Scott Benner 3/25/25 Scott Benner 3/25/25

#1472 Tao of Tom

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Tom, 29 (T1D since age 8), overcame resentment, weight gain, and stigma to take control of his diabetes while working in commercial real estate.

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

Scott Benner 00:00 Hello friends and welcome back to another episode of The Juicebox Podcast. Today I'm speaking with Cassandra. She's a returning guest who was initially on episode 829, called Chinese hamster ovaries. She is giving us an update on how things are going with her PCOS gastroparesis. She had SIBO. She's an awesome guest. She's had a lot of success. Jump on here with us today, find out what she did to help herself. It is really, really exciting. 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. AG, one is offering my listeners a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of d3, k2, and five free travel packs in your first box. So make sure you check out drink AG, one.com/juice box. To get this offer, don't forget to save 40% off of your entire order at cozy earth.com. All you have to do is use the offer code juice box at checkout. That's Juicebox at checkout to save 40% at cozy earth.com Are you an adult living with type one or the caregiver of someone who is and a US resident? If you are, I'd love it if you would go to T 1d exchange.org/juicebox, and take the survey. When you complete that survey, your answers are used to move type one diabetes research of all kinds, T, 1d, exchange.org/juice, box. It should not take you more than about 10 minutes. This episode of The Juicebox Podcast is sponsored by Medtronic diabetes and their mini med 780 G system designed to help ease the burden of diabetes management, imagine fewer worries about mis Bolus is or miscalculated carbs thanks to meal detection technology and automatic correction doses, learn more and get started today at Medtronic diabetes.com/juicebox the show you're about to listen to is sponsored by the ever since 365 the ever since 365 has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get ever since cgm.com/juicebox

Cassandra 02:28 Hey, my name is Cassandra. I'm a returning guest, and some of you may know me as a group expert from the Juicebox

Scott Benner 02:36 Podcast. What do we call you online? Princess in Cassandra, excellent. So nice to talk to you again.

Speaker 1 02:44 Yeah, I'm so happy to be back because I have, I guess, a lot of new things to share. Yeah,

Scott Benner 02:50 no kidding, I'm looking at your list here. We're gonna, we're gonna really get into some stuff, give people maybe just kind of a high level overview of what your last episode was about.

Speaker 1 03:00 Oh my god, about so much and nothing at the same. I feel like,

Scott Benner 03:05 how? So, you know, everyone says that. So let me, I'm gonna get somebody's opinion here. So everybody listening. What you don't know is that when most of the interviews end, people say the same thing, hey, if you don't want to use that, it's okay. Everyone always thinks that their episode was about nothing. It wasn't good, like I listened to the podcast and all these other episodes are so helpful to me. And I know I didn't help anybody, but I always say to them, I'm like, delete episodes like the ones you're feeling helped by those people thought the same thing as you when it was over, that this just was not valuable at all. Right? So

Speaker 1 03:40 I don't think necessarily it wasn't very valuable for anyone. I just think, like we covered so many topics, and probably the main thing for me was, even if life gets complicated, especially with diabetes, especially with complications, you still can have a good life and perspective matters.

Scott Benner 04:05 Yeah, yeah, for sure, excellent. So we don't have people back very often, so you're special, of course. Do you want me to call you Cassandra or princess? Where you at with us? Cassandra? Okay, so Cassandra, I guess let's keep it then last episode. Tell people your episode number. Do you know it? 829, 829, okay, so medically, what did you tell people about? We

Speaker 1 04:29 talked a lot about Chinese hamster ovaries, about immunosuppressants, about chronic urticaria, about retinopathy. We talked thyroid.

Scott Benner 04:44 What do you have going on that brings you back? I kind of want to jump into it. Yeah.

Speaker 1 04:48 Well, at that point back then, when we recorded the PCOS, I suffered from since, like forever, was kind of at bay and didn't. Bother me as much as the last couple of years, and it kind of got urgent or more severe, I feel like, towards the end of my 30s now, and maybe that played also into it. And every time I asked my gynecologist about it, she just told me to eat healthier and do more sports. And maybe one thing you should know about me, I have a pretty active lifestyle, and I try to eat as healthy as I can. So it was basically just gaslighting

Scott Benner 05:41 so your ovaries were giving you trouble. And she was like, have more kale and go for a walk. Yeah? That seems helpful. This

Speaker 1 05:49 works, but not when your BMI is 22 Yeah, right, yeah. I was at a perfectly normal weight. I mean, a lot of people who suffer from PCOS, obviously, are overweight or obese, but that wasn't my problem. I had an a hormonal imbalance. Even

Scott Benner 06:09 if they have a hormonal imbalance, you can help your hormones back into balance by being at a healthy weight, not carrying fat. Has a lot with your hormones. So I get it. If a person was in that situation. They're like, hey, let's get you active and and maybe get some weight off of you and see if that helps. But you're saying not your situation at all. No, right, okay. And

Speaker 1 06:29 then I switched endos, and there again, the topic PCOS came up, and he told me, like, well, I could try some anti testosterone medicine, blah, blah, blah and all this stuff just didn't convince me, because they came with an array of side effects that you don't want. Yeah, and then I told him that I want to go to a specialist who is only specialized in PCOS and talk to them. And in the back of my mind, I had kind of a plan what I wanted to do, because I did some research, also, how you can manage PCOS without hormones, like because I knew when I walk in there, the first suggestion they will give me is just take the pill. Yeah, and I didn't want that. I found out that they actually perform a surgery on some women when they try to conceive. But it doesn't work. They use a treatment called laparoscopic ovarian drilling, and that kind of drill. They drill holes into your ovaries for what, so they can get babies.

