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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: Thyroid

#432 Bolusing Brothers

Scott Benner

Tula and Beans

Katie is the mother of two boys who have type 1 diabetes.

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 their favorite podcast app.

+ Click for EPISODE TRANSCRIPT


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

Scott Benner 0:00
Hello friends. Welcome to Episode 432 of the Juicebox Podcast.

Today's show is with Katie and Katie has two sons who have type one diabetes, and they were diagnosed pretty far apart. So she has an interesting perspective about being a young mother with a type one and a more seasoned mom with a type one. I think you're gonna really love this episode, Katie's excellent. And I really enjoyed having her on the show.

Please remember while you're listening 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 for becoming bold with insulin.

If at some point after this you'd like to find Katie and her boys on Instagram you can their bolusing underscore brothers.

This show is sponsored today by the glucagon that my daughter carries g vo hypo Penn. Find out more at G Vogue glucagon.com forward slash juice box. The juice box podcast is also sponsored by the Contour Next One blood glucose meter. You can find out more at Contour Next one.com forward slash juicebox easily the most accurate and simple to use blood glucose meter that my daughter has ever had.

Katie 2:00
Hi, I'm Katie. I live in Bloomington, Minnesota. I live here with my husband. We have been married for almost 10 years going next month I married my high school sweetheart. We have two kids. Caleb who is 12. He was diagnosed with Type One Diabetes when he was four. And Micah who is three who was diagnosed about two weeks before he turned it.

Scott Benner 2:22
Okay, I'm gonna write this down because there's two things happening and then I'm gonna get messed up. So Caleb and Caleb right.

Katie 2:30
Yep. Caleb.

Scott Benner 2:31
Is 12 diagnosed at four. Yep. And give me the second one again.

Unknown Speaker 2:36
Micah Micah,

Scott Benner 2:38
who was recently diagnosed right?

Katie 2:40
recently. Yep. So it was like his one year anniversary and January.

Scott Benner 2:45
Oh, wow. And how old is he now?

Unknown Speaker 2:47
He is three,

Scott Benner 2:48
three. He's cute, too. Just assuming you know already. But he's adorable. So I know you through Instagram. Is that right?

Unknown Speaker 2:58
Yes. Yep.

Scott Benner 2:59
What's your handle on Instagram?

Katie 3:01
It is bolusing brothers. So b o l u s i n g underscore brothers.

Scott Benner 3:07
What made you start the account.

Katie 3:09
Um, I started that account after Michael was diagnosed. And I was looking to be more connected with the community that I use community, I had my own, I still had my own personal one. But that I would post things there. And a lot of my friends and people just didn't know what I was talking about. So I figured, why not branch off and try to find a community of people who can relate to what I can do.

Scott Benner 3:31
What I know about you initially had an account, and it was it was about you and your family. And all of a sudden you start talking about bolusing and things and they were like, I don't know.

Katie 3:40
I think there was a time where I posted something and I was like at the end of his appointment. I was like no appointment times two. And they're like, what endometriosis? I was like, No.

Scott Benner 3:50
Is that what the jumpsuit? Do you have endometriosis? No.

Unknown Speaker 3:53
That's not what I meant. But okay.

Scott Benner 3:56
So then the other account makes sense. Yeah. What? So you're, you were initially looking for contact with people? Did you find it?

Katie 4:03
I did. I think after starting that, I just put like a post of my family. I was like, This Is Us. And I'm just looking forward to meet people. And everybody was just really welcoming. It's just kind of grown from there. But I've met so many different people from all over the place when it's like I need help. Or if I just need to vent. It's just so much support that I just love. That's cool.

Scott Benner 4:25
That's great. So you got what you wanted out of it. And and you're giving something back probably whether you realize it or not just kind of sharing how things are going. I want to know. I guess you're you're interesting because you have two kids and one's been diagnosed for so long. That the technology that he started with, right that Caleb started with, it's got to be different than what Miko started with.

Katie 4:49
Yes, so it's kind of up Sorry,

Scott Benner 4:51
no, no, I was just gonna say tell me first about how it started with Caleb.

Katie 4:54
So Caleb, Caleb was diagnosed as four so just like preschool. So at that point He was just like really, really sick for a long time where it kept going. I was like undiagnosed, like, every time you want to say was, he's got the flu. He's got this. He's got everything besides diabetes. So he got to the point where that started in, like November. And then by December, he was really sick, to where he was lost all the weight was really skinny. He couldn't see straight, he was like always falling over.

Scott Benner 5:27
So he was in DK,

Katie 5:28
he was in full DK.

Scott Benner 5:30
And it took about a month or five or six weeks to figure that out and coach him. So you kept going back to your general practitioner, and they kept saying it's this it's this and trying different things. And it was the prescription always wait allowed to get better?

Katie 5:43
Yes, yeah. Yep. Oh, and it was kind of like a crazy time because my husband was working three jobs at this point. And I was working too. So there's a lot with my mom, okay. And my mom was like, I'm taking him in. I think he has diabetes. And I was like, I kind of slacked it off that she was just like, crazy. Like, I didn't know anything about type one. So I'm like, diabetes, are you sure. And crazy enough, I got a phone call while I was at work from the doctor sitting with my mom. And she's like, you need to leave right now. Your son's being taken to the hospital, and you need to go right now. Wow.

Scott Benner 6:15
And did she say for? Like,

Katie 6:17
your diabetes? Yes.

Scott Benner 6:18
So I was gonna say were you first more shocked that your kid had to go to the hospital that your mom was right about a little bit? I would love to be in that moment. And in your head, just to hear the like, dammit, she was right. She was right. Was that now Why does my kid Why does my four year old have diabetes? Like what is that? What was your understanding of diabetes at that point?

Katie 6:38
Honestly, I didn't have much of a nice thing besides like, type two, so are just like things associated with like diet and weight. And I'm like, okay, it's fine. It's healthy. What do you mean, he has diabetes? I didn't have any concept of like the pancreas and everything that goes into type one. I didn't know.

Scott Benner 6:54
I don't know. I wouldn't blame you. Any. Now in hindsight, any people in your family with other endocrine issues?

Katie 7:02
Not that we know of my husband doesn't have any. And I only have a relationship on my mom's side. So if there's anything going on my father side would not

Scott Benner 7:09
you wouldn't know, man. Yeah, I'm adopted. So very frequently, when people ask questions like that, I'm like I have, I have no idea. To tell you, I'm as far as I knew, the first person in my family. starts here. So and it hasn't been it's not good roots to the tree so far. years from now, my children's children are gonna look back and go, what was wrong with him? Exactly. All kinds of things. Well, okay, so there's nobody to really lean on. So you're starting fresh. And you and your husband have like you said, you work a lot. So what happens then to Caleb's care? Does it go to your mom, mostly does it fall to you? How do you handle that?

Katie 7:50
Well, when he first started out in this journey, it was my mom. So I took time off. And I stayed with him like he was at a hospital for a week. So I stayed there the entire time. My husband was in and out. But when it was time to go back, he would go and bi moms. Okay,

Scott Benner 8:08
so she had him during the day, where I guess if you're working that many jobs, it's not just nine to five, right? You're,

Katie 8:15
for me, it was a nine like a nine to five, but my husband, it would be a 16 hour days off pretty long. Gotcha.

Scott Benner 8:22
Okay, so he's okay. So even when it wasn't your mom, then it was mostly you?

Unknown Speaker 8:27
Yeah. And

Scott Benner 8:28
did it? Did it eventually grow? Or has your husband sort of stayed? Like, did you guys like, Go look, you go make money? I'll take care of the diabetes are how have you? broken? Yes.

Katie 8:38
Yep. So as time went on, he still kind of works a lot. He slowed down, but I only work one. So I go. Right now I currently work in the same school club goes to so we go to school together, we leave school together or home. That's nice. I

Unknown Speaker 8:51
just nice.

Scott Benner 8:51
I have to tell you, if I could trade 16 hours worth of work every day to not think about diabetes, it might feel like a fair trade to me. Is that all I have to do to get out of this?

Unknown Speaker 9:03
A little up?

Scott Benner 9:05
Probably doesn't think so. But I put it does. You know, that's, it's really interesting. But I listen, I think it's reasonable. For care to be in one person's hands more than the other because of the nature of it. Just it's difficult to pass it back and forth, and back and forth. And we still lose track. Just the other day, I went to the store to go grocery shopping, and I came back and I just walked in the house. I was like, does anybody see origins blood sugar, but me? Am I the only one that sees it? Am I the only one that cares? I'm like, flipping out. Like everyone obviously cares, right? And I hear like, I didn't hear beeping. I didn't hear beeping. I'm like, it's beeping. And you know, and her blood sugar gets to like 180 it's not the worst thing in the world. We get it back down. But my wife goes, Well, you didn't tell me you weren't gonna pay attention to it when you left. And I thought, well, that's reasonable. You know, so she's got this idea in her head. She's working. And she's thinking he's got it. And then all of a sudden I leave and just comment, it felt like comments. Like, I'm not in the house anymore, you know, Could someone else do it, but because of the share, it's not like I'm really disconnected from it. So I was like, Alright, you know, I didn't say anything. You're right. And, uh, so the next time I left, I was like, I'm leaving now. Could anyone pay attention to this besides me, please? And, you know, everybody looked at me really, like kind of snotty sounds like, Alright, I understand what's going on. But no, I think it's a good idea. And that's mainly, so tell me about Caleb's. Like outcomes in those first, you know, I guess, 567 years in there, where they where you wanted them to be, where were the struggles that and wherever the, you know, wherever the, the good parts?

Katie 10:40
Well, when we first started out, we were doing okay, I wouldn't say we were doing great. It was I was a lot of overwhelmed with like, all the information and everything. And I didn't really seem to, like figure out everything that worked. But he, we went about like six months before he got on Omnipod. Which was nice, because he really hated the injections. That was really hard. But we went through this like spiral of just like burnout, burnout for years, it was very unhealthy, very stressful for him. And for me, here's a one See, I believe, when he started out was higher, and we were able to get down to like an eight. But for at least like a good three to four years. I couldn't break anything underneath a ton.

Scott Benner 11:26
Okay. So for the first three or four years, you couldn't get under a tent and you were working like you're not. You weren't just like this will be fine and not attention to it. Right. Right. Right. So describe that a little bit like what what did those days look like when, when that was going on? You wake up in the morning, did you test right away like habits like seriously, like start to finish? How did the day go?

Katie 11:48
So when it would be like a weekend or a day he was with me? It would be wake up test for breakfast test before meal. So the directions are doctor's test before meals, or if he's not feeling well. And that's pretty much what I would did. So it'd be before breakfast before lunch before dinner before bed. And then in between if he didn't feel well.

Scott Benner 12:07
Did you have a feeling that this wasn't the right thing to do while it was happening? Or were you just thinking you were bad at it? Like, you know what I mean? Like, what's the feedback that what's the feedback feel like when it doesn't work?

Katie 12:17
I felt like I was bad at it. Like I have the directions from the handle. And I'm doing what they're telling me to do. I'm testing I'm correcting and bolusing when he's getting in, or when he's eating something. But the outcome is always he's not feeling well, and he's high in the ANC is always high.

Scott Benner 12:35
So from your perspective, the only thing you can figure that's wrong is you because you're doing all the things you've been told to do. That's terrible. And I and it does weigh on you right. Like, people call it burnout. But it's the overwhelming feeling, especially as a parent, and you know, maybe I'm taking that back, whether you're an adult with type one or a parent of someone with type one. It's this feeling like you're just a failure, just constantly failing and failing and failing. And and it's got to be you because some guy in a white coat, right? Like who went to school longer than you did. And people call him sir and doctor and stuff like that. He told you what to do, or she I feel badly for you. And I felt the exact same way. I just thought this is me. I'm doing this wrong. You know? It turns out you're not though. So what was the first like light bulb moment for you that led you away from that?

Katie 13:24
It wasn't until his brother was diagnosed. It came to a point like building up so when his brother was diagnosed that last like year was really tough. I had the newborn wasn't a newborn, but I had a new baby him and it came to a point where we weren't on a Dexcom at this point quite yet. We tried like an earlier version of the Dexcom. And he hated it. So getting him on that wasn't gonna work. He wasn't convinced he didn't want to go on whenever again. And then he would eat and not Bolus he would hide it. He was sneaking food, he wouldn't test his fingers. He wouldn't do any of those things. Yeah. And so it was kind of like me trying to control diabetes in the dark. What do

Scott Benner 14:09
you think leads to the sneaking Do you ever does hindsight ever tell you did you see something happening? Or do you think it was just the the unrelenting You know, this isn't working because I don't know about you, but I have a hard time. Back in the day. I had a hard time pretending everything was okay when it obviously wasn't and everybody knew it wasn't you know what I mean? Right? Right. Which which did you go for? Do you go for it's all fine. Don't worry about it or were you more honest.

Katie 14:34
I was more honest. Like it really did frustrate me and I would just tell them I mean if you want eat the snack, eat the snack but we have to do something about it. I don't know if he kind of felt like he didn't want to be bothered with it. Like this is what we're going to be doing every day. We'd go to the end oh you know with that agency and it was always bad news all the time. So you're always getting like beat up I think both of us between all of that just kind of gave up. Did you

Scott Benner 14:58
did you feel like he Where did you begin? Give him any perspective for what it really meant. It's so hard at that age, like you're thinking four to nine, basically, we're talking about in that range, right? Like, how does he like, how do you tell him like, this is really bad for your health? Like, how do kids quantify that? You know what I mean?

Katie 15:13
Free and I don't know, if he fully did. I mean, we would talk about different people are different, like outcomes that could happen or just even comparing it to how he felt. Because they mean days where he'd wake up feeling like crap and would throw up and all that's just related to his blood sugar. So it wasn't because he was sick. And I'm like, if you don't want to feel this way, we have to get on top of it. Wow.

Scott Benner 15:33
It's interesting. Interesting, it's the wrong word. It's overwhelming for me to hear that. Because, you know, I think of you now, like, I don't know, you know, you, but I'm aware of your face. And I know what your children look like, you know what I mean? And, and we, we talk back and forth sometimes and and to feel like your son was so high that he was vomiting is like, his feels crushing to me a little bit that like that happened to you? You know? Yeah. And, and I can't imagine being in the moment, because you're standing there going, this is not okay. And yet, we don't have any real answers. Now. Do you not have answers? Because I don't know what I want to know. Like, when you go back to a doctor and tell them that, how do they respond to you,

Katie 16:19
we would go through is like kind of like re education, but it's like the same pieces of information. But one of his, his nurses, she has her son is like a year older than Caleb and her son is a type one. And she's like, you really have to get this Dexcom. So it was like the newest version. And she kind of just talked him into it. And this was like leading up because at this point, this was what maybe she'll lie. Right before so July 2019. Okay, we were preparing for Caleb to go he was going to go to Kenya for an entire month with my husband and family. So I'm saying here diabetes lady who manages everything is staying in the States. And they're going so his, the nurse was just like, you should really sign up for this. And that was like the stepping point right there was getting that prescription for that.

Scott Benner 17:10
Were you out of your mind that he was going away for a month without you?

Unknown Speaker 17:13
Oh, my gosh, well, yeah, a little bit, I think

Scott Benner 17:17
I would have been like, but he doesn't. He's been working. He didn't know anything about this and not for nothing. I don't appear to know anything about it either.

Katie 17:25
Going away. And it was crazy. Cuz he was my husband and my sister in law both came to like appointments building up to that to get all their questions answered. And everything, tried to be squared away the best as possible for sending him?

Scott Benner 17:37
Yeah. Let me ask you a question that might be a little more unpleasant. And don't answer it if you don't feel like you want to. But have you ever cognitively thought that you're treated differently? For having brown skin in a doctor's office? Do you think there's the the Hey, they those people, quote unquote, don't care as much about their health as other people because I've heard a lot about that lately, that there's there's actually data that says that doctors might subconsciously believe that brown people don't care about their health as much. I don't know where that would come from. But have you ever seen that?

Katie 18:10
I have, not necessarily in Caleb's diabetes experience, or even my cuz i arendal is actually Middle Eastern. And she's a very sweet lady, and she gets us in our stands us. But thinking back to like experiences I've had personally, I have definitely seen that. For example, when I had Caleb, I was 20 1920. And my husband and we're not married yet. And when I went into labor, I feel like we're treated differently in the hospital. Caleb was born with an issue that I can't even name to this point where he has spent a week in the nick you. They kind of were like we were brushed off and people weren't giving us information. I feel like it was treated based on the fact that the way we looked the fact that we were young, unmarried couple and the type of insurance we had, yeah, and I remember like my sister in law was a few years older than us like going in and like yelling at these nurses and yelling at the doctors like about this issue and how they're adjusting and treating us.

Scott Benner 19:07
That's a tough I mean, that is you were like 20 years old. That's it? Yeah. I don't know how to stand up for yourself when you're 20. In that scenario, you don't mean like you need kind people to say, it gets so simple, isn't it right to look and say there's some unmarried young people here having a baby who's come out, and it's having an issue? we could we could lift them up here. You don't I mean, like we could, like common sense voices for them. We could point them in the right direction. But it how much of that feeling of over being treated differently? I wonder is you really being treated differently? And how much of it is you feeling like that imposter syndrome, like you don't feel like you belong there because I've had that feeling in my life to do you know what I mean? Like, my wife and I got married pretty young. And I remember being in a furniture store. And we had an apartment and we wanted a sofa and we had money. For a sofa, and we stood and stood, and salespeople just walked past us and walked past us. And no lie. I've never told this anywhere before. I took out my credit card and held it up over my head and said, I have money and I'd like to buy a sofa. Can someone help me? That's literally how I got somebody to help me buy a sofa. And I don't have any issue with my color that, you know, in that way. And it was really, it was crazy. I was like, Oh, my God, they don't assume I'm serious. Didn't mean like that, or that. I don't know what they didn't think. But they just avoided us. like the plague it was, you know, not the same thing. But I remember feeling then moving forward, that we weren't serious players in like an adult life, if that makes sense. Yeah, and it takes a while to get past that, then, especially if people are gonna keep treating you that way. I just I was really was really interested. And I'm glad to hear it. It doesn't exist with your endo. But your endo also has a different perspective, I guess. Yes. That's that's really something. I wonder if it happens, despite the color of the doctor. Like, I wonder if it is a systemic issue. Do you know what I mean? Like that? That's the feeling. I don't know. That's very strange. That did you ever feel like you weren't interested in your own health?

Katie 21:19
No. Like, if I'm there, and I'm paying business, like No, that's not it.

