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Podcast Episodes

The Juicebox Podcast is from the writer of the popular diabetes parenting blog Arden's Day and the award winning parenting memoir, 'Life Is Short, Laundry Is Eternal: Confessions of a Stay-At-Home Dad'. Hosted by Scott Benner, the show features intimate conversations of living and parenting with type I diabetes.

Filtering by Category: Juicebox Podcast

#1360 Best of Juicebox: Jesse Was Here

Scott Benner

Originally aired on December 13, 2016. 

Sensitive topic - please consider not listening with children present.

Michelle has been a strong advocate in the “d” world since her son, Jesse, was diagnosed with Type 1 diabetes in 2000 at the age of 3. After the sudden loss of her son at the age of 13, she continues to advocate and educate.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon MusicGoogle Play/Android - iHeart Radio -  Radio PublicAmazon 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.

Scott Benner 0:00
Welcome back, friends, to another episode of The Juicebox podcast.

This episode originally aired on December 13, 2016 it was episode 90 of the Juicebox podcast called Jesse was here. It's marked as a sensitive topic, and at the time, I wrote, please consider not listening to this with a child present. Michelle has been a strong advocate in the diabetes world since her son, Jesse was diagnosed with type one diabetes in 2000 at the age of three, but after the sudden loss of her son at age 13, she continues to advocate and educate. I'm running this today as part of Diabetes Awareness Month to memorialize Michelle, her husband, Jeff, Josh and Tammy Stahl and Barry Sievers. These five people all part of breakthrough T 1d ride team recently passed away in a tragic car accident. Please keep Jeff, Michelle, Josh, Tammy and Barry in your thoughts and prayers, and think of their families and loved ones. Nothing you hear on the Juicebox podcast should be considered advice medical or otherwise, please Always consult a physician before making any changes to your health care plan.

This show is sponsored today by the glucagon that my daughter carries. G vo hypo pen. Find out more at gvoke, glucagon com, forward slash Juicebox. This is a content warning. This episode of the podcast deals with life and death. As I know that many of you listen with your children. I just wanted to let you know that you might want to skip this episode with your kids.

Michelle Bauer (Alswager) 1:54
I'm Michelle alsweger. I've been involved in the world of diabetes since my son, Jesse, was diagnosed at the age of three on march 3 of 2000 I became a director of jdrs in those early years. I helped begin some ski snowboard camps called riding on insulin, which my son participated in, and I kind of stepped away from diabetes for a few years, my son was kind of sick of talking about diabetes, so I took a job at a woman's magazine and just kind of volunteered my time in the world of diabetes. And then on February 3, 2010 my 13 year old son, Jesse, passed away from his type one diabetes, and I became an advocate, more so for people who also have lost their children to type one diabetes throughout actually, all over the world, I mentor about 100 families through a private Facebook group, getting them connected to each other so that they have the support that they need. That's

Scott Benner 2:54
really amazing. Oh, okay, so how old was Jesse when he was diagnosed?

Michelle Bauer (Alswager) 3:00
So Jesse was three years old when he was diagnosed.

Scott Benner 3:03
What was the presentation? Was it average? Normally? Yeah, it

Michelle Bauer (Alswager) 3:08
was every typical, you know, everything he was, the little, skinny three year old boy, all of a sudden, started wetting the bed again. And I was kind of flustered about it, because we had a water container in our refrigerator, and I caught him getting up in the middle of the night, getting himself water. I thought he was just fascinated with the fact that there was a spigot that he could mess around with, but it turns out he was just really super thirsty. And it was a Friday afternoon, and I was ignoring the warning signs. I didn't want it to be diabetes. I grew up with five aunts and uncles with type one diabetes, my grandma raised five and back in the day when insulin, you know, came in a glass syringe, and it was even before urine test strips. I was around people who use test tubes to check their urine for all of that. So we, you know, the typical signs took them to the emergency room. It was one finger poke. Simply, I was very fortunate that there was no misdiagnosis, and they just simply said he has diabetes. And so

Scott Benner 4:06
you, you had a fair feeling from your your past, your history and your family, that that's what was going on. Yeah,

Michelle Bauer (Alswager) 4:13
absolutely, I definitely wanted to be in denial and but you know what, there was also that point where, you know, I'm driving to the hospital and I'm, you know, saying out loud to whomever the universe, you know, please don't let that be diabetes. And then at the time, I was thinking, Well, wait a minute, I hope it is diabetes. Don't, don't let it be something like leukemia that could possibly take his life, right? Never occurred to me that it could possibly take his life.

Scott Benner 4:38
Okay? So, three years old. Gosh, that's a while ago now, injections like, like, just, there's no glucose monitors or stuff like that right at that moment.

Michelle Bauer (Alswager) 4:50
No, there were meters when in 2000 so he had meters. He actually, at the age of five, went on an insulin pump. Okay, he was one of the first kids in our area to go on at. Because I fought with the endocrinologist to make that happen. And actually, you know, if you flash forward to 2010 he actually did have a continuous glucose monitor. He actually didn't wear it very often. It was at a time where they were still a little bit sickle, and he decided he didn't want to feel like the front of an airplane, you know, dashboard. He felt like were too many devices hanging off of him at the time.

Scott Benner 5:27
So was he? Was he wearing it at the time of his

Michelle Bauer (Alswager) 5:30
passing? No, he was wearing his pump. He was wearing a pump. Okay, so,

Scott Benner 5:33
okay. So I think we should just dive right in, because, like I told you before we started recording, it's, I always think to talk to you, because it always becomes my concern that, you know, inevitably, someone passes away. And I don't want to say how frequently it happens, because I don't know it. It feels like at least once a year you hear about someone that that's lost their life, who's had type one diabetes and living with it. And then it's always my fear that when people see that they that they become more cautious about their own care, but maybe in the wrong way, maybe in the way where they're like, Oh, I'd be happier to accept the high blood sugar because, yeah, maybe they kind of incorrectly think that the way somebody's passed is just because their blood sugar has gotten very low. So

Michelle Bauer (Alswager) 6:15
yeah, your podcast is timely, because this has been a topic that there's many of us. They've been talking about this topic, the high blood sugars, right? Yeah, Derek rap, who is the jdrs CEO. He and I have been conversing about that exact topic, and I've been talking with beyond type one about that topic, because I think it's, it's phenomenal, right now, I'll back up just a little bit. When Jesse, when Jesse died back in 2010 nobody was really talking about death due to type one diabetes, right? We're all kind of scared. We don't want to talk about it. And let's face it, endocrinologist didn't really tell us that diabetes was something you could die from, right? So, you know, it was something we said, no, just take good care of yourself. You live a long, happy life, right? So when he died, because I had international attention from a documentary I had done. People knew me, and so they thought, oh my gosh, if this can happen to this mom, it can happen to any of us. And so it puts everyone in panic. And so I think every time you hear of a death, and you know, you said, once a year, I hear from someone at least once a week that has lost a child to type one, at least once a week, some become more public than others, because some people just, you know, when they when they passed away, they their way of dealing with it is to kind of go inside. They're they're not going to be proactive, and they just needed, they just, that's how they're going to grieve. So what's happened is, everyone talks about dead in bed, right? Which is, I'm so afraid my child is going to have a low and he's not going to wake up in the morning, which is rightfully so. I get it, and, you know, it's a fear to have. That's why CGM are so amazing and alert dogs. But what people don't think about, and they're not talking about, is the high blood sugars. The one thing I've learned through all of this is, I call it the dangerous cocktail. The dangerous cocktail. Everyone's got their eye on those low blood sugars in the middle of the night. They're waking up in the night. But I don't see parents panicking as much when their kids are at a 500 or their meters are just reading h i They're not testing for ketones. I know a lot of families don't even own keto strips. I know a lot of adults with type one that I work with in our endurance community don't carry keto strips, which they don't realize. The dangerous cocktail is this. This is what I've learned from the depth is if you have a high A, 1c and then you tack on and you add that you have a high blood sugar right now, and you have large ketones, that is a recipe for disaster. So like, for instance, if you have a teenager who's currently an ANC of 12% their bodies, and I'm no medical expert, right? I'm just, this is my opinion. And what I've seen, of course, is there if their blood sugars are high, and they have a high ANC, and those large ketones, and they are in DK. And as moms and dads, we're not as afraid of those high blood sugars. And we also have a fear of taking our kids to the ER, because we've learned over the years that we feel like we know more than the residents that are there, right? I mean, I bet you there's 100 people that will listen to this podcast and have a memory of taking their kid to an ER, and the resident starts to load up insulin drip instead of a glucose drip, right? And you're like, Whoa, what are you doing? Right? So we have this, we have this doctor mom and Doctor dad syndrome, where we we think we can take better care of them at home than at the hospital, and then by the time they get to the hospital, it's too late.

Scott Benner 9:40
Yeah? And that makes no it makes a ton of sense. And I think it feeds right into, you know, everything that you've said so far, plus everything that I see, usually, hold on. I have to tell arm to drink a half of a juice, just texting her, we're good, okay. And so, you know, so I think that what you see here is that, first of all. Yeah, like you said, when you start off, I remember getting, you know, somebody handed me glucagon, and I was like, What's this? They're like, Oh, you know, it's in case they get really low extension, you'll never use it. Don't worry about it. And so then that's the overall feeling, like, Oh, she has type one diabetes. It's horrible. It's going to be with her forever. But even the emergency thing, I don't even have to understand that well, because it's never going to happen. And then you know, as you're acclimating yourself to trying to figure out how the insulin works. The message from medical a lot is better high than low. And then you're and then that the you're sort of the human part of you takes over, right? Well, they said 150 to 200 was okay, but it's only 210 so that's fine, right? And then your body, you start to accept it. Well, 250 I mean, that sucks, but it's not terrible. I can get it down. And before you know it, 180 200 is your norm. You live there. And then when you see a 320 suddenly it doesn't seem that horrible anymore, even though your blood sugar is now at 323 times what it should be, and, and, and there's not that panic. You do see it all the time, like people say, Well, I want to get them, I want to get their blood sugar high overnight so I can sleep. I don't even understand that I'm up as much when my daughter's blood sugar is high as when it's low, maybe more honestly, when it's high, because more difficult to deal with. It takes longer to adjust and fix.

Michelle Bauer (Alswager) 11:15
And a lot of a lot of parents aren't actually informed either, though, that you know, in their kids, there's a child can have 150 blood sugar, which, you know, fine. It's an it's in a range. But if they're, if they're sporting any kind of ketones, and they're not getting, like, you can be 150 and say, Oh, if I just don't dose insulin, they'll be fine. Their body constantly needs that insulin. You constantly need to be feeding that system. So you can be in danger at 150 if you have large ketone, yes, if you're not, yeah,

Scott Benner 11:43
it's my daughter's sick right now. She's why she's home from school. She has a head cold. She doesn't have a fever, she doesn't have the flu, just has a head cold. And for the last two days, her blood sugar has been difficult. It sticks at 200 I have to give her enough insulin to knock a horse over to get it to move down overnight. At three o'clock. She's growing on top of it, so overnight, I get three o'clock in the morning the night before, it just it tried so hard to go up, and I, I felt like I was, I was putting insulin with a funnel instead of with a cannula, you know. And and then last night, I just didn't wake up, I think, beeped and beeped and beeped. And at 6am I opened my eyes, the first thing I heard was it beeping, and I thought, and I looked at the graph, and sure enough, at three o'clock, she went from like 120 like straight up. And I went in. I tested her. She was 310 she had been 310 for three hours. You know, for the most part, I Bolus so much insulin. I mean, just two and three times what moving her 200 points should take. And I still had to Bolus again and again. And by the time she was down to 80, it took me, I'm gonna say, the better part of four hours, and I gave her, you know, so much more insulin than I would have in a normal situation, because very likely, and I didn't test her, but very likely, she had ketones, plus it's more difficult to affect the high blood sugar. You know, once your blood sugar is high, it takes more insulin, normally, those sorts of things. And then I think that's how people get caught in the loop. They see a 250 and they go, Oh well, you know, it should be this much insulin, and then they end up using half as much as it takes. And then two hours later they go, Oh my God, it's still 220 and they try it again and again. Before you know it, it's time to eat, and then it just, you get caught in this horrible cycle. It is very hard on your body, and so you know, and it's, it's not going to kill you this second, but it doesn't mean it doesn't have a hard effect on you. And I think that's hard for people to hear that they're that they're they or a child, has a disease that has two sides of a spectrum, and both sides of it are equally dangerous, just the timing of the most dangerous, like, do you want to, do you want to have something horrible happen to you right now? Do you want to have something horrible happen to you 10 years from now? Do you want to have something horrible happen to you three months from now? And what, I think what happens is that becomes so overwhelming for some people that they just panic and pick a side and they give up in some way. And I'm always trying to tell people that it's not as crazy as it sounds if you're struggling with it. It is much simpler to keep a blood sugar more around 100 than it is to keep it higher and and then it just takes practice and a little bit of knowledge. And a lot of times that is knowledge you don't get at the doctor, which is why community ends up being so important sometimes. But you know, that's why I asked you on I just, I just wanted people to hear from somebody who had lived through it and was still talking about it, that, you know that. So, I mean, I guess Can we go backwards a little bit, and I don't know how much of this you talk about, but do you know the the steps that happened, that that led to Jesse's demise? So

Michelle Bauer (Alswager) 14:48
it's interesting. It's interesting. So I'll give you my perspective on this. So ever since that happened, and every time there's a death in the D O, C deputies online community, you know. There's different sides that happen. There's times where I feel it's really awesome, like I'm so happy people talk about this now, because even if we save one life, it's like one parent decides to get up an extra time in the night, or one parent knows the warning signs, like, as long as we're talking about I think it's really good. Then there's this other side, where I like to protect the parent from seeing things. Let me give you an example. I'll go back to your actual question. So there was a recent death. The young lady's name was Alex, and it blew up all over Facebook, and it's so well intentioned, and the people who are posting it? Mean, well, right? Yes, but what I saw and made me sad, and a lot of the parents in the community that nobody wants to belong to, right? This lost community, we respect the parents privacy. So what happens is, someone posts that photo like I would rather see it. Say there was another loss in the community, you know, prayers, sadness, all of that, that's fine, but what happens is the threads blow up, and what you see is, well, what happened? What was the parent doing? And then you see hateful things, like, clearly the mom didn't know what she was doing. Or, how did that girl not know for 48 hours she was in D, K, a, such that that could have been prevented, that what I see in that is there is a mom out there who's suffering. She's going to suffer for the rest of her life. She lost the child. And these people are gossiping. It just comes off as gossip, because those those parents, as much as they want to know what happens, got you already know the answer. We know people die from extreme highs and extreme lows, and all you have to do is keep doing what you're doing, getting up in the night, checking what happened to Jesse is what I will tell you everybody is, I don't go through the steps of what happened that day, because when I'm asked to do that, you're actually asking me to relive my worst nightmare, Right? So there's, there's a, I call it the slideshow in my head. So I have to shut off the slideshow because I can't relive that memory. So what I do is I tell you simply this, you're already doing what you should be doing. It's highs and lows. The coroner actually told us he's basal and he labeled it as D, K, a, and I can second guess it. I could read the coroner's report. Nothing is going to bring him back, and nothing is going to save you know, Aiden, or anybody, right? And it you just have to keep, just keep trudging. And another thing I tell people a lot is you can spend so much time focused on the diabetes and asking me questions about exactly what happens, and you miss that your child, you know, gets hit by a bus walking across the street, or riding his bike, or riding an ATV, or, you know, he gets cancer. So, so that's kind of how I always handle that question, is, there's no there's no pinpoint, there's nothing that's going to save your child by learning exactly what happened. I mean, in all the families that I've encountered, the 100 families that have found me and found our private Facebook page where they can grieve and dream or share good details or Happy Days, is the college age kids. There is something there to be said that when you're sending your kids off to college, the biggest thing I see is death due to DKA. They go out drinking with their buddies, or they simply just don't tell their roommates they even have diabetes. Or how to give them a glucagon, or how to if I'm acting weird, you know, give me, give me a juice box. This is what these are the steps you need to take. What happens is maybe they went out drinking and they're acting a little weird, and people just put them to bed thinking that they're just drunk, right? And then they don't wake up. There is a very big preventive measure you can take in that situation. Well,

Scott Benner 18:56
I would say that, and I asked you that question, hoping you would answer it the way you did, and more, just to kind of spur on this part of the conversation, I guess. So when you see people in the community or online or wherever it ends up being, and they start wanting to mine out the information. How did this happen? What are the steps? I always think they just want to know what happened, because they are just hoping that the story is opposite of what they do. You know what I mean? Like, like, they just want to hear that someone did something wrong, or someone did something, you know, in their eyes, it's not correct or different than they do, so that they can sit back comfortably and say, oh, okay, good. I'm not doing it the way they did it, so my kids gonna be okay and and it's just, it's just to me. It's let me know how to put it really. It's just a wild like flailing into the world, like, you know, just, please let this not be my story. And I need to hear, I need to hear your story so I hear so I find out it's not mine. And, and in the end, that they don't see how horrible it comes off. Is, is fascinating. And I'm not saying you don't have those thoughts. I mean, you you spoke about the the little girl, or the the girl who who passed recently. And I try very hard not to pay attention to just any of that. I don't think it's any of my business. I don't pay attention. And I heard one person say that, you know, the kid had it was in decay for, you know, days. And it did pop into my head like, God, didn't they test? Didn't they know, but at the same time that my next thought is is very simply this, and I mean this completely, completely honestly, it's a really terrible disease to live with. The factors that affect you come from so many different directions and so fast, and everyone's understanding of it is different to blame anyone for anything that happens with type one diabetes and the use of man made insulin and not having a pancreas that works is just flatly not. It's not human You can't blame somebody for that. It's no different than blaming somebody for, you know, being in a car accident, or, you know, falling off of a bridge, or, I don't know what the hell like anything. You don't even there's some things in the world that just happened to you. You can't be blamed for them. And it's it's wrong to try. I think so

