#1381 There’s No Such Thing as Free
Kathryn works at Integrated Diabetes Services as an exercise physiologist and diabetes care specialist.
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Scott Benner 0:00
Here we are back together again, friends for another episode of The Juicebox podcast.
Catherine is an exercise physiologist and a diabetes care specialist. She works with Jenny. She also has type one diabetes. She was diagnosed when she was 12. We're going to talk all about her life. Get some pretty deep details about some stuff that happened to her when she was younger, and what else here? Oh, she loops, and she's delightful. 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. Don't forget, if you're a US resident who has type one or is the caregiver of someone with type one, visit T 1d exchange.org/juicebox right now and complete that survey. It will take you 10 minutes to complete the survey, and that effort alone will help to move type one diabetes research forward. It will cost you nothing to help to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code Juicebox at checkout. That's Juicebox at checkout to save 40% at cozy earth.com if you're looking for community around type one diabetes. Check out the Juicebox podcast. Private Facebook group Juicebox podcast type one diabetes. This episode of The Juicebox podcast is sponsored by Omnipod five, and you can learn more right now at my special link, omnipod.com/juicebox you the episode you're about to enjoy was brought to you by Dexcom, the Dexcom g7 the same CGM that my daughter wears. You can learn more and get started today at my link, dexcom.com/juice, box. I start every day with a delicious drink of Ag, one, you could as well drink ag one.com/juicebox
Catherine Alvarez 2:05
Hello. I'm Catherine Alvarez, and I am an exercise physiologist and Diabetes Care and Education Specialist, and I also personally live with type one diabetes. I was diagnosed at 12 years old, and I utilize DIY loop for my personal management right now. But of course, I try everything out. So just recently on trio and wearing all the things nice you are. How old now I am 2727
Scott Benner 2:33
so 15 years with diabetes? You got it? Yep. Diagnosed 12. Any other people to type one in your life for your family? Yeah.
Catherine Alvarez 2:40
So my mom also has diabetes, and it's a crazy thing, you know, you would think like she would be really involved. It would be kind of a story where we enjoyed memories, or, you know, like helped each other through diabetes. Unfortunately, she just kind of ignores her personal diabetes diagnosis. She likes to pretend as much as she can that it's not there. There's no
Scott Benner 3:09
camaraderie between you because you handle things so differently, or because she doesn't talk about it at all,
Catherine Alvarez 3:15
right? She, I mean, she really doesn't talk about it, and we never had that shooting of in relation to living life with diabetes as I was growing up. How old
Scott Benner 3:25
was she when she was diagnosed?
Catherine Alvarez 3:26
She was like, 42 Wait, did
Scott Benner 3:30
you get it first?
Catherine Alvarez 3:31
No, she did. She was diagnosed during pregnancy, actually, with you, my brother, with
Scott Benner 3:37
your brother. Okay, so she was gestational or just and then type one or just type one diagnosis during the pregnancy.
Catherine Alvarez 3:43
Well, they thought it was gestational and then they realized post pregnancy that was actually a type one diagnosis, okay, and he
Scott Benner 3:53
your brother is older than you, yes, okay, so she's got diabetes for a few years before you were diagnosed. Yep, okay, she's 42 when she's diagnosed, pregnant, but you weren't born.
Catherine Alvarez 4:07
How much later? 18 months later, I
Scott Benner 4:09
see that was the part that threw me off. You didn't say, what do they call that? Irish twins? Yeah, no, not twins. No, no, you've never heard Irish. You're so young so far, for people who know, like, who don't know, Catherine held up a cable that had an audio plug on the end of it for headphones. And she's like, I don't recognize this connector. That's how she because it was like, like a round plug, like everybody listening would remember sticking in the top of their Walkman or their iPod or something like that. Anyway, so Irish twins is a, like, a euphemism for, you know, a Catholic person who has babies back to back. Oh, okay,
Unknown Speaker 4:47
never heard that. No. Super
Catherine Alvarez 4:48
interesting. I'm Catholic, so who knew? Yeah,
Scott Benner 4:50
I know, but now, now you do. Yeah, I think it's pejorative, in case you're wondering. But I think it's colloquial enough that we can get away with saying it. She had you right after. And then 12 years later, when she's 54 ish, you're diagnosed, yep, okay, all right. Is there any other autoimmune in the family?
Catherine Alvarez 5:09
There's quite a bit. Okay, yeah, all the autoimmunity in the family. What
Scott Benner 5:16
else do you have? Personally,
Catherine Alvarez 5:19
I don't have any other autoimmune diseases. I potentially, like, I had a test done that potentially rheumatoid arthritis, but at this point, I'm not doing anything to treat it. You
Scott Benner 5:31
had creaky wrists and knees and stuff like that. I have a very crooked
Catherine Alvarez 5:35
elbow, like, it looks like my arm is broken. It's kind of weird, like, a lump on your elbow. No, like, it's, it's literally not straight. Like, if I put out my arm as I'm trying to straighten it, it goes, like, off into a curve. And they
Scott Benner 5:50
think that might be Ra, yeah, interesting. But no pain. Oh,
Catherine Alvarez 5:54
yeah, lots of pain. Oh,
Scott Benner 5:55
you're like, oh, no, wait, did I? I didn't mean to say that. No, there's tons of pain where, like, all your joints, or certain ones?
Catherine Alvarez 6:03
No, it's all. It's just in that elbow. Just
Scott Benner 6:06
in that elbow. Yep, interesting. That sucks. Do they do anything for it? They shoot a cortisol. Nothing. I got cortisone
Catherine Alvarez 6:13
once, and I just it wasn't worth it. That shot is painful. Blood Sugar stuff,
Scott Benner 6:20
yeah, they say the juice isn't worth the squeeze. Have you ever heard that one?
Catherine Alvarez 6:24
I've never heard that, but I would agree with it. You and I are
Scott Benner 6:27
gonna have fun. I can tell Okay, what else like? You don't have to tell me the members. But like, what other like, are we looking at thyroid, celiac? What's going on?
Catherine Alvarez 6:35
Yep, yeah. So sorry, Hashimotos. And actually, nobody has celiac but my aunt. I have an aunt with rheumatoid arthritis
Scott Benner 6:46
and lupus, mostly on your mom's side or your dad's side.
Catherine Alvarez 6:50
Yeah, all on my mom's side, my dad's side is like the picture of health that you're just all live these long, healthy lives. Nothing wrong, nothing
Scott Benner 6:59
wrong with them? Yep. Let's try to understand a little bit what's happening. You're 12 and you're diagnosed, and you've lived your whole life with your mom. Would you say hiding it? Like not? Yeah, just don't see it.
Catherine Alvarez 7:13
Yeah, don't see it. She doesn't check her blood sugar. She does injections, but not, you know, to the point that she should be
Scott Benner 7:22
okay. Do you have any context now as an adult, what her care was like as far as outcomes?
Catherine Alvarez 7:27
Yeah, it was, I mean, it was horrible. She now is legally blind. Unfortunately, she's had a heart attack multiple strokes. Did
Scott Benner 7:36
you become a CD? C? Is that right? CD, CES, why did they change it?
Catherine Alvarez 7:41
Yeah, yeah.
Scott Benner 7:43
All the letters, did you become that to help yourself or to help other people because you couldn't help your mom? Have you talked to a therapist? You know why you did this? Yet
Catherine Alvarez 7:51
for other people? So my mom, I when I was actually, when I was diagnosed, I told her, this is a good thing, like, I'm going to be able to help you, because I'm going to learn about this and you're going to start to do better. And then I did just kind of figure it out. Since I was 12, I always did all my own management. Nobody ever helped me growing up and then why I became a CDC, yes, was actually because of my boss. He hates when I say this, but it's the truth. I read, think like a pancreas in undergrad and and just answered so many questions that I always had, and I was like, you know, everyone needs to know this information. Nobody ever told me this stuff like I've had all these questions. Couldn't find the answer until I read the book. So that's when I decided I want to be just like him and meet with as many people as I can to help educate them and provide these answers to why things are the way they are?
Scott Benner 8:50
So you in college read Gary's book, yep, and then became a CDE back then, well, it
Catherine Alvarez 8:59
was CDEs. Remember
Scott Benner 9:01
you just did this.
Catherine Alvarez 9:03
I mean, it was, what, like, three or four years ago. Oh,
Scott Benner 9:06
so you so when did you take the like, when did you become a CDC, yes, two years ago. Okay, so, did you work for Gary prior to that?
Catherine Alvarez 9:14
Yep, yeah, I got my hours and everything working with Gary. Oh, that's
Scott Benner 9:18
awesome. No kidding, when you told your mom, 12 year old, you Mommy, I'm gonna figure this all out, and we're both gonna be okay, uh huh. And then you figured it out, she is like, never mind.
Catherine Alvarez 9:33
Well, she, she's come a long way. I mean, she finally wears a CGM, which is huge, and she'll talk to me about, you know, like, some blood sugar stuff, why things happen the way they do. But
Scott Benner 9:45
you haven't put her on a on loop, for example, no,
Catherine Alvarez 9:49
not on loop. She, you know, with, with the vision. And so I live in Florida, she's in Pennsylvania, and my dad has to, like, change your CGMS. And. And stuff. It just would be dangerous for her to be on a pump because she wouldn't change it out.
Scott Benner 10:04
So do you have any hindsight on why she ignored everything so much? I guess it's
Catherine Alvarez 10:09
kind of her personality. You know, she did the same with kind of other health related things. I think pretending it's not there is her coping mechanism.
Scott Benner 10:18
Did she understand the ramifications of ignoring it, or did she just think it wasn't going to happen to her? Do you have any idea what her expectation was when she wasn't paying attention to it? My daughter is 20 years old. I can't even believe it. She was diagnosed with type one diabetes when she was two, and she put her first insulin pump on when she was four. That insulin pump was an Omnipod, and it's been an Omnipod every day since then. That's 16 straight years of wearing Omnipod. It's been a friend to us, and I believe it could be a friend to you. Omnipod.com/juicebox whether you get the Omnipod dash or the automation that's available with the Omnipod five, you are going to enjoy tubeless insulin pumping. You're going to be able to jump into a shower or a pool or a bathtub without taking off your pump. That's right, you will not have to disconnect to bathe with an Omnipod. You also won't have to disconnect to play a sport or to do anything where a regular tube pump has to come off. Arden has been wearing an Omnipod for 16 years. She knows other people that wear different pumps, and she has never once asked the question, should I be trying a different pump? Never once omnipod.com/juicebox, get a pump that you'll be happy with forever? Yeah,
Catherine Alvarez 11:37
I think, I think she was so scared of it happening that it put her in a point of not even being able to deal with it. If that makes sense. Like, I know that, like, rationally it doesn't, but you know, kind of going through it, I think she just, like, didn't want it to happen so bad that she made it happen.
Scott Benner 11:55
I'm just not going to look. And then there, if I don't look in the closet, the guy with the AX won't jump out. Exactly, feeling. Okay, all right, exercise physiology, that's what you got out of college, right? Yep. Okay, then you go find Gary. Sounds like you lived in Pennsylvania for a while. Gary's in Pennsylvania. You go find Gary. You get a job. What are you doing for him? At that point,
Catherine Alvarez 12:15
I was so as a little intern, I was mostly running the social media. And then I was also helping get people scheduled and sitting in on a lot of appointments.
Scott Benner 12:25
Okay, so through sitting in on the appointments, you gather your hours that way. Yes.
Catherine Alvarez 12:30
And then I also began, so I had to also teach people in getting those hours as well. So I did like exercise programming. We did a class at a local hospital, so I was able to actually help teach that class.
Scott Benner 12:46
Okay, so then you gather enough hours to take the test. Is that how it works? Yep, you think the podcast counts as hours. It doesn't. And I've never looked into it, but I'm assuming it doesn't. I don't know there's
Catherine Alvarez 13:01
this, like, unique pathway. So, like, I think you can, like, run your own business, and, like, as long as a diabetes education, I don't know if you can make your argument. I feel like anything's possible, interesting.
Scott Benner 13:11
I don't want to be a CDE because they changed the CD CES, which did no one say it out loud before they changed it. It's hard to say, right? Your brain gets lost in it. You're like, CD C. Wait what
Catherine Alvarez 13:25
nobody is that. It's not a CDC asking, CDC, yes, that's just
Scott Benner 13:29
no. Also, it doesn't flow like there's no rhythmic loveliness to it. Do you see I'm saying, Yeah, CDE, bang, bang, bang, lovely. Yes, like that. Yeah, everyone knew what you meant. No,
Catherine Alvarez 13:38
it's okay. Thanks. Yeah. No, just, I just say I'm a diabetes educator.
Scott Benner 13:42
Yeah, you know, they change it back, if they could, I bet, I bet there's four people in a room. There's like, what do we do there?
Catherine Alvarez 13:47
Yeah, I feel like JDRF is probably feeling the same way. Oh, you
Scott Benner 13:52
think we're breakthrough? T, 1d,
Catherine Alvarez 13:54
yeah, great. This just not taken. Everyone's still saying JDRF just
Scott Benner 14:00
floats. It floats off the tongue. Hard to change the name. It's, it's, you know, you can't even change like the color in Facebook. People have a
Catherine Alvarez 14:07
stroke. So exactly, people don't like that change. I
Scott Benner 14:10
don't mean to go back to your mom for a second, yeah, do it. But as she's having poor outcomes, and you're diagnosed, and she's not interested in helping you. Do you have, like, a, like, a personal separation from her that happened over that? Like, did your relationship go differently? No,
Catherine Alvarez 14:30
it was more like, I wanted to take it all on. I didn't want anyone else to be involved. So she, like, I remember the first week, like she was doing my shots for me. Very faintly remember that, but I remember the way she did it was painful. And then our good friend was a dentist, and he did it, and he just kind of jabbed it into me, and I realized, like, all right, well, The Way She Does It is just slow and painful and traumatizing. So I. I mean, I think that if she had to, she would have done it for me. I think I just realized very quickly that I would be happier if I did it myself. Was
Scott Benner 15:09
it I'd be happier if I if I was in control? Or was it like she doesn't seem to know what she's doing?
Catherine Alvarez 15:16
I don't know. I guess it was like a combination, like the way she did it was painful, more painful than what I realized it had to be. And also, you know, at 12, you don't want to stand out. You're trying to do everything you can to fit in. Yeah, if I had control over it, I can. It's a lot easier for me to be
Scott Benner 15:33
able to you can manipulate how people see you, if you're in control of everything exactly, yeah. So it wasn't you cognitively saying, like, I don't think the lady knows what she's doing right now.
Unknown Speaker 15:43
Yeah, right.
Scott Benner 15:44
What age do you realize that that's true? Probably 12. Okay, same year. Like, you would handle a meal differently than she would. She'd have problems afterwards. You wouldn't like that kind of stuff, right?
Catherine Alvarez 15:58
And then, you know, I wasn't perfect either, but like, I was this crazy 12 year old. I had my little car book. I looked everything up, I wrote everything down, and, you know, figured out how to make things work. Plus,
Scott Benner 16:10
you're right in that age when kids start thinking, like, I think dummy and what's your name over there? Don't know what's going on, like that, which is the thing that happens, wait, do you have a give any kids? Not yet? Well, you get one one day, and then wait like, 1015, years, and then it'll look at you one day and go, I think you're an idiot. Like, Oh, okay.