Scott Benner 21:25
Right? Right. You're not disinterested? Right? So. So the key here, it seems to me is that somebody on the other end, no matter what the scenario is, has to have the compassion to walk you through something no matter who you are on the other side of it. You know, I mean, your interest level like that, because there are people who are just overwhelmed and decide to write off their health because they don't feel like they can do it. But you could reach those people if you worked at it and tried, I think, yes. And so what was it was it seeing the Dexcom is that what brought things into focus for you see and data. g Volk hypo pan has no visible needle, and it's the first premixed auto injector of glucagon for very low blood sugar and adults and kids with diabetes ages two and above. Not only is chivo hypo pen simple to administer, but it's simple to learn more about, all you have to do is go to G Vogue glucagon.com forward slash juicebox Jeeva shouldn't be used in patients with insulinoma or pheochromocytoma. Visit g Vogue glucagon.com slash risk. When you're using a blood glucose meter, you want it to be accurate, you want it to be easy to use, easy to read, and easy to see in the dark. And if you had a Contour Next One blood glucose meter, you would have all of those things. Arden has never used a meter that is so accurate, or so simple to carry with you. It's tiny, but not so small that you can't hold it. It's simple, but yet does everything you needed to do. And if you want it can connect to your phone by Bluetooth. And you can use the contour app to do even more. But you can find out about that at Contour Next one.com forward slash juicebox. While you're there, you'll also be able to find out about their other products, their test trip savings program, and you may even be eligible for a free Contour Next One meter, you'll find out when you get there at Contour Next one.com forward slash juicebox. YouTube can simply and affordably use the best meter that Arden has ever had. And last but not least, to support type one diabetes research and studies that are helpful to people living with type one including you. All you have to do is be a US citizen and have type one or a US citizen who is the caregiver of a person with type one. And in just a few minutes. You can add incredibly important answers to simple and easy questions right there from your sofa right on your phone or your tablet and help Type One Diabetes Research to move forward T one D exchange forward slash juicebox. Alright, let's get back to Katie.

Katie 24:23
Seeing the data for Caleb started putting a focus seeing that what's going on in between those checks are even when he wasn't checking, but it was still problem. Still problem. We had a problem. But it was like a problem from the time where he was at my house the time he left. So problem at home problem my grandma's problem at school school is a big issue. The nurse throughout elementary that was an awful, awful experience. So just like seeing all of that building up. We're already like in a tense mess when his younger brother was diagnosed Wow. So

Scott Benner 24:58
you slap the seat GM on him to go on the trip. I do think I want to find out how the trip went. But but but now you see everything that's happening now it's not just this random mess. It's an actual mess you can look at right? Yes. Yeah. And then your other kid gets diagnosed?

Unknown Speaker 25:14
Yes.

Scott Benner 25:14
Oh my goodness. Did they make it to Kenya?

Katie 25:18
They did. But Kim was not on the Dexcom yet. Okay, you didn't actually get on like a proof to everything and tell. So we started that process in July, I think July and he didn't get that Dexcom till December.

Scott Benner 25:31
Okay, so the trip had happened in between them. So it was really just business as usual while he was born. Wow. Pumping or injections,

Katie 25:40
pumping stuff. So we've been on the Omnipod consistently since six months into his thing, right? And, and,

Scott Benner 25:46
and so and I don't mean this as a judgement, I really am asking, at any point, did it feel to you prior to Dexcom his blood sugar's high, insulin makes you lower. He should have more insulin did that ever? Like

Katie 26:02
it did it did but I had this constant fear of insulin, like I was drilled in my head that if I give him too much, my kid's gonna die. Or he's gonna have a seizure. I'm have to dig out the glucagon and give him a shot. I was really afraid to give him too much. Or even change the settings in that talk.

Scott Benner 26:20
So the fear Got you. That's reasonable happens to a lot of people. And so were you trading so you weren't unaware of what high one season? High blood sugars we're gonna do to him long term? You were aware of that as well?

Unknown Speaker 26:33
Yes. Okay. Yeah. So

Scott Benner 26:34
you were just sort of trading? One for the one for the other. Yeah. Like, I always think of it. I know, this is like more of it. But I always think of people who jump out of windows to avoid fires. Right? You know, like, just just sort of like, well, this is gonna kill me now. And this is gonna kill me later. I'm gonna go with later. And you know, it's just a it's a, I bring it up, because I think that people could see it as an excuse. But it's a coping mechanism, and a survival instinct. Right? You know, it really is. And so fears is good enough reason is any so Okay, so how did the data stop you from being afraid?

Unknown Speaker 27:11
It did it.

Katie 27:14
I would call it out. And I was constantly emailing his team. And it was always correct. Two hours, correct. Two hours. So I'm doing that thinking that I'm making a difference, right,

Unknown Speaker 27:24
but I'm not.

Katie 27:27
But it was just kind of like a whole bunch of series of events that led us to making the change. I think that that was that. But then, Caleb was also right around the same time where Michael was diagnosed, Caleb was scheduled to do a GI stem test, because he hadn't grown in about two years. Okay, so no, wait, no hype, just kind of plateaued at the same.

Scott Benner 27:51
Yeah. And it's funny. So they want to do it. What test then

Katie 27:54
is called a cheap gh stem test growth hormone stimulation test,

Scott Benner 27:59
I would think they would want to give him more insulin so that he could. Okay. Yeah, but I hear you. So that test happens. I'm assuming that led to what? Nothing?

Katie 28:10
legia there was nothing wrong. Yeah. Diabetes.

Scott Benner 28:14
Yeah. What I mean, it's like, I don't know if people don't understand this or not. But, you know, you need that insulin, that's important. And it slows down other functions of your body. And if you look back, I don't know any of the details on this. Somebody not use any of the words, but a long time ago, people who had diabetes would not they would call it not thrive, right. Like they wouldn't grow or gain weight or anything like that. But it really just was they didn't have enough insulin, you know? Wow, that, so how big was he then when you got that test? You remember? Um,

Katie 28:49
I don't it's kind of black. But he's, he was about he's shorter than he is. Now. Let's say that he's, he's put on a good like six pounds since then, since we've kind of made a turn around and he's definitely put on height.

Scott Benner 29:02
Okay. And in how much time?

Katie 29:06
So if we go back to when we actually started, like making big changes, it's about a year.

Scott Benner 29:13
Okay. Let me share this with you. It's gonna come up in an episode eventually, but I don't think I've ever said it anywhere. When we found out Arden had hypothyroidism, so she wasn't getting enough, you know, of the hormone that she needed from her thyroid. Arden was five feet. Was she five, one or two, and weighed 75 or 80 pounds. And now I think we're three years later. Arden is 571 30.

Unknown Speaker 29:47
Wow.

Scott Benner 29:48
And I think if we don't figure out that she has hypothyroidism, she doesn't get a chance to grow. Right and I just I listened. I'm obviously not a doctor, but it seems to me that when your body is struggling like that, Other systems close down? Yeah. And and that's it, but I can't even tell you. She's one of the tallest girls in her school. Wow. You know, and she was one of the smallest people you'd ever met in your life like, no lie. She was out recently, well, before all this, she was out with my wife in a store that my wife said she bumped into somebody who used to coach Arden and softball, and they're chatting. And while they're talking, Arden realizes what's happening and walks up behind my wife sort of stands over her shoulder, but doesn't interject. She just stands behind her. And Kelly said that the conversation went on for minutes after that, until the guy went, Oh, my God, is that Arden. And she was taller than the guy. And like this grown man, and he had, he's like, I had no, he said, I just kept thinking, I wonder why this person is standing behind her while we're talking. didn't even ask her. So I'm excited to see you know, where your son gets to? It's Yeah, it's exciting. Are you bigger people? Like, are you tall? or,

Katie 30:59
um, I'm about five, four. And I think my husband's like five, eight, so we're not the tallest. But right, it'd be nice to see if he gets somewhere closer, even taller.

Scott Benner 31:08
I think the goal actually at that range, like the goal ends up being right like 5758. And then if they're going to be tall for your family to get to 510, something like that. That would be nice. I know, my son's pissed that he's not taller and blames me. I know, he's, I know, he looks at me, he thinks it's his fault. Yes, my wife is tall and all the men in her side of the family are very tall. So he's probably right. But again, I'm adopted. So I can just say it's not me. It's somebody else that we don't know. Okay, so I want to try to get the idea straight here a little bit. Okay. As you're trying to figure out Dexcom and you're starting to get the information back with Caleb. Yeah, mica comes online as a type one as well.

Unknown Speaker 31:53
Yes.

Scott Benner 31:54
Is it the I can't do this, the two of them feeling like what really, like, propelled you forward? Do you think do you think you just took a little while to figure out the Dexcom? Is it a weird coincidence that they happen at the same time or no?

Katie 32:06
No. Well, with mica, we had him tested through trial net.

Unknown Speaker 32:10
Okay, so,

Katie 32:12
so I knew so we were playing the waiting game for almost almost a year it didn't even even reach the airplane. We were testing him on a weekly basis. So building up with all these background things with Caleb happening, we're just playing waiting with Micah. So when Micah I noticed his blood sugar took one like fasting one, it was like 200 I immediately knew something was Sun was up. So we got into Caleb's endo and he pretty much told me you know, you have a year you have about a year with the with all those antibodies you have about a year before he gets it. So the waiting game goes on that 200 they diagnosed him that day, which is really weird because we were seeing an endo that Caleb used to see when he was diagnosed the same and always seen them and seen in the hospital. Okay, and that endo was the one we were squeezed into super mica. And they ran the agency I think Mike his agency was a like a nine. So like, I didn't need the doctor to come in and tell me anything at that point. We could have went home, but

Unknown Speaker 33:19
we're good. We're good. Let's go for a little bit and then we'll get going.

Katie 33:24
Yeah, so but it was January 17. The same doctor not in the hospital but in the clinic telling me that Micah had it which is the same day and doctor that told me that Caleb had it so it's like this little devil moment

Unknown Speaker 33:39
wait the same day?

Katie 33:41
January 17. May 17 2019 versus 2013 Wow, same doctor which we don't even see on a regular basis ever

Scott Benner 33:49
anyway that's weird if I was you I would never go into hospital on that day to get

Unknown Speaker 33:53
no

Scott Benner 33:56
I got shot like I'm waiting till tomorrow nothing good is gonna happen on this date and anywhere near Oh, doctor. Oh my god. Oh, sorry. That's Well, okay. So his is a nine Caleb's is still high

Katie 34:12
kills like a weapon or even like a 12. At this point. He's going up

Scott Benner 34:15
the other way because the food around you thinks you're not even able to keep it where you were keeping it. I got it.

Katie 34:21
Okay, no. And then I remember I had to continue work that day. We were short staffed. I came home after picking up my kids new prescriptions gave him his Lantus and he's screaming and he's crying at this point, which I don't blame him. You know, it's a whole different thing. And then I turn around and go in the kitchen. And there's Caleb, eating dinner without no Bolus, no checking anything and it just sent me off. I remember looking at him, and I kind of lashed out a little bit. I just remember telling him like, this is what you're going to teach your brother. This is what we're going to do. Are we going to do this for the rest of your life for my life, For his life, this is what we're gonna do. And I remember handing mica after my husband. And I was like, I can't do this. And I went down into the bathroom, and I closed the door and I turned on the ceiling fan and I just cried, like I curled up on the bottom had like a good ugly cry. It wasn't even like a, it was like a full breakdown. I think at that point, I just snapped, like, everything I had spent. And I think that went on for like, a good 30 to 40 minutes. And then I that was just like that aha moment, like, I'm not doing this anymore. I'm not gonna start it with mica, and I'm not doing this with Caleb. Okay. And that was a moment when I wanted to take an initiative that if I wasn't going to get help through the doctor, like I was gonna go and look and find it for myself.

Scott Benner 35:41
So I'm wondering, do you think that you just reset an expectation? Like, this is what we're going to do? And I'm wondering to how much of that because if I'm not sure how well I'm doing the math here, but uh, Caleb's 12. How old are you?

Unknown Speaker 35:58
I'm 32.

Scott Benner 36:00
So you had them when you were 20? If you would agree now at 32 you were a kid when you were 20? Right? Yes. Yeah.

Katie 36:06
Only not mature quite yet there? I

Scott Benner 36:08
don't think so. Is it possible that you start being a parent, not as an adult, and then it feels more like a collaboration like you don't mean like, there's this moment when you have to, like, I use my son as an example. He's a nice kid. And he's bright, and but sometimes he's gruff, and short. And I let him do that because too, he is. But every once in a while, I'll be like, Hey, I, what are you doing right now? Like, great, talk nice. And he's not like that all the time. Do you know what I mean? Like, it's every once in a while, it ends up being honestly, if he's exhausted, or tired, or he's just played for hours, you can't walk up to him afterwards and say, Hey, how'd it go today? Because he's gonna be a girl, you know, but and most of the time, I understand that, but but every once in a while, I stopped and I go, No, no, this is not how we talk to each other. And forget me, don't talk to people this way. Like, you're gonna end up with some girl who will put up with us. And that's not going to be good for you. Because nobody should put up with us like talking, you know, speak. And, and I think there's just a moment when you, you feel you feel like your job. I felt like my job was making my kids happy when I first had them. And then as you get older, you realize your job really is to direct them and to and to do the thinking for them that they can't do. And I just wondered if you got trapped in that in the beginning, so you know,

Katie 37:28
I think so. I think cuz I mean, I wasn't just that, like Mike and Caleb have two different life's like two different parenting experiences. Yeah. And I think when Caleb was little, like, I just wanted to make him happy. And I think I didn't put my feet down as much as I should have.

Scott Benner 37:51
Well, it's a Caleb got like the Ooh, wow, you got pregnant parents? Exactly. And Micah got that, hey, this is working out. And we're gonna have another baby parents. And yeah, we're gonna stay married and make a family. Those people right. Yeah. Now, you don't see that about yourself when you're young. And you're and you're, and that's happening to you think oh, or have a family now. But really, everyone else is looking at you going? I wonder how long this will last? You know, and for most people, it doesn't last very long. And you just end up being too, you know, intelligent, reasonable people who want to make a family and keep doing it. That's really interesting. Don't have a third baby.

Unknown Speaker 38:27
Oh, no, we're done. Back

Scott Benner 38:29
kiddo. Get like back it'll get like, old tired. You just like I don't care what happens?

Unknown Speaker 38:36
yourself.

Scott Benner 38:37
Whatever. Yeah. So to you, you basically walked up to Caleb while he was eating and said we can't do this. This isn't what we're gonna show your brother. You went in and did what you did. I know. I've been on the other side of that before those three boys sat in that kitchen. They were like this. Oh, yeah.

Unknown Speaker 38:57
Yes, she

Scott Benner 38:58
seems really upset. Did you come back? More of a? I don't know. Fierce. How did you come back up the steps. I guess.

Katie 39:07
I came back. I was actually calm. And I was like, we're gonna try something new. I don't know what that is. But we're gonna do it. And I think Yeah, we'll just skip. So it's like, Okay.

Scott Benner 39:19
I don't need her getting into this and being upset and yelled at me. So I'll just do whatever she says. But isn't that interesting? Because at any point along the road, I guess you've had to live with that. At any point along the road. You could have gotten that you could have done this. Yeah. But it took this other thing to happen.

Katie 39:34
Yeah, it's kind of like, in a way I know. sounds awful. But I feel like mica things happened for a reason. And maybe it took my gut getting that diabetes to shake, shake me shake me awake to take that control.

Scott Benner 39:48
Well, I mean, at those agencies, if you want to use that analogy, his diagnosis could very well have saved Caleb's life honestly, you know, because you guys weren't, you weren't getting it, and then you got the CGM and you had that That very there's some people talking about getting a glucose monitor then being overwhelmed by the information. Is that how you felt? At first? Okay. Yeah. And that's because you didn't have any tools you didn't know what to do with the data once you had it. Right. Yeah, that's that that really is. That's still a gap. Right? Like you can't you can't just be have all this thrown at you suddenly, cuz you already struggling. Now you're struggling with numbers you don't understand. That's not good. You know? What did you already well, what did you go figure out? It's time to find out.

Katie 40:32
So at this point, what we're in January, January, I started just like looking at things. So in my head, I was like, I can control his blood sugar if I limit the carb intake. Okay, so I was starting to look up like different things about I didn't fully consider doing like, keto or super low carb. But I started challenging Caleb to have less carbs, especially during the day. So when he is not with me, let's put a cap on how much he's eating for lunch, or because my mom would pack his lunch. So I would talk to her about what what's in his lunch today? Can we keep it under 40 grams of carbs? What about breakfast? So we started there, and I started seeing a small difference, but it wasn't slight. So maybe he was hanging around 300. Now he's hanging around 250.

Scott Benner 41:11
Okay, for me, but still a move? Mo Yeah, little cause and effect, you're saying at least.

Katie 41:17
Mm hmm. And then I remember, like going on Pinterest, I think it was Pinterest, and I was looking up different recipes. And they came up with grit, like a different group. I don't quite remember which group it is. But they're very, like intense about being very low carb and finished, intense. And I was like, well, maybe I should try this. But in my head. I was like, if I push Caleb this way, this could have a negative effect. Because he's already at an edge. I don't want to take away food and things and have him have another negative relationship with the day.

Scott Benner 41:48
This was just too far. The other way. This was your eat an egg. Now don't eat anything. Have a sprig of lettuce like it was Yes. Okay.

Katie 41:56
And then when I'm so switching up these recipes, I had an ad or like a picture of someone posted of your podcast.

Scott Benner 42:03
Oh, cool. This is the part I love. These are my favorite parts of the podcast good.

Katie 42:06
Yeah, I just saw. I saved it. I saved that in a little little board thing I had for a diabetes. And I kept it moving for a couple more weeks. But I was I had idle time, which I usually didn't have much, especially while Mike goes like, smaller. And I turned it on and I had Listen, I think it was your most recent episode. At that time. I think it was Katie and the old man. Okay. And listening to this teenage girl talk about how well she was managing her diabetes. While I'm over here struggling as like a 30 year old woman. Thank you, man wait for her. But I was like a light bulb went off. Like people actually can do this. And they're living and finding their story isn't my story, right? Something's up.

Scott Benner 42:52
Yeah. How do I make this match better and make it make sense? Hey, in that episode, I was the old man, right? Yeah. I seriously couldn't remember for a second. I was like, did we do like an interview with her and a father? Is that like, I wouldn't call someone else. Oh, this must have been about me. I really, but it's interesting, that that had so much impact on you. And as you were talking about, I thought, I don't remember that. All I can tell you is that from the title. I must have listened to it and felt like an old person talking to a young person. And that's why I call it that. And but she did a remarkable job of of handling herself. Yeah. And and that made you think like how this kid can do it? Like, what am I doing? Like, I gotta be able to do this right? Don't you think she'll be thrilled to hear that when this comes out one day? Oh, look what I did. So that's very cool. And so did you delve in Then did you start listening from live? Did you go back would you do?