Michelle Bauer (Alswager) 21:09
well. And the reality is this, there is not a parent out there who's lost a child isn't already dealing with blame on their own, right. So there's, there's so much Coulda, Woulda, Shoulda, no matter how it happened, where it happened, when it happened, if I spent all my time blaming myself or my ex husband, I wouldn't live day to day. And like, people don't understand sometimes that for the first few years and sometimes, I mean, I have people that I've been part of this group for seven years, we've kind of gone through this together. They never kind of escaped the constant pain and suffering of it, they just That's That's where their grief took them. It's interesting because we're talking about this because someone shared an article with me today about grief and loss of a child, and like, seven things I've learned from from loss of my child. So well written and it's and like, step number seven just really resonated with me is that because of the deepest pain that we have felt, we really experienced joy more than the average person. And I don't know if you can completely understand that, but like, because we know the bottom of bottom, like when we see joy, it's such a strong emotion. And the same with grief, like any kind of loss we feel now, like, say, someone goes through a breakup, I call it. How do I explain it? It's like, it's like, you already have a sunburn, and then the sun shining and burning it worse, right? So everything you feel painful is twice as painful, and everything like joy, really stands out. And I say that because, like some people can see me on the diabetes online community, I write a lot for beyond type one. I, you know, I've written for D life, and I share my joy a lot. And I, you know, I am living a great life. I tomorrow, I leave for Rutger Ridge, Colorado, and I get to ski with, you know, 25 type one key coaches and help train them and and then run a camp on Saturday up there for kids with type one diabetes. I'm living a really good life, and I've decided when I say things like, people ask me, how are you? And I can say I've never been happier. It used to really pain me to say that, because I would always think, what is that person thinking in the back of their mind? By God, she lost her child. How can she say she's happy well, because I have to move forward. I have to continue living. I can't live in doom and gloom every minute. But don't for one second think that a parent who's lost a child isn't feeling this underlying, constant hole in their life. They're just they're just learning to live with just like, much like you learn to live with, you know your child's diagnosed diagnosis, right? Well,

Scott Benner 23:43
I was gonna say yeah. I was totally Yeah. I was just totally gonna say I it's, I mean, I'm prefacing it needlessly, because I don't feel like you need me to, but it obviously, it obviously doesn't compare. But at the same time, I know what you mean about the joy thing. Like, I always tell people like, now that my daughter lives with this chronic illness that does envelop a lot of our time. It does loom over top of your head. Is she okay now? Will she be okay later? How is this gonna affect all these things that when something good happens, you really do feel it very purely, and at the same time, when something that you used to think of as being bad happens, you can laugh it off almost sometimes, like, sometimes I'm just like, That's not important. Is that person upset about that? You know? Like, they totally should get up with me tonight at 230 and watch Arden try to eat a banana in her sleep. Like, like, I think that would definitely change their mind about what bad means. But at the same time, I heard what you were saying. I guess that when you see something bad that it brings all of your emotions to the top more, because I can't imagine how strong you are to be able to get to the point where you can say, This is the happiest I've ever been. Because being someone who has not nearly gone through what you've gone through, I'm having a hard time imagining being able to get past the idea that I'm allowed to be happy. Me after and and that I should be or that I'm not hurting something, and that you figured that out, that path that's magnificent. I'm so glad you're sharing it with other people, because it's not something anyone can imagine, obviously, unless, unless it's happening,

Michelle Bauer (Alswager) 25:14
the only way you can, the only way you get there is with support.

Scott Benner 25:18
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Michelle Bauer (Alswager) 26:30
And you know, I was just very fortunate that the people I chose to surround myself with, you know, I have to tell you, like, there's this very weird thing that happens at boss, you and I have written about it, but when you when I lost my son, I also, I was very involved in the diabetes world, you know, I'd done a documentary I had, you know, given to, you know, done every JDRF ride every year, all over the country and and all sudden, like, who's going to want to Be around the person who lost their kid to diabetes. If your kid, you know, if you as the parent who have a healthy type one living at home, you're going to want to spend any time with the mom who lost a child. I really panicked I was going to lose this entire community, and I was very blessed and fortunate that my my people rallied around me and, you know, and it's, you know, I talked about, you know, I'm very blunt. I talk about, you know, the loss of Jesse and and moving forward and what I continue to do for the community. But I just, I guess, I just feel very lucky that I was, you know, allowed to stay here. Of course, I use my time wisely in that, you know, when I'm in a riding on insulin case number camp, and I'm standing talking to a 10 year old kid, you know, and he says, How old was your son when he was diagnosed? I just say three. And yeah, he asked questions I would never talk to, you know, those kids, sure, you know, and tell them, I lost my son because it's not inappropriate. He

Scott Benner 27:59
was about your age when he passed. Yeah, there's, there's, there's, there's no value in that. No value. Yeah, exactly, and, but it is really cool that that people did that because I, I tried to imagine, do people struggle with how to speak to you when they know? I imagine they would, right,

Michelle Bauer (Alswager) 28:16
sure. Um, I mean, the worst is when someone doesn't know. I mean, now it's been seven years, so it hasn't been as bad, because most of the people I know know, but you know, in the in the early first couple years, it's just so horrible is, you know, you run into an old neighbor and they're like, gosh, how's Jesse? And you're like, Well, you know, and you what's hard for those families, and myself included, is if forces you, they're grieving for the first time, and you're forced to re grieve something. You've you've gotten your you're at Step 29 and they're at step one. And you know, so you see their pain and you see their grief, right? So, you know, I, I don't even reach out, like if, if a family is lost, I don't reach out to them. I kind of wait for them to find me, let them come to me when they're ready. And some are never ready. Some just decide, you know, it's just not their thing to grieve with. Others, they just, they just don't find a need for it. But it's a solid group that helps each other, and I'm really proud that a lot have gotten involved. And, I mean, I don't know if you know, but like, beyond type one is really involved in the whole DKA movement to get information to every pediatrician in the US. Yeah, warning signs. And while that's not going to save a Jesse, it is going to save kids, and it's going to save lives. And I'm like, I'm just so proud of the people beyond type one that they took a sensitive topic that I know that they've been contacted by others in the online community who are saying, you're scaring people with this topic. And, you know, I think that their opinion, and I can't. Really speak for them, but just from conversations I've had with them, is they're like me. They don't care if it saves one kid. It's worth talking about.

Scott Benner 30:08
Yeah, I interviewed Mary recently, and we were talking about all these different ideas and and I can't see, I can't agree with that more, and at the same time, like you're scaring people, the idea that you're scaring people by bringing that up, I that that starts to scramble my head, because here's what I'm scared by. I'm scared by all the people I see online who say things like, hey, my kids blood sugar has been 300 for three hours. Should I correct again or I don't, you know? Do you think it needs more insulin? Like, and I'm not scared because they don't know. I'm scared because someone hasn't explained it to them, because their doctor didn't tell them, because they got some sort of info. Some sort of information that led them to that thought and and you can, you can shine a light on things like DKA, you know, awareness, and try to pretend that that's scary, but that's not the scary thing that's going on in your community. What's going on in your community, I think, simply put, is that most people don't understand fundamentally how insulin works and how to use it. I really think that's the most scary thing, because at some point then, and I know most scary is not English, I'm pretty sure, but, but most, very scariest is what I'm saying is, is that, is that none of us really get taught how to use insulin and how it works. And then, you know, I,

Michelle Bauer (Alswager) 31:23
I have a, I have a really interesting story like, just to share quickly on that is so one of our elite coaches, I'll use her name, because she won't care, Lauren, Lauren and I have gotten very close over the last few years, because she also did the Ironman Wisconsin with our group this last year and doing it again. So we've gotten to be friends. And she's She stayed at my home, and she was over in Austria. She lives over there quite a bit of the year because she trains with the ski team over there. And I follow her on her Dexcom share. There's a few people that I follow just because they look at me as someone that's kind of an outsider, not a parent. You know, I'm not going to chastise them, but I'm kind of a safety net for Lauren when she travels. That's cool. And so she's seven hours ahead of me, and she is having roller coaster blood sugars. And I'm talking up to high, down to low, up to high, down to low. And I mean h, i and l, O, W, and so we're in constant contact, and she's just staying in a place with a 20 year old kid who has no understanding of type one diabetes. She ends up having to administer her own glucagon. So I just kept her on the phone for a couple hours, and we just hung out while I worked, and I kept her safe and just watching her graph and trying to help her, I just finally said, You know what, Lauren, I know you're not going to want to hear this. You're scaring me. Your numbers are scaring me. The fact that you have large ketones are scaring me. You need to be in a hospital. And she said that I'm in Austria. I'm afraid of the language barrier. I'm afraid they're not going to know what to do. And I said, You need to be where the right equipment is and get the help. And I think if Lauren didn't know me and didn't know Jesse's story, I don't know that she would have gone to the hospital, but she went and she she was very grateful. She said, Thank you for pushing me. I was in severe I was severely dehydrated, and I was definitely in DKA. Now, had she gone, kept going at home, I don't know what would have happened to Lauren. And so I, when I when I hear that, you know that lets me sleep at night, that I helped Lauren, that I know that Lauren went to a hospital simply because she knew Jesse's story. And I'm sure there's other parents all over the world that I don't even know, know of Jesse's story, and probably had a similar situation. And you

Scott Benner 33:44
and I have never spoken before this, and we don't, we don't know each other, and yet you come into my mind frequently, yeah, yeah, and so, and it's always wrapped around this issue, and I don't want to, it's funny, we always talk about this community online, but and I wonder if people realize when they're in it, I'm kind of going backwards, but when they're in it, that they're not that they're likely not going to be in it forever. And so as a person who has had a blog for 10 years, and I'm sure that you have a similar idea, the names and the avatars, they come and they go, and they come and they go, and people get in there, and they either get the information they need, or they stay till they're comfortable, or whatever it ends up being. But in the moment that they're there, they believe that this is the world, that it's always been like this, and it'll always be like this, and they've just added themselves to it. And what I know as an outsider looking from, you know, a back a little bit that in six months, they'll stop coming around, they'll understand insulin, they'll not be scared anymore. They'll get the answers they need, the comfort they need, whatever it ends up being, and they'll go back to living their lives. I always feel good when I see people disappear. You know, when I see them leave, I always imagine that they just have everything they need and they just want. Go back to their life and and at the same time, when you see somebody who is just so fervently, just arguing or trying to make points, or what did this person do? Like that whole thing, I think they're missing the point of it. The there's this there's this comfort there. There are some people who have been there for so long, they could come really help, like you did with Lauren and and I just wonder if sometimes it's not lost on them that they're not the driving force of what's happening, that the the entity is the driving force of it. I don't know if that makes any sense, or even why I got off on that tangent, to be perfectly honest with you, but it just always, it always strikes me when someone's raining or raving or or coming out, like they're just like, I know what to do. And I'm like, Yeah, I feel like you've been here for three weeks. But go ahead, tell everyone what to do, and you know, and then and then, and they get going, and then and then, I always look at the threads and I think, oh my gosh, this person asked a simple question. There is a simple answer to it. You can agree or disagree that I know what that answer is. And then six people come in and say six different things. And I always try to picture the person either and going, I asked a question, six people answered six different ways. I don't know what to do now. Like, who do I randomly pick? Do I just take the person whose avatar looks the most pleasing to Me and decide to believe them? Like, how does it end up working? But to know that there's someone like you who you can trust. What's coming from them is huge. And I think that those are as are the community, even though the people who are maybe the loudest in it or the most active, maybe they may never know that, you know, but, but so it's a it's a really huge thing you're doing, and I think I'm thanking you in a very long, convoluted

Michelle Bauer (Alswager) 36:45
the do see, you know, the whole online community, it's such a resource. And the same breath, when I meet a newly diagnosed family, I say, just be so careful on the do see, because there are the shamers. The shamers being the ones that say, Oh, my child's never been above 170 I'm calling the F on that, okay, because we've all been there. And, you know, you're not magic, you're not a unicorn. You know, there's the shamers and those people that know everything, or, you know, they're there. I think some of the D, O, C has gotten a little bit, dare I say, out of control again. I'm probably gonna get my throat cut to that. But there are some, I mean, I've been blocked from a major one that I never have once made a comment on. Never once they

Scott Benner 37:33
just decided you were out, huh?

Michelle Bauer (Alswager) 37:34
I got I got shun based on somebody else I knew. And I'm like, Why did I get shown from that, but turns out, I don't really care. But you know what I mean? It's just, it's like, it's a drama filled, you know, do see situation, and I don't need to be there, but, like, I warn people, it's like, just be careful the information you're seeking and where you're seeking. It wasn't,

Scott Benner 37:53
I'll be, I'll be completely honest. If you asked me, my honest answer would be, there's good information, there's bad information, and there are crazy people. You have to figure out what those three things are, yeah, yeah. And so it just, it, just, I maybe can stay out of it a little more. I know this is going to sound completely backwards, like I'm in 1982 or that I, you know, voted for Donald Trump or something, but, but I think because I'm a guy, I don't get it as hard, you know, I think there's something to that. I think that I'm not one of the moms that it just doesn't it doesn't hit me as hard, but I still get it. You know, for every this will sound like humble bragging, but you know, for every 10 emails that are like, Hey, I listened to your podcast and my kids a 1c is down two points. Thank you very much. I didn't understand how to do this, or I never thought about this before. You know, every once in a while, you hear from somebody who's like, you're a pompous jerk, and you think you know everything. And I'm like, I don't think I know anything. I'm trying to tell you what works for me do whatever you want with that, you know, and so, and at the same time, I've had someone yell and rant and rave at me, because I, you know, I let my daughter eat whatever she wants to within a certain degree, we deal with it with instant. So I get hammered for that. And and, and I just have taken a very interesting tactic where I don't care, and so I just really, I pay no mind to it, and I do sometimes. I do sometimes. Thank the fact that a number of years ago, I wrote a parenting book, and I got these reviews, and the reviews were mostly very glowing, and then some of them were not. And then I just realized it was like, someone read this book and loved it, and someone read this book and hated it, I'm not in control of that, you know, like I can't possibly be in control of that. And I think of this the same way, my information is not dangerous. I always preface what I'm going to say. We'll say it right now. Nothing you hear on the Juicebox podcast should be considered advice medical or otherwise, always consult a physician before making changes to your medical plan. There, I'm not telling you what to do, and so you do whatever you want. And at the same time, please don't yell at me, because I don't like that, but I am just going to delete it if you always,

Michelle Bauer (Alswager) 39:55
you know, you make an interesting point. And like, you know, like I said, beyond type. One has given me a really good voice. And like I said, I appreciate them, and I did an article about etiquette. When you hear in the D, O, C, that someone has passed away, how do you handle yourself? And like, one of the biggest things I say is don't make this about you. And you know, don't, don't reach out to that parent, because I understand the empathy I understand. Oh my gosh, I too, have a child with type one diabetes. You're living my worst nightmare. Yeah, we know we're living your worst nightmare. You telling me that you still have a child that is breathing isn't helping me. You're helping yourself. You're making yourself feel better. You're not making me feel any better. So just, I just say, Stop yourself. Don't post on their, you know, funeral page, don't, you know, gosh, my child has diabetes, you know? And you know, I

Scott Benner 40:47
can commiserate with this, yeah? Because you can't, yeah. Draw, draw a strong line to your point with this. Almost every wedding toast, or someone who stands up at a funeral, who these people try to speak about the departed, or they try to speak about the people getting married. But if you really listen to what they're saying, they're telling stories about themselves, even when people don't mean to do it, it's hard for them not to relate things back to themselves. It really is a very human trait, you know, like, I boy, I can't say who, but I remember sitting at a wedding, listening, and I was like, Is this person ever gonna mention the bride and groom? Or no, I don't think, I don't think they're going to No, no, this is all about them. They but they thought, they thought, thought they were talking about the bride and groom. It was fascinating. Yeah, you know,

Michelle Bauer (Alswager) 41:38
I really do believe the majority of people, they absolutely mean well. And I know that. And you know, like, I always tell people to it's like, if you don't know what to say, just say, I don't know what to say, if that's okay, that's saying something, yeah, or don't say anything. It's okay. But it's it's amazing to me. Like, in an article about etiquette and explaining, don't, and I write, don't. Don't ask the person what happened. If they want to share, they're going to share. I say that in my article, and I will kid you not in the thread that follows on beyond type one, I was completely attacked by people saying she's not telling us what's happened. She we have a right to know. We have a right. She's hiding something. I'm like, by God, you did not read my article. So my article says, Don't ask me. I'm telling you not to ask me. And you're, you're telling me, I have to tell you, No, I don't, I don't have to tell you. And you know what, there are people who have asked me, and I, of course, tell them, you know, detailed information, and it just, it's, it's a right moment or a wrong moment, and I get to choose when that is and or who it is. Or, you know, it's like simple things tangent wise is like, you know, you're shopping at Target, and someone asked me, you know, because they're looking at the groceries I have on the card or whatever, like, oh, how many kids do you have? I don't get into details because I'm not going to forage a friendship with the cashier, right? I have four kids. I don't need to elaborate. Now, if it's someone I value in my life, I'm going to say I have four children. Unfortunately, my son, Jesse, actually passed away when he was 13, because I know I'm going to have a relationship with that person, and it's worth me telling and going through pain where and actually putting that person through pain, right? Because the target cashier really probably doesn't want to

Scott Benner 43:26
know that, and I wasn't trying to make you feel badly. And now they think they did and they probably didn't. And so here's what we've learned. I think, Michelle, shut up is the is the it's the right thing to do. It's everyone shut up. Don't, don't. You don't have any thoughts you you haven't perfectly crafted your comment to be the exact right comment. You know, you don't have a story that's so close to someone else's that they're going to be happy to hear it, that this person is going through such a multi faceted thing on an emotional level that you'll never understand. Just don't, just don't, you know, like there's nothing you can do, you know, make a donation to a diabetes charity in the kid's name, but then don't go out in the world and tell anybody. Do it for yourself. Don't do it for someone else, or so that someone else knows what a great person you are, or so that you can feel better about it, or feel comfortable it's not about you. Somebody had a horrible tragedy. Leave them alone. Am I close? Is that close? Or have I gone too far? Have you hung up like, you know what? That was too hard line for me.