Scott Benner 07:48 And does that work or no? Yeah, it does. Wow, okay,

Speaker 1 07:52 well, but that wasn't also wasn't my situation. I don't want to have a baby. I think we talked about that also last time. But, I mean, I wrote this, read this paper a little further, and they saw in this research that it also normalizes hormone levels and gives you a regular cycle. And I thought, yeah, bingo. That's all I need. I don't care how fertile I am, right, right. The main thing is, I have a regular cycle. Did you do this? And it worked well, and then the whole gas lighting started over because Doctor said, Well, no, it's, we don't do this here. It's far too dangerous. Just take the pill, because it could be that you enter a perimenopausal early and it will be far too dangerous, okay? And then another doctor told me, Well, yeah, it's just you talk to manage and babysit your diabetes. And I really was at the point where my cycles were anywhere from like 28 to days to three months, and ovulation started at day 14. And there is where the craziness started. My body tried to build up. The hormones to ovulate. Insulin needs went up. The ovulation didn't take place. Hormone level dropped, insulin needs dropped, and that for weeks and weeks and weeks and then all over again. And he just said, yeah, that's just your job. Now, the only other thing he could offer me would be the pill, but only the pill would be much too dangerous for me, so I need, would need to take blood thinners. Additionally, tell people

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Unknown Speaker 11:49 because I don't want to gain weight.

Scott Benner 11:50 Yeah, that was, that was your main concern. Yeah. Okay. Why would you have to take blood thinners?

Speaker 1 11:56 Yeah, because I'm over 35 and they are concerned for your cardiovascular health, then,

Scott Benner 12:03 oh, if they put you on the pill, they put you on a blood thinner as well. Yeah,

Speaker 1 12:06 okay. And I mean that this plan already sounds ridiculous to me. And then I went to a third doctor, and he said, Yeah, let's do it. And and then

Scott Benner 12:20 what happened? And I did it well, tell me what happened. What was that like?

Speaker 1 12:23 And also in the same time frame, I know, can I this all took so long to figure out I was desperate and I wanted some relief, and it was also at the time where you started talking about authentic Okay, so I went to my end all and said, Please put me on the lowest dose of authentic. I want to try this. And it was all kind of in the same time frame, seven months ago. Now, okay, ever since the surgery and the authentic, I had a regular I have a regular cycle. Wow. I mean, it's not picture perfect 28 days. It is somewhere between maybe 28 and 3540 but it is regular, actually. And I never had that before in my life. It's

Scott Benner 13:14 awesome. So my question here is, with some hindsight now and out of the problem, the, I mean, the bleeding, forever and ever, the pain and everything else that came with it. Can you look back on that time that you felt that way and really quantify it, like put it into words for people, what it was like? What, what was that thing you were so desperate to get away from? I mean,

Speaker 1 13:35 there's not really words for that, because I was just chasing a monster, like six weeks, eight of us out of eight,

Scott Benner 13:46 yeah, like heavy bleeding. I didn't

Speaker 1 13:49 have any bleeding at all. I don't have had I didn't have pain, I didn't have bleeding. It was just kind of could tell when my hormones started to raise, and then went down. And that's what my insulin needs. Just constantly changed, and, like, they doubled, and then in one hour, I was back down to normal.

Scott Benner 14:13 And so for you, it wasn't as much about the classic problems of an extended period, it was about taking care of your diabetes, yeah, yeah. And how long had you been doing it this way? Like, how much of your life? Like, tell people how old you were when you got type one. And when did this all start with the PCOS? I

Speaker 1 14:30 mean, I got type one when I was 11. I never had a normal period, so it's the you could say I was diagnosed with 14 when my period never started. And

Scott Benner 14:45 do you look back over that time and see insulin issues the entire time? Or did it start when you got older?

Speaker 1 14:51 I mean, I was so unmanaged, you can't tell, but probably, probably, yeah, and then, I mean. Some years I had an IUD, and that was better, not good, but better. And then when the replacement came up, I tried an IUD again, but I was basically just crying out of nowhere for a month and that IUD had to go out.

Scott Benner 15:19 The hormones from the IUD just put you into a tizzy, as they would have called it in the 50s.

Speaker 1 15:24 I was just crying out, starting to cry out of nowhere, right? I wasn't myself anymore, terrible. And that's also a reason why I said I don't want to try a pill. Yeah,

Scott Benner 15:36 right, right. Okay, you did the ovarian drilling and you started a GLP med. Do you think it's a combination of the two that helped, or do you think one of them is doing something and the other one wasn't valuable? I don't

Speaker 1 15:49 know what I can tell you from the TLP side is that I was able to lose some weight on parts of my body where I always had like a little extra,

Scott Benner 16:05 where did that? Would you mind sharing, where it gathered on you, on my belly, your belly. Okay, I'm

Speaker 1 16:11 a lean person to begin with, but my belly just always stored some fat, and I started out on the authentic at around the 130 pounds, and went down the first week five pounds and lost now in total, 23 pounds. Wow,

Scott Benner 16:35 you didn't feel good for so long. But can you like separate the things? Can you tell how just weight loss itself has impacted you, or is it more about the fat being gone? I feel

Speaker 1 16:45 now that I'm at the weight that is reflecting my lifestyle, and it's kind of fair. Do you know how I'm mean?

Scott Benner 16:56 Has it changed things for you, socially, or just the way you feel about yourself.

Speaker 1 17:00 It hasn't changed anything socially. No, okay,

Scott Benner 17:04 your attitude about who you are and everything that hasn't changed. No, okay, what about this? The way you feel, health wise, do you notice a difference? Yeah.

Speaker 1 17:15 I mean, my cholesterol, for example, was always like, not high, but a little bit on the higher side where they want you as a diabetic, it's completely normal now. They were always concerned about my kidneys. They are functioning completely normal now, and that's all since I started the TLT, you

Scott Benner 17:42 didn't go up, right? Are you still on a low dose? No.

Speaker 1 17:44 I mean, I always stayed at the point two, five milligram because, I mean, my BMI is now almost underweight, so I even I can't afford to go up.