Katie 43:48
I started like my, that process. I was gonna start from the latest and then go backwards. But I remember I messaged you. And I was like, Hey, I just discovered your podcast and I laid out my situation a little bit and then you messaged me back which I was shocked. Because I was like, podcast, people message people back, which is

Scott Benner 44:05
a thing. Like I remember your story making me feel very sad, which is what got me back quickly. And yeah, here's the trick for people if you must know, children with big agencies, or adults that sound like they're about to, you know, close their eyes and fall off a cliff. That gets me pretty right in the heart. Just so you know. So. Okay, so, okay, but then what? And

Katie 44:26
that was me both of those things. Maybe I was like,

Unknown Speaker 44:30
a bit of a mess is what we're saying.

Katie 44:34
And then I remember You shot me a message and you said start with these episodes. So that's where I started. So what's the different pro tips ones that you had at that point? And then like the ones about like insulin and just like resetting? Mm hmm. So I started there and I started taking notes. But the one thing you had said that will just make like a bit of a difference was Pre-Bolus Singh. So as soon as I got that message, that's what we did immediately. That day was starting 20 minutes set a timer, Mike is is 10 because he Flores with turtle. But doing that. And then I just remember having a conversation with him. I was like, Hey, we have nothing to lose. This was about spring break for school at this point, I was like, give me a week. See how you feel? See if it's something we can do. And just trust me, do you trust me? And he said he did. And within that week, we had seen numbers from that 250 inch cluster that 200 to higher 100. And to him that was like a win. Yeah, right. We're making process. So he we were all in at that point. Cool.

Scott Benner 45:39
He must have felt when did he start feeling low at like, 150?

Katie 45:42
Yes. So that was the conversation. So just like, just try to tough it out. I know, it's just your body adjusting, we just have to give it time. If it gets out of control, then we'll worry about getting some carbs in there. But that's really cool. It took a while for him to get that adjustment to be able to sit at like 80 and feel okay,

Scott Benner 46:01
right? Well, I mean, there's so much to it. Like you can say the steps. I think it's why the podcast is is valuable is because it's easy to say like I'll tell you right now, like here it is. Get your basil right, then Pre-Bolus. then learn about glycemic index and glycemic. There you go, you're done. Right. And so the problem is, is that there's a lot around those three ideas. And it's not as easy as just being told you know it, it's not, hey, listen, here's the steps for getting out of this room, stand up, turn the knob pull the door towards you like it is that but you know that you can you can imagine when someone says to you. Okay, so you started Pre-Bolus. And he went from, like, into the higher hundreds. That gets you excited. And you're like, what do we do? So what was the next step, but you keep doing what

Katie 46:44
I do. So then I was listening to like the bezels. And so that was a scary moment for me, right? Because I already had a few of insulin. So I'm gonna change something and said, I've never changed anything in the pump, without the doctors. So I remember listening to that episode, I was like, You know what, I'm just gonna do it. I don't think it's gonna kill him. So I'm just gonna do it. And once I started this, like that, that basil pro tip episode made all of the difference, Miko was a little bit easier. You still had him winning. So his was a little bit easier to get down. But Caleb, I would set the basil, I'd watch it for a couple of days, study it and make changes. And within like, a month, month and a half, we would see such a big difference in like his clarity app. Yeah, I remember there was one day we had like a family get together. I think this was June. So by June where he had hit like, 98% in range. Wow.

Scott Benner 47:35
And what's your range set out again?

Katie 47:37
for him? We had it set from 70 to 140.

Scott Benner 47:41
Wow, that's really great. That's exciting. Wow, good job. Congratulations. How did Caleb feel once his blood sugar got low and stable?

Katie 47:52
He was fine. And he was so excited. Like he would be so proud that that was it. And then you would see some of the other things that came with those high blood sugar starches. So like, he used to be really aggressive or kind of short. Um, I can't say for school, because that was summertime. But as we went into the fall, like his focus, his grades, his things, everything about him change,

Scott Benner 48:15
okay? Just the end, and for the better in your mind. And

Katie 48:19
the better. Okay, the better way better. All different kids.

Scott Benner 48:22
I know that I once got this some private note from a woman. And in the course of the note, she admitted that I used to just think my daughter was a bitch. Those were her words. And, and she's like, she's not. And you know, it took me, it took me finding a podcast to figure that out. And you know, that, I always think of that, because I feel like, like, you know, just for the same for you, like you could have had a relationship with your son for his whole life, or he's not really being himself, and you feel like this is who he is, you know, and that's just not something fair on it is just every level. Wow. What did the doctor say?

Katie 49:05
So let me see. So he didn't see her. I seen her right before we had to start the journey. And then we seen her in August. So I'm off for the summer. So we work this entire summer portion, working on getting it down. And I remember we went in, and then they ran my guess first I think what Michael was like a six. So he went from like the nine to a six. Yeah. And then Caleb's came in. And I think he was what like seven? Well, it was he was down there. And then like the look, he started, he lit up instantly. When because that's the first part we started. They take the agency, then they take you off to the wait for the doctor.

Scott Benner 49:41
Right, right. Yeah, that's how are supposed to.

Katie 49:43
And so when the doctor came in, like she was smiling, and she was just like, I had to make sure that when I printed this out that I had the right last names on here, because this is not what I see. Right? Especially like I double checked a few times before I came in, to make sure that I had printed out the right All

Scott Benner 50:00
right, right. I have to tell you, um, hold on one second. My wife asked me a question. Sorry. So I get them the mica thing. She might have seen that and just been like, oh, the kids honeymooning. This isn't reasonable. But she sees Caleb's. And is he is he from an 11? To a seven or attend to us? Yeah. Wow.

Unknown Speaker 50:22
Did you

Scott Benner 50:23
get the talk? Like you're making him love a lot talk? Is that the next Oh,

Katie 50:28
she was just like, onboard. She's like, what are you doing? Tell me everything. What? What changed? Wow, what changed? Because the last time I seen you, you were struggling. We were getting ready. Like I was setting up an appointment to see like the diabetic psychologists do everything like you are in a whole different space, what's going on?

Scott Benner 50:48
There, we're gonna send them to a psychiatrist,

Katie 50:51
like our family, like the therapy for like burnout, because we were just not getting anywhere.

Unknown Speaker 50:55
Right. Wow.

Unknown Speaker 50:57
And

Scott Benner 50:58
Geez, you were close. See? It's interesting, because you were close to if you go to therapy, then not that you shouldn't have. But if you do now, that's like now you've said, this is the problem, right? Like we burn out. If we can't do this, that's a problem. This problem needs to be fixed. And you start putting effort into fixing what you think is the problem. But the problem is just a side effect of not understanding how the insulin works. Right. Oh, wow. You were close to falling off a cliff there that you might not have gotten back up from? That's really interesting. Wow, this makes me feel nice. I'm happy for you. Yeah. This is very good. Wow, how long ago was that?

Katie 51:43
So that was so that initial one that was last, I guess. But like this last we had a telehealth one. What was it in March? Okay. Caleb is at oh my gosh, 5.8. Wow. And it comes to a point now where when she comes in, for the thing, she asked me, is it okay, if you want to change this Basal rate? It's okay. Are you okay? If we change these things?

Scott Benner 52:08
Let me just ask you, your thoughts on this. A little bit has to be, I don't want to say embarrassed, right? But there's got to be a part of it. It's gotta be like, Wow.

Katie 52:19
It's funny, cuz she's just like, I wish I could just bottle up what you do and give it to my other patients. And I was like, suggest the podcast.

Scott Benner 52:27
Yeah. Tell her I can talk them up and sit in a corner? I'll tell them for sure. Yeah, seriously, I like that, that makes me feel like I would love to. I would love to be able to do that. I would love there to be a talk at a hospital. And I could just give that first hour, answer some questions and then point people towards the episodes that would support it. I don't think that everybody would get it, get it right away. But I don't think that that many people would not get something from it. You know what I mean? You're always very kind online. Like saying, like tagging me and stuff. And I really appreciate that. But it's because it gets then I get the watch. Like you just talked about. Your son had diabetes, basically for eight years. For seven of them. He's it's just a disaster. Like, it really isn't. Things are going completely wrong. You take the bull by the horns when when Mike is diagnosed, and really you change everything. Like it's easy to sit here and be like the podcast, the podcast, but you decided to do something. And then you found something. It could have been something else, like you could easily be, you know, somewhere else right now saying like, Oh, thank you. I mean, obviously, this is the best place. That's not what I'm saying. But, but as long as you find something that's, that's really wonderful. Do you I want to know how it's changed your life. Like personally,

Katie 53:53
personally, at first, I was a little stressed because I was constantly kind of obsessing over looking at everything, but now I feel like even though diabetes is such a big part of my life with two diabetics and everything that goes into it, I don't think about it as hard. Like when I see a blood sugar rising, it doesn't stress me out as much because I know I can get it back. Right? I know that even if because those days like I'm not a super ninja yet. There's days where Caleb might get to a 200 if I didn't nail something but instead of being that old person that I was where I would wait two hours, like I know I can get it back and I get it back quickly.

Scott Benner 54:31
Yeah. Arden's blood sugar goes up and down. And we deal with it the way we deal with it, you know, as best we can last night. You know, we're all just sort of feels like we're all just laying around the house at this point, you know. So, like, both of my wife and I are able to work from home which is really lucky. And, you know, artists, it's summer vacation now. So last night, I think I said around like seven o'clock, I think our washers going which is just No, I had this conversation with my son where he's like, what's the big deal? I'm like you don't understand. Like, no one wants to buy a washing machine. It's just the saddest thing to do with your money, you know. But I, I felt like I had to go out to a store to look at a couple of them. I tried to do it online as best I could. So I laughed and Kelly's like, would you grab some soup and bring soup back for everybody? And I was like, Yeah, whatever. So I brought the soup back. And Arden's blood sugar was great, like, for a long time, you know, after the meal and everything. But she started to get low later at night, like, I think 1130 she started dipping down, and we thought we stopped it. But we didn't. And so we were kind of trying to just nudge it with some carbs. But we were trying not to give her too much. And then finally, she had to have a few more. So there was a moment in their blood sugar kind of dipped down into the 60s, and we got it back up. And now I'm trying to get it back up without it getting, you know, high. And I did. And I can remember being you and thinking, Oh great. She's low. And now she's going to be high. And I'm going to be up all night. And then that all starts to like build on itself and you get upset and anxious. And then there's no way they don't feel that you know, but last night, I was just like trying, we were joking around, like you know, and and fixing your blood sugar. She asked me for a little ice cream, like little frozen ice cream cones. They're probably not really ice cream. But you know what I mean? They're, they're in the freezer. And we came I came up in the top of the roundness of the cone was offset on the cone itself. So it was way off to the side. And I handed it to her. And she said my ice cream cone appears to have Spina Bifida. And I went wide. And then we like I was like, oh, there's something up with it. Like we're like nudging the top of it back again to the center. And then she ate it and leveled out exactly where I thought, you know, her blood sugar's 103 right now 12 hours later. So it does get easier once you have enough experiences over and over again. So you really feel like you're sort of in the beginning of it, but you're doing Did you ever limit carbs? Like you're talking about a one season a fives?

Katie 57:08
Um, so no, I don't like when we did that plan. I kind of let it go. Because I felt like he was pushing back. So he gets what he wants. See? Wow,

Scott Benner 57:16
that's so cool. And he can maintain this with grandma just as easily as

Katie 57:20
Yes, because well, now at this point, like he doesn't go karma so much in Marcos. He's now in middle school. And I work at the same school. So we go and we live together. So it's a lot of text communication. And mica goes to daycare. So when well, pre COVID he went to daycare, but she'll text me and sometimes he'll kind of a little but for the most part, it's not that you were

Scott Benner 57:43
able to handle the daycare to do text with them is that I handled? Yep. So

Katie 57:47
she'll text me back and forth. her grandma does when she's got him too, because he kind of splits between a couple days a week daycare a couple days a week, grandma

Scott Benner 57:55
got it. Dexcom Dexcom is amazing. All the pods amazing. I love Arden's meter, you know I that's why they're all advertisers. But if I could take text messaging as an advertiser, I would tell you that it's an amazing diabetes tools, just being able to text with somebody and have more immediate interactions so that you can kind of stay fluid with the blood sugar while it's doing what it's doing. It's trying to be variable, and you can stay with it. I'm very happy for you. Anything that we didn't talk about that you wanted to? This was really great. You were nervous, right?

Katie 58:28
I was nervous. I it's kind of funny. I don't do well talking to adults, even though I work with middle schoolers, and they're super judgy. And I'm fine with that.

Scott Benner 58:37
Do you imagine this means that I'm not really an adult? I'm perfectly comfortable. While we're doing this, I realize what you're saying. And I hear you. I'm sort of like a child. No, seriously, did we miss anything?

Katie 58:50
I don't think so. I just want to say that, you know, if you feel like you're in that spot of burnout, just get help. I feel like I should have gotten help a long time ago before all of this. But once again, everything happens for a reason. And guess where we're at now.

Scott Benner 59:06
I have to agree with you, I guess wherever and when you're struggling. I was saying the other day to some By the way, the entire time we've been doing this. I've been looking at Katie and there's a giant trolls that are behind you. And I have not been able to not see it for like an hour. And at first I was just like, what is that? And then I started figuring out I'm like, but it looks huge.

Unknown Speaker 59:26
Is it huge?

Katie 59:27
It is huge. This is our random room down here. And it's an office and a twice storage place.

Unknown Speaker 59:34
It's really big. And the sun's coming through the windows hairs all lit up. And

Katie 59:40
it was funny because it was just storming a little bit before we got on it was like pitch dark and stormy. Yeah,

Scott Benner 59:47
I I'm sorry. It was what I was gonna say is that I really believe. Obviously, nobody's perfect in any walk of life, right. So while you're running around day to day feeling like I'm doing great. There are things you're doing that are not right. Right, like they're or they could be better or, you know, I sometimes think, you know, in interpersonal relationships, you feel like, oh, we're good. But the other person might be thinking something. And there's a better maybe there's better than what good is, and we don't know, we get really comfortable with where we are. It's hard to talk to people, it's hard to ask for help. But this is just it's such a big deal. Like you can't, you really just can't ignore things and, and be and you know, your numbers are bigger. So they sound kind of more crazy 10 and 11, or whatnot. But the truth is, is that if you're a one c sitting at, I don't know, at an eight, or seven and a half like you, there's better. And it's not that it's not it's not any harder to be seven and a half, or eight and a half. It's no no, it's not it's not a ton more work to be six and a half versus seven and a half, like I mean, look at you. You're in the fives from 10. It's, it's insane. I really, I don't even know what to say. Like when you said that. It's crazy. Congratulations, I guess.

Katie 1:01:08
Thank you. Honestly, I would have never thought that we would be here. So it's such a good feeling to know that we can do it. And then as my boys get older, that they'll be able to do it.

Scott Benner 1:01:19
I'm glad. I'm really glad for all of you. I'm I hope we stay in touch over the years because I'd like to know. I'd like to maybe get one of those. Get get one of those kids older and get them on the podcast in a couple of years. And I'd love to know about that. It's really interesting. It really is. Can you hang on for a second? I have a question for you. That has nothing to do with this podcast. Okay, good. Thanks so much for coming on. I really appreciate it.

Unknown Speaker 1:01:40
Thank you for having me course.

Scott Benner 1:01:41
A huge thank you to one of today's sponsors, g Vogue glucagon, find out more about chivo hypo Penn at G Vogue glucagon.com Ford slash juicebox. you spell that GVOKEGL Uc, ag o n.com. forward slash juice box. And of course the Contour Next One blood glucose meter. Check them out with the links that are in your show notes of your podcast player, or there's links at Juicebox Podcast comm if you can't remember Contour Next one.com forward slash juice box. And of course that T one D exchange is that T one v exchange.org. forward slash juicebox.

Thank you so much for choosing the Juicebox Podcast. I'll be back soon with more episodes just for you. And a special shout out to all of you that take the time to put up those great reviews and ratings wherever you're listening. And of course, a special special thanks to everyone who shares the show with someone else. You're helping it to grow every day. It's absolutely fantastic of you to do and I could never say thank you enough.


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#431 Switching to an Insulin Pump

Scott Benner

Community Feedback

The Juicebox Podcast: Type 1 Diabetes social media community sent their tips for switching from MDI to pumping.

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 their favorite podcast app.

+ Click for EPISODE TRANSCRIPT


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

Scott Benner 0:00
Hello friends and welcome to Episode 431 of the Juicebox Podcast. Today's show is about switching from multiple daily injections to a pump. And what I've done is gone on to the Facebook page for the podcast and gotten people's feedback about what was most valuable to them when they did the switch from injections to pumping.

Before I jump in and get started, I'd like to remind you to check out T one D exchange at T one d exchange.org. forward slash juicebox. And here's why. You can support T one D research and the Juicebox Podcast by checking out the T one D exchange because they're looking for type one adults and caregivers who are us residents to participate in a quick survey that can be completed in just a few minutes. You can do this survey from your phone or your computer. And you never have to leave your home or visit a doctor's office to make a substantial impact on Type One Diabetes Research. This is 100% anonymous HIPAA compliant. And every time one of you completes the process by using my link, T one d exchange.org. forward slash juicebox. You'll be helping to support people with type one. And the show past participants just like you have helped to bring increased coverage for test strips, Medicare coverage for CGM, and they've helped to change the ADA guidelines for pediatric ANC goals, you can give back in just a few moments. Okay, I've done this a couple of times. And it's incredibly popular. So we're doing it again, and went on to the Facebook page Juicebox Podcast, type one diabetes, it's a private page where listeners can talk about whatever they want. It has well over 8000 members at this point. And it's just a hotbed of discussion around diabetes management. So I put the question up there. For those of you who have transitioned from MDI, to pumping, please share your tips, things to look out for and remembrance. Here's what came back that I thought was very interesting. Right off the bat, Nicole says, start with what the endo suggests, but only give them 24 hours. If you've listened to all the podcast episodes, you know what to do, if you have a Dexcom Be bold. Marianne said that Initially, it was a little difficult to get over having a device attached to her, but that she eventually did. She said, you'll probably need to adjust your dosages with the team, be prepared for that. And nothing's really permanent. So if you don't like it, she's like, just send it back. She also suggested trying to create a time for the transition. That's a less stressful time in your life. Because there is a commitment involved in understanding it. I take Marion's point, but I also think sometimes there's never a perfect time. So I guess, you know, figure out what would be best for you. But I would caution against waiting for the perfect time. And I would also caution against immediately wanting to give up, because it is going to be different. And if you've been doing shots for a while, and succeeding with it, you know, you might just be used to things working. And the truth is you're going to have to start over might not just work perfectly immediately. Jen said that she switched from MDI to pumping over 20 years ago. And all she really remembers was being terrified. She got a quick doctor's office visit tiny bit of training, they sent her home. But she called technical support a number of times the beginning. So she wants to let you know not to be afraid to ask for help when you need it. Katie says not to forget that you're no longer using a slow acting or long acting insulin like levemir, Chrissy but one of those that your pump is giving you all of your insulin, it's doing your basal insulin, as well as your meals and corrections. So if there's a problem with your pump site, you need to be aware that DK a can set in much more quickly than is likely with MDI. So if you get up in the morning, and you're you know, MDI and you shoot your your letelier Lantus, let's say, it's in there, it's doing something, but if you get up in the morning and put a pump on and there's some sort of a problem with the site and you're not getting your basal insulin, you may not know right away. So you know, what I would do in that situation is test more frequently or pay attention to your glucose monitor if you have one. In my opinion, it's not something to be scared of. It's just something to remember. You're getting your basal insulin from your pump now. Ashley said that the first few pumps that she put on just didn't go well. And she didn't realize that she could have them replaced. infusion sets or if you haven't on the pod, the pot itself, and she was just throwing them away. But if you have a failure, especially in the beginning, when you don't know what you're doing, call the company, they very well may replace your items.