Michelle Bauer (Alswager) 44:30
I mean, like I said this, you know, this book by, I believe her name is Amanda Miller, I literally just shared it with, I mean, it was so poignant and and just explaining, like, what, what we're feeling, how we're feeling it, and the best thing you can do is just be supportive. You can be supportive and loving without understanding, if that makes sense. No, it does. I don't want you to ever go into your brain and try to imagine what it feels like not to have your child. No one should feel that pain. I don't wish that upon. My worst enemy, because I know what it feels like. I want everyone to stay in their bubble, their happy bubble, really honestly, for as long as they humanly can, because it's a really nice place. You don't really realize how nice it is until you're on the other side of

Scott Benner 45:12
it. And it's not just with the death of a loved one or a child, by the way, too. You will eventually get out of that bubble. Like I remember being a young person in my 20s who was just married. I was like, this is all perfect, until the first time that, like, my hot water heater broke. And I was like, life's not as perfect as I thought it was. And then I fought with my wife one time. I was like, Oh my gosh. How did that happen? And then, you know, like, just your bubble continues to degradate it. It breaks down over time, until, and I hate to sound like, you know, but till the till the actuality of the real world hits you from all sides, like you can only insulate yourself for so long, hold on to this part of it for absolutely as long as you can. Don't let this part go. You can assume that the election might have been rigged by Russians. You can think that your neighbor probably is a bad guy who is dumping bleach in your Bush because he doesn't like the way it's blocking his driveway. That all that stuff is probably happening. It's okay to know that, but try to stay, try to stay blissfully ignorant about this, right? Just it's always going to be great. Everything's going to be great. I love my kids, I love my life, I love everything. And this is always going to be like this, because one day when it's not, yeah, it's going

Michelle Bauer (Alswager) 46:16
to hit you, right? You don't know. And that's always my advice to people. I say, please just go let your type one live their life, because you don't know when anybody's bus is going to hit, so just go live. That's the best advice I can give to anybody, and that's that's why I keep doing what I do at riding on insulin and and watching all these kids and and the adult. I mean, you know, I have, you know, 100 endurance athletes all over the US and Canada, that race, you know, with type one diabetes, and like, I see them living life and mentoring and speaking and, you know, telling people to live their best life. I mean, that's, that's how to live it, yeah.

Scott Benner 46:54
But do you remember the egg crack challenge? Okay, so the boy that that was for who I can't believe but his name is, it's just slipping my mind at the moment, I interviewed his. I interviewed his. Karen Mendo, oh, yes, thank you. I interviewed, I interviewed Miss hover, yeah, year, a year ago, and in the course of that, that conversation, the one thing that stuck with me, it sticks with me every day I might think about her constantly, is that she said that no matter what the outcome with her son was, even though he passed away, she would not have changed anything about how he lived his life. And she just talked about how happy he was and how Grady was doing at college, and he was the captain of his lacrosse team at school, and that he was a happy, fulfilled person, and that she thought if she restricted that because of diabetes and he got an extra day, she just didn't think that that those days would have been valuable, as valuable as him just living his life. And man, I really do think about that all the time, because it is easy. It is very easy to wax poetic about this, like, live your life. The bus might hit you, like all that stuff, and I believe it, but to really do it that's like, that's top level brass balls. Like she's she believes that now today, as much as she did then, and I give her a ton of credit, and I think you fall right in that same category. So I just think it's just a wonderful message for people you really do just need to live for today and be happy not worry about what's gonna happen tomorrow. You kind of can't, you know? Yeah, yeah.

Michelle Bauer (Alswager) 48:27
She's a friend of mine, and she is part of our group. She's found us. She's a she's an amazing lady, so she still has a big, loud voice out there,

Scott Benner 48:36
just to stick to your guns after that, to not one time go, You know what? Okay, maybe I would have changed like to not do that is such a respectful position for her son, you know what I mean like, and for her family and her life and their decisions and all those other things I I'm always there's a couple of people I think about a lot when I look at my daughter, because it is not, it is not a stretch to be going along, living your life just as easy as could be, getting great blood sugars for weeks on end. Hey, my a one sees 5.8 I'm kicking this right in the butt. I should start taking care of other people's kids. I'm so good at this, blah, blah, blah, like really starting to feel it, you know. And you could be going along as well as that. And still, sometimes I walk into my daughter's room at night to, you know, look at her CGM, test her blood sugar, turn off the fan, whatever it is I'm gonna do. And every once in a while, I do look at her and I think, My God, is she gonna make it the whole way? Like, maybe not, right, you know. But I never think that of my son, but he stands on a baseball field with someone throwing a ball 100 miles an hour, and I never think I wonder if that ball hit him in the head and kill him. Like, I never think that, you know, and in the end, both are fairly likely. So isn't it weird how being attached to the disease then suddenly makes you feel like, oh, is this something I need to be focused on more. Michelle, let me tell you a secret. I don't drive this. Hate limit, you know, and it's funny, and it's funny. I never think I'm about to slaughter my whole family. It never occurs to me, you know, never once. And so you can get yourself in the right mindset. And I think you proved earlier by what you were talking about that there is no mindset that you can't become happy with if you if you work at it hard enough and have the right support. Honestly,

Michelle Bauer (Alswager) 50:21
I get asked. I get asked all the time, you know, why do I choose to continue in diabetes? Like, how do I do that? How do I how do I put myself around the disease every day? And I, you know, that's my way of grieving, that's healing and coping. Like, first it was coping, and then it became healing to be around others that I get to still accept that as part of my life, and I don't know any different, like I want to help other kids. I want to make sure another family doesn't go through what I go through. And the piece that and people who've heard me speak have seen this because I use it as a PowerPoint slide. Is about three weeks after Jesse died, I was feeling very, very sorry for myself, and sitting at my dining room table crying, like, what am I going to do with my life? And you know, this is horrifying, and you know, everything, every thought you can think of, and I got my nail and one of his teachers sent me his last writing assignment, and she's like, Oh, I, you know. And it was a very kind of like, oh, by the way, I thought you might want this. And I'm thinking, Oh my god. Thinking, Oh, my God, you have no idea what this piece of paper means to me. And it was a, it was his last essay that he had to type or write up, his handwritten actually, and he could write about any topic he wanted. And the topic was, my mom is courageous. And the entire, the entire thing, just in detail, this is a kid who said, mom stopped talking about diabetes. He would say it all the time, but in writing, he put I am so proud of my mom. She does the JDRF bike ride every year, and if that wasn't enough, she became a director of JDRF, and if that wasn't enough, she decided to do an Iron Man for me, and I got to cross the finish line with her, and she did a documentary, and he just keeps going. And he said, I just am so proud that my mom has always put me and my diabetes first. So for me, it was just like, well, there you go. Jesse has told me what I'm going to do with my life, and that's why I do what I do. It

Scott Benner 52:19
meant so much to him that you were on his side like that, and now you're just on everybody's side. I, you know, I was gonna make a comparison, and now it just seems small, so I'm not going to, but just gonna let it go. But I think that a lot of people who stay in the community and work really hard like this, I think they feel very similarly. I think that it's just you, just you said it before. Like, how do you this is what you know. How do you stop doing it, right? How do you I some days feel like, sometimes you see online, someone who's struggling with something, then you're like, wow, it's such a simple fix. I wish I wasn't running out the door right now. I would just send them a message and say, you know, if you call me right now in 15 minutes, I can explain this to you. You know, like, I don't want you to struggle like this anymore. Like, I don't want your kid to feel like that. I don't. I don't want to live knowing that somewhere you are broken down in your house because you can't figure out this simple thing that I know the answer to. And at the same time, I can't spend my entire life talking to people about things like this, but you found a way to dedicate a ton of your life to it. I'm trying to do it with a podcast. You're doing it with your work and and there are a lot of people doing it in a lot of different ways, and I think that's the core of what the community is, and it's obviously driven by stories like yours, with Jesse's letter and and just tons of other people who have had impactful moments in their lives that have that have drawn them to want to help somebody else. You're everything you said is beautiful here. Thank you. I appreciate you doing this

Michelle Bauer (Alswager) 53:52
well. Thanks for having me

Scott Benner 53:53
on. This is enough. This was a you know, when you have to thank me. Now stop it. So let me, let me, let me. We have to do something pleasant, and I'll beat for a second. Hold on. Would you share your favorite happy memory of Jesse with me?

Michelle Bauer (Alswager) 54:10
Oh my gosh. Favorite happy memory? Well, I don't know if you've ever seen Have you ever seen like a little green Jesse was here. I don't know if you've ever seen it, but I use it a lot in my photos. So summer of 2009 right before he passed, we all, we went on a family camping trip, all the kids, and we were, we were, I don't even know how to explain it. It's Wisconsin, right? So you're up north, kind of hick. I don't know how to play it. So the camping spot had a it was a makeshift shed that they kind of turned into a bar. We're all inside, because it's Wisconsin. You can bring your kids into bars. Yep, I shamelessly just told you that my

Scott Benner 54:52
brother lives in Wisconsin, drinking beer was like the state sport, I think, isn't it? If not for the Packers, it would be like. A legal thing is so I'm sorry. So why not bring your kid to a bar? I live in Wisconsin, I understand.

Michelle Bauer (Alswager) 55:05
Go ahead. So, so we're there, and the walls are this dark green, and the people that own the place give you these gold markers, and you can write all over. So there's writing on every single wall. And so I write on the wall, my daughter writes on the wall. And then, and then there's the at the time, it was 12 year old, Jesse, and he simply writes, Jesse was here on the wall. And why did I take pictures of him writing that? I have no idea, but it was this fun moment. And he wrote, Jesse was here. And so he passes away. And this is kind of a crazy story, because it goes beyond just a favorite memory of Jesse, but that clearly was a favorite. And there's some reason why I took a picture, I you know, and I'm sitting with my brother, and I said, Oh my God, they're gonna, they're gonna paint over that someday, like every year, that's what they do. They just paint over start again and start over. And the new people that come to this campground write their new memories and thoughts. So I said to my brother, I need you to go up there and use part of Memorial Fund to cut that out, and we'll redo it, and we'll whatever it takes, but I need to own that real estate, that piece of the wall, and he goes up there, and it's it's it's foreclosed. Bank foreclosed on it. So it's locked up. I'm not going to say how I got it, but that piece of real estate is in my living room, and it is something that every year on the anniversary of his death, which is February 3. So the number 23 I don't know if you've seen that, but 23 has become his number, and it's used all over the world because of February 3, and people changed their profile picture to that, that Jesse was here, and it's become kind of a movement. And you know, jdrs is even, you know, mile 23 of every JDRF bike ride is a mile of silence in his honor, artists have changed drawings and put 23 in it, and I own actually the 23rd print of something that they did in honor of Jesse. So I guess happiest memory is that I'm so glad that I have that piece of him that he wrote, and that people are inspired by that. But and here's a goofy, funny, funny Damn kid like he, he was very contagious in his his mannerisms and his way of dealing like, you know, you have to walk through like, a really crappy part of this, our city to get to school, like we are sub our subdivision kind of was in kind of a lower income area, and all the kids loved him, like every kid would talk to him, and he'd talk about, you know, if that kid wants to beat me up, I just say, Hey, I bought some Cheetos. Want some Cheetos? You know, he just had this way about him. And, you know, there's still a plaque that hangs at his his middle school about him and inspires others, and I'm just proud of who he was. I wouldn't give up one single day of those 13 years that I had with him.

Scott Benner 58:12
Well, I appreciate you sharing that that's spectacular. And even as I asked the question, I was like, What a dumb question. Why would I say that you answered? And I was like, wow, I've worked out. Okay, oh my gosh. Well, I'm just, you know, we're up on an hour. I don't want to keep you any longer, but I just genuinely appreciate that you came on, and thank you for having me on. No, you're very welcome. Is there anything that you want people to know? I mean, is there a Facebook group, something that you

Michelle Bauer (Alswager) 58:38
know? The thing, I guess, is if people are still listening to what I had to say, would be if, if you if, if you know of a family who who loses to type one, and know them, you know the right thing to do is connect them, you know, like, with a group like mine. Because, man, I would have done anything to have my group when Jesse passed, I I needed to know there were other people who stood in my shoes and understood, don't try to fix them. You know, I see some deal the do see, like, try to manage those people, and we're here for you, and, yeah, you're there for them. But like, don't make it about yourself and just pass them on to this group. Like, it's not even my group. I don't it's not even my group, it's, it's, it's everybody's group that's a parent who's lost and and, you know, connect them with me. I'm happy to you know, on Facebook, it's called families of type one losses. And you know, it's only for the parents. So if I get a request from someone who's just wanting to see what we're talking about, they don't get added. It's definitely a place for the parents to breathe and have privacy and and feel the hurt maybe a little bit, yeah,

Scott Benner 59:47
and people who have a very special set of tools that they can help you with, and they're not, they're not tools you have. So let them get to that families of type one loss, yeah, okay, all right. So. Well, I hope you have a happy holiday. Merry Christmas, and your new year is fantastic. Have a great day. Scott, you too. Bye, bye.

A huge thank you to one of today's sponsors, gevok glucagon, find out more about G, VO hypo pen at gevok glucagon.com, forward slash juice box, you spell that, G, V, O, k, e, g, l, U, C, A, G, o, n.com, forward slash juice Juicebox you

breakthrough T 1d who, of course, formerly was the JDRF put out a lovely blog post about the accident. I'd like to read it to you now. It says the leadership staff and volunteers of breakthrough T 1d mourn the tragic sudden loss of 5t 1d champions on Friday, November 1 2024 that night, five people who were pillars of the breakthrough T 1d ride community died in a tragic single car accident. The group included two married couples and one single individual, all very close friends and veteran breakthrough T 1d ride participants. All five people were inside the vehicle at the time, and there were no bicycles involved. Understandably, the tragedy sent shock waves through the tight knit ride community, as well as the entire breakthrough T 1d organization. Chris Eaton a lead volunteer partner for breakthrough T 1d ride, and the ride Advisory Council knew all five people well. Ride is the greatest group of people you wish you didn't need to know. Our friends embodied that feeling of inclusion, hope and a steadfast focus on getting to a cure, said Chris, they will be sorely missed by their families, friends and the ride community. Jeff and Michelle Bauer were highly involved in breakthrough T 1d ride especially Michelle the breakthrough T 1d RIDE program is a family, and Michelle exemplified this, day in and day out, said Anthony garrossi, National Director of ride and endurance, Michelle has been a dedicated T 1d advocate since her son, Jesse, was diagnosed with type one diabetes in 2000 at the age of three, tragically and unexpectedly, Jesse passed away at the age of 13 on February 3, 2010, after Jesse passed away, Michelle continued to advocate, educate and push the envelope in His name in honor of Jesse, the day he died, and generally, all people who have passed away from T 1d mile 23 of each breakthrough T 1d ride is written in silence, whether it was riding 1000s of miles in memory of her late son, Jesse authoring a book to help grieving families, Bringing her husband, Jeff Bauer, into the ride family to join, to joining the ride Advisory Council. Michelle was all in. Anthony added in her spare time. Michelle had a number, excuse me, in her spare time, Michelle had numerous other T, 1d focused projects, including Jesse was here, which encompassed her work with other families around the world who had lost loved ones to T 1d Jeff proposed to Michelle in 2018 at mile 23 of a breakthrough T 1d ride. The couple had a lake house in Wisconsin and spent a lot of time there. They were avid boaters. Jeff and Michelle are survived by their blended family of five children, Alexander Bauer, Claudia Bauer, Samantha al swagger, Joseph alswager and Sarah alswager, all of whom are now adults. Josh and Tammy Stahl became close friends with the Bowers through the RIDE program. They rode together mostly, most recently, in late August, Josh started riding in 2010 for his and Tammy son, Gavin, who is now 17, who lives with type one diabetes. Josh had completed and competed in 13 rides, including Lake Tahoe, lacrosse and Death Valley. I've been fortunate enough to talk to Josh and Tammy at rides over the decades, said Dan Wolf, Executive Director of breakthrough t1 DS Wisconsin chapter, who has long been involved with ride, most recently in La Crosse, excuse me, were where we traded stories of our spirit jerseys, kids. Rides and what makes the RIDE program special? Which are the friends you make along the way? Josh and tam are survived by their son, Gavin Stahl and Blake Stahl Barry Sievers first ride was 10 years ago. He had completed five rides, including Nashville, Loveland, La Crosse, while he had no direct type one diabetes connection, he was always willing to help with a smile. He hosted training rides at his house and even helped transport bikes with his trailer. Barry's infectious smile and boundless energy embodied our team Wisconsin Spirit wrote Joe Brady and Scott Hagan in a statement they issued together. Joe lives with type one diabetes, is a veteran ride Coach Scott and Scott is Barry's best friend who recruited him for his first ride a decade ago. Barry was the senior financial manager of an Institute for Clinical and Translational Research at the University of Wisconsin at Madison. He is survived by his adult son, David, and two school aged daughters, Emma and Addison. Thank you so much for listening. I'll be back soon with another episode of The Juicebox podcast. You.


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#1359 Camp Sweeney

Scott Benner

Dr. Fernandez has served as Camp Director for Camp Sweeney since 1991. Listen to the end for a chance to win a FREE spot at Camp Sweeney!

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon MusicGoogle Play/Android - iHeart Radio -  Radio PublicAmazon 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.

Scott Benner 0:00
Here we are back together again, friends for another episode of The Juicebox podcast.

I don't do these very often, but today's episode is also going to give you the opportunity to win something. I'm going to be speaking today with Dr Fernandez. Now, Ernie has been the camp director at Camp Sweeney since 1991 he's a pediatrician, a diabetes specialist, and I think after you listen to this, you're going to also realize he's quite a lovely person. Ernie is going to give away. He'll explain to you the details as we're talking he's going to give away a slot at Camp Sweeney to one lucky kid, and guess what else us? Med is gonna sponsor this episode, and they're gonna send a second child to camp Sweeney absolutely free. Details on how to enter are at the end of the episode. Please don't forget that nothing you hear on the Juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. 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 you can get on my mailing list by going to Juicebox podcast.com and scrolling to the bottom. And later, you'll see why that's important. Today's episode of the podcast is sponsored by us Med, and this is usually when I tell you about how we get our diabetes supplies from us Med, and the phone number to call, and the website you can go to, and all that great stuff. But today us, med has said, don't worry about all that. Scott, tell them about that another day. Today, I want you to tell them that we are sending one lucky child to camp. Sweeney, absolutely free. There'll be details at the end of the episode on how you can do that. Thank you so much to us, med, US med.com/juicebox,

Dr. Ernie Fernandez 2:06
thanks Scott for having me on board. My name is Dr Ernie Fernandez. I'm an assistant professor in pediatrics division of Endocrinology at UT Southwestern I'm also a private pediatrician in the Dallas area. Drives me the most in life when people know me well, know me as my passion and the honor of serving as the camp director of Camp Sweeney the last 41 years.

Scott Benner 2:23
Ernie, 41 years you've been the director of the camp. 41 years, it's

Dr. Ernie Fernandez 2:27
been an incredible, wonderful experience. You know, this is the 76th year of Camp Sweeney, and for me to be been part of it for these 41 years has been extraordinary. That's

Scott Benner 2:38
awesome. So camp Sweeney has been is it in one location, or is it throughout the country? How does it work?