Catherine Alvarez 16:27
None of us really know what that we're doing. Then
Scott Benner 16:31
you have to make that decision. By the way, do you double down on pretending your way through life? Or do you just look and go, Look kid? I gotta be honest with you, there are days I'm stunned. We have a roof over our heads. I don't not know what's going on. I'm trying my hardest. You're working with Gary. You're doing your thing. You get your hours, then you have to go take a test, right? Like an actual Yep, yeah. How many times you have to take it to win? Just once, look at you. Show off, yeah. All right. And so now you become a newly minted diabetes educator, and you start working for Gary in like you cut, you do what Jenny does, right? Yep, yeah. So you see patients, yeah,
Catherine Alvarez 17:09
virtually, yeah. And Jenny and Gary were really they mentored me through it, her and Alicia. In addition, I sat in spent so much time with them, just learning talk about
Scott Benner 17:20
that a little bit like when you sit in a room, just use Jenny as an example, because people know her, although I know a lot of great things about Alicia, but like, there's Jenny. She's got away, she talks to people. What is it you learn? Like, is it how she asks questions to get to what's going on? Is it like, what do you take from it that you think, okay, that's the piece of Jenny that I'm going to move into who I am. Well,
Catherine Alvarez 17:41
Jenny just has an incredible way of connecting with people, and I think she's very empathetic and just really good at forming relationships with people. So I think just from Jenny, one of the biggest things that I took away was I always want people to feel that they're incredibly cared for, because that's definitely what Jenny gives like she makes everyone feel like they are important, and she's there for them, and she wants to see them succeed, as
Scott Benner 18:16
much as I think that comes across when I'm recording with her. I've had private conversations with her, and her desire to be helpful to the to people is so much stronger and deeper than you would even imagine, right? Yeah, she's really driven incredible to be valuable to other people with diabetes, yeah, yeah.
Catherine Alvarez 18:36
She's a very special person.
Scott Benner 18:38
I know everyone's different, but when you meet a new person, how long, just general, these are generally, you know, generalized numbers. But how long does it take you before you go, Oh, I know what's going on here. Do people fit into boxes? Like, like, how do you virtually help somebody be you're not with them, like you. And I talked before we started, and I said, you know, I've been talking to somebody online, and the person's just lost, and I'm basically right now just asking them a lot of questions. I'm half trying to see if I can figure out what's going on from the questions, and I'm half hoping that the questions make them think of something that they haven't considered yet. But at what point do you think, Oh, I know which way to take this or I know how to attack this problem, and how often does that actually even work? Dexcom g7 offers an easier way to manage diabetes without finger sticks. It is a simple CGM system that delivers real time glucose numbers to your smartphone, your smart watch, and it effortlessly allows you to see your glucose levels and where they're headed. My daughter is wearing a Dexcom g7 right now, and I can't recommend it enough, whether you have commercial insurance, Medicare coverage or no CGM coverage at all, Dexcom can help you. Go to my link, dexcom.com/juicebox, and look for that button that says, Get a Free. Benefits. Check that'll get you going with Dexcom. When you're there, check out the Dexcom clarity app or the follow. Did you know that people can follow your Dexcom? Up to 10 people can follow you. Dexcom.com/juicebox, links in the show notes. Links at Juicebox podcast.com and when you use my link to learn about Dexcom. You're supporting the podcast before. Ag one, I didn't have a comprehensive idea about how to support my gut health, but now that I drink ag one, I do my goals for 2025 are simple, stay on this path drink ag one, every morning, and keep things moving, and I mean that figuratively and literally in the right direction. So this year, try ag one for yourself. It's the perfect time to start a new healthy habit, and that's why I've been partnering with ag one for so long. Ag one is offering new subscribers a free $76 What is this? Offering new subscribers a free $76 gift. When you sign up, get out of here. You're going to get a welcome kit, a bottle of d3, k2, and five free travel packs in your first box. So make sure to check out drink AG, one.com/juicebox For more information, check it out.
Catherine Alvarez 21:19
Well, we before we even meet with people, we have them fill out a very intensive assessment packet. So oftentimes, just from that alone, you can identify some of the important points for education, just from all the questions that are asked in there. You know, we're asking things like for their data so we can look at all of their patterns and blood sugars and insulin delivery. We're asking them about like the glycemic index, and, you know, asking us, asking them to explain these different things to us to see, you know what their starting point knowledge basis is. That's really helpful. I would say we really just start with, like, the educational points in conversation. You just eventually are identifying these things that are coming up, and we have their blood work and everything as well. So
Scott Benner 22:14
yeah, so there's other outliers, like untreated thyroid or something like that. You can see that as well, right? Okay. And so then how much of the conversation that you have with them is about continuing to mine information, and how much of it is just, you like, tearing the whole thing down, starting over at basics and building them back up again?
Catherine Alvarez 22:36
Oh, yeah. It really depends from, you know, the person that everyone is kind of coming in at a different point. So some people, and they come in and they they know their stuff, like they have done so much self education, you know, just kind of clarifying pieces, and then really teaching some of them, just like that. How do you analyze your data and know what adjustments need to be made, or helping them pick, like, what system might work better for them based on their goals, what other people they need? Like, you got to cover every educational piece with them, because they're kind of starting from up spot of
Scott Benner 23:19
and it doesn't matter how long they've had diabetes, right? You can see a person who's like, I'm lost. I don't know what I'm doing. I've only been doing this for six months a year, but you could meet somebody who's been doing it for 10 or 15 years, and they could be in the same position, yeah,
Catherine Alvarez 23:32
exactly. Because a lot of times what happens is these people that have been living with it for so stinking long, I mean, they get a little burnt out, and they they don't follow up with the latest stuff anymore, where these people that were just diagnosed, especially if they have a little one like, they just pour themselves into everything that they can find. Yeah,
Scott Benner 23:50
yeah, no, I know there's this thing like that. I'm always trying to figure out, like, at what point that a person's had type one for a really long time, do they just end up going, like, I don't know, like, I can't impact this. It is what it is. I'm just gonna live as long as I can. Like, you know what I mean? Like, and and what happened to them that got them so off kilter? Like, Is it as simple as someone didn't explain basics to them, and therefore they're having all these responses to insulin and food that they can't make sense of and and then they just get to that point where they're like, Oh, I guess this is what this is. Or is it a burnout thing, where you're just like, I can't put any more effort into this. Or does it, do you get burned out because you're putting so much effort in, but you're putting it in the wrong places because you don't know any better, and that's what causes burnout. Does that all make sense?
Catherine Alvarez 24:42
Yeah, yeah, absolutely. And I think everyone's reason for getting to the point of burnout is different. I think some people are just doing too much and having like, their life revolves around diabetes. Some people, you know, just the fact that they have to do so many extra things. Every single day just gets to a point of it just not feeling fair, and they don't want to do it anymore. So I definitely think it comes from a different from different places.
Scott Benner 25:10
I always find it the saddest when a doctor misreads that. You know, when someone's is putting in a bunch of effort, but they're learning so quickly and having such great, you know, these great outcomes, and they're really putting all the pieces together. And just as it starts to make sense to them, by the way, just as they get to the point where I think they're actually not going to have to put as much effort into a day to day, because they really kind of got it down a little bit, a doctor will sometimes step in and say, oh, you know, you're going to, you're going to make yourself crazy. You got to stop. But I want to see your a 1c go up next time. Yeah, that really beats people up when that happens too.
Catherine Alvarez 25:45
Yeah, it really does. I mean, it almost makes some people, like, some distrust, I guess in the end, though, because they feel like, you know, they're doing so well, and the end is like, well, now you're doing too good. Yeah. I mean, I've, I've said similar things before, if you're not sleeping because you're just panicking about your kid all the time, and you're dosing them every five minutes because you're scared when their blood sugar gets to 120 that they're going to die. I mean, those are unrealistic. It's
Scott Benner 26:14
a different problem. Yeah, yeah.
Catherine Alvarez 26:17
So there is times where I mean that commentary is true. They are over obsessing over diabetes. And, I mean, it is true that that will likely lead to burnout or a heart attack for that parent from not sleeping. Yeah, they're just in a constant state of stress. Yeah,
Scott Benner 26:35
I'm always hopeful that they can transcend that moment and that, you know, after some time of, you know, like you said, Bolus, single 120 blood sugar, you know, like that, they can start saying, oh, you know, what, if I would have done this in the past, then we wouldn't have got to this 120 or like, same thing with a low like, you know, if you're always stopping lows, you can start looking back at your meal and saying, you know, maybe if I would have used the insulin differently at the meal, we wouldn't be low here. But I do take your point, and I do believe, from what I've seen, is that as many people as can transcend that moment and move forward, making better decisions earlier, stopping problems from happening more frequently. There's also the same number of people probably who get stuck in that moment, aren't and are treating that that number forever and ever and ever, until, like you said, they can't sleep anymore and they go crazy.
Catherine Alvarez 27:24
Yeah, well, and, I mean, in some ways, the technology is is almost hurtful, because it's so in our face. So, like, we almost feel like we should always be responding. We see it, and so naturally we want to do something. But so
Scott Benner 27:39
interesting how the different personalities react differently. Like, there's some people who like, Oh, thank God, this thing beeped. I can do something about it. You know, a different person would be like, This thing keeps beeping. I hate this, and I don't want this to happen anymore. There's so many different variables about who you might be in this scenario. Like, that's why I think seeing a person one on one should be helpful, if you can get somebody to actually focus on you. So why are you able to Why is Jenny? Why is like when somebody basically pays a concierge person to help them? What's the difference between that and a doctor's appointment? Because people want to say it's time, and I know the time is limited with a doctor, but do you not think it's more than that? I think it's more than just the time doctors have to give.
Catherine Alvarez 28:25
I think a big difference is just the compassion of it. You know, all of us personally, we live it, we experience it, and we want everyone to thrive like we don't want anyone to be held back. We want to see people happy and healthy just that point of living with it. I think we're so much more motivated to stay up to date on all the latest technology and
Scott Benner 28:55
and to ask bigger picture questions too, right? I mean, I'm in a weird position, whereas I don't normally speak to a person like face to face, you said something really kind before we started recording about like, you know, you talk to a lot of people who listen to the podcast and they like the podcast. I don't want to put words in your mouth, but it helps them. Is that about, right? Yeah. Okay. So how do you help people without knowing any of their details. You know, that's why I think over and over again, I just, I stick to the basics. I think that that has the best chance of helping the most people. Like, I don't think it's going to help everybody. I don't think everybody's going to have the same response. You know, for every person who's like, oh my god, this saved my life. I'm sure there's somebody who's like, I listen to what you said, and I gotta be honest with you, my life's no different. I know that that's the case, but it's all I have, right? Like, it's, it's, it's the best that I can do. I just said, look like here are the things that I figured out on my own that seemed to help my daughter, and I hope they help you too. Or maybe you can cherry pick. On it and take some of the stuff that helps or doesn't help. You know, it isn't until, like, I meet Jenny, and we start talking to each other. Like, my first thought about Jenny when she came on the podcast the first time as well, she and I think about diabetes so similarly, like, it's, really is, like, it's, it's awesome. Like, you know, like, it's crazy. How, like, like, lock step we are like when somebody says something, our responses are so similar. I realized later, because I don't really know at that point, this is going to sound crazy to people, but I've never read Gary's book, and I think I've only met Gary one time, and it was in passing where someone was like, Scott, that's Gary. He wrote, think like a pancreas. And I go, Hey, how are you? And someone goes, Scott writes a blog. And then I think we walked past each other. I've spoken to him on the phone once, and that was only more recently, like in the last six, six months, and that was maybe for 15 minutes, and had nothing to do with diabetes. Yeah. So I'd never read his book. I don't know any of the like conclusions he's come to, or the things he talks about. But then when I meet Jenny, and I realize Jenny works for him, she's probably working off of, like, some ideas that he, at the very least, like that. He's, you know, talked about, and I thought it's crazy, that book and this podcast are incredibly similar to each other. And then I meet one time I speak with Dr ponder, and he starts talking about how he thinks about diabetes, and I think, but that's how I think about it. And then you realize, like the people listen to Dr ponder have a lot of success, and the people that read Gary's book, Gary's book seem to have a lot of success, and the people listen to the podcast seem to have a lot of success, overwhelmingly, not everybody. And you go, oh, there's got to be building blocks basics within this that lead a lot of people to an understanding that helps them continue on and to have better outcomes. And it's interesting, isn't it, that three people saw it in their lives differently, like a doctor, and you know, I mean, who has type one, Gary, who has type one, and myself, who, like, you know, just raised somebody with him, is just looking at it from from an outsider's perspective. But in the end, we all came up with similar, like, touch points, right? It's really interesting. You know what I mean? Anyway, I don't know why I said all that, other than to say, like, I think, I mean, it's
Catherine Alvarez 32:09
like, the fundamentals. You just, you know, that's you find these fundamental things and, yeah, kind of take off with it.
Scott Benner 32:15
Thank you. That's my point. My point is that those fundamentals are so important to learn and then to try to adapt them and apply them is, is the part that I can't be helpful with. The book's not going to help you with, like, none of that's going to help you. Like, you learn this part, and then you say, Okay, how does that apply to what I just ate, how I just ran around, how I live my life, how blood sugars act in me, like all that other stuff. It's not like they're not hard and fast. Rules that if everybody just does them, it's just all gonna work out great every time it's it's not that. How long have you been doing this now, where you're actually sitting down one on one with a person trying to help them figure out the problems they're having? How long you've been doing that? A few
Catherine Alvarez 32:55
years. Yeah, I guess I'm, uh, like five years now, okay, it's a
Scott Benner 32:58
fairly long time. If I asked you, what are the fundamentals? What are they from your perspective? Well,
Catherine Alvarez 33:05
a big one is gonna I mean, it really depends on what system they're using, in a way too. But basal testing is huge, knowing what we need just kind of in a steady state, from a background, insulin standpoint, and how to do that type of testing, how to test your insulin to carb ratio, what factors in lifestyle are important to note and because they're going to have an impact. So just kind of like, you know, learning about stress impact and sick day management, growth hormone, those kinds of things that you see a huge impact on blood sugar with
Scott Benner 33:43
when you see people struggle, is there a is there a generalization to make? Like if I said, do you finish this sentence, most people struggle with what pops into your head?
Catherine Alvarez 33:54
Definitely different, but most people struggle, I would really depends on the population. I think most parents struggle with the unpredictableness of their child. And really that growth hormone is a big one, where adults, they struggle with food. Food is a huge thing. Yeah,
Scott Benner 34:14
consistency with Bolus,
Catherine Alvarez 34:18
yeah, that timing of the doughs, and then, I mean, protein, fat really gets people. That's a big one. Yeah?
Scott Benner 34:25
No, I know. Until we started talking about that on the podcast, I didn't even realize how many people were like, wait, what?
Catherine Alvarez 34:31
Right? Yeah,
Scott Benner 34:34
carb, carb, yeah. They're just counting carbs, right? And they're and they're not really thinking about the I mean, for me, making the podcast over the years, like, the impact that timing of digestion has on diabetes. I mean, now seems like an obvious thing to me, but back then, like, when I first started, I didn't think about it, and it wasn't. It's interesting how it all builds, like, right? Like, until someone said. Said, you know, fat slows down digestion. I was like, wait. And then the carbs are in there impacting longer, right? And they're like, Yeah. And I'm like, oh, that's what happens with pizza, yeah. And then you start applying it to other things in your life. You're like, Oh, my God. And then it just all starts to come together. You're like, oh, that's what happened when I had a cheeseburger and exactly, ice cream. Like, it really wasn't until, like, one time, I think when Jenny, like, said to me, like, you know, pizza isn't pizza. It's bread and sauce and cheese and, like, it's four things, you know, and maybe there's meat on it too, like, there's a protein to hit, like, and what about more cheese or less cheese? And, like, no one looks at their pizza and says, Oh, that's a thick cheese. My spike is gonna come later. You know what I mean? Or like, this is a hand tossed Neapolitan pizza that just has a couple of pieces of mozzarella put over it. Like, this isn't gonna hit me as hard and it's but now I think about all of that when I look at food, you know, again, like when people are so stuck counting carbs, like cheese, in your mind is like, free, like, Ooh, you know? And then the extent that you get normally, when you learn more is somebody goes, cheese isn't free, it's not free. But then it's not followed up with more conversation. It's just, you know, and you're like, Well, what do you mean? I flip the package over, it says zero. No such thing is free, right? Everything's impacting something somewhere, yep. Yeah. Okay, tell people a little bit about like you do something. I don't know if you call it part time or you do it like, in addition to your job, but tell people the other thing you do, yeah.