Scott Benner 17:58 My point was that you're getting these benefits without ramping up the medication more and more and more. Yeah, yeah. How about the eating? Are you able to eat? Or are you having, like, what are your fights with glps? I mean,

Speaker 1 18:10 the fight is that that I'm actually, I had gastroparesis before I started the authentic so that was a concern. But from what I can tell, it didn't get worse on the authentic so it's it was a bit worse, like the first two weeks, I wasn't able to eat that much and had to divide portions and eat more snack type things. But like, after two weeks, this was fine again, but only, like, maybe two months ago, I found out something very interesting. Go ahead, I started to log my calories because I was pretty certain I'm not getting enough calories with your Sen big I would say I was able to eat more and still lose weight. If I had eaten that much prior to authentic, I had gained weight, I'm sure

Scott Benner 19:11 interesting, I will tell you that. Well, I'm using zepbound, which is, you know, a GLB from a different company, and I didn't eat poorly before. Do you understand? Like I Yeah, me neither, yeah. I found myself thinking this. Arden and I went out yesterday afternoon, and she helped me pick out glasses, and I took her to lunch. First, I got a sandwich. It was a, it was a brisket sandwich, right? So it was a, it's not really what I wanted. Cassandra, but I was at a restaurant. I was limited options. I got a brisket sandwich, just two pieces of rye bread, some shaved brisket inside the tiniest bit of cheese. They sent it out with some fries. I think I had eight fries, and I was like, oh, it's enough. And I was able to eat half of the sandwich, yeah. And I looked back and I thought, prior to the GLP, would I have eaten? All of this, maybe right? I might have, I don't think I would have cleaned my plate, but I probably would have eaten a little more of the sandwich. I might have had a few more of the fries. I drank an unsweet tea with it, you know, in a glass of water. But my point is, is that I looked around the room and there were other people in that restaurant eating far more than I was eating, and they were all thin, and they didn't look like they had health, you know what I mean, like visually they and I thought if I ate this without the GLP, get it, I'd weigh 50 pounds more than this. Yeah, I just would. So did it change how I eat? I don't eat quite as much, but not to the degree that you know, you guys have, if you've listened to the podcast, you've heard before, like, I would say all the time, like, I'd eat the the tiniest little bit of thing, I'd wake up a pound heavier. I was always like, I'd wake up the next day a pound heavier, like I either had to eat nothing, or, you know, really restrict down to, like, little bits of protein and stuff like that. My digestion still sucked all these other things. Yeah, but on the GLP, I'm not saying, like, I could go out eat a quart of ice cream every day and still be thin, but there's part of me that wonders if I couldn't, like, I don't test it, you know what I mean, because I don't care and I don't want that food. But I think some people are losing weight on it because they're taking in too many calories, and it's restricting their calories, and they're losing weight. And I think other people like you and me, and probably other people with autoimmune stuff in their families, something else is happening with it.

Speaker 1 21:29 Yeah, you know, I mean, I talked to my endo about it, just like a week ago, and it's like, you're talking to a ball. Yeah? They don't know. He just tells me, Oh no, no, you're just eating less than before. And I mean, I eat dinner every day with my partner, and I trust that he can touch pretty objectively if I eat more or less and it's the same portion size. And then he said, Oh yeah, maybe you had, like, snacks in between, and didn't even notice you had them, and you don't have them. Now, did you

Scott Benner 22:07 try explaining to him that that's not it, or did you just go,

Speaker 1 22:10 Okay, I mean, it's, it's ridiculous, and he's, he's, listen, no, he didn't, but no, it's just, there is no explanation. So it can be

Scott Benner 22:21 it's funny, because I'm sure you've heard Dr Blevins on the show, right? I did. I've had great conversations with him about glps, and he's much more forward to thinking than most people. But it always sticks in my head that at one point when I kind of broached the subject with him, his answer was, well, people are eating fewer calories. And I thought, yes, for some people, but I think for other people, for everyone, yeah, and, and I know he gets it, because you can tell by the rest of the conversation that he's very open to the idea, yeah. But at the same time, I wonder if doctors are just trained not to say more than the label says it does. You know what I mean? It must be that, yeah, yeah, because I don't know how to argue with what you're saying. I started

Speaker 1 23:06 to log my calories, and I've figured out I've eaten probably for the last decade, not more than 800 calories a day.

Scott Benner 23:16 Yeah, so you shouldn't be carrying 20 extra pounds.

Speaker 1 23:19 No, right? Also not losing weight, because 800 calories for sure, don't cover my knee. Yeah, should

Scott Benner 23:26 put you in a deficit, right? Exactly. This is awesome. Listen, Cassandra, I don't get enough credit on this podcast. So you learned about the glps on the podcast. I did. Yeah, basically I saved your life. Is that what you're here to

Unknown Speaker 23:38 say again and again and over and over.

Scott Benner 23:42 I'm teasing for the people out there, and for those of you who hate me, you're like, oh, he really, really needs this. No, I just want to point out that getting information like this can really change things for you. There are things you're not going to hear in other places, and the only reason you hear them on this podcast is through random events. Like, you know, we had to put Arden on a GLP for a similar idea. Like, we really consider that Arden has PCOS, and, you know, her struggles are different, and we put her on a GLP and injected, gosh, she started with ozempic, but Arden also has a significant needle phobia that we don't talk about a ton on here, because I don't really know how to talk about it. I'm actually going to do an episode with Erica about it, to try to dig into it a little bit. But so she had trouble with the ozempic pen, having to give herself because the visible, the needle was visible, right? So we took her to a self injector. But she just has a lot of psychological pain, like she just does from from the needles. Like, if you don't know a person with a needle phobia, I don't just mean like, I don't like needles. I mean like running for your life when you see them, you know, like, that kind of thing. So she powered through it for a while, and was doing it, but on the self injector, you're stuck with whatever the lowest dose is in the self injector. And it was too much for it was. Handling her blood sugars beautifully, and her acne would just about completely go away. And, you know, belly pain that she would have, like, gone, or periods got better, like all that stuff, worked really well. She just really struggled with the injections. So she did just start this week. We're doing a experiment with rebellious so a GLP, yeah, I was going

Speaker 1 25:23 to ask you if that wasn't an option, yeah. So we're

Scott Benner 25:27 trying it now. She's three pills in and right now the doctor has her. She's like, let's start every other day, because we want her to be able to eat, so we're watching it, but I think she's going to be able to go to it daily and still be able to eat, but it's a, like I said, an experiment. We're going to be at it for a little bit before, before we figure out exactly

Speaker 1 25:46 how to handle it. Well, I hope it works for her. Thank you. Thank

Scott Benner 25:50 you. We're also going to try working on the phobia. It's, you know, little bits at a time.