That would lead me to say that it is not uncommon in the first week or so of using a pump to have user error with the insertion or wearing of the pump, that it's important to, you know, keep trying get information, don't just think that the first experience you have is how this is going to be now because there are a lot of people who use insulin pumps of all different kinds very successfully, all day every day. So when you're starting at the beginning, and it's not working, if it's not working, maybe look inward before you look outward is my best advice. From what I've seen people talking about online all these years. Josh says that his remembrance for the beginning was that he just immediately felt more in control. And he started tweaking his basal insulin and extending his boluses that that made him comfortable. Amy brings something up that I see a lot. They had fairly good control with MDI and then move to a pump and recognize the transition, that it's not just a flick of the wrist, and everything's okay. Again. What I would say that I notice is that sometimes doctors offices can be careful when they set up basal insulin, I guess they think of it as careful when they set up basal insulin for the first time. So say you've been doing MDI forever, and you get 24 units a day. What I would do, there is the quick math and say, Well, maybe I'm about a unit an hour that. But sometimes doctors offices are scared to send you out dollar for dollar from the way you did it to the pump. And they kind of go without better high than low theory, and a lot of them will take back some. But if it was me, if Arden was using 24 units a day of basil, insulin, I'd start by setting her baseline one unit per hour. And I'd see what happens and make my adjustments from there. I guess the problem comes in where the doctors don't want you to touch the basal insulin. So they set it low to show where the highs are. So they can come back in later and add insulin. Being a person, the way we are here that makes those changes on our own. I would start about where I thought because here's what I see happen. Those ratios are kind of lost in the moment for people often. And what happens is, instead of thinking, Oh, I used to use 24 units a day, MDI, and now I'm only using 19, or something like that. I'm probably not using enough basal insulin, they think pumps don't work. So your brain makes this illogical leap that feels logical. And then you get caught in a little bit of a, you know, a shitstorm. And if you don't have a doctor's office that quickly gets back with you and makes adjustments, which a lot of them don't do sometimes, then you start blaming the pump, and you start having these feelings like I was better on shots, you know, and you could lose faith pretty quickly. I've seen that happen a lot. So that is definitely something to look out for. Some arrow warns that once you're on a pump, it's not a free for all of food, just because it's easy to Bolus. So you know, do your best to stay on track with how you eat. She also mentions that it's possible your insulin usage might go up, and that that's okay. I would say it's also possible that people lose track of the fact that they were taking 30 units of basal insulin of one kind. And using, I don't know, let's say they use 20 units are 25 units of, of, you know, novolog fast acting insulin for meals and corrections. So in their head, they're only using like 25 or 30 units of insulin a day because people just generally don't think of basil as insulin. For some reason they think of it when they're MDI, like, I inject this one story of the day. And then my fast acting insulin is from meals and corrections. Somehow the two don't go together. To me, that might be where some of that comes in is then you move over to a pump. And instead of using 30 and 30, you're using 60 of all one insulin. And I guess I'll just say here in case people don't understand that a fast acting insulin like a nova lager, a human blog, Arden uses a pager there's fiasco, those kinds of insolence. Go into the pump, and you get little bits of it, you know, spaced out all day long to act as Basal and then you get more of it to act as a Bolus. So you're used to using to insolence on MDI. Going forward with a pump, you'll only be using one Bob says how backup supplies, things will fail from time to time, and you need some backup supplies. He's

talking about MDI stuff. Don't give away all your needles. I still have syringes from when Arden was four years old, and we still use them once in a while. Bob's 100%. Right? He says, and if you're using it on the pod have a paperclip around. So if anomaly so different pumps have different situations where they're going to all fail, at some point, something will happen to the flow of insulin. The pump will recognize it and shut itself down for safety reasons. They all do it. When on the pod does it it beeps and sometimes the beeping doesn't stop and you have to flip it over. There's a little hole in the back and you stuck a paperclip in there, and it stops the alarm. So a paperclip is definitely something to have around. Bob. You're 100% right? I seem to remember one time and Arden was young and it happened at a baseball game, we use the post of Kelly's earring to stop it. That was a desperate moment. She now says you're not going to learn everything in one day. It's trial and error. Pay attention to your CGM. If you have one adjust accordingly. small bumps and nudges. She says I have anxiety and was freaking out when I didn't have good numbers at first, but I had to just keep adjusting. And now she's in range 80% of the time and she's happy with her pump. Tara says that patience is key. It can take a few days or even weeks to get all the settings correct. She said they started without a Dexcom. So it initially took longer for her son. Since then they've changed pumps twice with the CGM. And with being bold and the transition went much faster and smoother. what she's saying is, is that when you can see the blood sugar, and you feel the reading into what she's saying, but I feel like what she's saying is when you can see the blood sugar in real time, and you have that faith in yourself to make changes, it can it will go much easier. Some of you will use pumps that offer soft candles or steel candles. She said that they had great success with this the old ones, and that you can get your endo to write prescriptions for changes more frequently if you need it to to avoid absorption issues. And that's with any pump. Misty says it may get worse before it gets better. It takes time to dial in your settings. She's saying again, your rates from MDI will change and change again. But it's worth pushing through. And she suggests that Basal testing is definitely necessary. She found pick a timeframe at a time like I think that to start with overnight, then, you know, pick pick segments of the day to get I have to tell you too, and I say in other parts of the podcast. I'm a fan of as few basil programs as possible. Like I don't think you're outsmarting diabetes by having like a different Basal program every hour. You know, it's point three, five at three o'clock and point four or five at four o'clock and point to like, yeah, I think there's a balance in there you find you can find eventually, where maybe you'll have one, two, maybe three standard Basal settings throughout the day. I think if you start having more than that, there are other things you could be looking at. staska says start with the endo settings. But keep in mind they keep it on the safer side. I said this earlier. We give it a week to see they gave it a week to see how the body was adjusting. But she didn't want to keep things high too long. After a week, they started to make slow adjustments after talking to the endo. And once she was confident and she understood how the body was reacting to the insulin, started making the insulin adjustments on her own. She says you can be as bold as necessary as long as you're paying attention. Joanne said what I said earlier, which is don't panic right away and just decide this is a bad idea if it doesn't go exactly right. A lot of people came in to agree with her about that. And Jessica wanted to offer that she loves using the extended Bolus features and Temp Basal that pumping allows a different Jessica says listen to the pro tip episodes. Thank you, Jessica. Don't rely solely on your endo to make adjustments, watch the Dexcom keep track of your trends and make adjustments was necessary. When you leave the house, it's more than 20 minutes away taking insulin pen as a backup because in case you have a bad sight. So I have to say we don't bring extra insulin with Arden. If we're in what I think of driving distance. Like if it's an amount of time I wouldn't care if I had to go back. If I'm going to try to spend the afternoon at someone's house for a picnic and it's a half an hour from my house. We take extra insulin and some pumps with us. I don't bring needles I have to admit. But her point is valid and worth considering having backups is not a bad idea. Brent makes what I think is a great point. He said that it's just the new ballgame when you start over and this is something I find myself telling people privately as well.

Want to see how to put this, you might be doing terrific on MDI. But what what comes with a pump, you know, maybe you just don't want injections or you want more control over basil insulin or something like that. Anyway, it took you a long time to figure out injections. And it's going to take you a little bit of time to figure out pumping, it is a different game. But at the same time, it's really exactly the same. It's the mechanics of the pump, the nuts and bolts, how it works that you have to get accustomed to. And while you're getting accustomed to it, you will feel like where you could feel like I should say that you don't know what you're doing, which might lead you to have that feeling like why did I do this, I knew what I was doing. And now I don't again, but trust me, it's worth the effort. If it's something you're looking for. Amy makes a great point here. She said that after you're up and running and things are working, take a step back and look at the pump data, right look at what it's doing. Especially she says if you're using an algorithm based pump, because you'll be able to see the increases and decreases and basil when corrections go in and stuff like that. And it'll give you an insight into what's happening. Heather says that she felt like every new step was scary for her son, who was just diagnosed recently, and eight years old. They got their demo on the pod and just left it on the table for a few days until he was ready to try it on. She also figured out things about how to remove adhesive and overlay patches that help hold things on. So there's a little bit of a new world in there. Some people use patches, Arden doesn't we never put a patch on ardens Omnipod. It stays on fine for three days. But I like that she didn't rush here, she went out and got the Omnipod demo, and just was like alright, let's just leave it here till we're ready. I think that's a good vibe. Even though this episode doesn't have a sponsor, it's a great place to say, I really do believe when I say during the app in the ads for Omni pod, one of the greatest things about Omni pod is you can get a free no obligation demo, you can actually try it on and where'd the other pumps just don't lend themselves to that. But on the pods tubeless nature makes that accessible to you. My Omni pod.com forward slash juicebox to get that free demo. And you're helping out the podcast if you use the link. Allen's recommending the book pumping insulin which I've never read, but I've heard so many good things about I'm absolutely happy to say it here. He also wants to point out that the information that's available in doctors offices can often be lacking. And that's what led him to pumping insulin. He said back in. Let's see back in 2007. My doctor at the time told me they'd write a prescription for a pump. But if I needed help with it, I'd have to get somewhere else. He said he appreciated the honesty but finds that a little frightening. Lauren says keep in mind that you are probably rounding up your insulin amounts of MDI. So the same ratio on a pump might not work. So this is the exact opposite of what I was talking about earlier. But it's still really valuable to say that you might what she's saying,

Laurie, I'm Lauren, I'm sorry, Lauren, I'm speaking for you here. But what I'm saying is you might have been using a unit or a half a unit because that's what you could measure with a syringe when maybe point four or point six or 1.1 was more like what you need it. Brianna says to do your research to decide what pump is right for you. She spent a long time looking at the pros and cons of all the pumps that were on the market. She says that she eventually found that her body responded differently to insulin going in through MDI and through a pump that there was a big learning curve for she had to Wendy for 19 years and was previously on a pump years ago as a child but didn't use insulin correctly then and eventually transitioned to MDI, having been well controlled with MDI. She just thought the transition to a pump would be seamless. And it wasn't. Kristen says Try not to put too much pressure on yourself when you make the switch. She found it stressful to learn to use a new piece of equipment, and says give yourself or your child some time to adjust. And you may hate it at first, but give it time. She said it can be strange to wear something on your body at first, but one day, you'll probably barely notice it. I must say that I've worn a couple of Dexcom and some Omnipod demos in my time. And I have to agree with that. I've obviously never used them for insulin or for actually taking care of diabetes. But when I've worn the things myself, I have forgotten that they were there eventually they do become pretty seamless. And that's probably hard to imagine, especially for parents who are looking at their kids and thinking oh, they're so small and this thing, but I do think you just get accustomed to it. I know Arden Christian continues on that for her switching to pumping was life changing. It just took time to adjust. She says as far as management goes, you already know how to use insulin pumps to the same this is a great point that I really want to echo. You're just delivering the insulin a different way. That's it. The basil is going in a different way. The boluses are going into Way, instead of pushing in a needle and pushing on a plunger, you're pushing a button, it's going through a tube, she finishes by saying, take your time. And if you need help, come back to this Facebook group will help you Kaylee's saying something that I've heard people say before. A pump is not a cure for diabetes. And while it makes life much easier with type one, or type two, I guess if you need insulin, it still sucks, you still have diabetes, it's going to be work to learn a new method for both you or if you have a child for your child, too. Don't forget to write down your settings, she said. So you're not scampering around trying to remember things. And remember that technology can fail at times. So you're gonna want to not just rely on that programming to remember all your settings forever, write them down somewhere. But what she's saying is valid, that sometimes you can hear people outside of diabetes, say, Oh, do you have one of those pumps, and they say it like, Oh, you must have if you have a pump, it's probably just super simple, right? Probably makes the whole thing go away. If you're feeling that way, like a pump is just going to make diabetes disappear. And it's not going to you're still gonna have diabetes, you're still gonna need to Bolus your meals Pre-Bolus you know, understand your settings, just the delivery of insulin is going to be different, easier, in my opinion, and you're not going to get stuck as much, which is a big deal to me, Arden also being an omni pod user, I really enjoy the fact that she does not have to take her pump off to bave or to swim, which means we can get a nice stable basil setting and use it 24 seven kgs just jumped in and thanked me for doing the episode and said that they've been MDI for three and a half years and the idea of pumping scares everyone in our family. And I'm, I've got to tell you hate. That is unfounded fear, you really don't need to be afraid. You're just delivering the incident a little differently. You get rid of the shots, and you're picking up your ability to manipulate your basal insulin and create extended boluses. It's not scary. I know you're scared, but trust me, it's not actually scary. Christy said she wished that someone would have told her that or on the pod beeps to let you know when it's done. She was in a board meeting the first time it went off and she had no idea what to do. Christy, I would tell you that the on the pod came with a book and it would have explained all that in there. But I get your point, it would be nice if someone would just go over it real quickly with you. That's one of the great things about I don't know about other pumps, but on the pod for certain. let you know when your reservoir is getting low, let you know when it's coming time to change it. It's good stuff. Linda says they got a pump quickly and not had and at that time had not known about the podcast. So they were very reliant on their endo team for help. She said her diabetes educator was awesome and called several times after we placed the pump. In the days and weeks that followed. They were calling to make sure everything was going good to help with adjustments. This is great if you get this kind of no good knock on some wood Good for you.

She still says she remembers being overwhelmed at first by all the steps that it took to replace the site and being afraid that she'd forget something. That's just the I get that but that's the not knowing right? It's like you don't know what you don't know. So you're worried about everything. She has a tea slump pump. She said it's user friendly, told her exactly what to do. Her biggest advice would be to just know that there will need to be adjustments made. Julia says something I've heard a lot of as well. She remembers feeling like she'd just been diagnosed all over again. We kind of touched on it earlier, but it could give you that feeling. Heather says take your time. Listen to the instructions on how to change your sight. And if you're getting persistent highs, it could be that your candle is bent or something like that happened while you were changing your infusion set. We've only ever had that once where Arden got a bent canula and it took a couple of hours to figure out because we were swimming and she was away from her CGM. Had she been right with her CGM. At the time we would have noticed the rise right away. And he says I remember being in high school when pumps started really being used that her endo was all about it. Her mom really wanted her to get it and she didn't want anything to do with it. She didn't want the tubing, the pumping attached to her all the time, the newness of it. She just didn't want it. She got a two pump and had it less than a year and hated it. She'd get it caught on doorknobs drop it never had a pocket to put it in. She was in private school. She wore skirts sounds like everything was not going well. It wasn't until her sophomore or junior year of college that she got an omni pod and it was a game changer. Oh, well. Thank you my Omni pod comm forward slash juice box. That was nice of you to say any Thank you. Carmen, figuring out how to adjust the basil rates on time of day was a huge advantage. So you know my daughter you guys hear me talk about all the time but Arden needs less insulin from basil overnight than she does during the day. And you have the ability to make those changes you can say from midnight to seven, I want it to be point nine, five, but from seven to, you know, midnight, I want it to be 1.2. Sara says she's the type one she's had it for 29 years she used the pump for about 13 years, got tired of it went back to MDI was never super comfortable with extended bonuses and stuff. But she says, however, I am now trying to regain better control, and I'm about to switch back to a pump. She's got a Dexcom g six now, for about six months. She loves it and she's eager to get going with a pump again. And she's hopeful to lower her one season the sixes Sarah, I definitely think you can do that. Christine's talking about the power of Temp Basal, and extended boluses. There's things that I think a lot of people don't think about. I talked about them pretty extensively with Jenny in the diabetes pro tip episodes. I think these things are amazing tools that pumping offers. And please take a look at those episodes and try to figure it out. Dee says that when they started on on the pod, she had a couple of errors in the beginning. And it all seemed like a pretty big mess. But she stuck with it. Just remember basil is not going to be right right away. And the need to make changes. It's obviously you're hearing a lot of people say the same things because it's just what happens. Megan basil testing and patience is huge, especially if you're moving to an algorithm based pump. Like the Medtronic 670 G, for example. Both of these systems should be started with the algorithm off until basil testing is complete. So if you're thinking about doing that, she's 100%. Right? If you're starting with an algorithm, you start with the algorithm not working so that you can get the basil right before you start expecting the algorithm to do something. She said juicebox listeners know the importance of basil testing however, it seems there's not enough follow up in the transition from MDI. long acting insulin to pumping basil rates. I very much agree Megan it's a we do not talk about basal insulin the right way overall. Tara says if you have a younger child, oh, this is a good point. They're on the pod like ticks as it's getting ready to go in and she said it made her daughter anxious. They gave her headphones and an iPad so she wouldn't hear it. It's click click click. I have to tell you Arden's been working on the pod for 13 maybe years, and she still counts the clicks as they go in. So I hear you. I think everybody within the pod knows about the clicking. But the clicking is it's part of the game. It's how it makes tension to put the insert. It's not important. It's just you know how it works,

but the headphones to eliminate you being able to hear the clicking smart. Courtney's reminding us that the pump is only as smart as the settings that are in it. She had to remind herself that the pump was only going to do its job once she did hers. Here's a fun story from Danielle. She said my daughter was six years old when we told her how she wasn't going to have to get shots anymore because she was getting it on the pod. So she was very excited. The first time they put on the pump. The clicking and insertion scared her but they told her Don't worry, because you're not going to feel it anymore. No more shots. Then it came time to give her her first Bolus. They explained it again no more shots that her daughter ran from the house down the street to avoid the Bolus. She said when they finally got her to calm down and gave her the insulin. Her eyes went very big and she suddenly realized no more shots. She thought she was going to feel the insertion every time she got insulin. That was the one thing they didn't think to explain to her. That's a great little piece of advice and an amusing anecdote. Sara just says please, everyone share your tips so we can get this episode up. I need it. We're making the transition soon. Big smiley face. That's really great. People here we're waiting for insurance approval. A lot of people in the thread are just talking about we're getting a pump. Laura, I would say that the fear of making the move from MDI to pumping at least for her fear of change. Yeah, what's what we already doing something it's working. And then she said we should they were worried about and then she says they were worried about cost. Is this really something everyone would like? So a lot of those concerns? Okay, good. I was hoping this one came up with. Okay, good. I was hoping this one would come up. Martha says that her total basal insulin went down, that the initial formulas for pump therapy starting with about 80% of original basil dose had to be dramatically reduced. She went from injecting 18 units of to Joe to 12 units on the pump. See, everyone's not the same. And I'm not saying this happened to this specific person. But there are many people on MDI who are using way too much basil and find themselves feeding their insulin constantly. So as long as they eat on a certain schedule, they don't notice that they're using too much basal insulin, and it mimics really great control because you're being held low and steady. And as you try to drop you add food. I hope that makes sense. So there's a lot of different scenarios people find themselves in with their Basal. Some people don't have enough some people have too much, you know, etc. You'll find out who you are. When you change to a pump. Jennifer says, if you're using a tube pump, remember that you're going to disconnect it for, you know, bathing, for example, she says, Be aware that your child may take the pump off for a shower and forget to put it back on. Of course, whether you're a child or an adult for getting to hook back up to your