Catherine Alvarez 36:34
And I think that this has really helped me clinically, because I've experienced, I can't say what it's like to be a parent of a person with type one diabetes, but much more for San experience. So what I do is I also help a family where their little guy has type one diabetes. I moved from Pennsylvania to Florida two years ago, and he's five now, and I've traveled all over the world with them, and I spend most week days about two hours with them, but I also have sleepovers sometimes Tim as well. So I've just kind of learned for a very little one how different everything is, trying to be a pancreas for an ever changing little human being that you never know what they're gonna do next, and just the uniqueness and the challenges that comes with
Scott Benner 37:32
that. And so you think that just being around him, right? Yeah, being around this little boy, and seeing all the different impacts. Like, do you feel yourself leveling up constantly with diabetes? Yeah,
Catherine Alvarez 37:45
I think I mean, just professionally in this experience, it made a huge difference. I meet with most of the super little ones now that come to Integrated Diabetes services, because I have that first hand experience, yeah,
Scott Benner 38:02
it's a different world, isn't it? When, like, when you're trying to measure quarters of units in syringes, and, you know, they they eat, then they jump up and run around all of a sudden, and you're
Catherine Alvarez 38:13
like, I wasn't expecting that activity. Yeah, I didn't
Scott Benner 38:17
know that was gonna happen. And the growth
Catherine Alvarez 38:19
hormone is wild. I mean, like, just what they need sometimes, at when they first fall asleep, is just nuts,
Scott Benner 38:30
growth, menstruation, pregnancy. Those are the three that are just like, boom. I would maybe add to the end of that list, like the unexpected nature of how some anaerobic exercise impacts people,
Catherine Alvarez 38:44
right? Yeah, exactly. And I mean, just competitive sports like the adrenaline, that adrenaline, yeah, that's gonna that's tough to navigate, especially like when you have these different types of activity, you need a different strategy for practice versus game day. And, yeah,
Scott Benner 38:59
yeah, no, that's why I like the story that I ended up eventually telling on the podcast that I think has been the most valuable for people, because I hear them talk about it over and over again, is the idea of bolusing for a juice box if you think there's going to be adrenaline. And so, you know, I don't know if you've heard me say this, please stop me, but I have, oh, go for it. Okay, so Arden is, like, I don't know, young at the time, and she's playing this, like, in this little Sunday basketball league. And she'll show up, you know, it's always nine in the morning. These these games, they drag your ass out of bed. Like, you know what I mean? Like, you go over to the local school, to the gymnasium, bunch of little girls play this other bunch of little girls, and Arden has had diabetes at that point for a while, but still, it's like six years. And the truth is, is we're using a pump and a CGM at that point, but it's an earlier version of CGM, so it's kind of okay, like, you're still, like, hoping that the Bluetooth signals bouncing around on the metal deck ceiling of the gym and makes it back. Of the receiver, like, like, that kind of stuff, which, by the way, used to actually work, like, you could be in a room with a metal ceiling, and the receiver would work farther away than it would be if you weren't in a room with them. Anyway. So we'd get to these games, and some days her blood sugar would jump, like, into the mid two hundreds. And then some days it wouldn't. And so one game it would the next week, it wouldn't back and forth. And we, I was like, what is happening? And my wife and I are sitting there talking, and all I'm saying is, like, I we can't let her blood sugar keep going up to 250 like, like, we can't do that. And, and my wife's like, but, but last week it didn't So, what do we do? And I just, like, blurted out, I'm gonna Bolus for a juice box right before the game. And she's like, what? And I said, Well, if this adrenaline, that seems to be what it is, adrenaline, right? Like something's hitting her. And we actually eventually figured out where the adrenaline would come from and not come from, which is kind of funny, but I was like, here's the insulin. If the adrenaline pops off, then the insulin will will cut off the adrenaline rise. Now, she would still need food after the game, like it was still too much, but at least it got in the way of the adrenaline right? Yeah,
Catherine Alvarez 41:09
that sensitivity eventually kicks in. Oh, yeah. And that's, that's the big thing, is trying to figure out, well, how much insulin do you need to combat adrenaline rise?
Scott Benner 41:18
Yeah, well, so I still don't know how much was right, but what I knew was, if the adrenaline didn't come, I'd basically just pre Bolus the juice box. So if I didn't see the spike at some point, five or 10 minutes in the game, I'd be like, here real quick drink this juice to combat the insulin that we put in, right? And then after that game, she wouldn't need as much food. She still needs some, but not as much as if it the insulin was in there to battle the adrenaline. Now listen, this is very Listen, this is very rudimentary, but it worked, and it got us through it,
Catherine Alvarez 41:45
yeah. So you found your way. And this is what, this is one of the things I learned from Think like a pancreas, and I still use it to this day as like the starting point. But of course, everyone's different, so you gotta adapt every starting point. We say, okay, so her blood sugar usually went to 250 so we're gonna give a correction, assuming that's where she's gonna go. But because you are physically active, you're still gonna be more sensitive to that insulin. So you would do 50% less of what you would typically need to correct a blood sugar of 250 for the starting point, and then kind of go from there. What
Scott Benner 42:21
we figured out was, is that when she got to the game, like, Arden, like, was really competitive, and she'd assess the girls on the other side. I don't even think she knew she was doing it, but if she thought the game was going to be hard and that they would put up a fight, then she'd get this spike. And if it look, I usually say, like, if it looked like there were like, five little marshmallows on the other side, she'd be like, Oh, we're gonna kill these girls. And she didn't. She never got really excited about no problem. Yeah, listen again. It's a rudimentary way to take care of it. We got through it, everything, etc. But telling the story allowed people to realize, like, oh, adrenaline does that, and insulin will combat adrenaline, except later the adrenaline disappears, the insulin is still there, and then you have a problem, but I can still workshop that problem and try to get through it. And then eventually, one day, I adapted the idea. When a person said to me, you know, it seems like I need more insulin, but I don't know how much more to give at this meal, because we're not huge carb counters. Like, more like, Hey, I think this meal takes about this much kind of vibe. People would say, like, all I agree. Like, it looks like I need more at this meal, but if I've counted the carbs correctly, but I still need more, how do I make the leap of giving myself more? Like, it seems really scary to people to do just another unit or something like that. And so I adapted the thing from the basketball. And I said, Why don't you Bolus for the food that you know you've counted, plus a juice box, and then if you're too much, you can use the juice box to combat it. And if it's not too much, well, now you know that this much insulin plus this led us to this outcome. Do I need more or
Catherine Alvarez 43:56
less, right? And that's a cute way, I mean. And people think like, yeah, a juice box. You're right, that's not, it's not so scary. Doesn't seem
Scott Benner 44:03
too scary, etc. And that thing, when I go out into the, you know, into the audience, and I say, hey, because I've done this recently, I was like, Look, you know, over these 10 years, I've said so many, like, colloquial things that people will like, parrot back to me. Can you make a list of them for me? Because I don't. I've lost track of all of them, you know. And one of them that came back overwhelmingly was Bolus for a juice box. If you don't know how much more insulin to try, as crazy it is, is the slow progression of that story over years led people to be able to be a little more aggressive at their meals to see if maybe a little more insulin would be valuable for them. Crazy, you know what? I mean, yeah. So I like it, yeah, it's awesome. Like, the same thing with like, when people are like, I don't know how to pre Bolus for a little kid, they never eat. The same thing, right? You never know what they're gonna eat. And I just said one day, I was like, Well, is there a minimum amount that, you know, the lead, it just pre. Lost that much, and then, as you see it, go in, do the rest? You know, if more goes in, and that ended up being helpful for people, because the minute they see a pre Bolus actually work at a meal, it opens up a lot of other ideas for them,
Catherine Alvarez 45:13
right? And even a percentage of a pre Bolus is going to make a huge difference, yeah, yeah.
Scott Benner 45:19
So anyway, it's like little things like that that come from conversations and like and so you're getting to see those things with this little boy, plus you have type one. You actually have a rich layering of perspectives, because you watched your mom, I don't want to say she didn't take it seriously, but she wasn't putting the effort in where it needed to be put right. And then you figured it out for yourself, and now you're getting to watch a little kid live with it like, how long do you think you're gonna be like a Zen master at all this?
Catherine Alvarez 45:46
You know, something else that's super crazy too, that we haven't even talked about is my aunt. She has type 3c so she had her whole pancreas was removed because she had pancreatic cancer. Okay, so I get that too.
Scott Benner 46:01
Your mom's sister, yes, interesting. That can't be coincidental, right? The pancreatic cancer and the diabetes.
Catherine Alvarez 46:08
Well, right? I'm always so in all of us, my mom, my aunt and myself, we have it's called the Bronco two gene, so it puts us at, like, really high risk for breast cancer, pancreatic cancer, ovarian cancer. So my aunt, of course, was very unlucky and wound up with all the cancer. Okay,
Scott Benner 46:29
so what's your mom's background? What's her family? Her
Catherine Alvarez 46:34
family? Well, actually, Mom, we got a DNA test and found out that we're asking Ushi Jew, so that's why, that's where that everybody
Scott Benner 46:41
is. Everybody gets, like a 1% I believe, yeah, not everybody, but a lot of people, well,
Catherine Alvarez 46:47
a little bit higher percent, which puts you at high risk for this bracket two gene, really,
Scott Benner 46:51
no kidding, that's what does it right there. But are you guys like Irish English?
Catherine Alvarez 46:55
Yeah, Irish and Norwegian.
Scott Benner 46:58
I sometimes talk about my friend Mike, who's passed. I don't know if I've ever, like, added this layer of detail about his his life, but he was diagnosed type one when we were in high school, and his mom eventually died of pancreatic cancer, so I don't know it. And they're Irish and, like, you know what I mean? Like, I don't know how many different times you got to hear people's stories where you're like, this seems like, I hear about this, like a pattern, yeah, a little bit of a pattern here somewhere interesting. Are your mom and your aunt similar in their personalities, or did your aunt No, so your aunt took over and did what you needed to do.
Catherine Alvarez 47:34
Yeah, my aunt, we're kind of, we have similar personalities. She definitely is, but it's tough because she has a whole extra layer, like, we don't even realize, like, I never really appreciated the small things that my pancreas does do
Scott Benner 47:47
digestive sometimes. Yes,
Catherine Alvarez 47:51
yeah, it's just her, her trying to eat. Is it's quite complicated. Yeah, listen,
Scott Benner 47:58
I'm not a doctor and I'm not a researcher, I'm not anything, but, like, I hear a lot of people's conversations, and I so often when I see people with type one, you know, they always, Oh, my stomach hurts, or after I eat, or something like that. And I was like, Why does no one ever tell you, Hey, your pancreas does more than just this. And right? You know, a lot of you seem to have trouble digesting food, and then they'll tell you immediately that the doctor will jump to, well, you have gastroparesis then. And what if, just, maybe, you just don't have enough digestive enzymes, and you could buy them over the counter, by the way, and they're not particularly expensive, and they work really well. Like, why is that not talked about? I assume it's not talked about because they don't know the doctors, right?
Catherine Alvarez 48:44
Yeah, I always wonder that that same thing, you know, kind of talking, why? Why don't they mention the alpha cells? Yeah, I think it's just that. I know we talked a little bit about their time constraint. Maybe that's it. But,
Scott Benner 48:57
yeah, but how many times does somebody have to tell you my stomach hurts and they have type one before you go there, maybe I should say this out loud. And the amount
Catherine Alvarez 49:05
of people that don't even get checked for celiac antibodies is just shocking, right?
Scott Benner 49:10
Yeah. Or how about how many people's TSH has rise, and the doctor's like, that's fine, we're not gonna do anything about
Catherine Alvarez 49:15
that. Oh, right, yeah, as long as it, you know, they they're not looking for huge bumps every time. And as long as it falls within the range they're they're not going to
Scott Benner 49:23
see it. I love when a person's like, my hair is falling out, I'm cold all the time, and I can't sleep and I'm exhausted. My TSH is four, and the doctor's like, it's not that. And I have type one diabetes, and my brother's got celiac, and my sister's got a bump on her elbow. We're riddled with autoimmune issues. Like, that's probably not that, though.
Catherine Alvarez 49:42
It's probably your diabetes, honestly, yeah,
Scott Benner 49:44
have you tried cutting out flour? My thyroid is not well, you know, like, or I'm making it, my body's not picking it up correctly. Like, help. Help me. I. Leads me to ask you, have you. Helped anybody yet who's been added had a GLP added. What have you seen with that? Yeah,
Catherine Alvarez 50:06
yeah, there's, you know, definitely has increased in popularity, especially with these people in the DIY community, and doing it with unannounced meals. I've used it myself as well, but I'm not now, because I love to share too much information, but I'm trying to conceive, so can't take it during that time, but it's it is truly incredible just helping with that meal time and the fact that we are lacking in it really replaces a lot of what we're lacking in. So can make a make a huge difference.
Scott Benner 50:36
Have you seen anybody use it and it just didn't change anything for them with their blood sugars. Well,
Catherine Alvarez 50:41
what's more common is it did help them, but it negatively impacted them in many other ways that it wasn't worth it. Okay?
Scott Benner 50:50
So someone's like, Listen, I have diarrhea now, but my blood sugar is better. I'm gonna choose not having diarrhea, something like that, right? Okay, yes, but you haven't seen anybody just taken and just flatly, has not impacted their blood sugar.
Catherine Alvarez 51:03
I mean, you see people where it doesn't impact them from a weight standpoint, but no, from a blood sugar standpoint, I have not seen that. I'm sure I will. You know, no,
Scott Benner 51:11
I'm just trying to decide, like, I'm not in charge of anything. But I'm trying to figure out, like, Why did a guy come on the podcast, who was, I think he was, I don't know, 58 right? And he had diabetes for like, six years. He was probably lot. It was probably a really slow onset. He was overweight. They put him on GLP, gip one, and he loses a bunch of weight. But more importantly, like is literally not taking any insulin now. And he has excursions at meals. They go up 180 or so, they come back. He's clearly going to need insulin at some point, but his beta cells, like, had functionality. He was using a lot of insulin, like, as much as would make you I mean, he was comfortable calling himself a type one. So was this doctor. He was using that much insulin, right? And now suddenly he's not using any. What did that GLP do to free those beta cells up to handle the load, more or less? Like, do you know what I mean? And like, is there a world where his beta cells just weren't far enough along so they were able to be helped, like, with a crutch? And is there going to be a world where somebody's beta cells are so wiped out that even if you add that crutch, you're not going to see a benefit like, that's what I'm wondering, right?