Speaker 1 25:55 Yeah, that's not something you accomplish, like, in a week, no, no,

Scott Benner 25:59 when it got bad at the end, I wasn't sure if I was gonna ever share this on the podcast. But when it got bad at the end, she was home for a little bit from school, and she was at that time away at school, about a six hour drive. So I said, Look, well, I can inject it for you before you go back. And that buys you a week. And she's like, Oh, great. Well, what do we do next week? And I'm like, I don't know. Like, we'll figure it out, right? So she and I together in a room. We couldn't do it. She just, she was like, no, no, no. Like she turns into, it's almost like she's in the electric chair. That's terrible. And she'll say anything to keep you from pushing the button. It's, it's crazy how like, she turns into, like, a life or death situation for So finally, in that moment, she said, just have Cole come in and hold my wrists, like I'm giving you permission to just give it to me, but I'm gonna defend it. I think I'm gonna swat it away when you come at me with it. So have Cole hold my hands. And I was like, okay, so Cole came in, poor Cole. Was like, what is happening? And, you know, so he kind of just restrained her around her wrists, like holding her hands together. And, you know, it was difficult, right? It was really one of the more difficult moments I've been through recently. And as I do the and you know how quick these injections, if they take eight seconds, you know what I mean? And like, so I'm doing it, and I just hear colgo. She's biting me. She's biting me. Oh my god. And Arden, like, I look over and she goes, I'm sorry. I thought I was biting myself. Like she actually went to bite her own hand, like, out of like, desperation, I guess, and she got him and didn't like she couldn't feel anything she's like. So I just thought I was biting myself. And then Cassandra, as as horrible as that was and is, like, fraught with tension and peril and, like, honestly, seriously, I'm not doing a good enough job of telling you how tense it was. She just starts laughing, because it's over now and all that's gone. It just disappeared. Wow, that's crazy. We started talking about it later, and she said, I'm scared of the needle. She's like, I can I picture it like puncturing my skin. And she goes, but I'm also disappointed and embarrassed that this is my reaction. So she's fighting with all that at the same time. Yeah, so what are we gonna do next week? The GLP is helping her so much, and she now she's going to be away at school, and so I am a little embarrassed to tell you that every Sunday morning, got up really early and drove the six hours to her, gave her the injection. We had lunch, and then I drove home. I spent my whole day Sunday going to give her the shot. I did it like three weeks in a row, and then one day she was just like, please, I can't keep doing this. She goes, I'm dreading it the entire week. And I was like, Okay, well, then that can't be like, so took us a little time to get the rebellious, oh, we got some samples, and now we're trying it. So I'm definitely gonna knock terrible. But you know what she's trying to avoid, because you've been through it too, yeah, with the hormones and the impacts on your blood sugar and your life and everything anyway, my point was, is that you heard about glps and what they can do for that, because my daughter had a problem, and I'm trying to figure it out, and I talk about it on here, and that's just a weird combination, like so you could have gone your whole life and not heard about these.

Speaker 1 29:19 Actually, I heard about them like in the media, because obviously they're everywhere at the moment you and what helped me back was always the talk about gastroparesis, and that I actually have gastroparesis, and actually only one word or one sentence you said, with something in my head that I said, thought like I need to try this. That several times, this is not even a therapeutic dose,

Scott Benner 29:53 right? So maybe I'll just go down and try that and see if it doesn't hit me. Yeah, the hard i. I would not minimize anybody's problems seriously. And gastroparesis is super serious. There are two ladies on the Facebook group that anytime glps Come up, they'll race in and leave a comment about, like, you know, people have gastroparesis, and these drugs are going to bind their stomachs up and like, and I'm not saying that couldn't happen, but you have to know your situation, like, if you've had type one diet,

Speaker 1 30:23 and then in the end, every medication has side effects. Sure,

Scott Benner 30:27 yeah, no. I mean, yeah, the greater risk is, like you said, everyone's flipping a coin when they take a drug, right? But for the people who have had type one for 3040, years, you know, can look back with honesty and say, like, you know, I had high a one CS, I had a lot of variability. The technology wasn't as good back then. The drugs weren't as good back then, like I have gastroparesis. Now, this is not a thing I want to risk. I understand that. But if you've had type one for, you know, three years and your a one C's been, you know, six and a half the whole time, you don't have gastroparesis, you're not just going to magically get it for injecting the drugs. But I think some people,

Speaker 1 31:01 but I feel like that's what some people are worried about.

Scott Benner 31:06 Yeah, so. And then they worry about that, and they think that, and then they say it out loud, and it scares everybody off by the people they're tolerated by are very well tolerated by those people like you just have to figure out who you are in the situation now, and

Speaker 1 31:17 I think also you have to be aware that you have to carefully choose what you eat. Yeah,

Scott Benner 31:26 so you're making another point that I've seen with this is that some people think magic weight loss drug, right, like

Speaker 1 31:32 if you infect the authentic and go to McDonald's in the evening and eat, I don't know what? Three burgers. It's probably not gonna go well, yeah, exactly.

Scott Benner 31:44 You do have to put an extra effort, and it sucks, because I don't think doctors are gonna tell you about it, but yeah, that's true. Listen, I've been on it for a year and a half, maybe more. I'm at my lowest, literally, today, my lowest weight. Yay, congrats. Thank you. And forget the weight like you should see, like the other measurements, you know, like the other measurements of health. So I use this scale that measures a bunch of stuff, weight, BMI, subcutaneous fat, like, all this stuff, right? And when I started, all my numbers were red, and then slowly they became yellow. And now of the 369, 12, of the 13 things it's tracking. I have four items that are yellow and the rest are green. Wow. So it's stunning. It just it's and I feel awesome, you know?