Unknown Speaker 30:29
pump,

Scott Benner 30:30
we know you don't have insulin, and you will be surprised how quickly your blood sugar will rise to a dangerous level without any insulin. Tommy asks for me to talk about transitioning during the honeymoon period. Tommy what I would say there is if someone's honeymooning, and they maybe don't need very much insulin or at times it feels like they don't need any for 15 or 20 minutes at a time. Your ability to shut basil down or to tamp it back is going to be amazing for you. Here I'll bring this up. Never turn your basil insulin off. So you don't suspend your pump. When you want your basil to go away. You always do a Temp Basal decrease, because when they end, you go back to your regular Basal rate. suspending insulin and again, maybe forgetting to turn it back on is another quick way to get into DK always Temp Basal never suspend. Now I hope all of you find the diabetes pro tip episodes that are here in the podcast. They begin at Episode 210 with an episode called diabetes pro tip newly diagnosed or starting over. But if you've been through them, and just want to get back to some things that might be specific to this to 19 is about insulin pumping to 26 about the perfect Bolus setting basil, insulin 237 Pre-Bolus ng 217. These are all things that might have more stuff for you about using a pump like episode 218 Temp Basal. There's also one here about fat and protein rises, which we'll talk a little bit about using extended boluses. And that's Episode 263. You can find them all in your podcast app or at diabetes pro tip.com. All right back to the list. Kyle says Don't forget to rotate your sites, that's a great one. Don't always put your pump in the same exact place. Oh, he also says you can do a Temp Basal like 0% like Temp Basal off when you first start pumping until your old injected basil insulin gets through your system and then boom, pop it right back on again. You can just sort of match them up as close as possible. So you don't have an overlap of your injected basal insulin, and you're pumped basal insulin on your first day. Eva says that for her pumping was the first time she had any concept of insulin onboard, since it was now being displayed right there on her pump and sometimes scared her away from being as bold with insulin as she was with MDI. It was only once she pushed that out of her head that she was able to add insulin when she knew she needed more. So we talked about insulin on board through the pro tip series, I hope you've heard them. There's a lot about how your settings get set up on your pump, your doctor chooses an amount of time that they think the insulin stays in your system. If that number is not accurate, then the pump can imagine that there's insulin, it's still active when there's not. In other words, imagine that the pump thinks that the insulin stays in your system for four hours. But really, you use up the insulin most times in three hours. Then between that third and fourth hour, the pumps gonna still think there's insulin active in there working and say you go to have like three or four carbs. The pump might say no, you don't need any insulin. You still have some active, but he may not. It's a you'll figure it out. But don't just maybe I'll do an episode of insulin on board with Jenny sometime might be a good idea. Alright, let's see what's next. He says I need this episode. Now. very forceful IV is coming. Carrie remembers being excited that she would not wait. I remember being excited that I would not be as lazy of a diabetic since I would not have to get all the paraphernalia out just to give myself a single shot. But I wish I had a provider that once we had all the settings in would have done the little small test with me to really hone in the settings. Also remember that it's a tool, not a savior or a cure. We've gone over that you're still responsible for understanding. Absolutely true have a backup plan for failures with your pump. It is an electronic device and it could fail. Twain describes learning about a pump as an elephant that's charging at you. I think she's mixing her metaphors you're joining I think you're mixing your metaphors but I love it. I'm just starting this week so I'm a super noob But here is what I know it's an elephant a giant elephant that feels like it is charging you the classes and forms the logging pump the represent The logging, the pumper apps, the sailing start actually starting it more logging. It feels like you'll never see the end of the tunnel, but you get there. So an elephant one bite at a time. So worth it. So where she mixed is she said, I love this. You said it's like an elephant charging it. But I think the saying is how do you eat an elephant? One bite at a time, right? I'm not sure what you did there join. But I like the kid who I like what Vicki does here. She says I can wholeheartedly say it was the worst thing I've gone through in 25 years of having diabetes.

Looking back, I wish I really understood all the terms in the defining diabetes series before getting a pump. I went from MDI and basically had no knowledge of carb counting. I was diagnosed in 95. And I really didn't stay up with it. So overnight, I needed to understand basil correction factor, insulin on board, extended Bolus, etc. Also, she says work with your diabetes educator, when you're setting the basil rates, get them to teach you when you should make the changes. I was on 14 units of lantis on MDI, my diabetes educator who I later fired started me on four units. Yeah, that wasn't gonna work out with a pump. And would only let me increase it if she said it was okay, they need to teach you how to use the pump. I agree. And Vicki, I appreciate you bringing up the defining diabetes series. There is a series within the podcast called defining diabetes. And this is going to be a big deal for you. Because new terms are gonna pop up with a pump. If you don't know what they mean, you might as well be reading a different language when someone's explaining it to you. You need to understand the terms that you're going to be using. And I do believe, and I'm just you know, I know I made them. So I might be a little biased. But those defining diabetes series are an amazing way to learn a lot of things very quickly. Hey, Katie, you have a great post here. But we covered everything that you said already. But I want to thank you for it. Oh, I hear Jennifer says I recall being nervous about my son accidentally dosing. When he first got his pump. He had an animus Ping. So I learned how to lock the pump or use the second security feature that helped ease my anxiety and apparently there was a pin number she could use. Also, I recall being thrilled that our world got bigger once parents don't have to worry about the needles, he got invited to a lot more playdates and sleepovers. People were just more comfortable with the electronics. That's an excellent point. And leads me into the idea that I'd like to bring up which is that I know the Omni pod has limits that you can set I'm sure every other pump those as well. Max Bolus max basil rate so that you can't by mistake want to give one unit give 100 units as a Bolus or so you can set it wherever you want. I think ardens max basil is set at like six units are seven units an hour. So I can't mistakenly type in nine or 10 or 77, or something like that. And same with her Bolus. I don't remember where it's at at the moment, but I just took the biggest Bolus I've ever made in my life added a couple of units to it and limited it at that so that somebody doesn't end up doing, you know, 175 if they mean 17, but I'm also not in a situation where if suddenly she eats something more than usual, the pumps not stopping us from giving a couple of more units than we normally do. It's a very important safety feature. Please check it out. Kelsey, you're asking a lot of good questions here in the thread. They're all covered in the diabetes pro tip episodes. Stephen says best tips I got were in my original training from a CDE, who was also a T one D. The first was about changing sites, be sure to prime the kanila and add the appropriate amount of insulin to create the puddle of insulin so it can aid so it can enable the insulin to start the absorption breaking the clumps of insulin into single molecules so the body can use them. Steven, I am not following you because Arden's never used the tube pump, but I trust you as a great person on this site. So I'm going to continue reading. The second great tip was to use skin prep as a skin barrier. And adhesive enhancer been using it for over 20 years. The third was to understand that the basil rates will change and that the insulin to carb ratio will change no matter what you do. Don't take it personally, Steven, I'm gonna say I'm guessing tube pumps get air in them, you have to prime them through. It's not something I understand. Because I've never used the tube pump but I do know it's important. So if you have a two pump, make sure you understand how to prime it. If you have an omni pod, it takes care of that automatically. And what else did I want to say here? I just had a thought in my head Steven, what the hell you made me think of something and now it's gone.

Unknown Speaker 39:35
Oh, Tim, what

Scott Benner 39:38
about basil rates? I got it. Look at me. I lost my mind yet. Basil rates are going to change and that's whether you're MDI or you're pumping, you're gonna gain weight become more or less sedentary. There's all kinds of reasons why the amount of insulin you'll need will change, hormonal changes. It's not ever going to be set it and forget it, you're never just gonna be like, Oh, my basil rate is point seven, five an hour. I'll never think of that again. Don't think that's gonna happen. Jenna, this is brilliant. Start your first few sites around the same place on the body. for consistency. different locations can require different basil rates. Like for instance, Arden's thigh needs a little more insulin than ardens arms, very good, her belly doesn't need as much as her thighs, etc. That could be different from every for everybody. Jenna goes on to say different locations can require different basil rates, Pre-Bolus times and just overall insulin need and action time. Personally, when doing MDI, I recognize that I have poor arm absorption and great belly absorption. Jenna has great belly absorption. If you're ever on the podcast, Jenna, that's gonna be the title of your episode. So I started putting my pods primarily on my belly for the first few months. So I could figure out how to best use my pump. And its features without adding confusion of absorption differences. That's pretty brilliant. Also a great time to re mind you that you can't just put the pump in the same exact spot over and over again, very similar to you just can't inject over and over in the same places, you have to have a few sites and you should rotate them often. And don't forget that please. In the same vein, Arden has times of the month where she's more easy to control and less easy to control. I don't think that was English. But when I know she's going to be harder and need more insulin, I make sure that her pumps are on her sites that work better. And times when she's going to be easier. I put it on the sites that need a little more work. So it's not that drastic, but it is significant enough to mention that you should be paying attention to it. Okay, well, that's it. I appreciate everyone jumping in the thread and leaving their thoughts remembrances and tips of switching from MDI, to pumping. I remember the time personally as not that confusing or different, because I was pretty bad at it with MDI. So I didn't notice that I was bad at it with pumping, just just move one show from this side of the room to that side of the room. You know what I mean? I can say now looking back with hindsight that everything that everyone mentioned here is well worth understanding. But in the end, you're changing insulin delivery systems, you're eliminating using two different insolence, you're using just one fast acting insulin that's being dispersed by the pump, both for basil and Bolus. You need to know the terms of the pump stuff, because otherwise you're like, I don't understand what a Temp Basal is. You learn that kind of stuff, you learn what a kanila is that kind of thing. You start figuring out what spots on the body work better, which spots need a little more insulin, get that basil insulin, right? Don't sit and stare at it, especially, especially just do the math. If you were using 10 units a day, and now all of a sudden you're using five units a day of basil, insulin, and you're like, oh, the blood sugar is always high. Please don't say pumps don't work. Think, why are we not using all the basal insulin we used to? That's just such a big thing. Just I just see it so much with people. And here's one last tip for me. When you're wearing an insulin pump, and you think this site might be bad for whatever reason, and you're, you know, pumping in insulin, you're not seeing anything happening, you're not sure if the site's bad. Or if you just have a high blood sugar and you're not using enough insulin. making it an injection, as a correction will bypass the pump, right? So if you inject in that scenario, and your blood sugar starts to move down pretty quickly, that's a good way to figure out that the site might be bad. You say makes sense, Scott, but what I think of it in the moment, you probably would not, which is why I've mentioned it here. Anyway, I hope you enjoyed this, I really want to thank the people on the private Facebook group for the podcast. It's called Juicebox Podcast, type one diabetes, I hope to see you there. And that's it. They don't forget the T one D exchange. If you can go to T one d exchange.org. forward slash juicebox. And get involved in the registry. You'll be helping people with type one diabetes, a huge amount you'll be helping the show. That by the way is for us residents who have type one diabetes or us residents who are the caregivers for someone who has type one diabetes. And because we talk so much about it. I know there are plenty of other pumps. But of course the Omni pod is a sponsor of the show, and they offer a free, no obligation demo, it'll be sent right to your house, you can actually try it on my omnipod.com forward slash juicebox. There's

still links in the show notes and links at Juicebox Podcast comm I forgot to mention that the defining diabetes episodes are of course available, they're spread throughout the podcast. But if you go to diabetes pro tip comm and scroll to the bottom of the page. There's they're all there. So you can find them that way if you just want to find out what number they are and then Don't listen to the media player or you can listen to them right on the website. I really appreciate you listening. I'll be back soon with more episodes of the Juicebox Podcast.

If you'd think you'd be a great guest for the podcast, reach out to me by emailing me at Scott at Juicebox podcast.com. I'm currently booking for the second half of 2021 I think that's August or later. I'm looking for anyone who thinks they have a good story. Somebody who really wants to share help people or just want to be involved in the podcast. bonus if you think you have a good after dark episode and you email me, I'm Scott@Juiceboxpodcast.com


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#430 Poodle Power

Scott Benner

Diabetic alert service dog

Esther is a type 1 who has a diabetic alert service dog. She also has hypothyroidism.

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 their favorite podcast app.

+ Click for EPISODE TRANSCRIPT


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

Scott Benner 0:09
Hello everybody and welcome to Episode 430 of the Juicebox Podcast Hey show is with a young woman who has type one diabetes, and diabetes alert service dog. Esther knows a ton about this topic, and she's a lot of fun. Plus, she's got a great story. All you have to do is sit back, relax, or continue to march to the grocery store, do your dishes or ignore your family, whatever you're doing with your headphones on right now. And listen as we present to you another episode of the Juicebox Podcast. Please remember while you're listening 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 are becoming bold with insulin. If after this you want to find Esther on Instagram, she is chronically underscored annoyed, chronically annoyed, underscore in between the words understand the underscore Well, if you don't, you're not gonna find her. Or I guess you could just search for chronically annoyed and then look for dogs. And then I think you'll find her honest. Listen to my understanding of Instagram searches.

This episode of The Juicebox Podcast is sponsored by the insulin pump that my daughter has been wearing for over 12 years. Omni pod, you can get a free no obligation demo of the Omni pod tubeless insulin pump by going to my link at my Omni pod.com Ford slash juice box. And to learn more about ardens continuous glucose monitor her Dexcom je six, head over to dexcom.com forward slash juicebox. The Dexcom is perfect for anyone using insulin. And of course, if you're looking to get involved, where to learn more about a great organization, check out touched by type one at touched by type one.org. We're on Facebook and Instagram.

Esther 2:10
Hi, I'm Esther, I'm a type one diabetic. I'm an artist. I'm a teacher and I'm a service dog handler.

Scott Benner 2:17
Service Dog handler that's interesting. You You're you may I'm gonna probably use the wrong words here. But I'm not sure you own a service dog. Right? It helps you with your the dog helps you with your type one.

Esther 2:28
Yes, I have a diabetic alert service dog.

Scott Benner 2:31
But the but the terminology would be service dog handler. Is that to infer. But is that what am I making sense here? like is that so you? Yeah. Tell me about

Esther 2:44
being a handler and first, I own and rely on my dog? I don't train them for other people.

Scott Benner 2:50
Gotcha. That's what I wasn't sure about. So there are people who are trainers, but not necessarily users for the lack of a better term, I guess ball handler, right. I got it. I'm finding these things out. Okay, so let's talk. Let's start at the beginning. When were you diagnosed? How old are you now?

Esther 3:09
February 10 2000. And I am almost 23. At this point,

Unknown Speaker 3:15
you were three. When you were diagnosed?

Esther 3:17
I was barely two and a half,

Scott Benner 3:20
two and a half. Wow. That must feel like not even somebody that must not even feel like your story, right?

Esther 3:28
Yes and no. I don't have the usual diagnosis story. We had just moved. I am from a military family. And we had just moved to Arkansas and my dad had gone overseas to Turkey for a year long, single deployment. Okay. So we weren't even in a house yet. We were with my grandparents. And my grandmother is type two diabetic. And my mom was really obsessed with this very popular TV show. Maybe you've heard of it. It's called mash. She was

Scott Benner 4:05
a fan. Yes, I was as well, by the way.

Esther 4:08
And she saw the episode with the diabetic helicopter pilot. So when I started drinking like an inhuman amount of liquids and wetting the bed and showing these signs, she decided to use my grandmother's glucometer to check my blood sugar

Scott Benner 4:27
because of what she saw on mash.

Unknown Speaker 4:29
Yes. Wow.

Unknown Speaker 4:31
There we go.

Esther 4:33
So we we were in a very small town, she took me to the doctor an hour away. And next thing you knew we were at Arkansas Children's Hospital. And the doctors were like, how is she not in a coma? or dead or NDK? And the answer was mash. So I got diagnosed and we didn't even stay in the hospital very long. The only downside was My father wasn't allowed to come back for the diagnosis. So my mom had to take care of my older siblings and learn the whole diabetes shebang by herself.

Scott Benner 5:09
Yeah. In 2000. Right, right in around 2000. Yes. Wow. Mash, by the way, was on in the 70s. Mm hmm. So and I remember that exact episode. I mean, I say something that might embarrass me. But I received the entire run of mash as a gift. digitally, and in the past year or so I've watched the entire and there's a lot of episodes.

Esther 5:38
I started watching it on Hulu. And I haven't even gotten through a third of it.

Scott Benner 5:42
Yeah, I don't. I want to be clear that I don't sit down and watch I watch while I'm doing something else. Yes, yeah, dishes, laundry, you know, making food, things like that. I really don't want people to think that I sat for how many episodes going on forever. And I'm thinking now that the helicopter pilots name was smiling jack. And I remember I can remember the whole thing like he was he was like one of the best helicopter pilots and didn't want to stop flying. And the only need to bring home a couple more people to like, I don't know, like reach some sort of an award or something. And they figured out he had diabetes. I I've got the whole thing. Am I so embarrassed? I believe there were I'm gonna look now because I don't I don't want to be wrong about this. There were 11 seasons of mash. And that was back when, when you made an effort when you made a television show. There were a lot of episodes every season like usually 25 or 26 or something like that. So there's a ton of them. Okay, so mash figured out that you had type one diabetes, but then we had to move forward. There were no other episodes of mash to help your mom I don't think what TV show Did she go to next to figure out type one?