Dr. Ernie Fernandez 2:43
It's in North Texas. We've served over 35,000 kids over these years, and what we do is we operate three, three week sessions in the summertime. Kids come from about 35 states and four countries in 2024 and sometimes we'll have even more countries, depending on the year. Has a pretty good reach around the world. No

Scott Benner 3:02
kidding. I'm assuming the camp owns property. How much property is it on? Just

Dr. Ernie Fernandez 3:06
under 500 acres. About 470 acres,

Scott Benner 3:10
just under 500 acres. That sounds like a lot of acres to me. Wait, I guess I gotta figure out what the camp is, so let's jump into it, and then we'll pick around a little bit. So I'm there for a week. So

Dr. Ernie Fernandez 3:21
you're there for three weeks. There are three, three week sessions, and it's like any other summer camp. As far as the experiences, the summer experiences, you know, in the daytime, the kids get to pick from 34 different activities. We have a big lake with slides, trampolines, jet skiing, fishing, you know, we have all the soccer fields, lacrosse fields, football, baseball, Paintball is very popular, volleyball, cross country, hiking rivalry. We even own our own FCC radio station called kpsc, and it broadcasts on the whole North Texas area here. And the kids learn how to broadcast. They'd have a video production studio, a podcast studio. They do crafts, you know, they do CrossFit, weight lifting, all those normal camp things. Then at night is just like a regular camp. We have big camp fires with a live bands that come out. We take everybody to a nearby city in Dallas to do what. We rent out, water parks. We ran out trampoline parks. We have dances, we do we hike and do overnight camp outs. We do all those normal types of camp activities.

Scott Benner 4:20
Are the kids split up by ages? Or what's the age range?

Dr. Ernie Fernandez 4:23
So the kids are five to 19, and they're all there at one time. There's about close to 300 of them at a time. It's the largest program for kids with type one diabetes in the country. They're they're all together for really a specific purpose of how the program actually works through it, through its inspiration and mentoring cycles and what kind of sets camp Sweeney apart. And I'd love to share a little bit about how camp Sweeney has kind of grown a little bit over the years, please. You know, in the 1980s you probably, if you think way back to your early days, the DC CT, which was the big diabetes, you know, complication control trials, where. Being released, and they were ending, and the results were coming out, and it started to become incredible. And for people like myself, who was taking care of kids with diabetes, that just by implementing the different regimen plans that were coming out in those days, you could have profound effects on kids lives, not you know, their quality and their longevity of life. And it was really exciting for me and my colleagues to see that, that that was something that that we could seize on. Because, you know, prior to that time, when you were treating patients with type one diabetes, it was a little bit tough, because we didn't have the tools or the technologies, nor did we have the data that we could really, you know, change outcomes. And so we were looking at, I was, look, we're looking at Camp swinging, and we're saying, Gosh, canceling such a great kids come from all kids come from all over. How can we use this program to affect kids lives, not just when they're, you know, six or 16, but when they're 36 or 46 right? And that is what I have spent my whole life trying to do, and would love to share a little bit of that with you and your audience. You

Scott Benner 5:59
know, I'm interested. How long have you been an endocrinologist? Well,

Dr. Ernie Fernandez 6:02
since the early, late 80s, early 90s. I started at Children's at UT Southwestern in 91 but I had been there before, prior to that, in training.

Scott Benner 6:12
What drew you to being an endocrinologist?

Dr. Ernie Fernandez 6:15
I was a pediatrician, and when I took over camp Sweeney, you know, it drew me to take care of kids with diabetes and and it's what I've been doing all my life since, wow,

Scott Benner 6:26
do you have diabetes in your family? I mean, there's just the connection that you built once you've met the people. It was

Dr. Ernie Fernandez 6:33
just the incredible children that inspire me every day, and the things that we do with them, the things that we're able to help them with,

Scott Benner 6:40
that's beautiful. Well, for people who don't know about camp, I'm looking at the website while you're talking and there's so much happening. Just on the front page of the website. It's freaking me. There's a lake there. There's the I've seen kids on Jet Skis. I'm seeing kids climb. It just looks so kind of awesome, actually. Can I ask about how you manage diabetes for the kids, absolutely. And,

Dr. Ernie Fernandez 7:01
you know, that's what I love to share with because, you know, when we started looking at how you change long term effects, we came up with what's called our four pillars. And the first pillar is called normalcy. You know, when someone's diagnosed with type one diabetes and they're just like any other child, they're just regular kids, and they're going through life, and one day they feel bad, and they go to the doctor, and suddenly are diagnosed with this condition, and things change. You know, suddenly, you know they want to be have blood sugars and CGM and, you know, different types of regimens and pumps, and suddenly, the child and family get transformed into this world in which they're focusing on many things and thinking about going to a camp out, or going to their friend's house for a sleepover, playing soccer, then become a little bit of a challenge, and everybody is constantly a little bit outside the circle. Long ago, we realized the first pillar of Camp Sweeney was creating a place where they felt normal. And so we have a large staff. We have about 160 staff members that that work at Camp Sweeney and of them, 70 are amazing counselors, which I'd love to share with you in a minute. But 20 of them are our medical staff, and they are from medical schools around the country. We recruit all over the US and also here, from UT Southwestern their medical students, residents and our attending physicians. We want to create an environment where their diabetes disappears, so we have a year long program where our medical directors actually kind of scour through all of the data in an amazing way. They aggregate everything from the summer before, whether their kids are on OmniPods or they're on mobys or they're on Riley links, or they're on empty eyes, and they're able to aggregate all the data for every age and every gender of every day they're at swinging. And they run them through this algorithm. And I'm not kidding. This is something that these medical directors are incredible, Dr Edward Carey and Dr Sumter, and they go through that, and they come out with a protocol for each day, for each part of each day, for each type of regimen to maximize the control while they're there. And so imagine this, this facility. We have this beautiful facility up on the hill. It's called our medical center, our Ryan Medical Center, and in there there's this huge control room. It's like NASA, it's all glassed in. And all these medical professionals stay in here. The kids never see this. This is all behind the scenes. And they sit in front of all these computer monitors that are on the walls and on the screens, and they sit there all day and they're seeing all the data come in from where the kids are at paintball. They're low, they're going, you know, in the cabins, wherever they are. And they apply these protocols that have been developed throughout the year to maximize their yield, whether it's changing their sensitivity factor, changing their ICRS, whatever it is, it's been recalculated based on the data that was that's been aggregated each year. And the results of that is amazing. The time and range for most of these kids, and in fact, in 2024 was about 86% when if you look at the nationals, just average of an adolescent in the country, you know the time and range is under 50% and so. A lot of this comes from all of this passion of these people doing this work behind the scenes. But the net result is that while the kids are there, they don't know any of this is happening. They're just having kids having a great time. Everybody changes pods same time. So we all, you know, changes CGM, and it's just in the background. None of that affects how they play paintball, how they're all doing lacrosse, whether they're playing baseball, whether they're right, you know, doing whatever they're doing. And so for 18 wonderful days, their diabetes disappears. And I can't tell you how many kids tell me that, oh, in the last three or four days, oh gosh, in three days, my diabetes comes back. But for those beautiful 18 days, it disappears. And that's the first of the four pillars that makes Sweeney a little bit unique in the way that that is harnessed,

Scott Benner 10:45
right? Do you allow parents to follow CGM while they're there?

Dr. Ernie Fernandez 10:48
We don't, for a number of reasons. One, it is a vacation for the parents. And second, we have a very complex technological system there. We actually own 300 brand new iPhones. We just bought another set of iPhone 14 this year, and every child is transferred to one of our iPhones when they arrive. And we have this whole algorithm how we do that, so that their CGM go over, everything comes over. It's we've taken us forever to master this, and then it's all in our systems, and it's all being monitored all the time. And as I said, it's a large medical staff. And the medical staff we even have, obviously, a night staff that checks the kids at midnight, 12345, in the morning, going through all those cabins, making sure all that data is working, that nothing is out of charge. The Kitchener, you have to charge all these millions of devices, making sure that everything is staying in sync, that we're that we're able to make those adjustments so they're always being monitored 24 hours a day. The kids just don't realize it, because the entire medical center is up in this, in this big, giant building that the kids don't actually awesome. They

Scott Benner 11:49
almost made me cry, Ernie, can I call you? Ernie? Is that okay? Absolutely. Yeah. I swear to God, I was crying a second ago. I just like, just thinking about people looking after other people and and the kids getting a break and everything. You know, if you give me

Dr. Ernie Fernandez 12:02
a moment, I'd love to share these other pillars, because I can do them fairly quickly, and they tell you how it all comes together. Yeah, please. You know, the second pillar that we discovered many years ago is so kids get diagnosed and they feel different, and now they feel normal, but then they have to overcome their anxieties. And you know, all children have anxieties. We all do. Every one of us, every human, has anxieties, but kids with type one have amplified ones in many different areas, socially, in so many different ways. And so trying to get kids to overcome those is the key to success long term with these kids. And so what we do is we have a system that we developed way back in the early 90s in which we take these 70 amazing counselors that we hire, mainly from the Midwest. They're brilliant individuals. And I won't there could be a whole nother podcast. How we find these people. They're all incredibly brilliant. They all have GPAs above 3.8 3.85 is the average GPA of our staff member. The mass majority come from Notre Dame because we have an arrangement with them. And they come in and they're developed intensely for three weeks before the first child even arrives, because they have to be able to deal with this, what we call zoning model, this confidence model that we have, that we've developed over all these years, and it's how we get kids to have insight into their anxieties and how to get empowered to overcome them. Because kids have a lot of challenges. Some kids have Asperger's. Some kids have, you know, have developmental delays because they may have Down syndrome. Perhaps, maybe they have situations where they're oppositional defiant, perhaps, maybe they have issues where they've been bullied, where they've had tremendous where they've been victims, where they've been excluded. And what happens? Some have OCD, and we have the system that we have, where we allow our staff members to create situations where these kids can quickly identify their anxieties, and then they have plans for each one in a very safe environment for them to shine, to sparkle above whatever is holding them back, whether it's a public speaking, whether it's climbing up something they've never tried to do for something athletic, something, whatever it is, we have a plan. In fact, every morning, we get up super early, like it's six in the morning, and we go through every patient's chart, and we look to see where they are on these anxiety scales and where they are on these confidence scales. And every day, we put together a new plan to see how we can push that child to have that chance to really sparkle for that day. And it's an amazing thing, and it's an important part of how these pillars come together. The third pillar is something that we take for granted. We live in a very venial world. I call it the Tick Tock world, where the things that are valued tend to be incredibly venial. If you're great at at being a bully, you're valued. You see it in the media. If you're great at tearing other people down, if you take risks in your life. You're a substance abuser. If you're somebody that's worried about how they're dressed more than they are about including other people. People tend to value those things. And so kids are always in a free fall of trying to figure out what's real. And so for 18 wonderful days, we inspire these kids to value things that are real, things about. About them. And every day, these kids get so good at even the five year olds get good at this. They get in these groups, and they identify some virtue that they've seen in their little brother group or their little sister group, where they meet every afternoon. And it can be kindness, caring, helping the environment, including someone doing something to make someone else's life better. And they earn these little virtue beads that are colored based on the type of virtue, and they wear them on their wrists. But the thing is, each one of those virtues is identified by somebody in their peer group, and then the person starts to recognize that in themselves, that they really possess these things, and it makes them incredibly empowered to know that they can do stuff other than just the way they use their jargon or their language or whatever the world wants them to do. And finally, the most important part of swni is service. You know, when you have a chronic illness like type one, it's all about ourselves. We're always worried about, okay, am I going to make it through soccer practice without going low? Am I going to have trouble getting through that math test with God being high and getting blurred vision? It's always taking care of ourselves. And we all live in a world where I myself when I'm hungry, you know, I think, oh, I need to go eat, or I'm thirsty, I need to go drink. We always think about ourselves. And the problem is that we live in a world with others. And a lot of people think, Oh, these are my friends, or these are my people that are in my fifth grade class, or this is my soccer team. They're my friends, but they're really acquaintances, real relationships. Real friendships come from investment, from sacrificing each other, doing something for somebody else that's a little harmful to yourself, maybe, but better for them. And that's what gets these kids to start to learn how to develop those kind of relationships. And how do you do that? How do you teach a child to do that? How you teach myself? I mean, here I am, I'm a bit older, and you think, Oh, how would I ever learn to do that? Well, you do that through inspiration. You bring these 70 amazing counselors in, and they kill themselves. They work 18 hours a day for 77 consecutive days, no days off. And they do that because they're driven to help these kids. And these are, these are staff members that could be doing anything with their summers. They're very bright. They're sought after by many people, but they choose to do this passion, and the kids see that, and the kids are inspired. So then you create situations within the program. We do this mentorship program for all the kids 14 and older. Adopt everybody that's 13 and younger, and they're one on one, paired to be mentors, and they want to emulate what those concerts are doing. So they start sacrificing things for their junior mints. That's what they're called. The younger kids are called Junior mins. The older kids are mentors, and they sacrifice things for them. It happens all the time, and it's amazing. Sacrifice time. They sacrifice their merit tokens. They sacrifice a lot of things, and it becomes incredible. And they don't just stay together. It's summer. They're together, usually forever. I mean, they continue to keep up with each other throughout the year, right? And that's critical, because you know what happens is, after 19 days, all these kids go home, and they go back to the world they were in, where they were a little different, but they know what it felt like to be normal again. And they go back to all those anxieties and make them make poor choices, but they know how to overcome them. They go back to that world where they're being bullied or they're tempted to use language or bully others, but they remember what they possess that's better than that, that gives them greater satisfaction. And then finally, they've learned how to build the types of relationships that don't just last through elementary school or middle school, but for lifetime, they become better sons, better daughters, better brother, better sisters. And why do we go to all this trouble? Because all of the data shows that when you can grow a person, you can get get these children to do this, not just when they're six or 16 or 26 but when they're older. It has a profound effect on how they do with their type one, and how they do with many things on their lives. And one of the things we do in our data collection is we reach out to kids 10 years out, 15 years out, and we see how they're doing, check that the different objectives we're trying to accomplish. And that's how we're constantly adjusting these pillars to make them more successful. For these kids. I know I said a lot in a short time, but I know we have a very short time in this podcast. I don't want to bore everybody to death, but that's a little bit about how Sweden works. Hold

Scott Benner 19:08
on a second. Let take a second, because I'm gonna, I'm gonna forget a couple of my questions. So I want to go back to pillar two for a second, when you see these professionals come out and spend this time with the kids and help them with their diabetes and the and the social part of it, are you getting reports back from them later, like, how is that impacting their themselves professionally, and how they're dealing with children once they're back in their lives?

Dr. Ernie Fernandez 19:30
The professionals teach the counselors how to look for the signs of the different types of anxieties and how to work. That's what that three weeks of development is about. Okay? Now we get ourselves into situations where kids have what we call pathological DSM, you know, diagnosis where they have severe generalized anxiety or severe depression. Those kids, we have to refer to somebody to come in to talk to them, and we talk to the parents about getting them the kind of help. But most of the generalized anxiety that we treat a cancer. Of art are routine things that need to be met and need to be overcome. You know, hypophobia. How many kids do you know with type one, I know in my practice that are terrified about going low, and their parents are terrified about going low, or they're terrified about being in a social situation, terrified about trying something in a sports wise whether they had diabetes or not, they had those fears, but then they have diabetes amplifies it. How do you get them to overcome those things? And we have a whole system that our professionals teach our staff how you do that, and it's basically a little system that they learn and they become very good at, also

Scott Benner 20:34
the professionals themselves, though. I mean, where this is coming from for me is that I've interviewed a lot of doctors over the years, and one more recently told me that as he was getting into endocrinology, maybe the most valuable thing that he had done was to go work at a diabetes camp. And he said that seeing diabetes in real life happen in front of him just exploded his understanding of what he should be doing for people. And I'm wondering like you bring all these professionals in debate, did they ever report back to you that they leave with more than they came with? Yes,

Dr. Ernie Fernandez 21:05
well, you know, all of our counselors are pre med, so they all become doctors themselves, right? And so I have generations and generations of doctors that tell you that working with these children inspired them to pick the vocation and career that they're going through the people that help us train our staff members don't get to work with the kids directly, because they're they're just working. What's so critical about our program is what's called devotion. Each staff member has a group of children that they're, that they devote themselves to, and so everything goes through them, the way they communicate to the medical staff, the way they communicate to the professionals. And so because you want that one to one relationship to be able to inspire those kids, when you have a lot of people working with one child, it diffuses the effect of the inspiration that they get and the desire to want to do that. And so that's, that's one of the ways that these pillars work, awesome. And so the staff that work with these kids are more profoundly changed than the kids themselves. It's the same thing with the Mentor Program. This is, I always say this to everybody you know, the mentors, the older kids that that are working with the younger kids, are way more transformed than the younger kids are, because once you learn to serve and you get devoted, it transforms your abilities to do that, it makes you a much more powerful person in your life.

Scott Benner 22:24
Yeah, no, it really does sound crazy. I keep trying to picture like, you know, people showing up to do something for someone else. And I take a lot from what you said there, like, you know, when you do something for someone else, it does really, it really does kind of supercharge you in a way that you don't expect, you know, before you do it. And I just was wondering how many of those pre med, you know, medical students end up going back and being changed by because it sounds like you've been changed by it significantly. So I would it's why

Dr. Ernie Fernandez 22:49
I do this. You know, everybody at swni is a paid person except myself. I am the volunteer, because my life would be totally different if I hadn't had this opportunity to serve. And it started early on, when you first start seeing that you can change a path for a child. Let me tell you something. It just drives you to want to figure out how to make it better. You know, we spend year round preparing for these programs. We have meetings. I have meetings every night, this week, and all throughout the year, working on the little tiny details of every part of these pillars, like how the kids trays are put out, you know, where what music is played, what volume is played out, how you matrix the kids so you know exactly which type of child sits next to. Everything is so carefully calculated and planned out. It takes months and months of work to make that happen. And you know, the program doesn't end at the end of the summer. We have what's called PFC life. Our motto is perseverance, faith and courage, and so PS, PFC life operates throughout the year, from August through May. And it's, it's run by some of these ex counselors that that are now finished college. You know, they're, they're, they're actually been accepted to medical schools, but they, they choose to defer medical school for two years to go out there and do this mission of trying to help kids. And they do them in communities all over Texas, all over the United States. Just this week alone, last night, they were down in Austin doing a big laser tag for any kids without not they don't have to go to swni. They just show up. And we have these events for these kids. We're in communities three or four times. Tomorrow night, we're going to be doing a big trivia thing in Anna, Texas. Then Thursday, we'll be back down in Houston doing another big event. This weekend, we'll be down in San Antonio doing event. I know you know, you probably heard in the Chicago we're not allowed to sit cities around the country. We'll be in the north shore of Chicago on December 8 for a PFC life event. And anybody from the Chicago area with type one can show up. We're going to have a video game truck out there. We're going to have all sorts of entertainment for the kids. And then we'll be talking to parents about how swni works and and making that happen. On January 12, we'll be in Washington, DC. We'll have another big event. You know, there, you know, we're in different states every single month. We're in different cities. Every single week, three to four times a week. And these are all free events for kids that have never even had to go to swni. Never want to go to swni. They just have to have type one. And they spend some time together. And maybe they're inspired by some of our staff to do some of our pillars, and maybe to be inspired to come down to Texas and come down to camp Sweeney. That's part of all of this. I mean, we're not there necessarily to recruit them to come to Sweeney. It'd be great if they did, but we're there really to kind of help normalize these situations and be there for for kids in different parts of the of the country and of Texas.