Speaker 1 32:35 But, yeah, I mean, it's similar to my story. I always had the thing with my kidneys, where they were always concerned and always on the brink of putting me onto medication again and just gone now,

Scott Benner 32:51 yeah, I talked about it on here a couple times, but they did a study about the impact of GLP on kidney disease. Yeah,

Speaker 1 32:59 I know, and I was hoping I get some effects from it as well. And there you are. And then, like a month ago, I was at my lowest weight, and was concerned I'm losing more, because it was really like my BMI was only 18.1 then, and talk to the doctors, what we do about it? And I also had tried to up my calories, because obviously I'm not getting enough calories, but I can't eat more because not working, I don't think to eat and I would feel too full, probably also partially due to the gastroparesis. And I started now drinking high caloric drinks, which is a little insane. When you're on a PLP, to bring high caloric

Scott Benner 33:51 drinks, you're trying to get in the calories somehow. Yeah, and it's working the way it's back up. I drink up protein drinks sometimes, just because they Yeah,

Speaker 1 34:01 but they don't have enough calories for me. Yeah, I need like, 800 calories in drinks.

Scott Benner 34:07 What do you drink that does this for you? A doctor

Speaker 1 34:11 can prescribe those really, yeah, that's awesome. They do this like for people who have cancer, or for all people that don't have appetite, or for people with eating disorders, yeah, it's like, it's similar to a shake, and you can have like, 100 different tastes, and not

Scott Benner 34:37 bad, right? And you know what? It's funny, because you're basically, you're bio hacking yourself. The way I'm hoping for people to think about it is that you have all these different systems in your bodies, right in your body, and they all have different settings, basically, and your settings are off, and your body's not putting them back to where they belong. So you're, you know, use the GLP to move some of the settings, but now it's causing a problem with my. Caloric sense, so I'll put them in here. Yeah,

Speaker 1 35:01 and I actually was very worried that the doctors would see this the wrong way, because the TLP isn't the problem. My body is the problem exactly. There is no reason to take away the TLP because my body works now the way it's supposed to work. So we need to add the calories and not take away the TLP. And luckily, all of my care team agreed it's

Scott Benner 35:29 excellent. Well, and did you have to do a lot of explaining to them to get them, or did they just kind of go with it? They basically

Speaker 1 35:35 just went with it. Oh, that's awesome, because they also see all the benefits. Yeah,

Scott Benner 35:40 well, they're paying but, yeah, but yeah, but sometimes they see the benefits. I mean, think about the people with type one who find the podcast and go to their doctor three months later and they're like, Hey, how are you? I know my a 1c, has always been eight, but it's 6.4 now, and the doctors go, you're having too many lows. We need to cut back your insulin. Like they panic and like they see them out, yeah? So who knows when that happens or doesn't, yeah,

Speaker 1 36:02 yeah. And I guess also, because I was very proactive and told them, hey, my weight is dropping. It's not something I want to happen. We need to address this, and this is my solution. They were probably, yeah, more prepared to help.

Scott Benner 36:20 Yeah. Also Cassandra. If they're reasonable people, they probably thought, hey, this person's really paying attention. Like, you know what I mean? Like, they would probably like it if more people came in with solutions like this for their problems. So probably good for you. No, seriously, do you feel like we covered that part of the conversation well? Because I want to ask about the G poem surgery. Yeah. Okay, so think younger, excellent, excellent. It's great. It's great story. Actually, you have gastroparesis from years of I mean, what do you think? Why do you think you have it from

Speaker 1 36:49 years of not paying tension, from in checking insulin, from high blood sugars. Okay,

Scott Benner 36:56 so now you're trying to decide to do something about it. Did you get this G poem surgery. Yeah,

Speaker 1 37:02 I mean, last time we talked, I had the procedure where they dilate the pylus, and that worked great for three months, and then I had another one, and it worked again, great for three months, but it always was kind of destroyed by some side effects from meds that delayed gastric emptying, and I was basically back to square zero, and also got SIBO, the bacterial overgrowth in my stomach, also due to the gastroparesis and then my gastro suggested to make the cheap poem, basically, not even better my situation, or Sure, partially also to better my situation with the gastroparesis. But I didn't have, like, super bad symptoms, but because also, mainly to prevent that the bacteria return again. Can

Scott Benner 38:05 I read this real quick during G poem, a flexible endoscope is inserted through the mouth into the stomach. The surgeon makes a small incision in the stomach lining and creates a tunnel to access the pyloric sphincter, the valve controlling the passage of stomach contents into the small intestine by cutting the muscle around this valve, the procedure relaxes the sphincter, facilitating better gastric emptying. That's the idea, right? Exactly, okay. And so you had this done, yes, and it wasn't fun. I mean, beyond that description,

Speaker 1 38:36 I mean the surgery itself was easy, because obviously they put me under and the preparation wasn't that much fun, because the surgeon told me, Well, yeah, just don't eat after midnight and come in in the morning and we do the surgery. But I knew they need an empty stomach, and if I fast for just shy of 12 hours, my stomach won't be empty, right?

Scott Benner 39:00 Did you say to him, I have gastroparesis, that's not going to work. Yeah.

Speaker 1 39:04 And then we agreed on seven on a 72 hour fast, wow. And yeah, that was hard. How'd

Scott Benner 39:13 you keep your blood sugar up for 72 hours? It

Speaker 1 39:15 was actually pretty easy. With the loo. I didn't change any of the settings, and it was just smooth sailing. I was

Scott Benner 39:23 gonna say, Arden got up this morning early to go to the dentist, and so she's been up for a couple hours now, and her blood sugar is incredibly stable. So

Speaker 1 39:33 and that's also something I wanted to point out, because I see that very often in the group, that people are scared to go in with an empty stomach for anesthesia, if it's a planned surgery, it's actually the best time to basal test beforehand, and then you don't have to change any settings, and you just go in and change nothing. Yeah, I understand.