Esther 7:01
That's interesting, because you know, you were already writing your blog at that time. But my mother is not very tech savvy. So she didn't you know, jump on the whole internet train. Yeah. And we moved a lot. I am the fifth of eight children, military family, we moved a lot. I didn't grow up going to jdrf events or diabetes camp. It was just kind of me and mom, roughing it changing endos every couple years with every move. Yeah. Stuff like that. She read a lot of books. We have so many copies of the Pink Panther book. So she read a lot of books. And she learned as she went. And we made it work.

Scott Benner 7:53
That's amazing. I mean, I guess that's all you can do. Really? Yeah. 2000 I mean, the technology wasn't terrible, right? What? What are you using for insulin? Do you you know, have you ever asked?

Esther 8:04
I have asked I don't know what insulin I was on originally, but a few years later, I was on I was put on novolog and I've been using novolog ever since. They started us out with pens. However, I was a two and a half year old child and the pens were scary. So we moved to using regular syringes with miles until I was in elementary school. I want to say 2005 or six I was put on the Animas 2000.

Scott Benner 8:34
That's a pump that people really loved. We did you have it right up until it was just Hey,

Esther 8:40
no, no. So I had the NMS 2000. And it was top of the line it was water resistant. It was the first one where you could detach and put a placeholder in the site and just swimming without your pump. It was really really nifty. Until I broke it. I actually broke to animals to 1000s my younger sister chewed the rubber buttons off of one and the other malfunctions going down a slide at a Burger King playplace because of the static electricity,

Unknown Speaker 9:11
homos useless. Please tell me she was like 50

Esther 9:15
Oh, no, she was a she was a toddler. It

Scott Benner 9:18
would have been more fun if she was like 23 and she got the rubber buttons off of your insulin pump. So that's that's pretty funny.

Esther 9:28
But the Burger King slide incident happened in Germany. So that was a nerve wracking. But Animas pulled through and they got us a new pump very, very quickly. And the new pump after that incident was the one touch pain.

Scott Benner 9:46
That's the one I'm thinking of. Okay.

Esther 9:48
That was the first animus pump that came with its own glucometer and it had, I don't know if it was Bluetooth but it wireless wirelessly sent your blood sugar from the glucometer to pump. So I had the one touch ping up until 2009 when I decided I was done with the pump done with the wires and I went back on pens for many years until I got on Omni pod in 2016.

Scott Benner 10:16
Excellent. You know, I just did something while you were telling me about that that ended up being really, really a huge letdown I tried to translate Burger King into German and it's Burger King. Yeah.

Unknown Speaker 10:31
I could have told you that.

Unknown Speaker 10:32
What a letdown that was.

Unknown Speaker 10:37
Damn it. Oh my gosh.

Esther 10:39
He's on a military base.

Scott Benner 10:41
So I just said Burger King. Cuz you guys. I figured it'd be like a German translation for burger at least but it's not. Apparently there's not no

Esther 10:49
because it's a franchise.

Scott Benner 10:51
Such a letdown. I'm not joking with you. I was really there was a moment there. Oh, wow, this went wrong on me. Okay, why you have a lot of brothers and sisters. Did your dad just get your mom pregnant every time he came home from the military. How'd that work? Exactly?

Unknown Speaker 11:05
Yeah, pretty much. That's how it works. Yeah.

Esther 11:09
What's funny is that when my parents got married in the 80s, my mom didn't want kids. And my dad said, we'll cross that bridge when we come to it. And apparently they crossed it multiple times.

Scott Benner 11:18
He crossed it about every 10 and a half months probably it sounds like

Esther 11:22
my oldest sibling is 30 now and my youngest is 14.

Scott Benner 11:27
Do you think your parents call having sex crossing that bridge? Honey, it's time to cross the bridge again. Oh my gosh. Oh. Any other diabetes in with your family with those those brothers and sisters?

Esther 11:44
Not type one. But we have the genes. Both my parents have hypothyroidism, myself and three or four of my siblings all have hypothyroidism. My 16 year old sister was just recently diagnosed with an amplified pain syndrome, which is another chronic illness. We have food allergies galore, celiac tendencies. So it's like a sensitivity not true. celiacs disease. I'm lactose intolerance. Lots of fun stuff.

Scott Benner 12:14
You guys are a party. Your dog is probably like, I gotta get out of here. I'm gonna get sick. Ever see him scratch at the door. He's like, I gotta go. How did you end up with a service dog? What was your your pathway to that.

Esther 12:30
So this was really fun. I didn't really know a lot about service dogs. I knew Guide Dogs existed. But when I was a senior in high school, somebody put it on my Facebook page, they sent me a little documentary about diabetic alert dogs. And I was like, what, this is a thing. And of course, my animal loving, teenage self jumped on that train and Dove headfirst into research. And I went to my parents about it. I was like, Guys, did you know that this existed? This is amazing. And they were like, yeah, we looked into it when you were a kid. It was just way too expensive. I was like, Oh, well,

Scott Benner 13:06
great. Thanks. We just thought maybe one day a dog would come out. We have having babies, we would train the dog. We tried to train your sister wants to do it for you. But she ended up just chewing the buttons off your

that's good. I'm having a lot of fun at your parents expense. Don't let them listen to this.

Esther 13:25
I have a lot of fun at their expense, too. Oh,

Unknown Speaker 13:28
well, Lucky them. In fact, then

Esther 13:31
I'm the middle child,

Scott Benner 13:32
I can get away it just yeah, there's too many people on either side of it, you can kind of blend in if you need to. Well, so a lot of you know, a lot of issues that are all centered around autoimmune. And so and you guys move around a ton. So it must be difficult for all of those people to find doctors to help them. Does that. Is that a problem for everybody? Or, or how to work?

Esther 13:57
Okay, so when you move to a new military base or a new station, it takes a couple months, but you generally get set up with the on base clinic with your primary care provider. The problem is getting the referral for the specialist, you know the endocrinologist Okay. And then the problem is which endocrinologist take your insurance? And is that endocrinologist good for you? Or are you stuck with them and they're not really listening to you? So

Scott Benner 14:26
are you saying that your your general practitioner is on base, but then you have to leave the base to get more specialized care? Yes, I got it. Okay. Ah, oh, so how many times? How many different windows? Do you think you've had

Esther 14:40
more than a dozen? I have moved about 13 times in my life.

Scott Benner 14:43
Okay, here's an interesting question of more than a dozen. How many good windows Do you feel like you've had?

Unknown Speaker 14:48
For me? No three.

Scott Benner 14:51
who just got knocked off the list at the end there who almost made it? I'm trying to imagine that one. Like, there was four or no, you know, I don't want to count him?

Esther 15:01
Well see, I don't always have an endocrinologist, I generally will have an endocrinologist team. The question is, do I see the endocrinologist? Or do I see the nurse practitioner? Yeah, cuz some places, I see the endocrinologist once and then never hear from them again. And I always see the nurse practitioner. And then some stations, we've had to fight for the referral, because the primary care thinks that they can take care of the type one on their own when they have no idea when what they're talking about.

Scott Benner 15:31
Well, that's interesting. Sometimes they've tried to keep you on the base for the entirety of the care. We can handle this. Have you ever tried that?

Unknown Speaker 15:39
No, no. I wonder

Scott Benner 15:41
as you're getting older and older, if you'll decide, well, I guess, you know, let's ask this question. How do you feel about your level of care? Like, are you happy with where you're at? Are there improvements you're trying to make? Are there difficulties? Where are you? Where are you right now?

Esther 15:56
Right now with my care, my I had a very good nurse practitioner. She retired, so I'm about to start breaking in a new nurse practitioner in September. And I my, as far as diabetes ago, it's pretty average, I'm getting average care. Uh, the problem is that nobody is taking care of my thyroid. And that's what's really beaten me up right now. You know,

Scott Benner 16:22
I haven't dug completely into this yet on the podcast, but I will at some point when I have complete details. But I've watched my wife struggle with hypothyroidism, and then Arden. And we're in the middle right now. of, we have just found a doctor who's a more, I don't know how to say it a less actually in the box thinker, and is making adjustments and working on other things. And I have to tell you, like really making leaps and bounds improvements for both my wife and my daughter, just by having somebody who doesn't look at the testing and say, Oh, it's in Ranger, okay. And treating the symptoms instead of the number in the test. If that makes right. You know,

Esther 17:12
my current problem is that my TSH, my number for my thyroid is out of range. And my previous nurse practitioner didn't really want to take any drastic steps

Scott Benner 17:24
to fix it. What would a drastic step have been like more medicine?

Esther 17:29
No, I've gone through two dose increases, but I'm drastic step. something other than that, something other than just increase the Synthroid. Maybe we can look at other medications. Maybe we can look at a thyroid booster to take on top of the medication. Look at it from a different angle. Yes, they

Scott Benner 17:51
don't want to talk about vitamins or other other things that might be helpful. Do you have any joint pain or muscle pain or anything like that?

Esther 18:03
Yes, but it's it's not related to the thyroid. It's related to snapping my collarbone in half in 2013.

Scott Benner 18:11
Specific pain. Gotcha.

Unknown Speaker 18:12
Yeah.

Scott Benner 18:15
Was that trying to stop the dog from escaping? Is that what we

Esther 18:18
know that was flipping backwards off of a golf cart at like 20 miles per hour? I

Scott Benner 18:22
don't think you should have done that. Just in case you're looking for my fault. It was the drivers fault driver to golf too fast.

Esther 18:29
I did not eat myself off the back of a golf cart.

Scott Benner 18:33
Are you certain? No, wow, that's terrible. How bad how badly did but let's talk about that just for a second. How badly Did that hurt? Do you use insulin, then you need the Dexcom g six continuous glucose monitor. That is my opinion. Because when you use insulin fluctuations happen, and you're blind to them if you can't see what's going on inside of your body, but the Dexcom gives you that look, you get to see the speed and direction of your blood sugar. And it makes a huge difference. When making decisions about insulin and food. You also have to consider your safety at times. And the Dexcom g six has built in alarms to help you with that. You can set the low alarm wherever you want the high alarm wherever you want. And the Dexcom will tell you when you reach that threshold. That knowledge gives you the ability to stop a low before it becomes a problem or to stop arise before it becomes a high blood sugar that ruins hours of your day. Head over to dexcom.com forward slash juice box to learn more about the Dexcom g six continuous glucose monitor. My daughter has been wearing it for years. And that is at the core of how we keep her a one c between five two and six. For now over six years. I'm confident that the information that The Dexcom gives back to you could help you do the same. Are you using a tube pump or injecting your insulin and wish you weren't, you don't have to, you could use the Omnipod tubeless insulin pump, it is self contained. So for pumpers out there who are accustomed to getting their tubing stuck on door handles or ripping out their sets or taking off their pumps to take a shower or go swimming and then forgetting to put them back on, and their blood sugar's shooting up, none of that happens with Omni pod. You can check it out easily at Miami pod.com, forward slash juicebox. And after you're there, and you think this might be a good idea, you can ask Omni pod to send you a free, no obligation demo of the pump. And they will do that easy. You just ask and then they do it. It comes to your home. And then you can wear it or put it on your child, whoever needs to understand what it's like to wear it on the pod can before they buy. If you decide later, that only pod is for you. That's terrific. It's easy to move forward. And if you don't like it, it's not a big deal. It didn't cost you anything and there was no obligation. My Omni pod.com forward slash juicebox tubeless insulin pumping is next level. My daughter has been using an omni pod for over 12 years, she's worn one every day since she was four years old. It is an absolute friend in the journey with type one diabetes, and it could help you in your use of insulin as well. Last thing touched by type one is an organization dedicated to helping people with type one diabetes. And they would just like you to know about them to check them out. Touched by type one.org. You can also find them on Instagram, and Facebook. As a matter of fact, all of the advertisers are listed right there in the show notes of your podcast player, where there are links that you could find easily at Juicebox Podcast comm

there's a lot more left to Esther's story. So let's get back to it. First, we'll find out what it was like to be tossed off that golf cart.

Esther 22:09
It hurts so bad that I have memory loss,

Unknown Speaker 22:11
just tried to let the whole thing

Esther 22:13
out. He went into shock and I still don't remember. I remember going down. And I don't remember anything from hitting the ground to basically coming to on the way to the emergency room. No

Scott Benner 22:26
kidding. Were you actually playing golf? are you riding in a car?

Esther 22:29
No, I was at a summer camp.

Scott Benner 22:31
Ah, just going from place to place. Yes. I was gonna say How were you shooting up until then I was looking for your score. And what whole year just for the golf fans, you know, so they can understand. Wow, sorry about that. That's so terrible. I bring it up because Arden has those symptoms or had those symptoms. And we've increased her intake of some specific vitamins that have done away with them in conjunction with getting her Arden doesn't use Synthroid, she uses to rescind. And we've been increasing that slowly getting to a better level. So we finally had a doctor who was willing to look and say that, you know, by weight ardens tiersen. Those doesn't seem strong enough, her number seems in range. But her symptoms say she doesn't have enough of the hormone. And so this doctor was willing to move it up a little bit and add a significant course of vitamin B 12. And a very specific one like she moved us to a very specific vitamin and also vitamin D increasing Arden's vitamin D intake significantly. So just little things like that, and we've been at it for a couple of months. Now she just did a retest there, the tiersen is going to get adjusted again and then we're gonna move on and see if you know how that helps. But are you experiencing mostly the tired just that feeling you can't get rested? That is that your biggest problem?

Esther 24:06
My biggest problem is depression, ah, with the thyroid,

Scott Benner 24:10
and that's another thing people don't realize that if you move that up too much that thyroid the way you can go from hypo to hyper how you can tell is you'll start getting like heart palpitations, you'll get you can get sad, anxiety start crying for no reason. Like there's a lot of stuff that happens with having too much of that of that hormone, which I think is can be why some doctors are you know, hesitant to do it. But it's so necessary or you could go to a T three and T four together. I can't think of a T three name off top my head now. Damn, I'll think of it and it's so depression. Do you feel like it's really connected to the to the hypothyroidism

Esther 24:57
we can I was diagnosed with hypothyroidism and about Vitamin D deficiency when I was 13. So I've been, we've been dealing with it long enough that we can clearly link depressive episodes to a lack to when my thyroid numbers are not where they should be. Okay? Now, I

Scott Benner 25:13
believe that 100% you can't, nobody would be able to talk me out of believing that. And so what happens is your needs change. But it's difficult to change with the need, you don't notice the need changing until you have the symptom is that what is that the biggest problem?

Esther 25:30
It's difficult to describe the symptoms in a way to motivate the doctors to do something about it.

Scott Benner 25:37
Ah, ah, okay, so what what ends up happening is you just do you think they don't believe you? That it's related to that and they look back and they is your tea? Or your TSH? Did you say it was out of range or in range?

Unknown Speaker 25:54
Oh, it's out of range? lower high low, I

Scott Benner 25:56
would imagine. Hi. Hi. Okay. So you appear to have too much. You. You appear hypo?

Esther 26:04
I am hypothyroidism. The TSH is supposed to be between one and four minus 12.

Scott Benner 26:11
It's so what's the plan? Like what what's supposed to bring it into range?

Esther 26:16
the centroid supposedly, but it's not doing its job doesn't do that.

Unknown Speaker 26:20
Have you tried others?

Esther 26:23
No. But I'm hopeful that my new nurse practitioner in that I see for the first time in September, will finally you know, listen to me. And maybe we can switch something up. Try something new.

Scott Benner 26:37
Is the T for not being picked up by your system? Has anybody discussed that with you? Maybe I figured out the name of the T three. It's called psycho Mal. Maybe that's it. The tough part of it is is when you make adjustments, these medications, it really messes with you. If it's Yes,

Esther 26:53
it does. Yeah. And I already struggle with insulin resistance, hypoglycemia, unawareness, hyperglycemia, and awareness, hence the dog. So my, my, I, I'm over here, like, I tweak things all the time without talking to the doctor. I've been doing this for 20 years, I tweak things. But then when I need a change in prescription or change in dose or change in medication, then the battle comes of convincing the nurse practitioner to make those changes.

Scott Benner 27:24
And it's not as easy as saying, Look, I'm doing it and it's working. I just need the medicine.

Esther 27:28
Right. It's kind of like I will tell you something my previous nurse practitioner, we had one big disagreement point. And that was your podcast. Oh,

Unknown Speaker 27:39
that's a shame. He doesn't like it. And I have lost

Scott Benner 27:43
the listener. Terrible.

Esther 27:45
I the first day I the first time I asked her Hey, have you heard of the Juicebox Podcast? She looked at me and she said yes.

Unknown Speaker 27:53
She didn't like it. That's good. I was like,

Unknown Speaker 27:55
oh, okay, then

Scott Benner 27:57
she's still listening. I'm saying it right now. That's all that's fine. hyperthyroidism definitely comes with insulin resistance when you have too much, you know, going on it definitely makes it I've seen that while we're adjusting artists medications. If she gets hyper during the medication adjustment, her needs for insulin go up pretty pretty drastically pretty immediately.

Esther 28:23
Yeah. My my second biggest symptom that I deal with with the hypothyroidism is my inability to lose weight. My not my blood sugar's could be perfect. I could be exercising, eating great. And I can't lose weight. I don't gain weight either. Yeah, it's it's just stuck, stuck.

Scott Benner 28:43
Well, that definitely, to me says your hypo. Right. So why, you know, you gotta I mean, I know it's easy to say like, you got to find a doctor that can help you but there just aren't that many of them that are willing to think outside of and be and I think you're, you're saying something that's incredibly important. It's that being flexible around care, and being willing to make a small adjustment. Look, again, make another small adjustment you know, being willing to do blood tests more frequently to see where the medications putting you and not just trying something and waiting six months or whatever and then and then going back anyone how do you feel like you know, I'm

Esther 29:20
also a very impatient person when it comes to my health I I make an adjustment and the next day I'm like, okay, is it better? But I have to slow down cuz you gotta see what the change does before you can change something else. Oh, yeah,

Scott Benner 29:35
this medicine is I think weeks and weeks to be sure like you have to you have to choose and go and stick with it and see what happens. You can't You can't three days and go it's not working. I'm going to take more like that definitely don't work. Yeah. Wow. I'm sorry. It really is. It's not fun. Do any of your siblings have better luck with it than you are having?

Esther 29:58
Um, so none of my other friends siblings see an endocrinologist. Um, I'm the only one because of diabetes. So there's, as the rest of my family handle their thyroid, basically seeing the primary doctor, getting the blood test every three months, I'm adjusting the medication as needed and go on their merry way. But because I have the jackpot of both, I get to work with endocrinologist team,

Scott Benner 30:29
what are they doing better? Like? Are they having better outcomes than you are? Or no, not necessarily?