Scott Benner 25:34
Do you think that families of like both faith and non faith would find because you've used the words faith and devotion a couple of times, and even though I don't believe that you've said it out right? Like, these are fairly like religious terms, right? So like, is it a religious base camp, or is it not? It is

Dr. Ernie Fernandez 25:50
non denominational program? People say, What about the virtue component? Well, the virtue component is just the character traits that we all possess. No matter if we have faith or not have faith. We all possess the ability to be kind, to be caring, to be empathetic, to, you know, to help our environment, to be inclusive. And there are a lot of people of faith that work at our program, and there are a lot of people that are not. It's a wonderful mixing ground. But what has everybody in common, of course, is the passion they have for the for these kids with type one, right?

Scott Benner 26:21
I wouldn't want to scare off people who are like, oh, you know, I'm not looking for, I'm not looking for this impact, but I love what you're saying. Like, don't get me wrong. Like, I just want to make sure the people listening understand that it's for everybody. It's for everyone. Yeah,

Dr. Ernie Fernandez 26:35
absolutely. Did

Scott Benner 26:35
I stop you before you got to your fourth pillar? I think I did. No,

Dr. Ernie Fernandez 26:38
the fourth pillar was service. The fourth pillar was how we how people look beyond their own needs, that to build those relationships, right? And and that's a key issue.

Scott Benner 26:49
Tell me again, three weeks. And how many times a year do you run the camp for three weeks? All right, now this isn't an ad. I'm just here to remind you, keep listening till the end, and you're going to find out how to enter the giveaway to win a free slot at Camp Sweeney for your child. And we're giving away two today. One Ernie is going to give away. He'll give you the details about how he's going to give that one away. And then we're going to pick a second child at random. Both of these will be at random, and that second child will be completely covered by us, med, US med.com/juicebox, but all the details about how to enter, and trust me, I want to make it super simple to enter will be at the end of the episode. So

Dr. Ernie Fernandez 27:32
we have the three, three week sessions in the summer. You know, a lot of people say, Well, you know, what, if I live real far away, how do I get my kids there? Well, we have what's called a point to point service that's also available that people can from any city. Can fly their children to DFW, and we meet them there at the gate, basically with our staff, and take up the camp. Most families like to come down to Texas to least bring them, they'll use the return service that's available for that. You know, our website has all the the enrollment information on there. You know, it costs us about $6,700 to have a child there for three weeks. That's our cost. We ask our families to pay 4700 I spend my whole year fundraising to supplement every single child $2,000 to come, because I feel type one is expensive as it is, and it puts a lot of stresses. But in addition to that, 50% of the kids that do come get significant financial aid above that. I mean way above that. Some people come, you know, if they're on Medicaid or, you know, it's based on financial need for just almost nothing. We provide campership aid, and about half of our kids do qualify for that. You know, our motto has always been, we've never denied a child, a child with diabetes that comes to swni for financial need, we try to always make sure that we have that available. It gets tougher and tougher in this economy to raise that money. We're not a public organization. We're a profit, a non a private nonprofit, yeah, and so, you know, but

Scott Benner 28:59
I just did the math earning. I think the low number you need is 1.8 and that's, seems like that's the low amount of what you have to fundraise every year Am I

Dr. Ernie Fernandez 29:06
did 2.6 million a year is what we give out charitably every year. Wow. But that's, you know, that's my job. That's what I do. I mean, my job is to do that. You know, parents job or to take care of their kids. Parents jobs are to try to meet their needs. And you know, if Sweeney Can, can help in any way, you know, we try to make that available. You know, they can go to one of the meet and greets. We have virtual meeting reads that are available seven days a week. If somebody just goes to the website and signs up for one, one of our program directors will get right on them and go through all the little details, because people have a million questions, what do we do with our Riley Lake? What do we do? You know, with the laundry, how does the laundry service taken care of? Do you have dry cleaning? You know, all those questions that people have. You know, that's what those, those virtual one on ones are. Who's

Scott Benner 29:48
asking you about dry cleaning at summer camp?

Dr. Ernie Fernandez 29:52
More kids, more parents. And you want to know? I mean, it's unbelievable. You know, 40 years ago, that would have never been asked, okay? Mm. It. But nowadays, it's really the thing, you know.

Scott Benner 30:03
So if I can come in right say, I come to campus, we need to drop my kid. How long am I there as the parent before I'm vamos and how long am I there on the drop off? About

Dr. Ernie Fernandez 30:12
two to three hours. It's a fairly extensive process. We do a big session before you come that we do over the phone that gets all the preliminary gluco information, all this, you know, depending, I mean, I'm putting words in your mouth, depending on what regimen plan you're on. You know, we get all of that information ahead of time, but then we go through a fairly extensive procedure of being interviewed and making sure that we're not missing any nuances in the child's care, and make sure that you feel very comfortable with how they're moved in, and that all this stuff is taken care of. We want parents to feel very comfortable. We want the child to feel very comfortable. We don't want this to be an experience where, oh my gosh, I have this anxiety. I think first time, parents all have a little anxiety, but I'll tell you how they get over this. You know, everything we do is broadcast at night at Camp tween, so all of our things are broadcast live, and everybody watches everything. Parents always joke about it, that it's kind of their proof of life concept. You know, we have these flag laureates every night, and parents are we have 1000s of people that watch that live every night, people from different sessions and everything. And we every event, whether it's a campfire or it's a, you know, a talent share whatever, all broadcasts live. And, you know, it's become very sophisticated over the years. You know, you have multiple media people and stuff that that make these things happen. And you know that every one of those parents is glued to those, those things there, you get feedback immediately. My child wore the same shirt two days in a row. What's up with that? You know? You know, I mean, you get everything back. It's just amazing how much I don't think parents miss a beat after that and after the child has come to camp. Sweet for many years, they typically travel to Europe, and you can't get a hold of them until

Scott Benner 31:52
the flag lowering, but I did see Milan. Well, yeah, once they get comfortable with it, right? How about the kids like once, once a kid gets there, a new camper, does it take them a couple of days to I mean, I'm sure everyone's different, but is there kind of a marinating period?

Dr. Ernie Fernandez 32:09
You know, it's pretty quick, because we're very quick to identify, and I'm not going to go into this, we're very quick to identify anxieties. Long before the child even arrives. We're ready to meet that like, if we feel a child's insecure, like they potentially might be homesick before they even come, because we could tell that by the pre camp interviews. We are ready for that the second they arrive. I mean, we have we're ready to put them in left brained activities. We have things that we do right away to meet those kids needs so that they can become feel comfortable and secure. Because we don't want anyone to feel insecure. We want everybody to feel good. We want everybody to feel, you know, like they're part of that. And so we tried to anticipate that long before they arrived, right? So that we're successful with that. It's

Scott Benner 32:52
awesome. So Ernie, people are listening, don't know, but I, I figured we wait about a half an hour before we bring this up, because I figure people who are still listening are very interested. You're very generously going to do a giveaway for one listener of the podcast to send their child. Now you said that most kids pay 4700 and they have 2000 taken care of by you. But for this one person, you're going to ask people just to pay $500 that the amount is to pay

Dr. Ernie Fernandez 33:18
the just to pay the deposit. Only you know, once that that is awarded through through this podcast, we will contact our registrar, can contact that family and give them a special link and a discount code that would let them sign up. That's

Scott Benner 33:31
awesome. Okay, and we're gonna figure out how to give it away. But I would love for people to visit your website. Now, I know you can't go changing your website to accommodate my giveaway, so I'll take care of the giveaway on my side. But what is the website, if people want to go check out, is it just campsweeney.org It just

Dr. Ernie Fernandez 33:48
campsweeney.org and it's spelled a little funny, because it's got its camp and then S, W, E, N, E, y.org, a lot of people that leave out that E between the N and the Y, okay,

Scott Benner 33:58
all right. And there I'm looking at it right now. There's a tab for camp life. What parents would want to know how you can help summer live. Keep up with Sweeney. Join our staff. There's a ton of set you can make it, by the way, if anybody's listening, this doesn't have a kid to send to it, but thinks it sounds amazing. You can make a donation to camp Sweeney right there on the website as well. Help Ernie dig through that 2.6 million he's got to raise every year. My goodness, gosh, thank you. Must be out there hustling. Man,

Dr. Ernie Fernandez 34:24
it is not easy. But you know what? I wouldn't trade it for anything in the world. 41

Scott Benner 34:29
years. What's the biggest difference generationally? Like, what do you see change each generation about what the camp needs to offer people to keep kids engaged?

Dr. Ernie Fernandez 34:40
The superficial answer, of course, is all the technology. I mean, obviously staying up with all the technology and being on the cutting edge of what people are going to have and the tools that they're using to treat their type one diabetes, that's what's probably changed the most. Obviously, year to year, everything is got a new version, a new type. Highlights come. Now with a new pump. Actually, you know, before camp, I'm always looking way ahead of what's coming out to be prepared for that. Yeah, but actually, what is deeper that has changed the most over the generations is, really, there's a lot of stuff, you know, loss of value in our kids. I feel that the way media is being delivered to children these days is very targeted, and often vulnerable people are very subject to being devalued because of what is being, you know, driven their way through the channels that they become obsessed with. I could tell you my non diabetes practice, my regular pediatrics practice. You know, we struggle with so much anxiety and depression because there's so much addiction to to so many of these devices and these these social media streams that really lure these kids into basically thinking that that's what they need to do to become successful, is, is to is to be on that. And so Connor in that has taken a lot of work on our pillars. But fortunately, the basis of what we do with our kids, with the four pillars, is very successful in dealing with that, right?

Scott Benner 36:01
That's, yeah, listen, it's hard not to, like you said, it sounds superficial, because people say it all the time, but it's not. It's not lost on me at all. Like you can get a an incomplete or, you know, overly shined up view of what the world is. And now, if you're trying to make you know what is pretend online into reality. There's no way to do that, right? You're gonna fail at that every day. And so you're saying that these kids, younger and younger, are seeing something modeled in front of them that is unattainable, and they're striving to attain it, and then it's becoming a source of depression or anxiety for them that they can't get to it, am I understanding that right 100%

Dr. Ernie Fernandez 36:41
and you know, that's what one of our missions is. One of our pillars is to over, try to overcome that, and get kids to recognize what they really have right that that is, you know, gives them their superpowers.

Scott Benner 36:54
So, on top of everything else, at Camp Sweeney, they're not going to be on tick tock Instagram or whatever for three weeks.

Dr. Ernie Fernandez 37:00
No, you know, you you probably didn't pick up on this earlier, but you know what we I said, we have our own FCC radio station. Yeah, you may ask me, why on earth does the summer camp have a radio station? And, you know, it's so hard to get license. Takes years. You got to go to Washington. You got to plead your case for the SEC. It's difficult, and it's a big investment. And that was because in the early 90s, we realized that the media kids were being bombarded with had messages that were not positive for them, and so we recognized way back when, that we needed to create our own media sources. In those days, we didn't have the internet, we didn't have all this. So we said, You know what, we'll build a radio station. The kids will program. It will select music and programming that is, that builds these kids up, as opposed to taking kids down. That's how it all started, actually, you know. But once you have a radio station, it's difficult, because you got to keep it running year round. And so we have a local high school that has a broadcasting class, and they broadcast for us in the off season, and then we, you know, we run it the rest of the year. It's kind of a long, complex thing we've done, but, but it's all about what kids are hearing and what they're listening to and what they're seeing. Even our counseling staff, that's just remarkable in our other staff, you know, we have 160 total. You know, they're not allowed to have any cell phones themselves at Camp Sweeney. So when staff come, they're given a camp Sweeney iPhone, which is a real iPhone, but it's all locked into the apps that we use, and so that we're not bringing in social media from the outside, you know, because it's so easy for a staff member to get sucked in themselves and then, yeah, you know, you've lost their ability to inspire. I have a few people

Scott Benner 38:34
in my life. I'd give you $4,500 just to take them away from social media for three you wouldn't even have to let them swim in the lake. If you could just get that accomplished. I think it would be worth it would be worth the

Dr. Ernie Fernandez 38:43
money. Yeah, you know, you know, you just have to look for the good, you know. I mean, there's good things the media does, but so often these kids, these vulnerable kids, are very lured into it, and it, it doesn't help their overall, overall well, being, right? And that's what we're about, is, you know, it's great that these kids have a phenomenal time at camp Sweeney in the summer, but it's better for me to see them when they're 36 when they're 46 having a fantastic time in their lives. You know, being productive. You know, doing wonderful things while having to deal with a lot of the challenges and burdens of type one is bestowed on. It's interesting. You

Scott Benner 39:21
brought that up because it was my next question, because you've been doing this for so long, you must know adults who have gone through campus, kids. And is it, I don't know if it's a thing you're trying to quantify with, like, you know, follow up surveys and everything, but do kids end up having more desirable adult outcomes after after being campers,

Dr. Ernie Fernandez 39:41
absolutely and when we do our data mining, which we do in August, to rebuild our pillars every year, we contact a significant number of people 10 years out, 15 years out, and we have specific objective questions we ask that are mapped to what we're doing to improve our our pillars each year. And. It's hard to get these kids, first of all, because they don't live at home anymore, and you have to go through a lot of going through parents and going through people they know and to get to them. But we do that, and we have a set now, anecdotically, I have many patients of mine that went to Camp Sweeney, whose children, sadly or happily, have type one now, and also go to Camp Sweeney again, in the second generation that I've taken care of them. You can see those parents, you know, and you can see how they're affected. But from a more I don't want to get away from the fact that we're very data driven. And so all these pillars sound great, but if they're not really affecting the kids, then they're not great. And so we spent a great deal of time looking at our outcomes to make sure that the work we pour into doing this is something that's that's worthwhile. Yeah, I

Scott Benner 40:44
mean, that's what I'm taking away from. I'm wondering why you're not running NASA instead of this, I thought I'd ask the question. You would say, what you said, you know, like, I want to go back to your points, like you set up pillars. Anybody could say, Hey, here's some things. These are our rules, and we're going to go with these because it seems right to me, and I'm the one setting it up, but you're looking at enough data to tell you, like, I'm assuming the pillars were different five years ago, is what I'm saying. Like, you're a general, very

Dr. Ernie Fernandez 41:09
different 41 years ago. Because when we first started this, you know, we said, okay, these sound like good ideas. They could work in theory. And so many things did not work. I'm telling you, this was not, you know, swni Today is totally different than it was in 1991 it's different every single year. Because what we do is we create from those, from that data, we create what are called objectives, and then the objectives become initiatives, and initiatives go into the pillars. And so there's a whole process of a lot of people working on this. And it goes down to the micro detail. I mean, just how the snacks are figured out. You know, every single class, how it's taught that we make the right objectives in basketball this year. How did we do with paintball? What were the How did that work out? Were we able to reach this type of child? Were able to affirm this type of child, if a child had Asperger's, was the music not where they were sitting, was it too loud that it caused this? All those things are constantly looked at and reviewed to be adjusted in a micro level, there's a lot that goes into it. I gave you the Reader's Digest version. I mean, it takes the entire year to make this happen well, and it

Scott Benner 42:15
takes decades to see things that need those adjustments too, right? Like you have to, I'm assuming come together in meetings where somebody says, Hey, did you notice that in this thing we had the music was so loud, people kind of were disinterested and didn't care, and then you have to make that adjustment. Next thing you're not just saying, like there's a magical decibel level where people

Dr. Ernie Fernandez 42:33
there is for every type of activities. We have it written, we know what the we know what they are. We know the types of songs, we know the beats, all these little things are very carefully looked at. We have a very careful plan of how we roll all those things out. And every year we change it a little bit to make it better and to make it better. And we look at the parent feedback that comes back immediately. We look at our physicians feedback that comes back immediately. We look at the blogging that's happened all, all summer long, by the people that are observing, because we have people that's their job to watch. You know how staff are doing, and then we start looking at the kids that are number of years out. So all of that comes together to help us adjust. Are you?

Scott Benner 43:11
This might seem disconnected for a second, but there are you a family man? Do you have children? Are you married?