Scott Benner 39:59 Why it's scary. But once your settings are good, especially on an algorithm that's, you know, really dialed in, you can go a fair amount of time without eating, yeah, yeah. But it sucks not eating for 72 hours, I imagine, yeah,

Speaker 1 40:11 yeah. And then, I mean, after surgery, I couldn't eat for two more days.

Scott Benner 40:16 Oh, gosh, no kidding. Yeah. Oh, how hungry were

Speaker 1 40:21 you? Kind of the wound had to heal, and they couldn't the muscle had to relax, and yeah, the stomach chest shouldn't

Scott Benner 40:29 work. Did they give you IVs? Or did you stay in the hospital? I

Speaker 1 40:33 had to stay in the hospital for two nights for that reason, particularly, and actually on after the surgery, my sugar started to grow, and then I turned back the basal, but it wasn't enough. And they said, Yeah, you can have one or two dextrose tabs. I was like, yeah, one do nothing, but let's try.

Scott Benner 40:58 You say I need an IV with some dextrous and it is what I need. Yeah,

Speaker 1 41:03 well, they offered me that, but I was scared I'm gonna go high and I don't want high blood sugars when my body should be able to heal. Right now, I hear you after a few dextrose tabs, I agreed on the dextrose iwi, but said I'm deciding how much goes in.

Scott Benner 41:21 Nice look at you, and they listened. Yeah.

Speaker 1 41:26 I had a very, very nice nurse who listened, and that just rang the bell every 10 minutes. Like, go little back, go little up and like, within an hour, it was perfectly dialed in. I had some insulin going, I had some dextrose going, and it was smooth sailing again. Did you

Scott Benner 41:47 have like, daydreams about having access to this dextrose in your real life? Not use this at home some days?

Unknown Speaker 41:57 Yeah. Honestly, nice. The SIBO

Scott Benner 41:59 overgrowth. How did they handle that? Probably

Speaker 1 42:01 around 200 rounds of antibiotics.

Scott Benner 42:06 What kind oral or inject? Yeah,

Speaker 1 42:10 it's like a special antibiotic they only use for SIBO, and that always worked short time I felt great on the treatment, and maybe, like two weeks after, but I did a fair amount of research there as well, and there are also a lot of natural treatments, and basically the natural treatment worked better for me.

Scott Benner 42:37 Let me ask first about the medical intervention. So they're giving you the antibiotics, trying to get your gut to balance out, right? But do they know why it's like, Why do you have the overgrowth? They

Speaker 1 42:49 think it's from the gastroparesis. Okay, that's what I was just so much food in there. Oh, and actually, what I wanted to tell about the 72 hour fast after the surgery, I asked the surgeon, like if there was any food left in my stomach. And he said, Yeah. I mean, it was almost empty, but not completely. 72

Scott Benner 43:09 hours, and your stomach wasn't empty yet. Yeah. Wow. And then what did you find naturally to to address the SIBO

Speaker 1 43:16 Berberine, and then oil of oregano, and there's also a third one, like a combo of three mats that you have to take for three or four weeks. And, I mean, if you Google it, there are, there is a ton of research around that. There are dosing schemes. You can figure that out on your own. And actually, even my gastro knew about those treatment options and said For some the natural remedies just had better and that I should try

Scott Benner 43:53 it. Berberine and oregano oil, yeah,

Speaker 1 43:57 and something else. Are you still taking them every day? No, no, no, it's just like four week course. And I had to, I mean, I was on it, maybe on and off on meds for half a year, so it took quite a while to heal. And then I also did the low fault map diet, and just to help manage symptoms, and I still can't eat everything again.

Scott Benner 44:27 Where are you now? Like, in like, where's your health? Do you feel like you're still working towards something, or do you feel like you got there? I'm not

Speaker 1 44:35 back 100% but I'm fine where I'm at. I just tried to minimize my Gluten intake, I can't have too much garlic, and that's about it. And, oh yeah, and I have to pay attention around fruity stuff with fructose. That's still a bit tricky. But I mean, if I go to a restaurant and have spaghetti for one. Night, nothing will happen. I just don't do it three nights in a row.

Scott Benner 45:03 Yeah, the fructose, because it it kind of like, what does it seed your stomach with all that sugar, and you get the overgrowth. The low

Speaker 1 45:11 fault maps is all about different sugars that can ferment in your stomach and that that helps the overgrow to happen, I have

Scott Benner 45:22 to tell you, I'm really happy for you, because it's probably been a year or more now, for people listening who don't know like Cassandra is a group expert in the private Facebook group, and there's a pretty big handful of lovely people who kind of bang around in there and they see people's questions and they'll answer them, like, Hey, you should try this episode of the podcast. Or, you know, here's a post about that, like, just, you know, trying to help. It's a really big community, and you know, people need to be directed. Sometimes. A Facebook group is not a perfect way to introduce you to a podcast, but if people are there to say you should try this episode or check out this list, it's really helpful. And so Cassandra and a number of other great people are doing that, and I couldn't possibly begin to thank them enough. But at the end of the year, I usually call everybody and, like, we chat for a long time, usually, like, it's usually an hour or more, like, just kind of get on the phone and say hello and stuff like that, and you and I spoke. I don't know if it was last Christmas or the Christmas before that. I really don't know. But do you know last Christmas? Last Christmas? Okay, while I was driving to see Arden, I think, yeah, I remember we talked for a long time, and I remember getting off the phone and thinking, Cassandra's really going through a lot, and you sounded tired from it. I was, yeah, yeah, you found it really beat up. Like, not like you were giving up or anything, but just like, like, this had been going on too long for too many days without enough answers that how you felt, yeah,

Speaker 1 46:52 yeah. I mean, it was exactly in that period where I tried to figure out the PCOS. And then I guess also, shortly before our call was I switched over to Iaps and just couldn't figure the darn thing out. And felt really like a failure.