Esther 30:34
Well, it's different outcomes, because the hypo and the diabetes work against each other. And the other people in my family have, they either just have hypothyroidism or hyperthyroidism and something else other than type one diabetes, so their care is obviously going to look a lot different. And they're everyone else's numbers are good. Everyone else is great.

Scott Benner 31:00
How about how they feel? Or they keep weight off and things like that? Or are they in similar situation with that?

Esther 31:07
Um, I mean, we're we're basically Vikings. We're tall, broad people. But yeah, my siblings with hypothyroidism don't have as much trouble with weight fluctuation as I do. Gotcha.

Scott Benner 31:21
Okay. Well, and and, and so they don't need as much adjustment either. It's not they're not struggling to begin with. It's just working out better for them. Yeah, interesting. Yeah, that whole,

Esther 31:33
they're generally focused on the hammer collegiate migraines. So

Scott Benner 31:39
they've got a different problem

Esther 31:41
than they do we all have our issues. Oh,

Scott Benner 31:44
my gosh, wow. Your whole bloodline needs to be out in the sun more often, I think or something like that. You guys needed some vitamin D. When you were growing me. You said is what is your background? Like? Where do your parents? Where's the lineage? Run? I guess.

Esther 32:02
I'm on my dad's side is just a European and Cherokee. I'm just American. And my mom's side is mostly Irish.

Scott Benner 32:13
Yeah, that Irish is tough. It's tough on the auto immune for some reason. I don't know if everyone's noticed that or not. Yeah, the real pale people struggle with some stuff for some reason. And we've talked about stuff on the podcast before, you know, just the idea of like the potato famine, being really impactful on Irish people.

Esther 32:33
And I've heard you talk about that. And I literally, like it blew my mind.

Scott Benner 32:39
Well, you don't talk too much. Because you know, it's just a podcast, but it is definitely something I've heard about a couple of times and looked at once or twice.

Esther 32:47
I think it should warrant more like in depth study. Not by me. I don't have that.

Scott Benner 32:55
Someone besides me should look at it. I just know that there are a fair amount of people who I've met with autoimmune issues. hypo thyroid to be you know, be specific, who will tell you that they have you know, a pretty, a pretty strong Irish, you know, or that part of the world. background. And right. I don't know, is what it is, I guess, but all right. Well, let's find some good news in here somewhere. How do you find the service dog is is? Is it a good

Esther 33:29
Enzo? Um, so senior year of high school, found out about diabetic alert dog started researching kind of ignored the fact that my parents didn't really put a lot of effort into it. I'm pretty stubborn like that. And I spent three years researching, watching YouTube videos, reading articles, getting any piece of information I could get my hands on about diabetic alert dogs and service dogs. Almost got scammed out of $25,000. But I went to a religious conference, where we ran into a family with a service poodle, they gave me some information. And a year and two months later, Renzo came home. Wow.

Scott Benner 34:13
Service poodles. A great pairing of words, in case you're wondering, but I want to hear a little bit about how did you almost get scammed out of money because this is a pretty prevalent problem, isn't it with service dogs,

Esther 34:24
right. So in in the United States, dogs, service dogs, it's not a regulated industry. And there's a lot of misinformation going around. So I will not name the organization. But there was there's a prevalent service dog training organization that was placing dogs before they were actually trained. People were paying 25 plus $1,000 to this organization. And what people were getting back was an unruly untrained puppy.

Scott Benner 34:56
Wow, that's so you got a pattern. gotta feed it that and everything else. And it's right. It's costing you money, no problem.

Esther 35:05
I got I contacted the organization, thinking they were legitimate, and I was approved, and they wanted me to start fundraising the $25,000. And as I was starting the fundraising process through the company, they got sued. So, a miss, dodged that bullet, thankfully. And I actually got an even better trained dog for a fraction of the cost from a local company to me, gotcha.

Scott Benner 35:35
What did you end up paying for the dog? If I can ask you just so people can have an idea of what it really should cost?

Esther 35:41
$8,750 for a dog who has public access trained, obedience trained could detect high and low blood sugars responds to fainting episodes and retrieved at General items. Wow.

Scott Benner 35:53
Can they bring you like a remote control? Where's that above and beyond? Well, the dog look at you and be like, that's not my job, or

Esther 35:59
no, dogs aren't robots. never stops, service dogs are not a finished product. Honestly, that's how a lot of program dogs end up failing, once they're placed with their family, because the family won't keep training. And the service dogs aren't a finished product, they don't come out of training, and poof, they're perfect for the rest of their lives.

Scott Benner 36:19
It's interesting how much time in a month that you give to continued education for the dog.

Esther 36:25
So rienzo's, each dog is different, but my dog, we do tend to minute 10 to 30 minute training sessions a couple times a week, I try to make sure we go out into a public place so we can maintain manners. A few, like at least three times a week, but um, you can it's just a matter of consistency, honestly.

Scott Benner 36:49
Wow. That's, that's interesting. I hadn't considered that that there's upkeep, basically maintenance, you have to do yes, to keep it going.

Esther 36:57
I've also added on to his training. At this point, we've been together for a year and a half and two thirds of what he knows as far as commands and tasks I taught him.

Scott Benner 37:08
It's like when you buy a Tesla, and then you want it to drive itself and you give him like another $4,000 and they add it to it. They just upload it to the car. You just continuing to upload things to the car. That's really cool. Like what do you have goals for the dog that franza that he that he hasn't reached out that you're working towards?

Esther 37:25
Yes. So recently, just when we went into quarantine a few months ago, I registered Renzo with the American Kennel Club because he has a purebred Standard Poodle, and he just passed and received his novice trick dog title. There's five levels of trick dog titles. I hope that we can get all of them. I also want to get his Canine Good Citizen certification through the A Casey. I have big plans for my dog.

Scott Benner 37:52
Wow. What can he then? Sire other dogs? That would be good service dogs or is there no correlation? Oh, I got you. You don't want him wandering off looking for a girl? Oh, well. Oh, wait, no, wait, I'm joking. But is that a real thing? Like do is is a service dog always spayed? or neutered or no,

Esther 38:13
no, it's up to the owner. Except I went through a program and the program requires all of their dogs to be fixed before placement. So he was neutered long before he was even matched with me.

Scott Benner 38:23
I gotcha. Okay, well, that's interesting. Well, then he's definitely not gonna do that. Or where he'd be amazing if he did?

Esther 38:31
No, he's not up to standards, so he wouldn't be a sire anyway.

Scott Benner 38:35
Oh, really? Like, is there? Am I using this word with quotes, but are there imperfections about him that would stop that from happening?

Esther 38:42
Yes. So he's only 26 inches at the shoulder, which is within standard AK standard for the breed. But he only weighs about 50 pounds. He's a very lanky boy. He's also a party poodle, which means he's black and white and the A Casey doesn't actually recognize the multicolored poodles. So that's actually why he got donated to the service dog program because he was he came from a show line and it can't be a show dog. So he became a service dog.

Scott Benner 39:07
No kidding. That's super interesting. You just use the a lot of terms I've never heard before. lanky boy and party poodle party poodle, strong contender for the name of this episode, in case you're wondering, but I am afraid to Google either of those terms. Because

Unknown Speaker 39:26
it is my term okay.

Unknown Speaker 39:28
But party poodle is not right.

Esther 39:31
Party pa RT refers to the coloring of his coat. You can have solid coded poodles, party, poodles, Phantom poodles,

Scott Benner 39:42
I don't even know all of them. Well, you can safely Google just for the I would keep the lie off of it, just in case. I'm not sure where the internet will take you then. Actually it just redirects you back to p. e AR ti. Well, that's really cool. Like there's so much about this that obviously, I don't know about And it's a lot to consider. How much time do you give to, to Enzo? I mean, at what point I can ask a thoughtful question here. At what point? Is Enzo, a family member? And at what point? Is he a tool? Or do you not consider him a tool? like, Okay, you know what I mean? Like there's a, I'm trying to understand how that feels.

Esther 40:23
Yes. And I will. I'm so glad to answer this question, because it's a question I get a lot. So Renzo is a dog. He still has the basic needs of a dog, he needs stimulus, he needs exercise, he needs affection. When the vest is on, and we're in public, he's working, which means he's ignoring his surroundings, and he's ignoring other people. And he's focusing just on me, when we're at home, and the vest is off, you know, he will roam around the house, he will play with dog toys, he'll play with the other dogs, he'll cuddle with everyone in the family, he'll harass my pet rabbit. But if he smells, my blood sugar, doing weird things, he will find me in the house and still alert. So he'll still do his job, whether he is quote, on duty, or at home. He like the whole reason I have him is that he's a tool in my diabetes management toolbox.

Scott Benner 41:16
So I mean, this really seriously like so that the vest that he wears, is that an indicator to him that he's, I mean, on duty for? Or will he'll, he'll just do it no matter what, like, he doesn't have to go find the vest if he smells your blood sugar low. But

Esther 41:29
no, no, that's so he can I can literally commit, like, give him a word. And he's like, oh, we're working now. But when I put the vest on, and I'm like, do you want to, like, let's gear up, that's the word I use. He knows that we're going to be in public, that's really his key to be behaved, because the service started in public needs to be out of the way and unnoticed.

Scott Benner 41:53
Gotcha. Okay. I understand. By the way, there's a great movie in this where the dogs can talk to each other. And like, you know, they're on the job. And they take it really seriously almost like, What am I thinking of Secret Service agents, except for service dogs. there's a there's a kid's movie in there, someone can write it. I'm just telling you. I think it would be amazing if talking dogs came home from work at the end of the day. And we're taking off the rest and like they talking about their long days and everything like that. I would be very

Unknown Speaker 42:19
nice. Really cute.

Scott Benner 42:21
Thank you.

Unknown Speaker 42:22
Like I could Yeah, I just,

Scott Benner 42:23
as you said like wearing the vest. I saw the vest as the uniform. And anyway, I don't have time for that one. So anybody can feel free to pick up and run with that. I'll take a writing credit at the end. It's not a big deal. That that's really interesting. It made your life better.

Esther 42:40
Oh, yeah, my, my agency dropped in the first few months after having Renzo his alerts are on point he alerts at ADM, below 190 and above. And if it's quickly rising or falling, his his nose is rarely ever wrong. And sometimes he catches it before my Libra or my meter. Like he'll alert and it looks like he is like wrong. But actually 15 minutes later, I'm either spiking or crashing. Did you

Scott Benner 43:07
give samples during his training? Or did they can they use anyone samples?

Esther 43:12
So I had to mail saliva samples of in range high and low to the trainer to use. But what's ironic is that renza his trainer was hypoglycemic, and renzoni nose is so sensitive that he has alerted like half a dozen other people other than me.

Scott Benner 43:33
Oh, no kidding. Like, somebody can just walk by with some low blood sugar and they'll be like, and I was like, Yo, what's up your low? And how does he tell you your low? I mean, sign language. What's he do?

Esther 43:42
He will pour me if it's an emergency, like rising or falling quickly, he will jump up on me. And if I'm having brain fog, and I'm just not getting it. He will bark at me.

Scott Benner 43:55
By the way, I feel like you just explained how married guys ask for sex. Dude. go through it again. He'll Paul you have it right. It goes say to get

Esther 44:06
regular alerts as a PA that has popped up on my leg. I hear it. If it's an emergency, he'll jump up on me.

Unknown Speaker 44:13
Huh? I was

Esther 44:15
not getting it. he barks at me

Scott Benner 44:17
telling you right now you just described that. Oh my goodness. While you trust me. It's not that funny. If you've been married for a while. Sorry. Oh my gosh. We know each other. Yeah. And and it was really great to meet you the time I did. tell people where we met.

Esther 44:37
We were we met at the Kansas City jdrf type one nation summit.

Unknown Speaker 44:44
We did and where

Esther 44:45
you were exhausted.

Scott Benner 44:46
I was and how good was I told the people?

Esther 44:50
Oh, you were fantastic. It made me feel special because you knew exactly who I was when I walked up was a dead giveaway.

Scott Benner 44:57
Well, I'm gonna I'm gonna tell you for sure. Fisher that the poodle did give it away. But I appreciate you saying how fantastic it was without being prompted, I want to say about Kansas City, I had never been before, and got in the day before and went and got some lunch and had these chicken wings. That really made me happy. I just never had chicken wings to make me that happy before. And I went and did the whole the whole thing the next day. I actually have to thank people right here. Because later that night, you know, the people who brought me out from the jdrf chapter there in Kansas City, were just like, yo, let us take you to dinner and I, I get a little like, I'm like, I'm just gonna go home, like, let me just sleep and get back on the plane and get out of here, you know? But I said, No, no, that'd be great. Let me go. So they took me to this place. And as we're approaching it in the car, I think I'm gonna get off like I'm getting shot like this is it this is this is a hit, because we're like in some industrial park and the window was down a little bit and it smelled a little like cow manure. And I was like, what is happening right now? Where's our rail yard going behind? I'm like, where are we like, this is definitely like they're gonna, they're gonna pop me this is what's going on here. I don't know what I did wrong. But I've upset the Kansas City mafia, obviously. And this is what's happening. So we pull up, and I say to the person driving me, I'm like, I gotta ask you like, Where the hell are we like, you smell the Commodore? Right? Like, this is the restaurant that's not the restaurant. I'm smelling, isn't it? And she's like, no, no. And she points to this building said there's a rail yard nearby. And these shipments come in sometimes. So it smells like this once in a while. I'm like, Okay, you got to like, understand, I'd never been there before. So I'm just like, whatever. She points to this building that really is just a nondescript square, you know, building. And she's like, this is the restaurant. And then I went in and had maybe the best barbecue I've ever had in my entire life.

Esther 46:50
Yep, that's Kansas City in a nutshell, is

Scott Benner 46:52
that what I just ate and it was so good that I came home. And when the Coronavirus thing started, I spent time learning about how to make barbecue because I realized

Esther 47:03
that Kansas City barbecue is the best. Well, I

Scott Benner 47:06
don't know if I realized that what I realized was that my entire life, I didn't like ribs. And then I had ribs in Kansas City and realized that nobody had ever prepared them correctly for me. Yep. And now I know how to make them myself. And I love ribs. ribs are good. That's fantastic. Yeah, so had I not come? I would never have had that experience missing out. I seriously would have been. I'm not joking with you. I made some great ribs the other day.

Esther 47:32
I gotta tell you though, something very funny happened at that event where we met during the break between your the the other woman who spoke and your that

Unknown Speaker 47:45
I wait other people speak while I was there. I did realize that.

Unknown Speaker 47:50
The jdrf lady? Oh, yeah, I

Scott Benner 47:51
didn't know. I only hear myself. I'm just kidding. Yeah, I bet. I didn't other other people there but God.

Esther 47:59
But I went to ask a question at the jdrf table. And they had to go find somebody to get my question answered. And so I was standing there with renzoni by the jdrf. table, and a line formed. And this couple came up and started asking me about Renzo and diabetic alert dogs. And I was happy to answer all their questions. It's something I'm very passionate about. And then they were like, thank you. And they went away and another person came up a line formed people thought I was a rep there to talk about diabetic alert dogs.

Scott Benner 48:36
weird feeling, isn't it? When it is? Yeah, trust me, I I hear you. It seems like from the outside, it would just be like, Oh, it's nice, so many people, but it's hard to like wrap your head around when it happens. I had trouble getting through the that area you're discussing to go back and be private somewhere and just eat something for a second because I would take a step and it was really trust me, please. It was very nice and not necessary. But people wanted to say thank you or they want to take a picture or something like that. I would chat with him for a little while. And then I would turn and think now I'm going to go get my lunch and take one more step and somebody would go Hey, and I'm like, Okay, I'm never getting out of the spot right here. Am I so I just kind of put my back to the wall and like just was like alright, everybody, let's let's go come on over. Well, you know, we'll do it at the same time. is it's very, it's very nice. It's just overwhelming if it's never happened to you before.

Unknown Speaker 49:30
shopping with a service dog.

Scott Benner 49:32
Everybody has a question. Yes. Is that the biggest issue with a service dog is keeping people from touching?

Unknown Speaker 49:38
Um,

Scott Benner 49:40
in public, I guess.

Esther 49:42
I can't say for certain what the biggest problem is. However, it is very common. Like I would say that people with service dogs don't go to the grocery store on the weekend because they want to avoid people because you take a few steps and then then it's Oh cute doggy. Oh, my pet. What's wrong with you? Oh, are you a trainer? Oh, how do I sign up for one? Like, it's not so much the touching as the overwhelming intrusion. I'm just trying to shop for peanut butter. Like, and I'm really passionate about the topic, I could talk about it for hours. But if I'm having a bad blood sugar day, and I am just out of it, and I just want to get through the grocery store, and a dozen people stopped me to ask to pet my dog or ask me questions. I don't want to be rude.

Scott Benner 50:34
He had spent an hour and a half at the grocery store either, right? No, I, it makes sense to me. Because everyone is just having their own personal response. They don't recognize that someone just asked you for seconds before and then when they walk away, he's gonna do it.

Esther 50:48
I remind myself of that every day. Yeah, each person who asks me to pet my poodle, who I think is a unicorn sometimes, because of people's reactions, they don't realize that they're the 30th person asking that day, they just see a cute dog and they want to pet it.

Scott Benner 51:06
Pet my poodle should be a T shirt. Kiss your honor. I think I just did some music. And I liked the idea of those words all together. Well, no, I hear you. And it's it. You know, it really does make sense on both sides. You You don't you don't have that time. And they don't have that knowledge and too bad mix. Right? So you're just trying to avoid Listen, I think we all try to avoid going to the grocery store when it's too busy. know for certain. Okay, let's see. How about your outcomes? Have your outcomes with your agencies and variability and stuff like that improved with a service dog?

Esther 51:43
Yes, my variability has really improved, my agency is still like, I have an 8.6. And the insulin resistance and the hypothyroid situation I think are contributing to that. However, I didn't even know what variability was until I heard it on the podcast. And so I've been really focusing on that. And renjo really helps with it. In fact, the original trainer taught him to alert above 200 and below 70. And I actually retrained him to do 190 and 80. Because I wanted to know if it was going up before it got to the two hundreds, my range is 80 to 135. That's where I want to be. But if my dog alerted to my specific range, she'd be alerting all but he'd be alert alerting a lot more than I would need him to. Because really, he's there to prevent emergencies. What do you think is holding you back from having the one see that you're

Scott Benner 52:44
looking for?

Unknown Speaker 52:46
Um, well,

Esther 52:50
I would like the short answer would be insulin resistance. The long answer is, I was I've been switching back and forth between the pump and pens to figure out what I liked better. And I really think I like the pins. And you know, going back and forth isn't the greatest thing to do for your body. Don't follow my example. But I finally because I was listening to your podcast, and I was translating everything you were saying to the pins. Once I went back on the pump, I felt like I was relearning it all over again. Okay. Well, I went back to the pro tips and everything. And I just personally feel more comfortable on pens.