Dr. Ernie Fernandez 43:15
I am not. No, this is what I've done. I've made. I had that choice. I had to make that road change early on in this program, because it was, this is what I you know, I run my practice. I teach at UT Southwestern. I do this. So it's, it is something we do. I have a lot of great people that help me. I mean, we have a wonderful staff that runs, works year round, doing all these things I

Scott Benner 43:38
couldn't imagine. Actually, I was sitting here thinking like, There's no way he's married and has kids, because how would he do all this stuff like that? It really does feel like a, I'm not trying to butter you up, but like it feels like it felt like a selfless endeavor, as you've been talking about it the entire time, and I was trying to figure out where you'd come up with all this time if you had, you know, those other responses absolutely, you

Dr. Ernie Fernandez 43:58
know, that was a decision I had to make early on, because I said, you know, it's either this or not. And as this grew over the years and it became bigger, it became something that, you know, you realize it becomes important to kids and important to families, and you want to make sure that you're meeting their needs every year you we glossed over this. But, you know, I laugh a little bit about raising the amount of money we have to raise each year. That is an incredible endeavor. I do that almost every day. Yeah, last night, I can't tell you how many emails I sent out last night, pleading and begging. You know, I have a little event next Thursday, and we're trying to get, you know, that's one of our one of, I do three big fundraisers, and it's one of them, and it's one of them, and just trying to get that event going is, is quite, quite the trick. But, you know, I find that that if people have a mission, people and it's a good mission, other good people come and join, and they all come together, and they, they say, how can we help? You know, what can we do? And and that's, that's how you grow things. You know, together. Yes,

Scott Benner 45:00
$4,700 cents a kid. That's right, exactly,

Dr. Ernie Fernandez 45:03
yeah. And do you know that's one of my admissions is to try to get people, kids sponsored. Probably not appropriate. But canceling that org, we don't have a link to this, because it's we. I never link our fundraising things to our main website, but if you put slash gift, it has the fundraiser I'm doing next week, and that has an online auction and stuff. And if somebody felt the compulsion to bid on one of those things or give towards that, I would it would be great. You know, as I said, all of these fundraisers, I don't usually tell our families about I do it, you know, because I they're burdened enough, and so that's why I don't have direct links from our website for them. But I do have indirect ones that I give people that I try to fundraise. You know, one of the other things is that, you know, breakthrough T, 1d which was formerly jgrf, you know, they do a lot of great work in our country, and I try very hard not to try to take any funds from them. So all the fundraisers that swni does is really, in the non diabetes world, I go to people from my general practice that I take care of, and that's the population that I try to raise money. And so then I have to teach them what type one diabetes is, because none of them know anything about it. I have to try to inspire them to want to give, right? And so it's a little bit of a taller order, because I don't try to go after the people that they go after, because I feel that's they. They do such good work. And I don't want to, I don't want to, to cross that, that line with them. It's

Scott Benner 46:27
interesting. I'm looking here you have a silent auction. There's some great stuff here. There's sports tickets and getaways and hotel I know.

Dr. Ernie Fernandez 46:33
I'm sorry that I said that. I don't usually tell people about this. I'm

Scott Benner 46:37
happy to tell them about it. I'm just going to tell you, you're going to have trouble getting people bidding on these cowboys tickets, though, who I

Dr. Ernie Fernandez 46:43
know I know, very promising, does it? I

Scott Benner 46:46
mean, I'm not going to tell you that I grew up in Philadelphia, and yesterday was the best day of my life watching the Cowboys suck for four hours, but I

Dr. Ernie Fernandez 46:54
don't think you would ever be even interested in that, but,

Scott Benner 46:58
but this is awesome, man. Do you really? You're doing really great work. I don't want to, like, I don't want to embarrass you, but this is really wonderful. I mean, just really,

Dr. Ernie Fernandez 47:07
yeah, I mean, we're just starting. I just have those things. If you were to accidentally put, you know, between you and me, you would you would put slash 5k up there. You would see one of my other websites that I've that's an that's a big family thing that I do, but that's not till May. But people are welcome to look at all those things.

Scott Benner 47:23
I hope they do like I said, we're gonna, we're gonna get a bunch of people tell them about camp Sweeney so they can come look at it. One person's gonna win. You know, basically it's gonna cost you $500 to go to camp Sweeney and nothing else for your kid for three weeks, which is just, that's just insane. I really appreciate that. What else can I do to help get the word out seriously? Take these couple of minutes at the end and tell me. End And tell me we

Dr. Ernie Fernandez 47:43
would like to serve as many kids as possible in the summer of 2025 we have extra capacity this, this coming year, just to get to know us. If you can't come to one of our events, you know, if you could just go under, under the parent involvement and just sketch, you know, schedule one on one. You know, you could talk to me or to one of our program directors, and have time, you know, to visit and learn a little bit more of, really, what we're about going through a typical day, what the kids do, what? What are the things you know, going through the schedule, you know, making sure the child gets excited about this. You know, if anyone has any medical providers that want us to send stuff to their offices or do a virtual lunch with them, sent, you know, to talk to their medical providers, to give them information. That's what we're here for. Is to is information, is to share what we offer, you know, to try to get as many kids to Sweeney as possible every year. The last year was the first year that we were 1% off on our enrollment. We're always in 100% capacity, always. And last year we were at 99% and I was thinking, how did that happen? And it happens because sometimes you don't get the right ages or genders to fill everything exactly right, right. But I think the economy in the last year or two made it more difficult for some families to be able to it. And so I think people don't realize that we do have campership aid available. You know, for children, we try to make it work for them as best we can. So that's one of the reasons why, you know, we try to get out everywhere to tell them, You know what we're about. Because I think a lot of people don't know about our program, and I would love them to be be part of the swni family and our mission. Well, I

Scott Benner 49:13
hope this helps you do that. I really do. I appreciate you taking the time to come on and explain this to me. It's really wonderful. I forget how, like, somebody got me in contact with you. Yeah, a listener that, I guess, that sent a kid they, they sent me an email, and they're like, you know, you should, you should talk to Ernie from, from this beautiful camp. And I'm just really glad we did this today. Thank you. It

Dr. Ernie Fernandez 49:33
was, it was a listener from the north shore of Chicago there, I think, a wonderful, wonderful family, Mr. Sharon, you have Sharon, I think you must have met him at some time, and and his little boy, I think is a youngster, maybe seven or eight years old, and comes from that from Chicago there. Yeah. In fact, they're the ones that are hosting the big meet and greet that we're doing there with the video game truck and all. Okay, you happen to be in the Chicago area. That's going to be quite the event coming up. Out there on

Scott Benner 50:01
can I learn about that at Camp sweeney.org No, we

Dr. Ernie Fernandez 50:04
actually don't have those on there. I wonder if we should. But yeah, they are on there. Absolutely. They're honored that that that on the bottom, where it has all of the events that are scrolling on the bottom. It absolutely has that on there. So this is the December 8, the Chicago Oh,

Scott Benner 50:16
I see the scroll. Okay, I'm scrolling now. Oh, you have so much going on. That's why it's not right there in the front.

Dr. Ernie Fernandez 50:22
It definitely would be on there. Awesome. There's so many things that I apologize. It's hard for me to keep up with all that different. I

Scott Benner 50:28
don't know how you're awake. When do you sleep? Exactly? Not much. Is that the answer?

Dr. Ernie Fernandez 50:34
You know, there's plenty of time for sleeping. You know, you have to find time to serve. Can

Scott Benner 50:38
I ask you one last question? It's got very little to do with this, but more about about this thing. You've been involved with swni for 41 years. I haven't asked you how old you are, but you're not 43 so no, you give a lot of thought to how to, like, how do you pass this torch to someone else at some point? Absolutely,

Dr. Ernie Fernandez 50:55
I think about it all the time. I feel like I have another easily, 10 to 12 years. But there's so many people that do help. It's true. I'm the only one that really kind of does this year round. There are a lot of people that believe in this mission and passion, and I know that as it gets to be that time, somebody will submerge, to come up and be and do this. Because, yeah, 7576 years is just the beginning for Sweeney, you know, right? People always ask me, What are you going to do when? When diabetes cured? I'm always asked that question by children. I always say, you know, when diabetes is cured, we will be done. That will be our mission for that. But knowing what I know in all the years that I've taught this, I know that working towards secure is working towards the kids that have diabetes now and giving them more successful, healthier lives, and that's really the cure we can give. I mean, that's what we're about. There's a lot of stuff in research that I'm excited about and could be coming down the pike, but the one thing that is sure is that kids have diabetes today, yeah, and they need to feel good about themselves today. And that's that's really what our mission is. And what swni is

Scott Benner 52:07
you can't undervalue what it is to be hopeful, to know people are out there trying, whether it happens or not, they're trying, you know. And I always tell people that you should live like a cure is not coming but, but hope, like one it's right around the corner. I just mean by that is like, sometimes I worry that if people think, Oh, it's this isn't going to be much longer, that they maybe don't take as good care of themselves in the moment, thinking it's not a forever thing. But I like that balance. Just take great care of yourself today, be ready for when it comes, and then, you know, hopefully it comes in your lifetime and you can enjoy it, but until then, there's a ton of value. I think you've been talking about it the entire time. You've been talking really and understanding that there are people out there hammering away and on your behalf, whether you know about what they're doing or know who they are. I think that should make people feel good.

Dr. Ernie Fernandez 52:54
Absolutely true. Yeah, no, absolutely that is absolutely true. And

Scott Benner 52:58
I only asked you the last question honestly, because I've built this thing now, and I don't think I work nearly as hard as you do, but it is my 24 hour a day job. And I do wonder, like, I see all the people it helps, and you think, like, well, once I can't do it any longer, like you've got this fully formed thing that you know what it does for people. Like, how do I make sure it continues on? Beyond me, I struggle understanding what to do about that, so I just thought it was interesting question to ask you that's all well, that

Dr. Ernie Fernandez 53:26
is so important, and you are so kind to do this and to share the Word of sweetie to others. And we're hoping that this first conversation to families across the country to come visit our website and maybe visit do a virtual one on one with us, and just talk to us. I

Scott Benner 53:42
hope so I really do. All right, Ernie, I appreciate you taking this time with me. Hold on one second for me. Okay. Was I right? What a lovely man. So we're gonna pick two kids, right, absolutely at random. Ernie is gonna cover one of them, minus the $500 although we're looking for ways to get that 500 covered. But at the moment, one of you is gonna win a $500 all inclusive trip to camp Sweeney, just for 500 bucks instead of $6,700 what it usually costs. And one of you is gonna get an absolutely free trip to camp Sweeney. That's three weeks of camp, Sweeney on us. Med, now what are you gonna do to win? Well, I'm gonna tell you about that in just a second. Hey, kids, listen up. You've made it to the end of the podcast. You must have enjoyed it. You know? What else you might enjoy? The private Facebook group for the Juicebox podcast. I know you're thinking, uh, Facebook, Scott, please. But no. Beautiful group, wonderful people, a fantastic community, Juicebox podcast, type one diabetes on Facebook. Of course, if you have type two, are you touched by diabetes in any way? You're absolutely welcome. It's a private group, so you'll have to answer a couple of questions before you come in, but make sure you're not a bot or an evildoer. Then you're on your way. You'll be part of the family. Me. Okay, I'm back. Here's all you have to do to enter ready. Now the first thing is, we want to make completely sure that your kid wants to come to camp Sweeney. So first you're going to go to camp sweeney.org and spend some time there, really figure out what the camp's all about, where it's at, and if this is something your child is genuinely and truly interested in doing. If it is, that's step one. Step two. If you're a listener of the podcast, which must be because you're listening right now, but you're not following or subscribing in your app, just go back into your app and follow or subscribe. So if you're in the Apple podcast app, hit follow. If you're in Spotify, hit follow. Other apps call it subscribe, but subscribing or following is basically the same thing. So go into your audio app and hit subscribe or follow if you're listening online right now, that's cool. Just, you know, go into Apple podcast or Spotify any free audio app and follow or subscribe to the show. Okay, so now you've gone to camp, sweeney.org, you've looked around. You're super sure your kid wants to come. They're awfully excited. You've hit subscribe or follow in your podcast app where you're already subscribed or following, and then all you do after that is go to Juicebox podcast.com scroll to the bottom and subscribe to the newsletter with an email address that will reach you. That's it. Everybody who subscribes from right now, which is, let's see when's this gonna go up, November 15. So from November 15 at midnight until you know what, let's do it. Let's do it straight through Diabetes Awareness Month and through the weekend. So let's call it December 1 at midnight. So from now until December 1, at midnight, Eastern Time, everyone who subscribes to the newsletter follows the podcast and checks out campsweeney.org is entered. Then we're going to do a random drawing. And let me make sure I say how I'm going to do this first the first person I pick out will be the winner of the camp Sweeney Award, and the second winner will be the person who's going, thanks to us. Med, how's that sound? First one I pick is that? Second one I pick is us. Med, and I'm gonna pick a couple of extras in case one of you gets flaky, or something like that, or your kid, you know, is like, I don't want to go to camp. Whatever Am I done to happening? We're going to pick a few. How many will I pick? Just to cover myself, I'm going to pick six. Okay, six names. We're going to get the first two locked in to go to camp, and then those last four, I'll find something nice to send off to maybe a little swag from the website, or something like that. Campsweeney.org look around, make sure it's something you want to do, subscribe or follow in your podcast app, Apple podcast, Spotify, anything like that at all. Apple, Amazon music. I Heart Radio anywhere you can get audio. And then go to Juicebox podcast.com scroll to the bottom and subscribe to the newsletter. Now you're saying, Scott, what if I'm already subscribed to the newsletter? You make a fair point. If you're already subscribed to the newsletter, you can go down there to the bottom at Juicebox podcast.com and hit contact, and that gives you an opportunity to send me a message through the website. In that message, just say, I want to enter the camp Sweeney giveaway, and I'm already a newsletter subscriber, that's all you have to do. I'm incredibly excited to bring this opportunity to you. I was really touched to hear from Ernie. He's just a lovely person. After talking to him, it motivated me to reach out to us Med, to see if they could help me send another child. They very graciously and immediately agreed. It's awesome. I'm feeling so good about this, especially around World Diabetes Day and Diabetes Awareness Month. I hope you're excited as well. I'll talk to you soon, and if you want to do me a rock solid one, even though I wasn't supposed to add it in here today, hang on for another minute and listen to this ad from us med. I used to hate ordering my daughter's diabetes supplies. I never had a good experience, and it was frustrating. But it hasn't been that way for a while, actually, for about three years now, because that's how long we've been using us Med, US med.com/juicebox, or call, 888721151, 887211514, us. Med is the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor for Omnipod, the number one fastest growing tandem distributor nationwide, the number one rated distributor in Dexcom customer satisfaction surveys, they have served over 1 million people with diabetes since 1996 and they always provide 90 days worth of supplies and fast and free shipping us med carries everything from insulin pumps and diabetes testing supplies to the latest CGMS like the libre three and Dexcom g7 Nine, they accept Medicare nationwide, and over 800 private insurers find out why us med has an A plus rating with a better business bureau at US med.com/juicebox, or just call them at 888-721-1514, get started right now, and you'll be getting your supplies the same way we do. 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 if you're ready to level up your diabetes care. The Diabetes Pro Tip series from the Juicebox podcast focuses on simple strategies for living well with type one. The Pro Tip episodes contain easy to understand concepts that will increase your knowledge of how insulin works. And so much more, my daughter has had an A, 1c, between five, two and six, four, since 2014 with zero diet restrictions, and some of those years include her in college. This information works for children, adults and for the newly diagnosed and for those who have been struggling for years. Go to Juicebox podcast.com and click on diabetes pro tip in the menu, or head over to Episode 1000 of the Juicebox podcast to get started today with the episode newly diagnosed. We're starting over and then continue right on to Episode 1025 that's the entire Pro Tip series. Episode 1000 to 1025 the episode you just heard was professionally edited by wrong way recording, wrong way recording.com, you.


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#1358 Blue Circle

Scott Benner

Wait until you hear about Bluecirclehealth.org 

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon MusicGoogle Play/Android - iHeart Radio -  Radio PublicAmazon 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.

Scott Benner 0:00
Welcome back, friends. You are listening to the Juicebox podcast.

If you are living with type one diabetes, blue circle health can provide you with support services and resources you need to help manage this difficult disease, and this is at zero cost to you. You might be thinking, wow, Scott's putting the ads up closer to the front of the episode now, but that's not true. That's not an ad that's about today's episode. Today, we're going to be speaking with Sarah from blue circle health, and wait till she explains to you what the organization does and what it will cost you. 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. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D drink, ag one.com/juice box. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's Juicebox at checkout to save 40% at cozy earth.com

Today's episode of The Juicebox podcast is sponsored by the ever since 365 the one year where CGM that's one insertion a year. That's it. And here's a little bonus for you. How about there's no limit on how many friends and family you can share your data with with the ever since now, app no limits, ever since, this episode of The Juicebox podcast is sponsored by the contour next gen blood glucose meter. Learn more and get started today at contour, next.com/juicebox 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.

Sara Lerner 2:24
Hi, my name is Sarah. I live in New York City, and I was diagnosed with type one diabetes just over two years ago in June, 2022

Scott Benner 2:32
How old are you now? Sarah,

Sara Lerner 2:34
27 years old.

Scott Benner 2:36
Okay, so you're 25 How about in your family? Is there like, just like a thought like, Oh, I'm definitely gonna get diabetes, because everybody has it, or thing you never heard of before, somewhere in between, yeah,

Sara Lerner 2:47
not something super familiar with. I do have one cousin with type one. Her dad has type one as well, who's not on my blood related side, but it wasn't even something I was super cognizant of growing up. I had one or two friends who had had type one, but it really was not on my radar when I was diagnosed.

Scott Benner 3:03
Wait, Sarah, you have a familial side that's not blood related, like, like a step father's brother or something like that.

Sara Lerner 3:08
The cousin is blood related, but her dad has it who's not blood related?

Scott Benner 3:13
Oh, I see. I don't know why that confused me. I apologize. I was like, Sarah's related to people she's not related to. What a great story. And she has it though, the cousin, yes,

Sara Lerner 3:22
but we didn't grow up living in the same country even, so we we weren't super close, so it wasn't something I thought about until, actually, a few months after I was diagnosed, one of my uncles said, hey, you know, your cousin has this too, and I hadn't even remembered. So that shows you that she was living with it really well, and that I wasn't, I wasn't even aware of all that was going on. But I think it's also one of those things that until it happens to you or you have a really close friend or family member with it, it's not necessarily on your radar, unless you live with

Scott Benner 3:48
it. Yeah, can I ask if you don't know, but does her the cousin, does her mother, have autoimmune issues? I actually have no idea. I'm interested, because if the father has type one, and the mom has auto immune. Then, is that, you know? I mean, like, is that the recipe that gets you there faster,

Sara Lerner 4:06
you know, I will go find that answer out. But I know auto immune stuff runs in my family. I mean, you know, we did the I sent the screening information to my siblings. I'm one of four kids. I believe two of the four of us did it, and I know one came back with, you know, positive auto immune. The other one did not, I don't know about the the other brother,

Scott Benner 4:27
Oh, wow. I'm glad you shared that with them. That's, that's awesome. And so awesome. The two of the three of them did it by, by the way, most people don't. So, yeah, yeah, you got a good return there. I did. So there's auto immune in your family, your mom, your dad, grandmothers, grandfathers, what's what's going on. I'm going to

Sara Lerner 4:42
sound really ignorant here, but I don't know the whole history of our autoimmune and haven't really dug into it. I should. I should go into it more. Now, you know, there's some blood conditions that run in the family. I know there's some different autoimmune pieces that people have. I have a few different health things that have gone on my whole life, but this is. Only one that really came up as a as an auto immune siblings with auto immune, as I mentioned, but it wasn't something that we grew up thinking like, Oh my God. We're this family with all of these auto immune issues, right?