Scott Benner 47:15 When we got off that call, I thought, oh gosh. Like, I don't think Cassandra is okay, but you sound so much better today. I am better. Yeah, it's awesome. That's really great. I'm still very, very happy for you, is all I wanted to say. Thank you. Yeah, it's a interesting to check in on people's lives and see they mean, I'm obviously not there every day while you're doing the work or or, you know, feeling the pressure to see you in, you know, gaps of time, gaps of time, and to watch it get better. It's just, it's uplifting, because you didn't give up. You figured out a lot on your own. These are not easy things to figure out. This gut stuff is not easy to figure out. You know, most doctors around gastroparesis are just going to tell you to eat a gastroparesis diet, and that's all, that's it. That's all. It's going to happen, and they'll give you pain medication for your stomach. They won't actually give you something to help you, because

Speaker 1 48:05 there also isn't that much for diabetes, gastroparesis to help

Scott Benner 48:11 you get something to numb your stomach, basically, yeah, and then that's that. But you mean, look at he did the, by the way, the G poem in surgery that we talked about as gastric parole endoscopic, my Myo to me, geez, no wonder they call it g poem, you know, like, that's the thing you had to go find out about, you know what I mean, and like, do your research about, and go through the, you know, the whole process of doing it, just to try to get some relief. How long ago was that surgery?

Speaker 1 48:41 It was in June. So six months is it still working?

Scott Benner 48:45 Yes, that's awesome. So did you have to adjust your insulin because of the rate that you were digesting? No, I

Speaker 1 48:53 also didn't have such a big effect as with the dilations. I feel like there I had to adjust my insulin more, but I feel like, since I'm on your same pick, my basal went down quite a bit, but I have to be more aggressive with my Bolus, because

Scott Benner 49:15 you don't have a lot of background basal. I'm not sure it might be are you using less? I mean, you probably are. But how much less insulin are you using now than a year ago? Listen,

Speaker 1 49:26 this is a very difficult comparison, because I'm eating much more now, but I can tell you my basal went down by around 40%

Scott Benner 49:37 Wow. Do you have a different relationship with food today than you did prior? I mean, not crazy.

Speaker 1 49:41 I always was a healthy eater. I don't use a lot of processed food at home. I tried to cook a meal every day. The only thing I probably noticed is, for example, if we go out. Out and then have dinner. And then the waitress comes again and asks if you want dessert. I'm like, nah, nah, it's fine. And before the authentic I would have thought about it more. Yeah, it's not that I don't like it anymore, but it says, In the grand scheme of things. It doesn't matter that much if I don't have dessert or something sweet doesn't

Scott Benner 50:25 bother you, don't feel like you're missing anything. Yeah, CNN did a special about glps, and I put it on, and I watched it, and it was a little like this. Part of me it was like, Is this an ad? Like, you know, I couldn't tell exactly what was happening. At one point, they go to this person who tries to make the argument like, you know, well, it's ruined eating for me. And I'm like, I don't understand the argument here exactly like, you were very unhealthy prior to this, and you're describing this insane improvement in your overall health, your weight, you know, all these other measurables, like, have gotten better, better, better, better, and at the end you cry like you're like, ah, but I want cake after dinner, and I'm like, go get a different hobby. Yeah, I

Speaker 1 51:12 actually had a very funny discussion a couple of weeks ago with my family doctor. He told me that he has a patient on a TLP, and he's on it for weight loss, and he said he wants to stop it every few weeks so he can eat normally.

Scott Benner 51:32 I don't understand. So people are

Unknown Speaker 51:35 like that,

Scott Benner 51:36 yeah, listen, I understand if that's how you feel. I guess what I don't understand is seeing all these improvements in your life that create such you know, I think

Speaker 1 51:47 you know what, Scott, I noticed this also from your stories that you're not so emotionally bound to Food. Sure, yeah, that's fair. And that's also something I'm not that emotionally bound to food. And some people are very, very emotionally bound to food. And for them, it probably feels like more like missing out, even if they see all the advantages it brings. Yeah,

Scott Benner 52:19 I mean, I would say, go talk to a therapist. Don't stop your medication for a week to eat differently. I mean, you know, and I don't even mean that funny, like, I'm just like, you know, obvious. Obviously you've got to, like, an issue. Yeah, you have an issue. Go figure out what it is. Like, you're so close now. And I, you know, my heart goes out to people who feel that way. I know people who have that attachment. I've seen some of them be able to push through it with GLP. And I've seen others like you describe I talked to this one person this past summer, and they clearly have pre diabetes, right? But it's probably type two already, and a weight issue, and their job requires a certain A, 1c, so they go on a GLP long enough to bring their A 1c down, and then get the test so they can keep their job. And then they go off and go off it immediately because they want to eat. And I had a very frank conversation with the person. I was like, You're killing yourself. You're you're gonna die, like, running around with an A 1c like, in double digits, you know? And I was like, just, don't, you know, like, and the person described to me that one of their joys is to come home after work, take a bag of frozen french fries, put them on a sheet pan, bake them and put cheese over top of them and eat them. Wow. And the person was like, I don't want to not do that. Yeah,

Unknown Speaker 53:43 you can't do that.

Scott Benner 53:46 No, no. TLP, yeah, you made the point earlier. There are going to be people who have stomach issues because it interacts poorly with them. Their body morphology is not able to handle it like but there are other people who slow their gastric emptying down with the drug, and then just continue to push in foods that are high fat, processed, not good food for you. You get stuck in there. Yeah, it's not like you're trying to digest a bunch of, you know, natural food. You're, you know, it's chemicals and additives and etc, and you're just jamming it in there in a slower digestive situation, and they're like, Well, I have stomach problems for the GLP, I would argue you have stomach problems from the bag of French fries, from the way they eat. And we need doctors to see the difference in that before they make blind judgments about, like, what this medication is for and what it's not for. You know, because I

Speaker 1 54:37 also had a person in my social circle who is overweight, and they tried the TLP as well. They tried it after I started. So I knew quite a bit to tell her how to handle the start and some tips and tricks. She couldn't do it. She just said, I can't eat such small portions. That isn't healthy for me,

Scott Benner 55:01 but they're significantly overweight. Yeah, yeah, I understand. Well, you tell yourself whatever. You tell yourself, I had side effects from GLP in the beginning, like, I probably didn't take what you would consider to be a well formed bowel movement for quite some time. And you know, my wife and I were doing it together, and she's like, are you gonna stop? And I'm like, I'm losing weight. I was like, No, you know, if this is how I gotta pay the piper to, like, you know, to get where I need to go, then I'm gonna find a way to get through this. And yeah, I had to take magnesium oxide to keep going to the bathroom. And it led to, you know, loose stool. And I was like, I guess this is the price I'm paying for, you know, for getting back to good. So I'll keep going, you know. And now it's not like that anymore, but it was like that for longer than I wanted it to be. I'll tell you that much. But I was like, I'm persevering. What have we not talked about that we should have? This is a good conversation.