Catherine Alvarez 52:23
And I think that would be the case, because if you think about, just think about people in the honeymoon phase in general. I mean, there is times where people don't need to initiate insulin right away. You know, they can supplement in some vitamin D, and with physical activity, they get away with not having to take insulin,
Scott Benner 52:41
or I wonder how much of that is inflammation, because
Catherine Alvarez 52:44
exactly that's yeah,
Scott Benner 52:46
I go back to, like, back before the podcast, where there was this one researcher who was trying, I don't, I don't remember any of the details about this. But other than to say this, one researcher was saying out loud, I don't think the beta cells are dead. I think they're frozen. They're inflamed to the point where they can't function. And I was like, Oh, that's weird. And then that's like, kind of the last time you thought about it again, right? Like it was back around when people were talking about stem cells a lot, and now you listen to people talk about GLP medications. Like I was just listening to a DR Drucker, who's like, kind of one of the pioneers of GLP, and I was listening to, like, a two year old grand rounds he was doing at a hospital recently. He's just talking about how the inflammation impact from GLP is almost like instantaneous when you put it in, like, they can see it impact your your inflammation markers almost immediately after it's put in your body. And like, I'm like, all that, like, wait till we figure out all this. But still, when they talk about it, like the researchers, I don't mean people who are like, you know, coming along, trying to find other research and uses for it. I'm talking about the people who, like, pioneered this thing. They still say we don't actually know how it works. Like, we have no idea what the heck is going on, yeah, which is not uncommon in man made medication, but to hear them say, like, yeah, you lose weight. Like, we don't understand why, yeah,
Catherine Alvarez 54:06
well, and not everyone does, though there's also some research. There's like, a blood work that you can do. I wrote an article about it. I wish I remembered it more like in a better way to explain it, but they can test something and see, like, predict if they would be a responder, really? Yeah,
Scott Benner 54:28
oh, that's interesting. So there's a blood test you can do to tell you if you're going to respond favorably to GLP,
Catherine Alvarez 54:35
right? Yes, huh? Yeah, I, I wrote a little article on it. So, yeah, I know it's out there somewhere.
Scott Benner 54:44
Is it a genetic test?
Catherine Alvarez 54:46
I don't even, I couldn't tell you. You know, I write so many different things. I wish I had a better memory. But
Scott Benner 54:55
no, don't, don't, please. I you know, again, these, how these good. Com. Conversations happen. Like, that's why none of this is, like, you know, it's, it's not medical. Like, this is a podcast. You don't even like, you're talking, you know. And you see if people don't hear something and go, Oh, I wonder if this is, you know, something I should look into. A C peptide test is one method that can help predict whether a person will respond well to GLP, right? So
Catherine Alvarez 55:21
well that, yeah, that's not what I read. That's not
Scott Benner 55:24
what you're that's not what you wrote about. Yeah, I
Catherine Alvarez 55:27
know C peptide, well, I would remember that. Yeah, no,
Scott Benner 55:29
but I mean, like, that's not what you're talking about, but it is what we were just saying about the other guy. Like, you know, if your beta cell still have the ability to, like, do some stuff, but it's just being held down by your body's inability to process the insulin and get the result, etc, that you want. Like, I can see why. I don't know, taking some of the like, it's weird to talk about even because, like, are you increasing your insulin sensitivity, or are you decreasing inflammation? Are both of those things happening, like, like, is it like a mix, and then it's just crazy when you hear the actual researcher talk about and they go, I don't know, but it works like, okay,
Catherine Alvarez 56:06
okay. I actually, I found the I found the article that I wrote about. It's called Hungry gut gene test shows who will benefit most from a govi, hmm, so yeah, I guess they're grouping them based off of this gut test, and it is a gene test. There's
Scott Benner 56:22
a genetic test available that's often referred to as hungry gut gene test, which identifies people who might respond better to GLP, one receptor agonist like semaglutide for weight loss. The test analyzes genetic variants associated with how the gut and brain regulate hunger and satiation. In studies, individuals with the hungry gut obesity phenotype showed greater weight loss up to 19 and a half percent compared to those without the phenotype. There you go. Yep, there it is, just like that. Yeah. Anyway, my point is is that this stuff's gonna is gonna help people, you know, and it's gonna get to helping people with type one. We were talking last night, like in a little private group, about how one of the big speed bumps for doctors, about giving glps and type ones is that in some people, and Dr Blevins has come on the show and talked about this too, it can lead to DKA, because their insulin needs go so low, right, that they almost can't use enough insulin to ward off the dka, because they obviously still Have type one diabetes, yep, and their beta cells aren't helping enough to ward it off too. So they're looking at protocols that will then make the FDA comfortable with the prescription being written. And that protocol may be as simple as you get a ketone meter and you have to test a certain number of times a day to make sure you're not in DK. And
Catherine Alvarez 57:41
that might get that good old precision x Oh, but yeah, yeah. But
Scott Benner 57:45
that literally might be the thing that helps it get written for type ones,
Catherine Alvarez 57:49
yeah, yeah. And it'll be a part of our CGMS. It sounds like too where alert us if we have ketones.
Scott Benner 57:56
You think CGM are going to tell people about ketones one day? Oh, yeah, there. I
Catherine Alvarez 58:01
mean, that's already kind of something that has been in the works, but it's almost like, is it too much information? Just kind of have to find that balance, yeah,
Scott Benner 58:09
yeah, overwhelming people with stuff. But anyway, I think that's interesting that like. So what this means is, if that thing is right about the ketone meter, is that the FDA knows it helps people with type one diabetes, and they just need to be able to put it into the world in a way that's not going to cause anyone to have DKA. And once they can guard against that, then they'll be okay with it being written, which then means it'll be covered by insurance too,
Unknown Speaker 58:31
right?
Scott Benner 58:32
Yeah, so that's exciting. Wait, wait, you trying to make a little Catherine? What are you doing over there?
Catherine Alvarez 58:37
Yeah, we want to bring a little human in to the world. What
Scott Benner 58:42
happened? You started watching this kid and you got what they call the baby fever.
Catherine Alvarez 58:46
I think I've always had the baby fever.
Scott Benner 58:48
Oh, are you like a little caregiver at heart? Yeah, I
Catherine Alvarez 58:51
just, I just love there's something so special about little ones. They're sweet innocents, and just adore them. How
Scott Benner 58:59
long have you been trying,
Catherine Alvarez 59:01
I guess, like eight months now, really, yeah, so taking a lot longer than you know what we had thought. But I think I'm probably just been stressing too much about the whole thing. So
Scott Benner 59:12
do you have any PCOS symptoms? No,
Catherine Alvarez 59:15
no, and I've been tested in everything
Scott Benner 59:19
stressing. Yeah, it's probably all it is no kidding. They say sometimes you just like, I'm sure I've said this before, but I'm adopted. My parents adopted me after being told like they could not have kids. Then, keeping in mind, this was the late 60s, early 70s, when they were being told that, and I'm not sure what the level of discourse was around this, they adopted me, and five years later, my mom got pregnant. I
Catherine Alvarez 59:42
keep hearing stories like that. It's so incredible. Yeah, and I told, I told my husband, Kenny. I was like, maybe it's just like, our calling, that we're supposed to adopt and then we can have far because, I mean, there's so many like, people need to adopt. It's has to happen.
Scott Benner 59:58
Yeah? Well, they. Doctor told my mom it was a fluke. She probably just relaxed enough for it to happen. I love the way they talk to women about their health. Literally, you don't have to worry about that. It's never going to happen again. And then five years later, she got pregnant again, pregnant again. Oh my gosh. So my brother is, like my youngest brother's, you know, 10 years younger than me. Yeah, it's huge. Yeah. We should have seen my mom, in her 60s, dealing with my like, teenage brother. She was like, Oh, the hell's going on here. Also, what was your husband's name? Kenny? Yeah. Kenny, yeah. I mean, Kenny wants a baby. But he's also like, I can't believe this. The fun part is lasting so long, this is awesome, so he's fine with it. Yeah, yeah. I bet you haven't heard him complain yet?
Catherine Alvarez 1:00:40
No, you're getting
Scott Benner 1:00:44
to the point where you're like, listen,
Catherine Alvarez 1:00:47
it's like, what's wrong with us? Yeah,
Scott Benner 1:00:49
well, you know, once it's on your calendar, now you're like, something's not working right. Where you're like, does it say here Thursday at two make baby. You know so well, I wish you a lot of luck. I'm I know it can be incredibly frustrating, for sure, yeah,
Catherine Alvarez 1:01:03
but you know, we're happy we have a crazy dog that really keeps us on our toes. So nice. Uh, because dogs are good practice, yeah, it makes me feel like I was not at all prepared. We, uh, we found our dog. She's a dumpster baby, and she has really humbled me. Oh,
Scott Benner 1:01:20
wow. Somebody threw puppies in a dumpster.
Catherine Alvarez 1:01:24
Yes, that happened. I
Scott Benner 1:01:25
guess that does happen. I don't know why I'm so surprised every time something horrible is brought to my attention, but Oh, wow. How did you like so somebody found them, brought them to a shelter, and you came and got one.
Catherine Alvarez 1:01:35
No, we found her. You found her. Yeah, just hurt her and, oh, my god, Catherine, what
Scott Benner 1:01:42
are you doing in a near dumpster? Are you okay? You're not living in an alley or something, right?
Catherine Alvarez 1:01:49
No, no, I'm not dumpster diving or anything. Gary's paying you, right?
Scott Benner 1:01:57
So you, you and Kenny are walking down the street and hear a dog in a dumpster? Yeah, we
Catherine Alvarez 1:02:04
just had eaten at our favorite sushi place. And yep,
Scott Benner 1:02:08
oh God, it wasn't the sushi place's dumpster. Was it?
Catherine Alvarez 1:02:11
Yes, it was,
Scott Benner 1:02:13
oh god. Did it make you wonder what you just ate in the sushi place? No, luckily,
Catherine Alvarez 1:02:16
the dumpster did not smell. So no, I
Scott Benner 1:02:19
don't mean that. I mean you anyway, oh, okay, I see what you're like, uh, oh, so you took the puppy out. It was a puppy, yep. What kind of dog is it a mutt or like, yeah, she's
Catherine Alvarez 1:02:31
mostly, she's pity Staffy bulldog and Boxer,
Scott Benner 1:02:35
wow. And how does it humble do?
Catherine Alvarez 1:02:38
Well, I mean, she is. She has eaten two couches, multiple dog beds, multiple shoes, purses, tampons.
Scott Benner 1:02:52
Yeah, it's a low moment when your dog's running around the house with the tampon.
Catherine Alvarez 1:02:56
Yeah, yep, and then has to go to the emergency vet because that's not freaking very bad.
Scott Benner 1:03:02
Oh my god, two like, so just chewed through sofas. Yes, so obviously you can't wish that you didn't hear the dog in the dumpster because of the moral implications of it. But have there been moments when you thought like, oh God, dogs not for us? Or just, no, I
Catherine Alvarez 1:03:19
love her so much. Like she has an Instagram I'm totally just at a reels for this dog. Did
Scott Benner 1:03:26
that? Flip you out when you realize the dog owned a phone, we're like, oh my god, the dog's smart enough to post on Instagram. Why doesn't it not know not to eat the sofa? Yeah,
Catherine Alvarez 1:03:36
I know, right. She is. She's really smart. I mean, she's gone through like, a lot of training, spent so much on that, and she knows she knows how to be a good girl.
Scott Benner 1:03:49
Oh, you're at this point now where you're looking at the dog going, I know you know not to do this. Why is this happening? Yeah, my wife thinks the dog looks at her differently. Sometimes she's like, he knows I'm like, I don't think he knows anything. I think his brain is the size of a walnut, and I'm pretty sure he doesn't know anything. Actually, Arden said on the podcast recently that, um, that she learned about consciousness and that dogs don't have it like, the the way dogs have consciousness is different than how, like, higher beings have it, like, it's something about the mirror test. Interesting.
Catherine Alvarez 1:04:22
Well, she makes these very like, I'm very sorry mom faces at me after she does something bad. So
Scott Benner 1:04:29
I believe they say that that's you giving human feelings to an animal. There's a it's called Adam. I can, I can never, like, pronounce the word Hold on a second. I sound like an idiot.
Catherine Alvarez 1:04:43
Do you know about that? I mean, it makes sense, but no, I don't anthropomorphism,
Scott Benner 1:04:47
it's a term that refers to the tendency to ascribe human traits, behaviors or intentions to non human entities, including animals, objects and even natural phenomenons. For example, saying, Oh, look, the dog feels guilty because of its body language after doing something wrong. That's a form of anthropomorphism. So you are doing that, not the dog.
Catherine Alvarez 1:05:11
Well, I'm still gonna believe that my dog is very sorry.
Scott Benner 1:05:16
You just want the dog to be sorry, whatever the just want the dog to be sorry. You're like, it must be regretful, because that sofa cost $1,000 No, she's sorry. Because if the dog's not regretful, you're gonna take it back to the dumpster and like, so you have to, like, tell yourself, it's not that you would do that. I'm assuming you would take it to a shelter and abandon it properly. Yeah, I would never abandon please take care of your animals. Like, please don't take on responsibility for an animal. Like, that's why. Catherine, how much do you listen to this podcast?
Catherine Alvarez 1:05:48
I wish more, but, you know, I not a lot. That's fine.
Scott Benner 1:05:50
So you don't know that I have a chameleon. Or you do know this? No, I don't know. Okay. So my family gets me a chameleon for Christmas. And my first thought was like, Oh God no. Like, I don't want to be responsible. Like I have, like, a strong sense of responsibility for things. Like, if you put me in charge of something, I'm gonna feel that very deeply. Yeah, and I actually think that's helped me with the podcast. And you obviously have that with that dog, or you would have lost it outside, lost it in quotes. Do you think that helps you at your job.
Catherine Alvarez 1:06:21
I guess. I mean, I guess I could make the argument that it does. Do you have
Scott Benner 1:06:25
less feeling that people feel guilty when they do something wrong than when the dog does it?
Catherine Alvarez 1:06:29
I think that my dog feels more guilty. Okay, let me
Scott Benner 1:06:33
ask you another question, because you've dealt with so many people. Okay. I've been asked this question. I've heard it said a lot of times. I don't actually think people don't care about their health, like, you know how people they'll say, like, they don't take care of that they don't care. Or I don't think that's true. I think everyone cares. I think that the way, the tools they have to attack that the problem are greatly varied between person to person. But I don't think there's any person who's like, I'm not gonna Bolus for my food today because I don't care. Like, I just, you know what I mean? Like, I don't, I
Catherine Alvarez 1:07:10
think they're, yeah, they're overwhelmed by it, or, you know, there's something else going on.
Scott Benner 1:07:14
I genuinely believe that too. Like, I'm not saying you can't get into a situation with mental health where you physically and intellectually can't I know that happens if, I mean every day to day person walking around who's not stricken by horrible depression or, you know, mental illness or something like that, I don't think there's anyone out there who's just like, I don't care if I live or die. And even if they say that, I don't think that's necessarily true. I just think they are lost and they don't know what to do next. Yeah, yeah. That sucks, yeah. I
Catherine Alvarez 1:07:44
mean, I think, yeah, they're just in such a such a dark place this world. I mean, sometimes it's hard to find the good in it. So
Scott Benner 1:07:52
yeah, is it hard when, like, you're younger, right? So, like, let's think about you for a second. You said you over shared. So let's keep over sharing for a couple more minutes before I let you go, right? Yeah. So you're diagnosed at 12. That sucks. You've got a mom who has type one but is of no help to you. You feel pressure to help her, because you realize she's not helping herself. That doesn't work out. You know, you get this job that you've always wanted because you know, you've read this book and you're like, oh my god, I could work with this person who you know taught me so much stuff. You go do that, you train yourself up. You become a certified diabetes education and care specialist. Does anyone hear it when I'm saying it? Why did you think this was a good Certified Diabetes Care and Education Specialist? Yeah, see what you did. You made it bad. Okay, so you become that thing, and now you're helping people, then you go off to like, you know, you help this little boy, you're trying to build your own life. You're having your own struggles making a baby. Like, all this stuff's happening. And when I gave you the opportunity to say something, you said, like, the world's hard sometimes, so why are you not beat down by it?
Catherine Alvarez 1:08:57
It's a choice. And I mean, so to add to it, like the hardest thing by far that totally overshadows, like all of my other struggles in life, is that my brother actually passed away. Oh my gosh, I don't think I'll ever go through something that was would be as hard as that was because he was like he was my
Scott Benner 1:09:18
person in life, unexpectedly from an illness. It
Catherine Alvarez 1:09:21
was from drugs. Okay? So, yeah, he was, he was just 21 but, you know, we were really close in age, and we really did everything together.
Scott Benner 1:09:30
This is only seven or eight years ago. Is that right?