Scott Benner 53:27
Yeah, there's nothing wrong with that for certain I just was wondering if, because you're you're paying a lot of attention. And and you're, you know, you know, when you're high and when you're low from different technologies and from from Renzo. And I just wondered that you think it's the insulin resistance and that might stem back to the to the thyroid? Yeah. I just I don't want

Esther 53:50
it to be under control so badly. Yeah.

Scott Benner 53:53
I don't think enough people appreciate the impact of thyroid when it's not working correctly.

Esther 53:58
I did it for a long time. Yeah. I was diagnosed when I was a teenager. What did I know? I just took the pill and everything was hunky dory. It's not

Scott Benner 54:05
Yeah, it's, it can work well for people or not. And when it doesn't work well, it's it's not normally an easy fix. And, like you said, it's a slow, it's slow going to make adjustments.

Esther 54:17
And it has to build up in your system. It

Scott Benner 54:19
has a half life, and you don't always guess right the first time so you could you know, make an adjustment, wait a month, you know, do another blood test and find out what didn't do it. You know, and and, you know, I still don't feel any differently. And then you have to just back the other way. It's a it's a long game, and you have to see the value in it or I think it's possible that you just lose sight of wanting to play that game. And you really if you have a thyroid issue, and you're having any of the thyroid symptoms, your medications not right. And isn't Yeah, and it would be incredibly beneficial if you put some put put the effort that was needed into getting it fixed. And part of that effort. might end up being finding a doctor who isn't so cookie cutter when it comes to fine.

Esther 55:06
I will say I liked my nurse practitioner, she did a lot for me, she filled out the paperwork for my dog, she got me on libri. She got me on Omnipod the first time around. But we disagreed on some big things like dawn phenomenon, I told her, we need to address this, we need to adjust the high blood sugars in the morning because I can't function at my job with the high blood sugars in the morning. And yet, she said, Oh, it's fine. If you're high in the morning, just take a correction. I'm more worried about the 5% of lows you're having. And so we really butt heads on that. Yeah. And so even though I liked her, I'm not incredibly sorry to see her go. I'm excited to work with someone new, clean slate. That was the longest I've ever had one. Doctor for anything. I had her for four years.

Scott Benner 55:57
Yeah. And you're and you're butting heads on a pretty big issue. Because Yeah, because there's a way to not wake up high and not have a bunch of lows. It's Yeah, it's not a zero sum game. You don't have to pick between them. You know,

Esther 56:11
that's what I was saying. I was like, can we address both, but the only way she wanted to address the highest was with a correction. And I think that's where the disconnect between endocrinologist who live with type one. And endocrinologist who don't is because she doesn't understand what it does to us. Like, you can tell I'm sure with Arden, if she wakes up in range, she's awesome. And if she wakes up high, she's probably a little more snarky and sluggish.

Scott Benner 56:38
It's a big difference in how you feel. Yeah, and in some ways that determines how our mornings go, how we treat people, how we perform at our jobs or in school. And it's a big deal. It could be it could also impact the decision you make about food first thing in the morning, by the way, and then lead you down a bad road. Like if you're if you're feeling like none of this matters. And you you know you don't you don't have the energy to cook the meal that you normally would. So you grab something, it's easier. And your blood sugar goes out. And it just you know snowballs from there. And you can't get back. Yeah, no, I know. I'm sorry for you. I'm glad you're switching. But well, I hope I can find some better answers and share them on the podcast through this journey with Arden. Hopefully it'll come together. sooner than later. I actually have asked the doctor if when this is done if she would come on the show. And I'm hoping she will because she's just thinks about it in a different way, which I find to be really helpful.

Esther 57:36
That would be really interesting. Yeah,

Scott Benner 57:38
I hope so. I hope I can work that out. Actually.

Esther 57:41
You think Arden's getting older? Do you think Arden will ever be on the show?

Scott Benner 57:45
Yeah, sometimes I think she will be. And sometimes I think she won't be

Esther 57:49
like a teenager to me. So no.

Scott Benner 57:52
I asked her once in a while. And once in a while she acts like she might. And then sometimes she says she won't. And I figured it'll happen or it won't happen. At some point. There's definitely things I'd love to talk to her about on the podcast. And so I hope she comes on it just for her. I mean, you guys might find that interesting, but I would I want to do it, you know, for her?

Esther 58:10
Well, I think I mean, I respect artists choice. But being someone who grew up as a type one diabetic child, adolescent teenager, not having the support network or community that I have now through the internet. Like, I didn't know anyone like me. I didn't know there were blogs out there or podcasts out there. Yeah. And being able to connect with people who are going through the same thing, I think would have changed a lot of how I went through my teenage years with Type One Diabetes. I agree

Scott Benner 58:49
with you. You spend some time on Instagram, right? sharing some stuff about your life. tell people what your Instagram handle is.

Esther 58:57
Oh, yeah. On Instagram, I am chronically underscore annoyed on tik tok. I am chronically annoyed. And on YouTube, I am chronically annoyed s d team.

Scott Benner 59:08
Nice. Although I read this morning that this tech talk is bad. And so I will find you the article says it's on board panda.com and it says I am a nerd who figured out how who figures out how apps work for a living. I've reverse engineered tik tok. It's scary stay away from it. Like that's interesting. So anyway, I'll share that written a place where you can find it too. I thought that was really something because it is incredibly popular. But no i to your to your point about you know, being there online so somebody else can see it. I mean, obviously I'm a big believer in that or the podcast wouldn't exist so

Esther 59:49
Oh, yeah. I I got on Instagram, I don't know in 2018 to to find the Type One Diabetes community and and to build Build a support system. Never did, I think I would have 1000s of followers looking to me for advice on any social media platform, and I don't give advice. I just share my experiences, and maybe some dumb jokes along the way. But the community that exists online is amazing. And I first got into it by downloading bianche type one. That was That was my first introduction to an online Type One Diabetes community. And it was amazing.

Scott Benner 1:00:33
I agree. And they had What did they have? Like? Almost like a message board? I guess? Is that how you would describe it?

Esther 1:00:41
It's similar to Twitter. I guess it is a message board where you can follow different topics and make posts, but it's all for type one diabetics or friends and family of type one diabetics.

Scott Benner 1:00:54
Nice. Is that still running? Oh, yeah, yeah.

Esther 1:00:59
It's had multiple updates. I still have that I'm not very active on it. But I've met some really cool people through beyond type one. I even got to meet up with another type one diabetic I met on the app in Denver A few years ago, and we went to an amusement park together, where we ran into another type one diabetic.

Unknown Speaker 1:01:21
So that was fun. Mm hmm.

Scott Benner 1:01:25
What do you get out of like, on your side of it from meeting those people? Like you said, you didn't know anybody like you what happens when you do all of a sudden, no, somebody like you?

Esther 1:01:34
Well, it, I wouldn't say it backfired. But it, it didn't turn out the way I thought it would. Because I went through the diabetes journey a lot differently than other people. I found that I had a lot of insight that others were lacking. So instead of gaining encouragement, I ended up giving it because I I've been doing this for so long on my own. That I found that I had a lot of stuff to give, but I still gained, I still gain information. I gained friends. And I just think it's very wholesome, the way we can share experiences and information.

Scott Benner 1:02:21
I agree with you. I really do. I think it's a it's a wonderful platform, especially for people who are distanced and don't have connection. And who really does. I mean, honestly, a lot of people have type one diabetes, but you know, still there's not that many to where you're always gonna know, three and four people with it. And you're gonna find them, you know,

Esther 1:02:41
and, you know, as a kid, I, by the time I was 10 years old, I had spent half of my life in Europe. So, I really didn't know a lot of people like me. There weren't there were no jdrf events to go to, or, you know, diabetes camps to be to go to it was just me and mom.

Scott Benner 1:03:03
What other places have you lived?

Esther 1:03:06
Oh, this is a fun one. Let's see. I was born in Texas. And then we moved to Arkansas where I was diagnosed, and then we went to North Yorkshire and we lived in Menwith Hill, England. And then we moved to Alabama. Then we went to Kaiserslautern, Germany. Back to Arkansas for another deployment. Back to Alabama, then off to Colorado, then we were in Virginia for a while and now, I have been living in Missouri for the past five years.

Scott Benner 1:03:40
I think I'm just impressed that you said them on order, which I'm assuming they were in order, but yes. Do you speak any other languages like German or British?

Unknown Speaker 1:03:48
I speak sarcasm.

Scott Benner 1:03:52
Me too. That's the only one I have

Esther 1:03:54
to speak type one diabetes in service dog handler. Know, out of out of my my family. Some a lot of people in my family speak languages. A lot of people in my family play instruments are very musical. I'm a visual arts person. I actually hold an associate's degree in Visual Arts and an associate's degree in business. But I'm taking a break from college right now. And I'm a teacher. Cool, what

Unknown Speaker 1:04:22
do you teach?

Esther 1:04:24
I teach public speaking, digital literacy. And this coming year, I will also be teaching art and running the library.

Scott Benner 1:04:32
Wow, look at it. Good for you. That's excellent. And Renzo comes to work with you. Obviously,

Esther 1:04:37
yes. Renzo loves coming to work with me because he loves children. Well, honestly, both both my dog and my students respect each other. And it's hard for them to have self control sometimes, but they respect the fact that he's there for a reason. And the reason is not for them to love on him.

Scott Benner 1:04:57
How old are the kids you normally teach?

Esther 1:05:00
Third through eighth grade. Oh wait this year I'm also going to be teaching high school.

Scott Benner 1:05:04
Wow. That's really cool. Good for you. That's excellent. Yeah, I think big just the government must have put you guys in in country and left you here just to stop having to cart all of you around the globe. It was probably get expensive.

Esther 1:05:20
My father retired in 2015. But yeah, it um, yeah, there's a lot of us. Okay, how

Scott Benner 1:05:27
long was he in total Dino?

Unknown Speaker 1:05:29
Oh, I

Esther 1:05:32
okay. But here's the thing. He was in the army first. And then he got out of the army. And then he was National Guard. And then he got into the Air Force. So I have no idea. Wow. No, that was all before I was born. A lot of serving.

Scott Benner 1:05:43
Yeah, no kidding. That's, uh, that's interesting. Did you prefer living overseas to here or vice versa? Do you have any?

Esther 1:05:50
I would? Well, here's the thing. I lived overseas when I was a child, the last time I was out of country, I was 13. I would have a much different perspective now as a young adult than I did as a child as a kid. It was pretty stinking cool. Yeah, I would imagine. I hear that. A lot of places. I've been to Italy. I've been to Austria, Ireland, France. lots lots of places.

Scott Benner 1:06:14
That's really cool. It was really it's a it's a rich experience, just to have as a little kid, you know? Yes. No kidding. Well, listen, I we've done this for an hour. I really appreciate you being on and And is there anything we didn't get through that you wanted to? I don't want to skip anything.

Esther 1:06:30
We talked a lot about hypothyroidism. Ironically. And Renzo? Do I answer all your questions about diabetic alert dogs? specifically?

Scott Benner 1:06:41
Yeah, no, I feel good about it. I think, you know, if I'm speaking from an outsider's perspective, I believe that a diabetic alert dog for somebody who wants one is amazing. And I can also see how another person might see it as another responsibility that they don't have time for, like I can, I can see both both perspectives, you know, pretty evenly. But I think the biggest problem, excuse me is that I don't want to see people spend a lot of money for something that didn't need to cost that much money and won't help them, you know, because it ends up being a shakedown, is there any central location that they can go to make sure they're not being taken advantage of? Or is it? Is it location to location?

Esther 1:07:24
It's, it's knowing the red flags to look for when looking for a program. And that is something you learn through experience and research. Unfortunately, I talk a lot about it on Instagram and Tiktok. But to what you said, it's so true, any diabetic could make use of a dog but not every but not every diabetic needs one. I honestly didn't need one until I started experiencing hypoglycemia and hyperglycemia. And awareness. That's the whole reason I got the dog. Having a dog with you. 24. Seven is a lifestyle shift that not everybody can handle,

Scott Benner 1:07:57
right? No, I can't I can imagine that being true. Hey, what are some of the red flags that that would tell me this might not be a great organization?

Esther 1:08:06
If they won't answer certain questions, like training methodology? How old are the dogs when they get placed? How long? Does it take the dogs to be fully trained? Are they public access, ready, when they're placed? Or do they just know the alerts? How closely do they work with their clients? Or do they not give you updates and stuff like that? Do they want you to pay the whole amount upfront before they start training your dog? Or will they take a down payment and start working with your dog immediately? Those are those are the questions to ask. Those are the big red flags to look out for.

Scott Benner 1:08:46
Is it just true that nowhere should it cost $25,000.

Esther 1:08:50
Unfortunately, if you go to a nonprofit organization, you're gonna spend anywhere between 15 to 50,000. It's in there in high demand, low supply, it takes up to two years to fully train a service dog. A lot of people have waiting lists, I went through a program called canine specialty training, LLC is located in Independence, Missouri, it is not nonprofit, therefore, it's first come first serve. And that's how I got my dog so quickly. So it's really it's really worth it to try and look for small local training companies or organizations rather than going to a big nonprofit organization.

Scott Benner 1:09:39
Well, let me just put this out there. I'm not a doctor, and I have no training at all. But for $50,000 I will come live at your house. Teach your kid how to keep their blood sugar, right or you as an adult, I'll stay with you for I mean, 50 grand, let's be fair, two months, and we'll make sure you're okay before I go. And that's it. 50 grand. That's I'll definitely live in your house for $50,000. If I if I ever buy a $50,000 dog, I imagined that I will need some sort of like mental health help because I'm so cheap. I can't even imagine it just that that Fried my mind would just be like when you started at 15,000 I was like, oh my god 15 pounds. Oh,

Esther 1:10:20
my dog was considered cheap. No kidding. And I actually didn't have to pay for all of them because I got a grant that is specifically for type one diabetics to get a service dog through cosmopolitan International. Everyone can find it on their website. Okay, it is application based, though.

Scott Benner 1:10:37
cosmopolitan International. Okay, I just want to go over one more time again, for $50,000 there's very few things I won't do. In case you're wondering like, do you need me to come paint your house or? I don't know, do change the oil on your car. just name it. Honestly, I'm happy to come over, just let me know. I'm sure a lot of people would fall in line with that idea as well. That's an amazing amount of money. And I'm glad you're you've shared some of those things to stop people from spending if they don't need to.

Esther 1:11:04
Well, I spent years doing research and trial and error so I'm happy to be a shortcut for people and share what I've experienced. Yeah,

Scott Benner 1:11:13
yeah. Listen, go find her on Instagram if you need not, don't go on tik tok. Apparently, that's the place where? I don't know they're stealing all your something or other. I'm not 100% sure. But the article was very interesting. Yeah, cool. Listen, thank you for doing this. I really appreciate it.

Esther 1:11:28
You're so welcome. Thank you for having me on. I was looking forward to it for like eight months.

Scott Benner 1:11:34
Sorry about that. Mark. Did you did you do you have a good time? How'd we do?

Esther 1:11:38
Oh, I had a fantastic time. Cool. I could probably could never get bored of talking to you. I love your sense of humor. And I love the information you put out there for people.

Scott Benner 1:11:46
I really appreciate that. Thank your people for introducing me to good barbecue. I really do think that it really changed my life honestly, like I I smoked a pork butt the other day. That is there not words I thought I'd ever say out loud. Had I not gone to Kansas City to speak at that event. I never would have had that thought in my life. So

Esther 1:12:04
well. I hope to see you come back.

Scott Benner 1:12:06
I would love that. I had a great time. By the way. Interesting little city like it's if you come in from the east coast, and you've been in a big city before it's a very feels like a tiny place. But it's this. It's this neat feeling. Yeah, like you know,

Esther 1:12:20
I moved here from Yorktown, Virginia. It was complete culture shock.

Scott Benner 1:12:25
Yeah. But it's it was a lovely like a little a great place to walk around and enjoy. While I had that free time in the first day and I liked it a lot. I really did. I thought it was cool. And the airport was I've never stood in a security line so short my entire life at an airport. It was where did you come in on a little It was like a little roundy is like a semi circle. Am I making sense when I say that? Yeah, I

Esther 1:12:49
Kansas City International.

Scott Benner 1:12:51
Oh my god, I got right. So I asked people, you know, what time do I need to get back in the morning to the airport to fly out here. I don't want to be late, you know, and I'm flying out of here. I want to get to the airport somewhere about 90 minutes to two hours ahead of time. And so I'm asking what time to leave. And my flights I think at 9am flight. And someone says Well, we'll we could pick you up at the at the hotel at 815. And I was like, wait, no, like, Don't Don't do that. Like, are you sure. And they were so sure. And I didn't want to argue with anybody. So I argued a little bit and I got picked up at like 745 and eight o'clock I was at the airport. And at 809 I was through security and sitting at the gate and I thought oh my

Esther 1:13:35
god. It's amazing. And they're actually redoing the airport, I saw that they can make that process faster.

Scott Benner 1:13:43
I don't imagine they can. It was it was magical, honestly. Anyway, maybe one day we'll all fly again. And I'll come back. So Alright, I am going to I'm gonna go get some things done here and I appreciate your time very much. Thank you for taking the time to do this.

Esther 1:13:57
Thank you for having me. Have a great day. You too.

Scott Benner 1:14:02
Huge thanks to Esther for coming on and telling us about her life with Type One Diabetes and her experiences with her diabetes alert service dog. Thanks to two touched by type one on the pod and Dexcom for sponsoring this episode of the Juicebox Podcast. When you support the sponsors, you are supporting the show and helping to keep it free and plentiful. Check out dexcom@dexcom.com forward slash juicebox Omnipod of course is that my Omni pod.com forward slash juice box get yourself that free no obligation demo and touched by type one.org and Instagram and Facebook. As a matter of fact, I'm pretty sure Dexcom and Omnipod are on Instagram and Facebook too. But I just never seem to say that. I'll see you soon for the next episode of the Juicebox Podcast. Thank you so much for listening for sharing the show with others and for leaving your beautiful ratings and reviews wherever you listen. Subscribe in a podcast player. These well If you're listening online, really consider a podcast that they're free. And they're easy, and thank you. That was an awkward, stilted end to this conversation. I'm not gonna do anything about it. I'm just gonna leave it there. This would be an example of a smooth ending. If you're enjoying the show, please tell a friend. Thanks so much for listening. I'll see you soon. See how much better that was. Didn't get all choppy and weird. Anyway, that's that I'm out of here.


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