Scott Benner 5:10
What were your other health issues growing up? I

Sara Lerner 5:13
was diagnosed with Ehlers Danlos Syndrome when I was in high school, connective tissue disorder, so that's something I was kind of always aware of. But, you know, it didn't deeply affect me, other than, you know, when I played sports, things were a little bit harder. Sometimes my feet were really flat. Led to some some injuries that I now currently have, a broken leg that probably has something to do with that condition as well. So it's just come up throughout my life, but hasn't been been the story of it, the way that type one came and became, yeah, now

Scott Benner 5:43
I'm gonna find out more about the so you got an auto immune issue when you were a kid. And that's for people who don't know that's ligaments and stuff extra stretchy, kind of that feeling, right? Yeah,

Sara Lerner 5:52
and you know, there's different types of it, so mine is more hypermobility. So I wouldn't, you know, there's genetic markers for it, but I wouldn't even it wasn't really an autoimmune issue that

Scott Benner 6:02
I had. It is, though, by the way, it is an autoimmune disease. Yeah, I just

Sara Lerner 6:05
didn't have any other, you know. I didn't have the heart condition related or anything else. Mobility, yeah, I see yours was stuck to the mobility, different strains of it, different types. Yeah. Oh, lucky

Scott Benner 6:16
you. Now, okay, how does the type one rear its head like, what makes you realize that something's going on?

Sara Lerner 6:24
Yeah, well, I was getting sicker for about four months. I'm sure that I was aware of some of the signs and symptoms just from growing up. I was an EMT volunteer EMT in college, so there are things that we learned about, you know, DKA and looking out for, but when it's yourself, you're not necessarily realizing that. So I was getting sicker. I knew something wasn't right, seeing a bunch of doctors. Nobody took my blood, unfortunately, until I was, you know, walking around New York City, passing, feeling like I was going to pass out at any moment. I got a COVID booster shot, actually, and that was kind of what got me really, really sick. You know, some people threw up once or twice after that, but I was throwing up constantly and just wasn't getting better from it. I think conversation with my mom where she said, Sarah, you really need to find someone to quarterback this like I know you something's not right. You're falling asleep during the day, like you're losing weight. Get to the doctor. I finally had a blood test drawn, and I was hospitalized the very next day for for several days. So a lot of signs that I think I wish I had recognized earlier, but once, once I did get into great care, it was, it was much smoother sailing from there. But I will say, like many people who are diagnosed as adults immediately in the ER, they said, you know, given your age, this looks like type two diabetes. We're going to start you on Metformin, you know, we need to, you know, give you insulin to bring your blood sugar down. And I was lucky, and then my antibody test came back while I was still in the hospital. And so I didn't live with that misdiagnosis for very long, as many people do, right? But I hope that you know, a takeaway that everyone who meets a type one who gets diagnosed as an adult is, is that, like adults do get diagnosed with this and and that stat is only rising.

Scott Benner 8:03
Hey, how long till your mom was like, I told you something was wrong.

Sara Lerner 8:07
Well, when I got hospitalized, my mom, you know, I grew up in Baltimore, and my mom got on a train within minutes, I think, with no belongings, and was in the hospital with me. So she was, she has been, you know, champion supporters. Has my whole family since day one, and everyone has really rallied around me. But she definitely knew, as moms tend to often know, that something, something was up, and I needed somebody to really help quarterback that care.

Scott Benner 8:30
What a lovely woman. She didn't roll right through the door going I knew it.

Sara Lerner 8:35
She might have said to other people, but I think I was it could have happened to me too, but I think I was too overwhelmed to realize nothing but support from there,

Scott Benner 8:42
you don't remember, but on the train up everyone she bumped into second, I was telling that girl, something was wrong. She don't listen to me. And

Sara Lerner 8:50
I think she was more bummed that she didn't know the diagnosis. And was like, How did I miss this? And I'm like, Mom, you are not a you know, you're not a doctor. It's okay. But I think it was more on that might help me not realize what this

Scott Benner 9:01
says. That's very nice. Okay, so how do you leave the hospital? Meaning they know you have type one because luckily, you got the auto antibody back, right? But is it like, here's some needles like go to the pharmacy, especially in New York City. It's kind of a different vibe. So what do you physically leave the hospital with type one diabetes? Can happen at any age. Are you at risk? Screen it like you mean it. Because if just one person in your family has type one, you're up to 15 times more likely to get it too. So screen it like you mean it. One blood test can help you spot it early, and the more you know, the more you can do. So don't wait. Talk to your doctor about screening tap now or visit screen for type one.com to get more info and screen it like you mean it. Yeah.

Sara Lerner 9:49
So I was actually discharged straight into outpatient care, which is very rare. So I got in with the endocrinologist in New York, and I literally went from inpatient hospital. Hospital too, I believe we got in a taxi with a whole lot of different medical supplies and went to my outpatient Endo, who I'm still with today. And so that was a very fortunate experience. And she sat with me for at least an hour and just answered questions non stop. And so I did meet with, I think, an educator in the hospital. Gotta be honest, I don't fully remember what happened in that hour long or 30 minute session? Or I'm pretty sure she taught me how to, you know, take an injection. They slapped a CGM on me in the hospital as well, which was, you know, helpful to have that from from day one. And then I did go straight into my endocrinologist office and got my tumd, 101, and in another thing that was really rare, credit, credit to the care that I've gotten at NYU, my doctor gave me the off, you know, off hours number, and said, Call me every single night for the first two weeks, we're going to adjust your your ratios together. This is going to be a team effort. And I want you to learn how to call this number. I want you to learn how to give yourself shots. But we're going to work on this together. And so that first two weeks, we really spoke, I think, every single day, as I figured out how to get my blood sugar down from, you know, the five hundreds, and I was diagnosed with an A, 1c over 13, and we got it down together.

Scott Benner 11:12
How much weight did you lose before you knew you were type one? I don't

Sara Lerner 11:17
actually know, you know, a number there. I was going to the gym really regularly for the first time in a good, good while. So here I was thinking I was killing it at the gym. And then we, you know, kind of realized that it wasn't, it wasn't a natural situation happening in a in a positive way. So I don't know, but I would guess, like, probably 1015, pounds.

Scott Benner 11:35
You're not a big person, because I met you once in person, right? Like, am I remembering correctly? You're You're slight, right? Yeah, I

Sara Lerner 11:42
think pretty average, yeah, look at you.

Scott Benner 11:46
I don't know if you took that wrong or not.

Sara Lerner 11:50
I now have a really good exercise regimen that you know. I've always been athletic. I've always played team sports growing up, and now have continued that on as an adult, but I do exercise fairly regularly. But, you know, average height,

Scott Benner 12:04
okay, yeah, no, no, I just, I meant, like there was 10 pounds when you might be a fair amount of weight. Yes,

Sara Lerner 12:10
look pretty pale when I when, you know, when I look back and see some pictures from the days leading up to my diagnosis, and I, you know, I would remember I was at a friend's birthday the day before I got diagnosed, and I was craving sugar like crazy at that time. So who knows what I did to my blood sugar that day eating like cake and cupcakes and ice cream. And I've never had that big of a sweet tooth, but in those months leading up to my diagnosis, like I my body was craving sugar so much that I was like every time I worked out, I was getting a smoothie afterwards, because that's what I kept feeling faint, and then I would have it and I would feel better, you know, I don't know what I did to my body in those months leading up to my diagnosis. Something.

Scott Benner 12:45
Wow. Okay, so now today, you have a job around diabetes, so I want to figure out from being diagnosed two years ago, like you weren't in this kind of work then, right? No, I

Sara Lerner 12:57
mean, I was a social worker, so I did work with in health and education, mostly with kids, and was working, you know, in that realm, I did make a jump into the T 1d space, and I credit that a lot to getting involved with the T 1d community. So early on, I'm a community person. I'm a relationships person. And so when I got this, this diagnosis, I think within three weeks, I had new friends with type one diabetes. I had gone to a meetup in Central Park three weeks into my diagnosis that I had kind of coincidentally found out about one of the girls who was at that Meetup is one of my best friends today, and I've met so many other people from from that community. And so I would say I have this mentality of, I need to I need to get my own care set. I'm going to lean into this community. I'm going to get involved. And then I think I probably knew while I was in the hospital that I would work in this, this space. One day, I recognized the, you know, the privilege that I was experiencing with my diagnosis, with the disease, with my access to technology and care, and never wanted to take that for granted. And knew I wanted to shift, shift into the space professionally. Wow. So where do you work? Tell people where you work. Yeah. So I work at Blue circle health. We're a non profit organization, and we have a T 1d free care, education and support program funded by the Helmsley Charitable Trust to improve the lives of people living with type one diabetes. We have this, this program. It's a virtual six month program for adults 18 and up. You know, we're live in five states right now. So it's live in Delaware, Florida, Maine, Vermont and Ohio. And we will be expanding to other states soon. And we exist to close the gap between what you get when you you know, have this disease from the traditional healthcare system versus what you really need to thrive. You know, when I say, I recognize my privilege and came into this disease getting a lot of resources like I did. I was able to get into a, you know, coaching program and get external education, diabetes education, and find community support, train my dog to be a diabetic alert dog. You know. Have a therapist who I adore, and has given me so much support through this diagnosis. So I received all this external support. I had a great healthcare team too, but I only get to see them twice a year to be able to have all that external support is what allowed me to manage my diabetes with confidence and get to a place where I felt like I was thriving with my type one, and so now with blue circle health, we have this program where we're able to fill in the gap from what you get from the traditional healthcare system and give people that education and that support. So we have diabetes educators on our team. We have endocrinologists on our team. We have social workers and we do, you know, case management and diabetes supportive counseling. We have insurance navigators, which, you know, personally, that's probably the area I need the most help with, because it's the most complicated to navigate for me, at least on a day to day basis. We have two and D support guides who all live with this disease and and can help me navigate the program, offer peer support, run group sessions. And we also have some other specialized services available, like a Prescription Assistance Program, but we'll pay for people's prescriptions. We have a CGM trial program. So there's all these supports that kind of seem a little overwhelming to manage all that, but it's really like a la carte, you know, patients get individualized care plans, and so, you know, you can use as much of those services as you need, or as little as as them, as you need, up to six months. So you may come in and say, I just want to meet with the insurance navigators and your educators three times and like, great, that's it. You may be out of there in a month. A lot of people we find, you know, stay for the the full six months, though,

Unknown Speaker 16:34
is it virtual?

Sara Lerner 16:36
It is virtual. So that's one of the eligibility requirements, is being able to connect with us virtually.

Scott Benner 16:41
Okay, so how does that? How does blue circle begin? How long has it been available? Like? How did it start? What do you, I mean, I know you, you haven't been there that long, but what do you know

Sara Lerner 16:50
about it? Yeah. So I joined the team in March, and at that time was when we were first really coming out to the world and saying, Hey, we exist. So before that, we were just in Florida. We, you know, started because there is a group of people at the Helmsley Charitable Trust sitting around and saying, What can we do to fill this gap? Like, we know the gap is there. What can we do to help people who live in the US and are struggling to manage this disease? Like, what can we do for them? And creating this virtual program with patient care as our North Star, as being able to work outside of the traditional health care system. We don't bill insurance because insurance system is what makes it so complicated sometimes to get the care you know that you really need, need and want, and what our providers want to give us, they often can't, because of that reimbursement system. And so a group of really amazing people sat together, and they dreamed this up, and it started with diabetes education, and then all the other service lines really built from there, from peer support. And our program was, first, you know, full services operating July a year and a half ago, and then in in around March this year, really January this year, but starting going out to the world in March. We opened it up so that patients could enroll themselves. They could go to our website, blue circle health.org and sign up directly. We still get provider referrals to, of course, but this is something that you know should be available to everybody, and we want to show what to Andy care can and should look like in this country. And we're out there trying to, trying to do

Scott Benner 18:14
that. And for right now, for five you're in five states. Is that right? Five states right now?

Sara Lerner 18:19
And then we'll keep steadily expanding throughout 2025 no more new states in 2024 we just went to Ohio and Delaware, November 1. So that was the last expense expansion of 2024 but then we'll keep expanding in 2025

Scott Benner 18:33
so basically, all these different ideas, like service points that you have, these people all also aren't at a location. They probably working from their homes or whatever. And then I meet you somehow, and I'm like, I just got diabetes, and I don't understand this stuff, but I don't know how to Bolus for my food. And you can put me through like courses to help me manage insulin. Contour, next.com/juicebox that's the link you'll use to find out more about the contour next gen blood glucose meter. When you get there, there's a little bit at the top, you can click right on blood glucose monitoring. I'll do it with you. Go to meters, click on any of the meters, I'll click on the Next Gen, and you're going to get more information. It's easy to use and highly accurate. Smart light provides a simple understanding of your blood glucose levels. And of course, with Second Chance sampling technology, you can save money with fewer wasted test strips. As if all that wasn't enough, the contour next gen also has a compatible app for an easy way to share and see your blood glucose results. Contour next.com/juicebox and if you scroll down at that link, you're going to see things like a Buy Now button. You could register your meter after you purchase it. Or what is this? Download a coupon. Oh, receive a free contour next gen blood glucose meter. Do tell contour, next.com/juicebox head over there. Now. Get this. Same accurate and reliable meter that we use this episode of The Juicebox podcast is sponsored by the Eversense 365 get 365 days of comfortable wear without having to change a sensor. When you think of a continuous glucose monitor, you think of a CGM that lasts 10 or 14 days. But the ever since 365 it lives up to its name lasting 365 days. That's one year without having to change your CGM. With the ever since 365 you can count on comfort and consistency. 365 days a year, because the ever since silicon based adhesive is designed for your skin to be gentle and to allow you to take the transmitter on and off, to enjoy your shower, a trip to the pool or an activity where you don't want your CGM on your body, if you're looking for comfort, accuracy, and a one year wear You are looking for ever since 365 go to ever since cgm.com/juicebox, to learn more.

Sara Lerner 21:07
It's not courses, it's really one on one, direct patient care. And so yes, we do have people all over the country who are on our team and able to connect with you virtually. They are licensed in the states that we're live in, and that's part of the reason why we're alive in those specific states. All of our providers are licensed in the states that that we're live in. They're giving you one on one attention, and sometimes, you know, it can be nine months until you can get in with your Endo. We make that turnaround time a lot quicker. So if you were to go on and, you know, be eligible to sign up for our program, let's say in Florida right now, on a business day, usually within three hours after signing up on the website, you get a call from our clinical enrollment specialist, and you start the process of getting in, and you may have your first appointment with our endocrinologist or an educator, an insurance navigator, within a week, easily. So it's it's really about giving people the care that they they need and deserve immediately. How

Scott Benner 22:00
long is like, when I get set up with the endocrinologist, like, how long do I sit with them? That

Sara Lerner 22:04
appointment can be up to an hour, and it's free. It's totally free.

Scott Benner 22:09
So we're understand, hold on.

Sara Lerner 22:12
Like, what's the catch?

Scott Benner 22:13
Stop it. Yeah, I feel like you're gonna be like, and then you have to send us your kidney and release because we sell them. Hold on a second. I understand Helmsley is behind it, yeah, but it's all public information, right? But, like, you don't make any money. No,

Sara Lerner 22:27
we don't. So we don't bill we don't charge anything. We are fully funded by the Helmsley Charitable Trust, so it's incredible, you know, generous work that they're doing and that they're able to, you know, fund us to make this happen, and we're able to dream big for people with type one, and we're constantly working on making this program better for our patients. We're really big on feedback. We're really big on collecting all of the information we can to improve this be as efficient as possible. But the goal here is to really keep patients as our North Star and do what's best for them, and that's how the entire program has been built and developed and maintained. And, you know, the majority of our clinical staff, they live with type one diabetes. So these are people who get it, and there's a lot of people beyond the clinical staff who live with it too, like myself. You know, I'm not a patient facing member of the team, but I live with type one I work with Scott Johnson, who many people know from being in the T, 1d, community for for many years, he lives with type one. And so the team, the team is really mission driven, which has been the coolest environment I've ever worked in. No

Scott Benner 23:32
kidding. So how many people work for blue circle?

Sara Lerner 23:35
I think we're close to 45 right now.

Scott Benner 23:38
Get out of here. Yeah,

Sara Lerner 23:40
we got a pretty, pretty large, growing staff. What

Scott Benner 23:43
happens if we put this podcast up and 2000 people call blue circle health, they still gonna like sign up tomorrow and get going? Yeah,

Sara Lerner 23:51
you know. So we have built out systems for wait lists and whatnot, just in case, in case that happens. But we've actually found that that that hasn't been the case yet, because people need to hear, hear from people who have gone through the program that there isn't a catch. Because right, like we've been taught nothing is is free in health care, and here we are saying, Hey, we have this free program. And so having people you know meet us, we're going to events. I met you for the first time at the touch by type one conference. So we're showing up events to say, hey, we're actually real, but we've had to do a lot of myth busting to get the word out. So I would encourage anybody listening to like, if you know an adult who lives with type one who's in one of the states I mentioned, Florida, Delaware, Maine, Vermont, Ohio, tell them about this program. Tell them about this resource. I really believe that there's something for everybody who lives with type one that they could benefit from this program. And and if there's not, I want to know it. We want the feedback. But I truly believe this is, this is top notch care. Sarah,

Scott Benner 24:46
when I met you at touch by type one, you started explaining this to me. I was like, This sounds like a scam

Sara Lerner 24:55
battle we're facing. And you know, my circle health is, is partner relations. So I spend my days talking to. Providers. I talk to patients directly. I talk to nonprofit organizations. And I love getting to do that, because I get to myth bust every day and be like, No, this is actually real. It's out there, and it's an incredible resource for the T and D community. It's a blessing that we're able to do what we do every day. And I'm, I'm excited for it to be even bigger as we spread the word. And, you know, work with partners like you to spread the word. But this is a resource that belongs to the T 1d, community, and I'm excited to get it out there.