Catherine Alvarez 1:09:33
Yeah, yeah, I'm sorry, yeah, like, I just came to a point in my life where it's like, am I gonna let like? Is this gonna be where my life stops, or am I gonna choose to keep going and almost try to make him proud?
Scott Benner 1:09:50
That could have happened? You could see that moment as an inflection point where you just kind of gave up to Yeah, yeah. How long did it take you to get past that feeling? Yeah?
Catherine Alvarez 1:10:00
Around two years, wow.
Scott Benner 1:10:02
Would you consider yourself depressed during that time? Oh, yeah. Did you have to do anything like, like, what did you do to manage that?
Catherine Alvarez 1:10:10
I tried talking to people I really fell into a dark place with, like, alcohol for a while in my college days. But eventually I, and this is going to sound so like cliche, but really, exercise is what ended up turning my life around. I found CrossFit, and I got really into fitness, and it was exactly what I needed to to heal me.
Scott Benner 1:10:40
I'm glad you found that. Yeah, see, now you should listen to more of the podcast, because eventually everyone says something like this, after we've been talking for a while, and then later they'll say, I don't know why I told you that, but I appreciate you sharing that with me. That was really lovely to be that open. Did you ever consider like because it feels like you went towards diabetes because of your mom and you. But did you ever think like, I could also help people with like, addiction or drug use issues, like, like, where does that like lay in your mind? Yeah,
Catherine Alvarez 1:11:11
that so I think that. I think that just hits too close to home. You couldn't be around it like that. I don't touch that so much, but when someone does lose a loved one, I think that I can definitely be a person that they feel safe confiding in,
Scott Benner 1:11:28
yeah, oh, okay. I know it's hard. I'm sorry. You okay? Oh, yeah,
Catherine Alvarez 1:11:32
I'm good, okay,
Scott Benner 1:11:33
I was gonna ask a different question. No, it feels like such a pivot. I'm sorry. Um, after you make your little, not dumpster baby, but but your actual own human baby. After that does, happens and the baby comes, comes and is in the world, are you gonna go right back to using a GOP again? Well,
Catherine Alvarez 1:11:51
I think that I will want to bring more babies into the world. So No, not right away, getting gonna
Scott Benner 1:11:57
do Irish twin it up. You're gonna go. Go twice. Real hard. Maybe. Let's do it again. My gosh, oh, my gosh. Well, that's, that's crazy. Like, we didn't talk much about or at all, because it just sort of came up. But you know, the amount of people that I hear come through here, like, when you say, you know, when you said earlier, like, you can kind of see pathways, like when I'm when I said, like, oh, I don't know how many people I have to interview who are like this happened to me. You know, I interview a lot of people who also have, like, a bipolar person in their family, or there's depression in their family. When you start thinking about depression, or, like, you know, bipolar and inflammation, and, you know, like, how this stuff seems to go hand in hand through bloodlines. Really? Do you think that the depression you had was solely from the incident, or do you think that it's a thing you've had or have had since? I
Catherine Alvarez 1:12:50
think, I mean, it's, it's definitely, you know, ongoing, it's a trauma that will always be a part of me now, yeah, but
Scott Benner 1:13:01
it started at your brother's passing. Or you think it was before that? Oh, it's probably before that too. Did you notice any alleviation on the GLP, no,
Catherine Alvarez 1:13:12
you didn't. No, no, no, it didn't, not with that aspect, not
Scott Benner 1:13:17
that it should, just that. I you, you don't know this. But like, a lady came on recently who said that GLP medication alleviated a lot of her child's bipolar issues, there's so many questions. And yeah, no, I was just wondering if you noticed, like a lightning of your load in that time or not.
Catherine Alvarez 1:13:32
Yeah. Well, I don't think I personally suffer from depression. I think that, I mean, I do. I have medication? I eventually found the right SSRI for me personally, that's,
Scott Benner 1:13:46
I'm glad you found something Well, I think you have laid out perfectly why people might want to contact you. I think maybe Jenny's calendar is going to open up now, because right now, if you try to get Jenny professionally, what's it take? Like, six months, right? Yeah, oh
Catherine Alvarez 1:14:00
yeah. Jenny is hard schedule to get on. Yeah, she's, uh,
Scott Benner 1:14:03
she made a lot of fans, so you can go steal some of those people. Now, would you share your email address at work? Yeah, it's
Catherine Alvarez 1:14:11
just my name. Actually, it's my old name. So it's K Gen teal, my old last name at Integrated Diabetes, com, G, E,
Scott Benner 1:14:21
N, T, I, L, E,
Catherine Alvarez 1:14:22
you got it?
Scott Benner 1:14:23
Okay? Well, if you're interested in Catherine helping you with your diabetes, that is how you would reach out to her. That's, I know that's not why you came on, but I just, I thought you did such a nice job, and, you know, laid out, you know, a path of of what you think and and how you know what kind of a person they might intersect when they reached out to you. So, you know, I hope you don't mind me saying that. Oh, thank you. Appreciate it. Oh, it's my pleasure. Did we talk about everything you wanted to talk about? Yeah, yeah, absolutely, I did. That always surprised. I
Catherine Alvarez 1:14:53
mean, I really didn't even have any plans, like, I was just like, No, can't wait to talk to Scott. This is gonna be super
Scott Benner 1:14:57
cool. We spoke on the phone once. Four, is that right? Yeah, you
Catherine Alvarez 1:15:01
helped me make friends at the children with diabetes conference.
Scott Benner 1:15:05
Oh, that's right. They don't let me come there, but I still knew some people. By the way, that's not fair. They just, I've never been invited. I'm sure it's fine, but I
Catherine Alvarez 1:15:13
think, yeah, they, I think they just have, I think they have a different approach. I don't know. I think I so. I've gone for the past two years now, and I love that conference. Oh my gosh. It is really fun. Yeah, I
Scott Benner 1:15:26
swear to you, I don't like I have no ill will about it. And if you know it's not a problem at all, I just every year I'm inundated with, are you going to be at friends for life? Are you going to be with children like people? So every I know it's like, on my calendar, almost like this is when it starts happening, when people ask me if I'm coming. And I'm coming, and I'm always like, I've, you know, I would come if I was invited. I've not been invited, that that's all,
Catherine Alvarez 1:15:47
yeah. So yeah, yeah. I just decided to volunteer, um, this past year, nice. And I hope that I get to volunteer forever, because I was tell me what you took from it, the connections that I got to see form, or the connections that were already formed just from so many years of attending. It really is just like they're a family, if you're looking for a family feel. I mean, I don't think there's a better place to be. Yeah,
Scott Benner 1:16:13
I just got back from an event where I was around a lot of people, and, like, I had so many different interactions that were just heartwarming and stuff I won't forget anytime soon, you know, from like, little kids who are just doing better, and you know, since the last time you saw them or watching people make friends, you know, had this really cool little conversation in this group of children where, like, we didn't Talk about, like, you know, and talk about diabetes management or anything like that, but I just there's, you know, I don't know, 50 kids in this room, and I just went around and just asked them questions, like, you know, like, What's it feel like to be low? What's it feel like when you're higher? You know, you know, you know. What do you struggle with? And then, as you let them talk, from like five years old to, like, 15, when they started relating to me the questions they had about their health and their life, and you really started seeing the things that they were thinking about. Like, not that I didn't think kids were thinking about that stuff, but it's, it's eye opening to hear them articulate it. You know what I mean to have a nine year old tell you I don't understand, like, what happens to me, and I wish I understood better. And you know, because I go to school and I try to take a test and my blood sugar shoots up and I don't feel well, and I don't know if I should Bolus or not, like, all this other stuff, like, and it's just this young girl, you know what I mean. And you know, then to explain to her, like, what adrenaline does to her, and then to watch all these little faces in the room go, Oh my God. And then they can start relating it back to their own lives. Then five or six people put their hands up. It's like, my blood sugar always goes up here. Like when I get to school in the morning. I said, Oh, that used to happen to my daughter. And I said, and then does anybody's blood sugar drop really fast when the school day is over? And so many of them are like, how do you know that you know what I mean and like? And just to see them feel like, Oh, this is not like an I'm not crazy, and this is an abnormal, yeah, and that guy's saying that it might be because of this, like one little girl, if anybody's listening, I would love to have her on the podcast. She came up to me afterwards with a notebook in her hand, and she had been taking notes the whole time. We were talking, like, in the in the hour. And I said, is that a notebook? And she said, yeah. I said, What are you writing in it? She goes, I was just writing down things, you said. And I was like, Okay. And she goes, would you sign it for me? Almost like, only if you want me to cry, like, you know, like, so, like, I signed it, and I was like, thank you. She goes. Thanks a lot. I have a lot to talk to my mom about. And then she just went away. So, so adorable. Yeah, it was awesome. I love those things, those those those groups are, are awesome. I'm glad you found them too. Okay, I'm gonna let you go. You've been on a long time. I apologize for keeping
Catherine Alvarez 1:19:00
you, yeah, well, it was an absolute pleasure. I'm glad
Scott Benner 1:19:02
you had a good time. Thank you.
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Are you starting to see patterns? But you can't. Quite make sense of them. You're like, Oh, if I Bolus here, this happens, but I don't know what to do. Should I put in a little less, a little more? If you're starting to have those thoughts, if you're starting to think this isn't going the way the doctor said it would, I think I see something here, but I can't be sure. Once you're having those thoughts, you're ready for the diabetes Pro Tip series from the Juicebox podcast. It begins at Episode 1000 you can also find it at Juicebox podcast.com up in the menu, and you can find a list in the private Facebook group. Just check right under the featured tab at the top, it'll show you lists of a ton of stuff, including the Pro Tip series, which runs from episode 1000 to 1025 okay, well, here we are at the end of the episode. You're still with me. Thank you. I really do appreciate that. What else could you do for me? Uh, why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribed in your podcast app, go to YouTube and follow me or Instagram. Tik, Tok, oh gosh, here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page you don't want to miss. Please do not know about the private group. You have to join the private group as of this recording, it has 51,000 members in it. They're active, talking about diabetes, whatever you need to know. There's a conversation happening in there right now, and I'm there all the time. Tag me. I'll say hi. The episode you just heard was professionally edited by wrong way recording, wrong way, recording.com, you.
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#1380 I Don't Understand... Jenny Five
Jenny doesn’t understand why care what other people are doing?
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends and welcome back to another episode of The Juicebox podcast.
Jenny returns today for another episode of I don't understand today. Jenny doesn't understand why we care so much about what other people do nothing you hear on the Juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. When you place your first order for ag one, with my link, you'll get five free travel packs and a free year supply of vitamin D drink. Ag one.com/juice, box, don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's Juicebox at checkout to save 40% at cozy earth.com. Are you an adult living with type one or the caregiver of someone who is and a US resident, if you are, I'd love it if you would go to T 1d exchange.org/juicebox and take the survey. When you complete that survey, your answers are used to move type one diabetes research of all kinds. So if you'd like to help with type one research, but don't have time to go to a doctor or an investigation, and you want to do something right there from your sofa. This is the way t 1d exchange.org/juice box. It should not take you more than about 10 minutes. US med is sponsoring this episode of The Juicebox podcast, and we've been getting our diabetes supplies from us med for years. You can as well us med.com/juice, box, or call 888-721-1514, use the link or the number. Get your free benefits. Check and get started today with us. Med, this show is sponsored today by the glucagon that my daughter carries, G VO, hypo, pen. Find out more at gvoke, glucagon.com, forward slash Juicebox. All right, Jenny, Hey, what's up?
Jennifer Smith, CDE 2:08
Hi, how are you
Scott Benner 2:10
good? Good. Let's keep going with I don't understand. I'm getting nice notes from people that say they're enjoying hearing you talk about stuff that you don't understand. So
Jennifer Smith, CDE 2:17
yay. Maybe they just like my accent.
Scott Benner 2:20
I hope so. I hope it's just that they're delighted by you like I am. Oh yeah, I'm gonna go with your next one on my list. Why are we so interested in strangers behaviors like how they dress and what they're doing? Yes, all right, what? What made you put that one on the list?
Jennifer Smith, CDE 2:38
I think what made me put it on the list is because we are in an age of a lot of visual to people that we don't even know, right with all of the different social media avenues and all of the different things that you can look up online. I ran into this again as I was sort of traveling for a conference and I was watching people. I am a watcher. I am. I'm one of those people. I love watching people. I got that from my dad. He could go to the mall with my mom, and he just wanted to sit on the bench, and he wanted to watch what people were like. Doing that from a wit, he was a weird, I promise, but just like an observational I got that from him, and I, I've noticed it more now with all of the different avenues of looking up, what are the popular shoes to wear, and how should I tie my hair back today? And is it now I flip my collar up, or should it stay down and unbutton so I watch people scroll through, yeah, like all the things and what, like kicks their interest, right? Human observation is really interesting. But I also I don't understand why it's interesting to see somebody you will never meet and you don't know and what they're doing with their life, I would personally rather navigate my own life, right? And do you know what I'm saying? It's like, I don't know why you put your energy into that when just take care of yourself and do what you like.
Scott Benner 4:13
Also, I think that very often, because of the format of the phone, and you're not really seeing them, you're seeing, like, listen, I make social media videos sometimes I don't come in here and make them. If I haven't shaved for three days, I don't stand in front of a messy part of my house and do it. You're not really seeing their situation. I will tell you that I like this one for a conversation, because I think it dovetails a little bit into diabetes, a little bit. Oh, it does, yeah, and I could, because I've seen, I guess we should go backwards a little bit. This is all for eyes, right? Like, if it's if you're trying to sell footwear or clothing or, you know, I mean, listen, I'm not proud. Save 40% at cozy Earth, calm with the offer code juice box, right? Like, sure, yeah, they send me clothes and I put them on. Then I buy some too. But, you know, I, you know, right? It's how this whole thing works. There's an economy around this now, of course, right, the high side of it is people can start their own businesses, you know, like, become incredibly popular, reach people they've never reached before. Do you see that girl the other day? She's having like, a, like a happiness stroke online, because Taylor Swift wore her like, sparkly freckle tabs or something at a football game, and she's got, like, this small business, and it's just exploding, because, right, right. So, and
Jennifer Smith, CDE 5:30
I understand it from that perspective that you, that you're bringing up,
Scott Benner 5:34
what you're saying is, why did somebody go buy the damn sparkly things, just because they saw her wearing them?
Jennifer Smith, CDE 5:40
Right? Yeah. Like, I have for a long time not been a part of I don't I don't know. I do what I like because I like it, not because somebody else told me to do it right. And I think we've become really interested in, what is everybody doing right, what is and to some degree, that can be a especially in what we've had the past number of years, that can be a very good way to feel like you are reaching somebody or connecting with somebody. But to another degree, I like real social connection. I really like to talk to the person that I might be saying, hey, I really like your shoes, right?
Scott Benner 6:23
But maybe the real question is, I don't understand. Why does it not work on you? And it worked because there are real reasons like marketing. Listen, here are the fundamental psychological principles that shape how thoughts and emotions and behaviors are manipulated by marketing, you use emotional appeal. You aim to trigger emotional responses like happiness, fear and nostalgia. You help to make a brand connection, like puts that like team thing in to place. You're like, oh, well, my team is winning, or people like what I like. Then you use social influences to, you know, show them look other people who you know, are doing it too. They also can create a scarcity or urgency, feeling that works on people. I mean, look, there was that dock worker strike recently that lasted all of four days, right? You couldn't buy toilet paper at Costco again, like I saw the greatest meme online. One guy said he put it up on his Facebook, and he said, If you bought toilet paper this week, please unfriend me. I don't want to talk to you right? Then they find a way. They can find a way to target it to you. They use cognitive bias that's a higher initial price to make a discounted price seem like a better deal. Like that happens all the time, right? Like, hurry up. It's going down in price. Like it's going up. You gotta hurry up.
