the topic is. Anyway, I used those resources the way people use me about diabetes, and was able to, fast forward, teach myself how to build an acrylic like it's going to be, I'm so embarrassed by this, but it's going to be four by four. That's awesome, two feet deep, because the chameleon that I got will, if all goes well, possibly grow to be 24 inches long at the end of it. Wow. So anyway, I built this. Is

Sarah 1:23:04
that the reason for the separate enclosure? Or can chameleons be friends? Like, can there be

Scott Benner 1:23:10
no, as a matter of fact, in between the two, I have to make it so they can't see each other. Yeah, yeah. So

Sarah 1:23:16
and, and not do a mirror. Like, isn't that what messed up people do with like, the the beta fish or whatever that like,

Scott Benner 1:23:21
you shouldn't do that either. Yeah, they shouldn't be seeing other millions. Yeah, they'll be together, but they won't be able to see each other, like, and neither here nor there. I got all done with it. It was all weekend, like I was at it from like Friday afternoon when I stopped working on Friday I started, and I didn't get done till like 11 o'clock last night on Sunday, and I got in bed, and my wife goes, Hey, you did a really good job making that thing. And I was like, Oh my God. Like, this is, like, the 50 year old version of sex. I was like, this is lovely. Thank you. I was like, Thank you. You really think so? She's like, Yeah. And I was like, why are you saying something nice to me made me upset. I thought I was maybe like, she's gonna be like, and the doctor called, and you're

Sarah 1:23:59
gonna be like, she's like, like, sandwiching things between, yeah, compliments. Also, I'm

Scott Benner 1:24:05
leaving like, like, you know what I mean? I don't know if she's trying to lift me up before she dropped me a little bit, but no. Good thing, you'll

Sarah 1:24:10
have two chameleons now,

Scott Benner 1:24:11
she just said something positive, and then it stopped. Hey, here. This is lovely. My God. Also, I can't tell you how thrilled I am with my my head on camera view. It's fantastic. I've never once felt comfortable like this in my entire life, and I do now. Well, shouts to skinny Scott, no Sarah, you've, you've, you've, you helped me a lot today. I wouldn't have said this to most people, by the way. I just I'm very comfortable with you because of how you've interacted with me online. Thank you. Thanks. Yeah, all right, this one's definitely called Kamikaze raccoon. That's it. I'll see you later.

Sarah 1:24:46
Hold on one second it's happening.

Scott Benner 1:24:54
I want to thank the Eversense CGM for sponsoring this episode of The juicebox podcast. GUEST and invite you to go to Eversense cgm.com/juicebox, to learn more about this terrific device, you can head over now and just absorb everything that the website has to offer, and that way you'll know if ever sense feels right for you. Ever sense cgm.com/juicebox, OmniPod five sponsored this episode of The juicebox podcast, and to get rid of your FOMO, go to omnipod.com/juice box. That's omnipod.com/juice box. No more FOMO. Huge thanks to cozy Earth for sponsoring this episode of The juicebox podcast. Cozy earth.com use the offer code juicebox at checkout to save 40% off of your entire order. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The juicebox podcast. The episode you just heard was professionally edited by wrong way recording, wrongwayrecording.com. You.