Scott Benner 25:26
I'd be remiss if I didn't ask you this. So, like, somebody found blue circle six months ago, right? And they're like, Hey, what's up? I'm an adult living with type one. My A, 1c is, like, 11 and a half, and I struggle all the time. Blah, blah. Like, if I found that person today, are you tracking their outcomes? Like, are you seeing how it's going? Do you see what I'm saying? Yeah, someone who signed up six months ago, yeah? Like, are they in a better place today? Yeah, absolutely. So

Sara Lerner 25:50
we're tracking that. We're tracking so many, many things. And you know, there's a lot of data scientists and engineers on our team who are doing great work on that, and because we've only had our program in its full form as it is now, for under a year, really out in the world, we are still getting some of that information back, so I think if you come back to me in three months, I'm going to have a lot more data to share with you. But our initial, you know, feedback, our net promoter scores, are wonderful. The feedback we're getting from our patients and providers is great. You know, I just heard a story last week of a patient who we saw really early on, and you know, she said her ANC is, is the best that it's been in in many, many years. And so we do hear those stories. We do have access to some patients, you know, CGM data, if they're on CGM. And so there's, there's a lot that we're tracking. We do a DDS score. So we're, we're looking at diabetes, distress at entry and exit. We're learning as much as we can, because we want you know, as I said, patients are a North Star. We want to deliver excellent patient care. That's our that's our mission here. But our mission is also to show what this can look like in a much bigger scale throughout the country. And so we are, we are taking those learnings so that hopefully this can have policy implications one day.

Scott Benner 27:03
Awesome. It's really great. How long are you funded for? Like, do you have a an amount of time, or you have to make this work? Or they're like, yeah, it's enough of you. So

Sara Lerner 27:10
they fund in three year cycles. But we're very confident that funding is going to be with us for a while. And with the funding that we have right now, we're able to care for 1000s, which is amazing. You know, I think there's, there's going to be a point when we want to be in all 50 states, and we want to be caring for 10s of 1000s of people, then we'll have to look into, you know, what does it look like to to have additional funding sources here? But where we are right now, we're very comfortable.

Scott Benner 27:37
I'm going to, I feel like I'm going to say something, but I don't want to be controversial, because I'm about to get, I love getting this story out about this, but I love this a little extra, because I have like, a, you know, there's some things in the world that bother you, yeah, so listen, I take ads, right? So I make a living making the podcast. So I don't want to come off, like, I'm just over here doing it, and, like, you know, like in the evenings, after work, like, it's a job I make a living, like, so I want to be clear about that. I've always been, like, you talk about North Star, like, when I started doing this, the way I thought about it was that people shouldn't have to pay for good health. Like, that didn't make sense to me, right? So you know, where a lot of people might, you know, make a podcast popular, and then tell you a couple things. Then say, Hey, if you click on this link over here and pay me. And pay me, I'll tell you the rest of it. You know, a coaching model, or something like that. And I, by the way, this is going to sound like I'm talking in circles for a second, Sarah, but I have two actual minds of thought about this. I don't mind people making a living. If you want to go out there and do like health coaching, I say, God bless you. I hope it helps people, right? But from my perspective, I don't like that. It costs people money, and so, like, the one thing you won't hear on the podcast ever is a health coach. Like, I don't allow health coaches in my private Facebook group. I don't let them on the podcast because I am not about you selling what, in the end, ends up being explaining to people how to, like, set their settings up and pre Bolus for their meals, and how to Bolus for fat. Like, I don't think you should be selling that information to people, so I make it all very available, very free on the podcast for the people listening. I'm very proud of that, but I am also a little personally irritated when people make money with coaching. So I not that I don't think it's necessary or Okay, and Sarah is not going to bad mouth anybody, because she's here kind of in an official like, I'm not bad mouthing anybody either. I don't like it personally. Like, I think, like, find another way to pay to get them this information. I found a way I sell ads on a podcast, right? And you guys found a way. And I think that's really awesome. Like, I'm super excited that you're gonna be helping people and not charging them money. I think that's wonderful. So thank you and anybody else who's involved in it, because I think it's really great. You don't have to respond even to all that stuff. I just said, I'm not asking

Sara Lerner 29:49
you to I think, look, health care in this country is an incredibly complicated thing. Our program is not available in every state, right? We want that to be the goal. And so we want this to spread. We want this, you know, we have to. Work hand in hand with the existing health care system to do what we do, and we love doing that, like we act as an extension of somebody's care team. That is, you know, a huge part of our mission, part of our eligibility requirement, is that our patients have a medical home or are willing for us to be, you know, connect them to one. Because we're a short term program. We want people to have that in person care. We also recognize that some people can't meet with a diabetes educator. I think I've only met with my diabetes educator once or twice since my diagnosis, and that's just because the health care system is complicated. So I say like, for anyone who can go out there and seek external resources and afford it like, that's amazing. That's an extra thing that you know you can do. We also want to make this available for people who can't afford it, and we started by recruiting out of free clinics and federally qualified health centers and giving people who had predominantly only seen a primary care doctor to manage their type one diabetes some specialty care. Now we've opened the doors and say, Hey, anyone who needs to help with their T 1d and is eligible, like, great. Sign up. We do this program, you know, in English and in Spanish right now, hopefully one day that's even, even more languages. But this is, this is a resource that that really belongs to the people with type one, but for anyone who can access additional resources, like, I support, you know, whatever you can, can build in your circle. Oh, listen, I

Scott Benner 31:17
for everybody that can afford it. Like, it's cool. Like, if you want to go buy a, you know, rent a health coach. I think that's awesome. Like, go do it. You know what I mean, like, but for all the people who can't afford it. So for as long as I've been in this space, a back room, conversation has been about reaching more people. Like, it gets nice to say, like, oh, I have a podcast, or I'm a coaching service. And people who go with me, they leave with, like, five, a, one, CS. It's awesome, but like, you're reaching people who have that access. You're reaching people who have the time, who have the wherewithal, who have the money to pay and what about everybody else? And I always hear people talking about, what about everybody else? But then nobody does anything about it, and this is actually doing something about it. Absolutely, yeah, I think it's even, I'm gonna listen. I'm just gonna come out and tell you, Sarah, like, there is very likely no other entity, person, whatever, in the diabetes space reaching as many people as I do, and I reach a small fraction of people with diabetes.

Sara Lerner 32:12
That's what we're finding, too. Is like the Facebook communities, like the one that you have built, that is where so much of the conversation is happening. And so that's where I'm hoping that we can take blue circle health into these groups too, to make sure that people know, hey, like, if you're eligible. And a lot of times it's parents who are in those Facebook groups with kids with type one who, of course, will become, you know, 18 and older and be eligible for a program. And we do a lot with that transition. You're going from Pete's to adult, you need a soft landing pad. It's a while till you can get into an adult endo or you're navigating new challenges of college early career. Like, we can help fill that gap. It's a huge area that we help, but a lot of times in these Facebook communities, it's not actually adults with type one who are there, but it's a powerhouse moms and dads and caregivers. So we're hoping to use that to spread the word about this resource and to be able to share, but it's also finding people who have said, like, I want this to be in the background, like, I don't want, you know, type one to be something that is my identity, like I'm the weirdo who's chosen to do that, right? Like, I talk about this with my team all the time, like we're like, we're the T, 1d, weirdos who have made this our careers and made this our social circles, and that's not the average person. So for us at Blue circle, like a huge task is like, how do we find the people who they may not want the T and D community to be their biggest thing, or they may not realize what that you know that could fill in their life right now, but how do we find them and offer them an extra hand so that they don't feel like they have to carry the burden of this disease all

Scott Benner 33:35
by themselves? Yeah, everyone needs help, like, right, but children and adults, but adults, I think, specifically because they don't have a parent with them, like, maybe you're going to get lucky and get a decent parent who jumps on a train and goes from Baltimore to New York, because you need help, right?

Sara Lerner 33:49
Does not do it justice for what my parents have done for me and my siblings and, you know, the whole, my whole friend group has has really rallied around here. It's

Scott Benner 33:58
amazing, but a lot of people don't have that right? Sometimes people have parents, and their parents just aren't like, go getters, you know what I mean, or they don't understand diabetes or whatever, but at least they're still with their parents, and they go to their doctor's appointments and they get to see doctors, you know, like they have more touch points. But once you become an adult, and you're by yourself, and if you didn't have good diabetes knowledge or practices as a child, and you become an adult with diabetes, it is only going to go in one direction. You know what I mean, like you and you need something that is, is a base. It's a firm foundation to say to you, like, look, here are the I mean, Sarah, this entire podcast, if you listen to the management stuff, it's really very simple stuff. No one's saying anything crazy that nobody knows about except for me. You know what I mean? Like, it's just, it's about have your basal right, Bolus for your food properly. Don't look at a high blood sugar all day. Bring it back down. Trying to be scared of being low. Fix it. Get back, don't, you know, don't get up on a roller coaster, up and down. Like, I actually think that once you have those, those tools, you. Diabetes is manageable, right? And I don't want to say easy, I don't mean easy, but it's easier when you understand the foundational stuff. And what I've come to learn over a decade is that most people don't get foundational information ever

Sara Lerner 35:15
Well, and what you don't know you don't know. So if you're taught one thing, like, I still remember that, you know, I was taught every time you go low 1515, grams of carbs. And so that's what I thought was the prescription there. And then I was going high every time I was doing that, and I was honeymooning at the time, and I I just didn't know that, you know, we were in control of adapting that, and that I could be empowered to make my own choices about that, and that, you know, I may not need a 15 grams of carb snack every time I was dropping a little bit low, and it may look different. And some days I only need five grams of carbs to correct a low, and sometimes I need 30 grams of carbs to correct a low, depending on so many factors of insulin on board and what activity I was doing and how fast it was dropping. And it's just impossible to put all that into a doctor's appointment once or twice a year.

Scott Benner 35:59
Never gonna happen. And I have found, speaking to countless adults over the years, that the ones who feel empowered to change their settings right to adjust their insulin, they're the ones that do better, and the ones who think I have to wait until I talk to the doctor, because he'll know better, she'll know better. I gotta wait. And they wait three months, the doctor turns their basal from point, you know, six, five to point seven. Like, let's see what this does. Well, the answer is my A, 1c, is like, you know, eight, it's gonna not do anything and like, and then we'll wait three more months and do it again. And then that gets frustrating, and the doctors forget. They don't listen. God bless doctors and all, but they don't remember you the last thing they do before they walk in the doors, open up your chart and go, okay, and then they run through the door. You remember them, because you're, you know, they're your doctor, but they look at you like, oh, you're a pat. I remember pat a little. They're not tracking your health the way you can, right?

Sara Lerner 36:55
And we have too many tools to do that now too, that it's just about learning how to to use them to our strength. No, 100% like

Scott Benner 37:01
this is super exciting, because I think you're going to learn a lot while you're doing this as well, lessons that maybe leap over the patients and go back into health care again, because you're you're paying attention, you're in a, you know, I mean, a few 1000 people. It's a nice, focused experience where you're going to really be able to, like, see lessons, see what repeats, start saying when we do it like this, this works more frequently, you know. And then that's good advice to hand out to doctors, too. I can see a world where one day doctors can come to blue circle to ask questions about, like, you know, what are the foundational steps? Like, what do I do to put these people in a good position? Because I don't think they know either. This is really cool, this is this has a lot of like, upside potential. You must be excited to be involved with it

Sara Lerner 37:46
absolutely. I mean, it feels like the the great honor of my life, and I don't say that lightly, to be involved with this organization and this group of people that's making it happen. There's just so much heart, like I go to work every day with this a smile on my face, getting to do what I do every day, and with this group of people, and most of them, I've only met in person once, you know, and actually it was my second diversary this year at our team retreat. And so I was still fairly new on the team, and I just was reflecting that day being like, wow, I couldn't imagine being in a cooler spot right now in my T 1d journey than at this in person team retreat on my second diversity and able to think about, you know, where I came from day one, because it has not been, you know, smooth sailing from the start. There was a period of time where I was eating the same thing every day for breakfast, lunch, dinner and like, that's what felt comfortable. And I had to learn How to gain Confidence with my T and D management, and now that I can work in this space and be, be putting this out there for other people with T and D. It's, it's an honor. Awesome.

Scott Benner 38:45
That's really something. Okay, let's go over it. Where somebody's listening to this, they're like, I'm going to try that. Where do they go? Yeah.

Sara Lerner 38:52
So blue circle health.org, you can sign up from our website. There's a button there to sign up yourself. You know, if you're a provider listening to this, you can there's a button that you can refer patients to sign up on the form. There's also, you know, a phone number that's listed on our website that you can call to with filling out the web form. You're like, I want to talk someone. I want a little more before, before I do this, you can do that. You can reach out to our team, team at Blue circle health org, via email if you fear, like, Hey, I'd rather, you know, set up a time and figure something out to talk and learn more about this. But we're on Instagram, we're on Facebook, we're on LinkedIn, trying to tell our story and share, share what we're doing. And so if you want to go explore, check it out. If you're like, I don't live in one of the states that you mentioned yet, Sarah, but hopefully you're coming to mind soon. Give us a follow. You'll be the first person to know when we go live and and I'm always happy to connect with people and share more so you can reach out to me. My email would be connect at Blue circle, health.org, and I would be more than happy to get on a phone with you, a zoom call and chat more about what we do. We're also showing up more at events like I saw you at, touched by type one and conferences actually was in Columbus, Ohio on Saturday for Ohio. Diabetes Day. So we're getting out there, and my team will be in Chicago for a conference this week, so you'll start seeing us, hopefully around more, but until then, you know, sign up on the website. Give it, give it a try. And I really hope that we can help you, and we feel honored to be part of your two and D Journey. Jeez, this

Scott Benner 40:18
is great. Oh, I'm so excited about this. Oh, thank

Sara Lerner 40:21
you so much.

Scott Benner 40:22
Seriously, actually, can I ask a personal question for a second? Absolutely. So you said you made your dog into a diabetes alert dog. You just come home and go, Hey, listen, rover, I got diabetes. Now you got to get involved. Or, like, how did that happen? Basically,

Sara Lerner 40:34
but his name is Louis, not rover. Now, okay, when I was hospitalized, one of the like, obviously I was not feeling, feeling my finest as I was getting, you know, re acclimated, and my blood sugar brought down. But one of the hardest part was that I lost my my vision. It was extremely blurry for about three weeks. But the worst was the, you know, five days I was in the hospitals, the sugar was coming in and out of my lenses, so I couldn't even use my phone or read a text at the time, my dog, Louie, was about a year and a half at the time. So I there, there again, mom, super hero. Mom was, you know, by my side. And I said, Mom, my dream would be for Louis to be a service dog. Like, can you look up? Can your your dog become your adult dog, become a service dog? So that's what I had my mom googling from the side of my hospital bed. I had wanted him to be a therapy dog. I said I was, you know, working in schools as a social worker. And so I'd seen dogs that went and you helped kids get confident with reading. And so he had great basic obedience foundation, but he had no, you know, he was a silly dog and had fun. And he's, you know, 50 pound doodle mix. I wasn't sure what would happen there. We found many dogs training. They're based out of Wisconsin. Annie, the head trainer, is absolutely amazing, and she has a program where, you know, she does board and trains and will fully train dogs, but she also has, you know, the ability to do an adult, you know, an adult dog owner training program. And so we zoomed twice a week for almost two years before Louie was fully, you know, a service dog, and passed his his test for public access, but he was alerting me within about six months. So he learned how to do my high and low blood sugar alerts, and he will go on runs with me and alert me. You know, he's he's sitting by my side right now, sleeping on the couch, but if my blood sugar dropped or rose, he would get off and come wake up and alert me. Same with overnight. He can smell it in his sleep, which to me, is still the craziest thing to wake up. To them wake me up. And he's usually 20 to 40 minutes ahead of my CGM. So I always say, like the technology is a huge tool, but it lags. It's not always correct. I trust Louis 1000 times over, and he sometimes will alert me at 130 and say it's low. And I'm like, really, like, Are you sure? And without fail, like the blood sugar is dropping within 20 to 40 minutes, is if he's given me that alert. So he's, he's pretty amazing. And there is actually, like, we've, we've worked, I've worked with Annie to start a diabetic alert dog scholarship program there to make it something that's more accessible to other people too. Because it's expensive owning a dog. It's expensive training a service dog, and it's something that has been a silver lining of my diagnosis, for sure, getting to go through life with Louie and train him, and have this extra, extra tool and silver lining. So we're hoping to make that available for more people

Scott Benner 43:15
too. Oh, what are you trying to be a saint? What's going on here?

Sara Lerner 43:19
I told you, you know, I've had a lot of a lot of people looking out for me since my diagnosis, and an amazing support system, and I've been able to take advantage of a lot of resources. So anything I can do to give back to this community, I want to be a part of

Scott Benner 43:31
lovely I feel the same way. Actually, that's wonderful. Am I missing anything? No.

Sara Lerner 43:35
I mean, I would just say that, like with blue circle health to me, like, you know, that's why we started this conversation. I'm so excited to be here spreading the word about spreading the word about that. And so do you know somebody, if you can share something on Facebook, Instagram, anywhere you're at in Facebook groups, know somebody who could use a hand with their T 1d please, please let them know about this resource. It's really free. It's really here to help adults living with type one diabetes. Florida, Maine, Vermont, Delaware, Ohio, more states coming soon. Please check out our website and sign up if we can help you out.

Scott Benner 44:05
Awesome. Okay, great. I appreciate you coming on doing this. Thank you very much. Thank

Sara Lerner 44:09
you so much for having me. Oh, of course, it's my pleasure.

Scott Benner 44:18
Your Kids mean everything to you, and 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, because if even just one person in your family has type one, your child is up to 15 times more likely to get it. But just one blood test can help you spot it early. So don't wait. Talk to your doctor about screening tap now or visit screen for type one.com to get more info and screen it like you mean it. The podcast episode that you just enjoyed was sponsored by ever since CGM. They make the ever since 365 that thing lasts a whole year. One insertion every year. Come on, you probably feel like I'm messing with you, but I'm not. Ever since cgm.com/juicebox Arden started using a contour meter because of its accuracy, but she continues to use it because it's durable and trustworthy. If you have diabetes you want the contour next gen blood glucose meter. There's already so many decisions. Let me take this one off your plate. Contour next.com/juicebox if you or a loved one, was just diagnosed with type one diabetes, and you're looking for some fresh perspective, the bold beginning series from the Juicebox podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl beginning series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player, or you can go to Juicebox podcast.com and click on bold beginnings in the menu. Learn more about what you heard today at Blue circle health.org I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of The Juicebox podcast. The episode you just heard was professionally edited by wrong way recording, wrong way recording.com, you.


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