Jennifer Smith, CDE 7:41
I would imagine inclusive feeling like on the list would probably be. I feel included in this group of other people who are wearing the same shoes or carrying the same purse or has the same sport hat on, like you said, right? You immediately feel like you are a piece of that group or that you belong, right? And that's important for some people, I guess.
Scott Benner 8:04
Yeah. Well, I mean, listen, there are people who buy ads on this podcast, right? And no mistake, they're buying them so that you hear the words over and over and over again. And one day, you're in a doctor's office and the doctor says, Hey, have you ever thought of getting an insulin pump? And you think, Arden wears that Omnipod. That's it right there. That's what they're shooting for. Now, I'm in a lucky position to take ads from places that you know, stuff we use, and so I can speak to it, but I take ads from stuff that I've never touched before as well, sure, you know. So I understand how it all works. It's just, it's interesting to see it happen in so many different spaces. I mean, from like, little things you stick to your face to like, Arden said to me the other day, do you think this patch works? It's supposed to make you more aware, or something like that, like brighten your mood? And I said, I don't know what's in it. I look it's vitamin, right? I texted her back. I said, take the fucking vitamin I sent to school with you. Yeah. Like, that's all that's in this, you know. But she saw it on tick tock, or she saw it somewhere, and she's like, Hey, this girl says she was more awake during class, and she knows enough to think, like, that might not be true, but still made her wonder out loud, yeah, yeah. She wondered out loud about it. So, yeah. So back to the question of like, Why doesn't it capture you? Do
Jennifer Smith, CDE 9:23
you think it's a great question? Really,
Scott Benner 9:26
I it's hard to know, isn't it? It is really
Jennifer Smith, CDE 9:29
hard to know, and that's why I don't understand why it grabs some people and other people could really care less. It's not that I don't keep up with things like fashion and what's you know out there. But I don't seek it out. I don't go to look at, gosh, what's the most popular new shoe? Mine is, do the shoes let me run like I want to run, and do they feel good when I wear them just every single day? Fabulous. These are the shoes. And I don't care what big. Name person wears them. They could be from the no name store across the street, and if they look like I like them, and they feel great, then
Scott Benner 10:10
my phone will ring. I still have a home phone. I know that makes me old, but whatever, it sounds better. And when I'm having important conversations, I make phone calls from my home phone because it sounds better, but you'll get 1000 marketing calls. I'll pick the phone up and I'll go, I'm not interested, and I'll hang up, and my wife will say, weren't you interested in I said, I don't know. They didn't get that far. Or like, One day this kid knocked on the door. I love this story. He knocks on our front door. I open the door. I go, Hey, man, what's up? He goes, I'm wondering if you're interested in and then he started talking. I went, I'm gonna stop you. I don't need that. And he goes, Okay, thank you. And then I started pulling the door closed, and he looks at me, and he goes, sir. And I'm like, he goes, How do you know you don't need it? I haven't told you what it is yet. And I said, if I needed it, I'd know. I don't need you to tell me. But thank you. Yeah, no, absolutely. Like, there's this idea that there's something magical out in the world that I haven't found out. Haven't found out about yet, and the kid at my front door is gonna tell me about it. You know, if you take insulin or so faucinyas, you are at risk for your blood sugar going too low. You need a safety net when it matters most, be ready with G vo hypo pen. My daughter carries G vo hypo pen everywhere she goes, because it's a ready to use rescue pen for treating very low blood sugar in people with diabetes ages two and above that. I trust low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily, jivo kypo pen can be administered in two simple steps, even by yourself in certain situations. Show those around you where you store GEVO kypo pen and how to use it. They need to know how to use jivo kypo pen before an emergency situation happens. Learn more about why GEVO kypo Pen is in Arden's diabetes toolkit at gevoq, glucagon.com/juicebox, gevok. Gvoke shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma, or if you have a tumor in your pancreas called an insulin OMA, visit gvoke. Glucagon.com/risk. For safety information. I have always disliked ordering diabetes supplies, I'm guessing you have as well. It hasn't been a problem for us for the last few years, though, because we began using us Med, you can too us med.com/juice, box, or call 888-721-1514, to get your free benefits, check us. Med has served over 1 million people living with diabetes since 1996 they carry everything you need, from CGM to insulin pumps and diabetes testing supplies and more. I'm talking about all the good ones, all your favorites, libre three, Dexcom, g7 and pumps like Omnipod five, Omnipod tandem, and most recently, the eyelet pump from beta bionics, the stuff you're looking for, they have it at us. Med, 88887211514, or go to us. Med.com/juice, box, to get started now use my link to support the podcast. That's us. Med.com/juice, box, or call 888-721-1514,
Jennifer Smith, CDE 13:21
right? Or that you're missing. And maybe that is the point. I don't feel like I'm really missing anything. And like you told that guy, if you were, you'd have it on your list of things to go searching for.
Scott Benner 13:35
Yeah, I would know what to do. Like I'm aware of the things that I'm not doing or need or whatever, and when they come up on my to do list, I'll take care of them. Then, right, exactly.
Jennifer Smith, CDE 13:44
We had a Bug Guy, kind of similar to your guy, that came to our door this past summer, and he knocked, he's like, have you noticed an increase in these kinds of bugs? And he pulled out a sheet, and he was gonna start pointing. And I was like, sir, you can tell that our lawn has all the dandelions in the neighborhood. Yeah, you don't spray, we don't spray, we don't do anything. The bugs that are here, there's a purpose for the bugs. We're good. I don't really need whatever you've got. He was like, oh, okay, same thing. Oh,
Scott Benner 14:10
I, by the way, that same guy has been at my house. It's like a laminated chart of all the bugs, right? He goes, these are probably living under your soil. And I was like, Well, I don't live under my soil, so I'm okay with that,
Jennifer Smith, CDE 14:19
right? They're not in my house. They're not invading anything great. He
Scott Benner 14:23
goes, they could come into the house. I said, I've been here 20 years. Hasn't happened yet. I'm feeling good about it. It's the same thing with warranties, you know, like, Would you like to buy a $50 warranty? I'm like, the thing only cost $150 right? I'm gonna ride the luck. If it breaks, I'll spend 150 and get it again. My wife did that to me, like, we have this little like drink cooler. And we had one for 12 years, and it died. And I bought another one. I bought the same exact one, but two years later it died again. So when I bought a third one, she goes, Are you gonna buy the warranty? And I'm like, No. I'm like, odds are in our favor, baby.
Jennifer Smith, CDE 14:57
I'm not doing that. We never. Either if we never take out the warranty because it's a waste. It's kind of like, and I hesitate to say it, because I haven't car I have car insurance, but it's like car insurance, right? It is. It's like those things that you pay for, hoping that you don't ever have to utilize what you're putting money into all the time. Car
Scott Benner 15:21
Insurance is a halfway good example, but you need it. I think legal. You can't drive without it. Yes, correct. But if you think about it, what it costs you every year and every year you don't use it, and then one year you run into somebody in a parking lot. Let's say, imagine if you could look at that person. Go, Hey, listen, I've saved $40,000 in the last 20 years not buying car insurance. I'll give you 20 right now. Just go home and like, and that person would be like, leave it alone. Get the hell out of here. Thank you. Of course, you kill somebody in a litigious society. You hurt somebody, you're gonna lose your home. But yeah, that's the point of the warranty idea, which is, if I buy a $50 warranty on everything I buy, I've spent 1000s of dollars probably, and then why don't I just use that, keep that money in reserve and use it if one of these things breaks, like, that's how my brain works about
Speaker 1 16:06
that? Yeah, absolutely, yeah. So
Scott Benner 16:09
this is interesting. I asked, I know some of you like to freak out, but I asked chat, G, P, T, why are some people not impacted by marketing? So it says that high skepticism or critical thinking. People who naturally question the motives behind marketing messages are skeptical about advertisements. Tend to be less persuadable, right? They have an analytical mindset that scrutinizes claims that are made in ads and other parts of life. It's funny, because that is how I would describe you like, if we started this off and the and it was like, does Jenny get impacted by marketing? I'd think about you for five seconds and think I would answer no to that. Probably, oh, yeah, yeah. That does not seem like a thing that would like motivate you.
Jennifer Smith, CDE 16:55
It isn't. And it is a hard thing though, to navigate now with children, because I've long time been like this. It's just, yeah, I don't know why. It is just me, but with kids now, who are, I can see the influence of friends, and I can see the influence of brands and different types of things, and trying to get across to them the base concept of things like need versus want, and the fact that just be calves you have the shoes doesn't make you more popular. It may make you feel like you belong, but it's a hard thing to get across to brains that are still developing and understanding and learning connections. And
Scott Benner 17:40
also, if your kid is already real self confident and okay with being, you know, not having 1000 friends or something like that, then they'll probably be fine with that. But if you've got but at the same time, like, if you've got a kid who's struggling with something and a pair of certain pair of shoes might make their life easier, then I don't. I probably wouldn't have a problem with that either, you know what I mean, but I'd still have those conversations with them. But hey, here's the shoes just in case, right? It also says that people who are just familiar with marketing tactics don't fall for them as frequently. So I mean, when I was coming up and I was young, I worked in the marketing department for a credit union, ah. And so I have to say that probably even before that, though, if you said to me, like if you start selling to me, I hear it right away, or I start thinking about what you're like, why are they saying this to me? You know what I mean? Like, right? What do they get? Yeah, if solar panels were really affordable, I'd have them by now. Like, that kind of an idea, yeah, you know, like, I'd be up for solar. I'll take some free electricity. But if you're selling it to me, that must mean that I have to spend $20,000 to get my solar panels to save $400 a month, or whatever, or something like that. Like I don't know how that's gonna take a while for me to make that money back, right? I'd love to help the planet, but I don't have 20 grand to throw at the problem, correct? So I see that it says that. Now this is interesting. Would you call yourself emotionally reactive or no?
Jennifer Smith, CDE 19:01
I would say it depends for me, okay, emotionally reactive when appropriate, like when my cat passed away. Jenny, very sad. No,
Scott Benner 19:12
Jenny's cat passed away recently. Yes, she got on the last time we recorded. I was like, Are you all right? She's like, I just haven't been a bad thing. My god,
Jennifer Smith, CDE 19:20
yeah. So emotionally reactive there, I think inappropriate scenarios, yes, right? But other tie ins and like
Scott Benner 19:28
you've never seen a necklace and ripped off all your clothes and run around excited or something like that. Oh, my God, I have to have this, right? No, not at all. Yeah. Well, so if you're a low if you're low on that emotional reactivity, you're less likely to fall for it. So the reason I'm talking about marketing is because, whether you know it or not, the people you're looking at on Tik Tok and Instagram, either someone is paying them to do what they're doing where they're trying to get popular enough so someone will pay them for what they're doing. No one. Is doing a fit check for you, just because they want you to see how cute your butt looks when you show them your shoes. Like, like, like, that's most people are like, well, if I can get this thing big enough, someone will come now, the joke's on them. Unless you get so big you really don't, there's no money to be made. Really. There are a lot of influencers that make $25 for something like, something where you're like, oh my god, I get so many. It doesn't work like that. Like, do some Googling and find out what a, you know, 1000 Yeah, 1000 views on YouTube. Make sure, for example, because it's nothing, not a lot. Yeah, all right, right, it's not. I think I could. I think I get a check from YouTube, like once a month for like, 98 bucks. And I'm like, not trying to be big on YouTube or anything like that. But, yeah, I don't know, I do a few 1000 downloads a month on YouTube, but it's because all I do is put my podcast up there, right if I was to make a video and put a nice background behind me, and put up some lights and pull out a device like an omnipot or a Dexcom, which are very sexy on YouTube. Oh, I don't want to talk about it like this, but, you know, like a bullshit tutorial about how it works. Like, you know, here, like, basically read from the manual, but into a camera, push the button,
Jennifer Smith, CDE 21:06
and this is how it works, and it'll blink at you here, and, yeah,
Scott Benner 21:10
those things will get you hundreds of 1000s of downloads. Yes, there's nothing to say about how a Dexcom works that takes more than about eight seconds, right? It's not a 20, right? Yeah. Like, it's almost like, when people say, like, there's so many episodes about how people manage, but those people use pumps. What if I use MDI? I go, Oh, just do the same thing. Like, it's, you can't do extended boluses, you can't shut off your basal. You'll have to inject more. That's it. Like, there, like, what you want a series about that? I can't make you a series about that, like it's about the insulin, not about how you put it in, generally speaking, right? Those device things are exactly the same. Now, if you do like a drill down episode, like I did with like, how Omnipod five works for people, that's different. But if you're reading from the manual or from the marketing materials, you're just trying to take advantage of people's fear that they don't understand how this thing works.
Jennifer Smith, CDE 22:01
They don't know what they've been taught, yeah, and they probably have, at that point of looking up a device, you're looking for more information that you feel like you didn't get when you were initially trained on it, or that you really maybe, maybe you don't read things well, and you do visually work better with like sight, yeah, you get to see how it works, where to push the button, what the screen should look like. I think there's, you know, validity in seeing that type of a thing for a specific learner,
Scott Benner 22:30
right? There's no reason not that. I'm not saying you shouldn't, like say it. I'm just saying that those videos shouldn't have hundreds of 1000s of downloads. Like, you can figure out how a thing works holding it in your hand one time. Like, you know what I mean? Like, it's and I get the like, oh, it's got insulin in it. I don't, okay, like, I don't disagree, but the amount of your basal per hour doesn't change because the screen looks different on this one than that one. Like, that kind of stuff, right? I'm just saying that that's taking advantage of, like, a fear, or taking advantage of your excitement about the thing, like, Oh, I got a thing I want to go. That's another thing that's new to this, this kind of life now too. Like, I bought this car, I'm gonna go watch 9000 videos about it, about it exactly the cars outside. Go look at it,
Jennifer Smith, CDE 23:15
right? Go take a peek under the hood. See what it does. What does it sound like? Is it supposed to do that? Then, great, right? You're all set. We're all set, turn the turn the engine on and move. But I think you're right in bringing, you know, a bit ago, you mentioned that this also, it does navigate into our devices that we use, or diabetes, and the visibility that we now have two devices, you know, years ago, when pumps and CGM and newer blood glucose meters and all those things were really starting to ramp up in their design and what they could offer, we didn't see fancy people wearing the device and, yeah, advertising them, because that's really what it is,
Scott Benner 23:58
right? Listen, I get it like, I get why people see What's that girl's name? Is that? Lila moss, the model? She's, yeah, and her mom was a model. I probably sound stupid right now, you know. And she's wearing, was she wearing Omnipod? Maybe. And, like, she'll wear it on a runway, which is awesome. Like, I think that's terrific. I also think she didn't have a lot of options. She does have type one diabetes, and she's working, she needs to wear her insulin pump, right? And it's cool that she's not hiding it, and I think it's awesome for people to see it. As a matter of fact, I've seen threads in my private Facebook group all the time where someone will just say, like, if you could just share a video of your kid putting on a device or, right, a picture of your son or daughter wearing this thing, it would mean a lot to my kid. I understand that, right? I 1,000,000% understand that there's a use case where I go, okay, that makes a ton of sense to me, right? But go ahead,
Jennifer Smith, CDE 24:52
I was gonna say and in the same line, not only other kids or other people that you don't really know kind. It goes back to my not understanding why we why you'd want to watch somebody you don't know. In this case, I find it purposeful. You find connection with another little kid who's seven years old, or another football player who's 14, right? But I think in terms of what we see in the bigger scale of media coverage, like the model or known personalities wearing them, I think not so much in as an as an adult, I don't care who wears what, right it doesn't affect me. It's great to see in personalities that are more famous, but from a kid perspective and even like a teen perspective, I think what it does provide is some visual to what is possible, right? The football that the football player has got the pot on an arm and a CGM on the other arm. You see that as a kid, and you are a football player, and you're thinking, I never thought that I could actually go that far. Oh,
Scott Benner 26:00
I don't have diabetes. And I saw a guy kicking an extra point the other day with an omnipot on, and I was like, that's awesome. Yes, that's just for people who think, like, gosh, this thing happened to me. I'm by myself, no one else. That stuff is great. Like, I'm not, yeah, I am definitely not saying that. I just don't. So here, I think here's the problem is that you start off saying I'm going to use social media to talk to people about diabetes, yeah, and then you come to realize that they don't care, and they're not going to pay attention, and that doesn't get you big numbers, and it's not going to happen. So then they start leaning into other social media trends to try to get the following, and that the idea is to like, but then they don't talk about the diabetes anymore, like, and it's not their fault. I'm just going to come out and tell you, no one's going to watch your tick tock, you know about, you know, like, no one cares. Like, like, here's 10 variables that might impact your blood sugar. Like, no one's like, that's not what tick tock is made for. Tick tock is made for, like, that's funny, that's stupid, that's crazy. Like, yeah. Like, right. So I understand what happens to the creators. Like, they're like, I'm going to share good information. Good information is not going to get you widely picked up. It's not how the
Jennifer Smith, CDE 27:09
the algorithm works, because it's not shiny and sparkly. Yeah, the algorithm is
Scott Benner 27:13
not pushing that kind of content, right? I shared with you before we started recording, and I'm happy to say it here is, like, some, some nice guy on tick tock, like, found something really interesting about one of my episodes recently, made a tick tock about he's got like, 350,000 like, views on it. Right now, I'm the guy that makes the goddamn podcast. I couldn't, I can't get 350,000 views on like, talking about my about it, but he did. He was like, but then when you look at it, it had a sensational bend to it, and I've been paying a lot of attention to that this week, because the same thing happened to me within my my private Facebook group. So that it's, I don't know what episode it is, right, but a nice woman comes on and tells a story of our kid who got 150 units of insulin instead of a unit and a half from her school nurse. I
Jennifer Smith, CDE 28:01
haven't listened to that one yet, but I can't imagine the horror.