Speaker 1 55:58 I think we covered everything that I wanted to talk about. Awesome,

Scott Benner 56:02 awesome. Hold on a second. Arden's texting me. Hi Arden. She said, the dentist, let me see if she's out now. She said, Are you recording? And I said, I'm almost done. Why? Let's see what she says, a drum roll. She's gonna want breakfast. What is she asking about? A lot of times, my kids just want me to cook for them. I'm hungry and I have to leave to get naughty in an hour or two, are you home? She could be in the house. I don't know. This is so boring, texting with Arden on, yeah, okay, I'll be down. She just wants breakfast. She's 20, by the way. She could use her hands and make it herself, but apparently it's better when I make it. But I think that's just convenience, yeah, well, that's it, yeah, exactly, right. They're like, Oh, it's better when you make it. I'm like, You mean, because I make it,

Speaker 1 56:44 yeah, in every aspect of it, you know, yeah,

Scott Benner 56:49 exactly I want to cook or clean up, or any of the stuff I have to get her back on. I've recordings with her. I'm starting to run out of my recordings of things she doesn't understand. Have

Speaker 1 56:58 to go do some love this series. You definitely have to continue. Oh, okay,

Scott Benner 57:01 good. I'll have to tell her, that's awesome. We were talking about the one that's coming out next week. It's about Bridget Mendler, like the Disney actress. No idea, nothing about this girl's like, a, you know, on a Disney TV show as a kid. Then she, you know, pumps out a couple of, like, hit pop songs, then she goes off to college, and, you know, who knows where she goes, and now she's running, like, running a satellite company, okay? And I'm like, What the hell? So Arden's just like, there's these crazy she's like, how did this happen? So we talked about, but I do love this guy. I like them. It's funny. I like them with Jenny too, because we talk more about, like, diabetes stuff in those Yeah. I think it's a great concept. Yeah. So I want to get more people to come on and do it. I'm going to, in 2025, I'm going to kind of put the call out for people and try to get people to pop on and just like, pick one topic, just like, I don't understand this, and I want to talk about it. And so together, we won't understand it. We'll figure it out. I'm definitely looking forward to that. Good, good. I'm glad. Oh, it's awesome to talk to you. Well, I'll see you. Oh, no, you're the oh, we're doing a group. What we're doing a group expert like, get together on Zoom. But we had to do it at a certain trying to stay up. What time of the morning? What time would it be for you if you were there 2am

Speaker 1 58:21 tell people where you live in Switzerland. Yeah, we

Scott Benner 58:26 adjusted it. We usually do it at one time, or Cassandra can come. But then it seems to mess up the people on the West Coast of America. So we moved it around a little bit so they could make it. But then it puts it like super late at night for you. So I will understand totally. Obviously, if you can't come, I'll try to manage you should pre record a message and send it over to us. This was really great to come back on and do a follow up like this. I really do appreciate it and all the hard work you put into the group,

Speaker 1 58:53 too. Thank you. Yeah, thank you for having me again. It's a pleasure.

Scott Benner 58:57 You're awesome to talk to. You're great to talk to because you have struggles, you pay attention to them, you research them, you put stuff into action. It works, or it doesn't work, you move on. And I think that's how more people should handle their health. Probably all people should handle their health. People like that are always very good at retelling their story, because they so authentically came to the answer that they really do understand the journey that makes sense. Makes sense? Yes, thank you. No, you're good at you're good at explaining your story. So it's always great to have you on. It's a pleasure. Hold on one second for me. Thanks for tuning in today, and thanks to Medtronic diabetes for sponsoring this episode. We've been talking about Medtronic mini med 780 G system today, an automated insulin delivery system that helps make diabetes management easier day and night, whether it's their meal detection technology or the Medtronic extended infusion set, it all comes together to simplify life with. Diabetes. Go find out more at my link, Medtronic diabetes.com/juice box. I'd like to thank the ever since 365 for sponsoring this episode of The Juicebox Podcast, and remind you that if you want the only sensor that gets inserted once a year and not every 14 days, you want the Eversense CGM, ever since cgm.com/juice, box, one year, one CGM. I can't thank you enough for listening. Please make sure you're subscribed, you're following in your audio app. I'll be back tomorrow with another episode of The Juicebox Podcast. Are you starting to see patterns but you can't quite make sense of them? You're like, Oh, if I Bolus here, this happens, but I don't know what to do. Should I put in a little less? A little more? If you're starting to have those thoughts, you're starting to think this isn't going the way the doctor said it would. I think I see something here, but I can't be sure. Once you're having those thoughts, you're ready for the diabetes Pro Tip series from the Juicebox Podcast. It begins at Episode 1000 you can also find it at Juicebox podcast.com up in the menu, and you can find a list in the private Facebook group. Just check right under the featured tab at the top, it'll show you lists of a ton of stuff, including the Pro Tip series, which runs from episode 1000 to 1025 Hey, what's up everybody? If you've noticed that the podcast sounds better and you're thinking like, how does that happen? What you're hearing is Rob at wrong way. Recording, doing his magic to these files. So if you want him to do his magic to you, wrong way. Recording.com, you got a podcast. You want somebody to edit it. You want rob you.

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Scott Benner 3/24/25 Scott Benner 3/24/25

#1471 Square Zero

Returning guest, FB group expert from episode #829 "Chinese Hamster Ovaries," shares exciting updates on her PCOS and gastroparesis success.