Scott Benner 28:06
Yeah, a fairly harrowing tale, like, I'm not gonna lie to you, and the mom was lucky enough to be at the school, but she panicked a little bit, and so it got really close, like it was not I mean, the kid's like, seven years old when this happened, 150 units. You know what I mean, right? It's episode 1323 it's called school nurse mistake. Now, in that same week, I had a woman come on and tell a story of her husband who had a borderline personality disorder, and she's trying to get her kids with diabetes away from him. Arden came on and talked about how she doesn't understand money. A 52 year old lady came on and talked about how the religion she grew up with was, you know, hard for her. You know, a 19 year old girl came on to talk about all of her health problems. She's off at college, and she and I tried to go through them together. You and I talked about what frozen shoulder is, like. A lot of stuff came out, right? There was a cold wind episode where a med device sales person came on, it was like, this job wasn't what I was hoping it was gonna be, right? None of them blew up anywhere. But the one about, can you believe that a nurse gave my kid 100 almost died? Like, right? Like, you know, I'm afraid that that'll happen to me like, I'm afraid that someone will give me too much insulin. I'm afraid they'll give to make it boom, it explodes,
Jennifer Smith, CDE 29:21
right? Because it's drawing from one of those emotional responses, fear, right? Yeah. And so it's going to get the
Scott Benner 29:28
hit. And you know that? Then I see somebody post in the face my Facebook group. I post in my Facebook group all the time. It doesn't matter unless I say something crazy. It doesn't matter if I go in there right now and say, I swear to you, you want your a 1c to go down a full point here. Listen to this episode. I guarantee you that you'll understand pre Bolus thing better. It won't do much. The algorithm won't push it. Nothing like that. If I jumped in there and said I had a bad day, or even if I say, Hey, by the way, I left the the editor left a curse in this episode by the. Thick. I'm sorry it's been taken out if you got it and offend you. I'm sorry it wasn't our intention that stuff blows up. Sure, that stuff all blows up. And
Jennifer Smith, CDE 30:07
what's it? Reacting to emotion,
Scott Benner 30:10
yeah, or titillating, you know, whatever it is, like curse words, like that kind of stuff. But so I see somebody posts in that group like, Oh my God. I listened to Episode 1323, about the school nurse and blah blah. That Facebook algorithm showed it to everybody that is in that group like it. Just pushed it and pushed it and pushed it. And I'm over here going, I wanted you guys to know what frozen shoulder was because,
Jennifer Smith, CDE 30:32
because it's important, it's important for you to know
Scott Benner 30:35
doesn't matter. It's not how it works. So I don't know, Jenny,
Jennifer Smith, CDE 30:39
I don't know. Would it push it better? I don't know much about the algorithm, or the algorithms, whatever it's using. Does it need, like, a tap dancing episode, like, does it need a video of somebody doing something entertaining to push it Well,
Scott Benner 30:54
here's the problem. Is that I get my tap shoes out, I feel like and I don't know if you know the phrase, it gives me douche chills, to do stuff like that so I don't get involved. I don't like, I honestly could take important information, I swear to you, and put it with a picture of a puppy, and more people would say it. See it, yeah, I can do that like that. Absolutely works. I've tried it for fun. I'm like, oh, that worked. I'm an adult. Like, I can't bring myself, like, right? There's a reason that when you open up any scrolling app, that if it's a girl, she's running towards you in the when the video starts, you don't know this, Jenny, because you're I don't,
Jennifer Smith, CDE 31:32
I don't have social media. I don't it makes, it makes their bosoms
Scott Benner 31:36
jiggle, okay, yeah, you understand how that works. Yeah, I'm a girl. And then people go, Oh, boobies. And then they hold for a second, right? Or, like, when the video comes up in the first person, the first thing they say is, don't scroll away, because you actually go, oh. Or wait till the end. There's nothing at the end. Let me tell you, it's nothing there. But if you stay to the whole end, the algorithm thinks you like the video, and then it shows it to more people, cute, I see that's exactly what like. So that's how these little things, like, you know, work. But the crazy thing is, is, we all know that's
Unknown Speaker 32:09
how it works,
Scott Benner 32:11
right? But I still buy the shoes
Jennifer Smith, CDE 32:13
Well, and that's the funny thing. So I mean, it's explained, I guess, a little bit better by Just Your short little blurb there, because I have seen, on the occasion that I've perused your your group, I have seen where people include a pic, a picture for the algorithm, like it's a picture of your dog. I don't understand, but clearly, dogs get hit. I don't know. Maybe people like dogs.
Scott Benner 32:37
Facebook favors images over video. If you put up a video of the same dog, it won't do as well. Interesting, Facebook doesn't love video. Instagram used to love pictures. Doesn't love pictures anymore. Now it loves video like so they they skew them towards certain stuff. But what that leaves it back to is you're either going to be a person like me who's like, Look, I am going to keep pushing out good content, and you guys will find it, but I am not going to whore myself like that, right, right? Or you get somebody who's like, I've got good information here. I guess I'll change my pump in a pair of shorter shorts, right? You know what I mean, like, I guess. And you see, listen, we all see people do it all the time, like regular or I'll go on a vacation and then do my diabetes stuff while I'm on vacation or on a beach, or I'm a little sun kissed, or something like that side
Jennifer Smith, CDE 33:24
during a hurricane. The ones that the news reels, that I actually would like to see are the ones with the men in the coats, like outside during the hurricane. I'm not laughing about the hurricane. I feel I feel terrible, because I do. I said that to Nathan. I was like, I feel bad that this poor man has to do his job outside getting blown away. See
Scott Benner 33:45
how nice you are. I walked into the room the other night, and, you know, I don't know who it was, one of the anchors was standing outside, and I said to Kelly, I'm like, I don't want anything bad to happen that guy. But how awesome would it be if he just blew away right now, just, if he just, if he was like, we think, once, anyway, it was just gone, and we heard him yell as he was going away. Like, because
Jennifer Smith, CDE 34:04
what you're saying, though, is sad that that is what grabs
Scott Benner 34:08
Yeah, well, they do it on purpose. I mean, they CNN, shoves. What's his name down there. He's wealthy, for God's sakes. He doesn't need it, but, um, Anderson Cooper, Oh, right. I mean, his mom was a billionaire, wasn't she? Like, I think he's okay, is what I'm saying. It's but, but he pours himself out and goes and stands next to that hurricane, right? Like, because that's what people want to look at. And I'm just like, look, I try. Like, I'll jump up and I'll make a video, and I'll be like, Hey, listen on this week's episode, we talked about this, this and this, it never catches on. Like, it just never does. Like, when even companies will ask me, like, why don't you try harder with your social media? And I'm like, the podcast is very popular, and people actually listen to that. They don't just scroll past it. You don't get 10 seconds out of them, and then they're like, and they're gone, you know? And what
Jennifer Smith, CDE 34:52
you're getting also is, it's more old school referral, it's, did you know about. About this, and because the community within diabetes on social media has grown in so many other places, there's the ability to share information, or now groups that are, you know, able to get together again. Did you hear about this? Or did you know about this? So you've got what is still the telephone call kind of right recommendation or referral. You don't need the cute dog with the bow tie? Yeah, I'm
Scott Benner 35:27
not, listen, I'm not gonna bounce myself at you. That's not gonna be me. I'm gonna put out what I think is good content and hope that you like it and listen to it and tell somebody about it like, that's my only that's my only option. But listen, I also can't tell you, like nobody would want to see me in my bathing suit talking about something, but if somebody wanted that, like, would I? And I don't think I would, because some of the things we talked about earlier, but I just saw the other day, and I have to pause here. I'm just gonna say it anyway. But I think these people are advertisers, but I just saw the other day this like, kind of glitzy, like red carpety event to push a thing. And there were diabetes influencers there. I know who they are, and I know how hard they're trying to get a audience so they can charge people money for their content. Like, I know what they're doing, right, and they're so happy to be there, and they're all dressed up. And I thought this influences no one, in my opinion, like, who looks at this and says, Oh, I'm gonna do this now, because the guy from the thing is Stan, like, he seems to be having a great life. Sure, he's dressed up very nicely. He's at a nice dinner. You're not there, like somebody
Jennifer Smith, CDE 36:34
paid him to be there, to be the visual.
Scott Benner 36:38
I also don't understand why that doesn't make people angry instead of, like, desirous, because I've seen people do that too, where, like, their thing blows up, and they'll get like, a real expensive item, like a car or a home or something, sure, and now they're showing it to people, and I'm like, I don't understand why you think that's attractive. Like, why do you think other people are looking at that and going, like, oh, he has a $300,000 car. I'll listen to him,
Jennifer Smith, CDE 37:01
right? I think that that's what it kind of boils down to for me, and my lack of understanding it's exactly what you're saying. I don't need to see all of your bling that I don't have, but I also really don't care about, yeah, and why should I? I've got other things I need to navigate, enjoy your
Scott Benner 37:18
car. Like, that's cool. Like, actually your thing worked out like that for you. Like, I'm actually one of those people. I'm like, good for you. Like, that's awesome, you know, but I don't understand that. If he's showing it to me, why, I would be like, Oh, whatever he's saying. I'm gonna do that because, look at that car. I don't get that. I just don't understand, especially in other walks of life. But we've changed there too like so I'm old, right? But I was there in Philadelphia when the first NFL player went into free agency. Oh, okay, so Reggie White, he filed a class action lawsuit. He got free agency for NFL players. I believe that NFL players should be able to sell their wares wherever. I don't think they should be restricted by who they're under contract with, right? People love this man. Okay? They loved him in Philadelphia, if you would have said Reggie White's outside and he needs you to cut off your pinky right now and give it to him, people would have run out of their houses holding their pinkies up in the air. But when the media told you that he got a four year, $17 million contract, people hated him after that, like, as soon as they knew how much money he had, and it was more than them, and they could do that, that's not fair. Like all he does is play football, that kind of thing, even though, back then you could have made the absolute argument, the only reason the Philadelphia Eagles made money was because of that guy, right? People turned on him right away. But then fast forward, how many years? 30 years, 40 years, people are like, Oh, he makes a lot of money. That's cool. Yeah, you're not going to make that much money ever. That's not happening for you. Like, maybe that's what social media has done. Is it allowed you to believe that you are just a couple of moments away from being that person that you're looking at?
Jennifer Smith, CDE 38:58
I guess maybe that's a interesting, interesting view on it. Yeah. And again, depends person to person, personality, I guess. And what's I don't know, not necessarily, what's important to you, but yeah, I don't know if people are interesting.
Scott Benner 39:15
I'm gonna Google this last thing before you go. Ready. Percentage of Americans that want to be an influencer. Reggie White, well, 57% of Gen Z ers want to be influencers. And
Jennifer Smith, CDE 39:34
do you think the real reason boils down to the baseline understanding that they think it's a monetary road more than
Scott Benner 39:41
half of Gen Zers think they can easily make a career in influencing
Jennifer Smith, CDE 39:46
a career. I guess that's where the hard thing for me is, because look at how, look at how fast trends change. And so if you become an influencer on these cool, fancy hoop earrings that monitor your heart rate. Yeah, right. You know, just great. But how long is that going to be around for you to influence on that particular like you're gonna have to continue to navigate the newest and the newest and the newest and I there's so much life to like, experience and enjoy that. I
Scott Benner 40:22
feel like, yeah, like, you'll make yourself a professional glitter sticker on your face influencer, and then that'll go out of vogue, and then you'll be like, uh, what do I do now? And the answer isn't, go find the next thing, because you're done now. You used up. You can't keep making it happen. It's very difficult to keep a thing going for like, take it from me, it's very difficult to keep a thing going for 10 years, for a long time. I'll share this with people, because I think it makes the point. And I don't think I ever would have said this on the podcast otherwise, at one point, I was aware of 100 other type one diabetes podcasts that began after mine and then failed, and there's a couple that are holding on, God bless them, like I really do feel like that. They should. I hope they're helping somebody. Yeah,
Jennifer Smith, CDE 41:06
because I think there's value in what gets put out there, in whoever it reaches. It's reaching somebody who needed something.
Scott Benner 41:12
My voice is certainly not the only voice, and that's wonderful, right? But those other ones, if you go look at charts, they don't chart really, it's great. They're reaching somebody, but they're not doing what this is doing. And this is it's random. I couldn't do it again, but
Jennifer Smith, CDE 41:30
you couldn't put a prescription to do this, then do this, and then move this way. You just kind of moved with the way that things were, and probably just the way that your brain thought about moving forward with the atmosphere of how things were changing? Yeah,
Scott Benner 41:44
I zig and zag. And also, for those of you who are out there killing yourself for trends and stuff like that, I ignored all of that the entire way. I never looked at social media. I always looked at what I thought was content that would help people. Sure, that's my main focus. Anyway, I don't understand why people are that easily influenced, although I guess I have a better understanding now, after we write about a little bit, yay, but I appreciate you doing this with me.
Unknown Speaker 42:05
Thank you very much. Absolutely.
Scott Benner 42:13
This episode of The Juicebox podcast was sponsored by us Med, US med.com/juice, box, or call 888-721-1514, get started today with us. Med links in the show notes. Links at Juicebox podcast com, a huge thank you to one of today's sponsors, gevok, glucagon. Find out more about G vo hypo. Pen at G VOQ, glucagon.com. Forward slash juice box. You spell that, G, V, O, k, e, g, l, U, C, A, G, o, n.com, forward slash juice box. I'm looking for guests for this series, so if you have a thing you don't understand, diabetes related or not, and you'd like to come on the podcast and figure it out together. Reach out to me through the website, Juicebox podcast.com let me know that you're interested in being on an I don't understand episode and what your topic might be. The Diabetes variable series from the Juicebox podcast goes over all the little things that affect your diabetes that you might not think about, travel and exercise, dehydration and even trampolines, Juicebox, podcast.com, go up in the menu and click on diabetes variables. Are you starting to see patterns, but you can't quite make sense of them. You're like, Oh, if I Bolus here, this happens, but I don't know what to do. Should I put in a little less, a little more? If you're starting to have those thoughts, you're starting to think this isn't going the way the doctor said it would. I think I see something here, but I can't be sure. Once you're having those thoughts, you're ready for the diabetes Pro Tip series from the Juicebox podcast. It begins at Episode 1000 you can also find it at Juicebox podcast.com up in the menu, and you can find a list in the private Facebook group. Just check right under the featured tab at the top, it'll show you lists of a ton of stuff, including the Pro Tip series, which runs from episode 1000 to 1025 Hey, you listened all the way to the end. You might want to know more about the Juicebox podcast. If you do go to Juicebox podcast.com scroll down to the bottom and subscribe to the Juicebox podcast newsletter each week. You'll get a rundown of the shows from the past week, just in case you missed something and you think, Oh, I would have loved that. Now I know, Hey, what's up everybody? If you've noticed that the podcast sounds better, and you're thinking like, how does that happen? What you're hearing is Rob at wrong way recording, doing his magic to these files. So if you want him to do his magic to you, wrong way recording.com, you got a podcast? You want somebody to edit it? You want rob you?
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#1379 Love At First Slice
Jay is 72, T1D since he was in his 30s.He started out in EMS and nursing and got into teaching. He’s passionate about 504 plans.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Welcome back, friends. To another episode of The Juicebox Podcast. Today,
we're going to speak with Jay, who's had type one diabetes for 40 plus years. He's been in EMS nursing teaching, and he's incredibly passionate about 504 plans. Nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code, Juicebox at checkout. That's Juicebox at checkout to save 40% at cozy earth.com. When you place your first order for ag one, with my link, you'll get five free travel packs and a free year supply of vitamin D drink. AG, one.com/juice, box. The Diabetes variable series from the Juicebox Podcast goes over all the little things that affect your diabetes that you might not think about, travel and exercise to hydration and even trampolines. Juicebox podcast.com go up in the menu and click on diabetes variables. Today's episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at contour next.com/juicebox Did you know if just one person in your family has type one diabetes, you're up to 15 times more likely to get it too. So screen it like you mean it one blood test can spot type one diabetes early. Tap now talk to a doctor or visit screen for type one.com for more info.
Jay 1:52
Hey, Scott, thank you for having me. My name is Jay. I started out my professional career in emergency medical services as an EMT paramedic. I even became a registered nurse while still working on the streets, and then got into EMS education. I realized that Elvis Presley was right with his song cold Kentucky rain, and used my RN to move into a hospital. Worked in neonatal ICU and adult ICU for several years and then move my education forward. And ended up teaching nursing for 27 years with other collateral duties. You know, how employers are they want to assign other duties for you to deal with. And so I ended up on the school safety committee, and that ended up with having to liaison with a middle school next door to us. And so we got into learning about lockdown and all sorts of evacuation things, additionally, because I was halfway good with throwing income paper. I was detailed to writing regulations related to nursing education, and now I currently do some beta testing for HIPAA FERPA, type of agencies on the Apple architecture. How did I get into Juicebox? The podcast, I really got into it for through the Facebook page and my diabetes started in my 30s. I was diagnosed type one after failing orals before they got good lab test to differentiate type one to type two. Went to MDI until about 25 years ago, Doc threw me on a Dexcom CGM, then about 25 years ago, because of hypoglycemic un awareness, and so then my pump journey has gone through animus, tandem pods. I've done clinical trials for several different pumping companies. One of my first was a u5 100 to go into a pump, and that failed because of kept getting the pod knocked off. I'm currently doing the limited release with insolette for the Apple platform, and that is going well, Jake, Jake,
Scott Benner 4:38
and tell everyone you're 45 years old. You got all this done the last 15 years. Right now, you just told me, like,
Jay 4:45
actually, I got it done in five years. My God, we
Scott Benner 4:47
spoke before we started. I know you're 72 you were diagnosed at 30. So were you an EMT before you had diabetes? Yes, you are. That's interesting. Okay, let's learn a little more. About you, and then figure out how you got involved in all this stuff and pick because there's a lot here. Also you, you had me on the first 10 seconds, I was like, I gotta go figure out what cold Kentucky rain is about. Look up. Elvis Presley, oh, don't worry, Jay, searching for his lost love through the cold rainy Kentucky. The song captures the feeling of longing and heartbreak. Is that about, right? But
Jay 5:19
the thing about it was that when you work in emergency medical services and you're outside working on a car crash or something of that nature, and you've got cold Kentucky rain dripping down your backside, it's a an awakening experience that you sort of want to get away from. Hard to focus,
Scott Benner 5:37
too, I would imagine. Okay, so, I mean, let me ask for a second, like, what got you into emergency services originally? Do you remember what your calling was?
Jay 5:45
It was strange. I was studying engineering in the dorm, they put out a notice that said, Hey, why don't some of you students join up with the Red Cross disaster team, and we'll teach you first aid, CPR, a few other good things. And this actually caught my attention. I went down that path, and along the way, was invited to join an EMS education, but got picked up an EMT card in Kentucky. And what was sort of ironic at that time was the TV show emergency playing off of the LA County Fire Department. Was a big TV show. Now it's showing up in reruns. But what was entertaining was that almost every paramedic in the United States was six feet tall, had dark hair and a mustache
Scott Benner 6:43
because of that TV show. You think, Well,
Jay 6:45
I don't know if it was the TV show or if they were. They were that good at picking up what the preponderance of first responders looked like, because it seemed like that, Oh, everybody was handsome
Scott Benner 7:00
and dark and tall and all that. That was it. I can remember one name from one character from that show. And other than that, nothing's coming to my head. But
Jay 7:10
how about Randy man tooth?
Scott Benner 7:11
Why is the word gage popping into my head? But somebody's named Gage? So there was a character named Gage. Okay, that's all I can remember. And but I remember the whole opening and how, like, crazy exciting it was, because it was a lot of, like, the opening of the show. I must have been a really young kid, but was like a first person shooter, almost, camera angle of like, the fire trucks leaving the firehouse at first, and then they, like, pick them up on the street and go through and like, yeah, I remember all that. That's crazy. So you're not sure if the producers did a good job of figuring out what firemen looked like or vice versa. No,
Jay 7:43
but I can say one thing, and this pops up in the Facebook Juicebox page, and that is Medic Alert Notifications. What do paramedics look for? Starting in the 1970s through today, paramedics are taught to look for medical alert jewelry at the neck, the wrist and the ankles, tattoos, because they can be injured read made illegible by road rash. In other words, somebody that got thrown down the sad term, but anything other than a standardized medic tag that has probably the star of life, which is that six pointed blue on white, see it on the side of an ambulance a lot of the time, but things Like the little clip ons to a watch band. Those are not really good because they can be ripped off. The watch band stays. But where did that little metal clip on notice go? And
Scott Benner 8:52
people think, because I've done a whole episode about this with an emergency services worker who said the same thing, like, we don't look at your tattoos, neck, wrists, ankles, and that's what I'm looking for, very quickly. I think that shocked everybody when that person came on and gave that interview, but I had known that because of I'd been a volunteer fireman for a few years when I was young, and I was aware of it. So I keep seeing people talking about it. I'm like, Look, it's nice. And you know, you might get lucky, like, maybe somebody will turn your arm over to put an IV and it'll say type one diabetes on you. But like, what if that tattoo blends in with everything else or whatnot, and I don't know it's the
Jay 9:29
other thing is, I went back to that night in Kentucky, cold, Kentucky, rain. I'm not gonna see in limited lighting. A tattoo. I'm gonna be feeling in the dark. Yeah?
Scott Benner 9:44
I mean, it makes sense when somebody breaks it down for you, you know, but sitting in your bedroom with like a giant tattoo on your calf, you're like someone will say this, but you know, not the case. So, necklace, bracelet, anklet, right? That's what you should be wearing.
Jay 9:56
If insolent is a sponsor this. A good one. OmniPods need to say insulin pod clearly on the outside of them,
Scott Benner 10:05
because they are used for other things as well. No,
Jay 10:08
because if I'm feeling this thing in an emergency situation, working as a paramedic, if I feel this thing on a person's arm, it would be nice if it had in clear block letters, insulin pop.
Scott Benner 10:22
I wonder if people would revolt if they started writing on the pod. It's interesting. You know what I mean? Because, for because the great I mean, for your perspective, it makes 100% sense. And then somebody else might say, I don't want that. To tell people what I'm I don't know. Boy, that'd be a hard one. But I take your point. You do this, you kind of work your way up through the ranks, and then you complete your RN while you're doing work on the road. Yes,
Jay 10:47
how was that? That was great, because I'd already been to paramedic school. Was already working with the paramedics. Matter of fact, I remember one night we made a an accident with injuries. Car was in a creek bed, and I'm hanging upside down, more or less starting an IV in a person waiting to be extricated a car down in the creek bed, but not in the water. And one of my nursing instructors had stopped also, and comes over and says, I'm a nurse. May I help? And I called her by her first name. She said, Oh, it's you. What are you doing? I said, I'm down here starting an IV. She said, Well, good. I don't have to worry about you for IV check offs in two weeks because we hadn't covered them in nursing school yet. But I
Scott Benner 11:37
guess if you could do them hanging upside down, I'm going to assume you can do it that,
Jay 11:41
and then going to neonatal ICU, starting IVs on premature infants, was just a carryover. It micro. It was a micro miniaturization. The one thing that was interesting there was when we had infants of diabetic mothers. This was so far back that the way that blood sugar was checked on an infant of a diabetic mother was with the old pink labeled bottles, I believe the manufacturer was Ames dextro sticks. And we would do it. We would cut those in half to save resources and do a heel stick. And then it was a color metric. We had to eyeball it before meters and all that other good stuff came out. You got
Scott Benner 12:29
to grow up with it from a professional standpoint. But did you ever think you might get type one? Was it in your family? Or was it a surprise?
Jay 12:37
Surprise? Well,
Scott Benner 12:39
it's interesting. Do you remember your diagnosis at all? It's
Jay 12:42
going to be strange.
Scott Benner 12:43
Oh, really, you're going to tell me a story that I'm not going to have heard before. I hope so good. I
Jay 12:48
hope this is one you haven't heard before because of my nursing background. When the IV fluid, dextrose gets spilled on the floor and it isn't wiped up, well, you'll start noticing black spots on the floor. I started being able to associate hold it. We spilled dextrose on the floor over by that bed in the intensive care unit, and now they're black spots. We must have spilled some dextrose when men go walk up to the commode in their home and let rip with a stream of urine. There's a splash, and I started noticing black spots around the commode in my residence. Get out of here.
Scott Benner 13:31
There you go. Jay way to come with a story no one's ever heard. Listen, I've never heard that before, and I have to share with you, and perhaps you saw this, but in the Facebook group last night, members shared that they were low in their car, and very uncharacteristically, just didn't have anything to help themselves with, and kind of panicked a little bit, and looked around their car and found, I'm not kidding you, it must have come out of like a shopping trip, a Can of, like condensed chicken noodle soup in their trunk, and she popped it open and drank it down and grabbed her blood sugar and brought it back up. I missed that one, and I thought, when I read it, I thought I didn't imagine people would ever like continue to be able to tell stories where I was like, I've never heard anything like that before. Found super nerd trunk, actually, if she's listening, you should come on the show. I I'd love to talk to you, hear that story first person.
Jay 14:27
And to go with that, because I was teaching endocrine nursing at the time, I was working with several of the meter companies, and just happened to have in my briefcase, backpack, whatever it was I had a couple of meters at home, and I said, black spots on the floor. I'm gonna do a finger stick.
Scott Benner 14:50
Are we calling the black spots like mold from the sugar? Do you think? No,
Jay 14:54
they were actually oxidized glucose. When you look at the oxidation of glucose. Yes, it does leave behind a cup a stream of or layer of carbon molecules as the water evaporates. That's nuts.
Scott Benner 15:07
What was your blood sugar when you tested? Do you remember over 400 so do you diagnose yourself right there with that tester?
Jay 15:16
Well, the other part is that my wife is also a registered nurse. And we looked at it, looked at each other, and said, Yeah, we got to see Doc, our family practice, Doc, you do what we were like. And so, yeah, it was self diagnosis, but he had to confirm it. So that insurance and all the other
Scott Benner 15:40
Yeah, sure, but you you knew, though, right then and there? Yeah, yeah,
Jay 15:44
it was, you know, the light got turned on
Scott Benner 15:47
the contour next gen blood glucose meter is the meter that we use here. Arden has one with her at all times. I have one downstairs in the kitchen, just in case I want to check my blood sugar. And Arden has them at school. They're everywhere that she is. Contour, next.com/juice, box. Test strips and the meters themselves may be less expensive for you in cash out of your pocket than you're paying currently through your insurance. For another meter, you can find out about that and much more at my link. Contour, next.com/juice, box. Contour, makes a number of fantastic and accurate meters, and their second chance test strips are absolutely my favorite part. What does that mean, if you go to get some blood and maybe you touch it, and, I don't know, stumble with your hand and like, slip off and go back, it doesn't impact the quality or accuracy of the test. So you can hit the blood, not get enough, come back, get the rest, without impacting the accuracy of the test. That's right, you can touch the blood, come back and get the rest, and you're going to get an absolutely accurate test. I think that's important, because we all stumble and fumble at times. That's not a good reason to have to waste a test trip. And with a contour next gen, you won't have to contour next.com forward slash Juicebox. You're going to get a great reading without having to be perfect from the very beginning. Your kids mean everything to you. That means you do anything for them, especially if they're at risk. So when it comes to type one diabetes, screen it like you mean it, because even if just one person in the family has it, your child is up to 15 times more likely to get it too. Screen it like you mean it, because type one diabetes can develop at any age, and once you get results, you can get prepared for your child's future. So screen it like you mean it type one starts long before there are symptoms, but one blood test could help you to spot it early before they need insulin, and could lower the risk of serious complications like diabetic ketoacidosis or DKA. Talk to your doctor about how to screen for type one diabetes, because the more you know, the more you can do. So don't wait, tap now or visit screen for type one.com to learn more. Again, that's screen for type one.com screen it like you mean it to
Jay 18:10
meet your wife at work. I was working as a medic at the time, and one of her co workers had been in a first aid class that I taught, and they had a problem in the food service in the hospital, and they were only able to feed the patients. The cafeteria wasn't open for employees, so her co worker called me and said, This is before the days of pizza delivery. Would you bring us a pizza? So we had love at first slice. First time I laid eyes on her was looking through the lock door of a psych unit. Jay,
Scott Benner 18:46
you've got, you've already given me so many different titles for this episode. I think you said Let her rip when you're talking about paying and and love it first place. I feel like I'm gonna have like, 13 things to choose from by the time we get done with this. But you have so much information in your head. Okay? I feel like I want to fast forward through, you know, you, you know, okay, you found out you had, you had type one. Is that how they diagnosed you? Yes, okay, because
Jay 19:08
I was a little overweight at the time, and Doc put me on Metformin, and it had no impact. Okay, yeah, so he said you, but if Metformin doesn't do anything, you must be type one
Scott Benner 19:20
to have you ever had, like C peptide or auto antibody testing?
Jay 19:24
I've had C peptides to get an insulin pump, okay? And those qualifiedly. And the other part, the antibodies are ambiguous, meaning
Scott Benner 19:37
you don't have any traceable or there's not enough.
Jay 19:40
It's, it's not clear. Oh, I see, huh, but you use insulin. I may be, I may be one of those oddballs that's got both type one and type two.
Scott Benner 19:50
Yeah, it's funny. We used to laugh, like, I've done it, where people were like, I have both types of diabetes. And I can remember thinking, like, you can't have both types of diabetes, can you? Yeah? Now. More and more. You know, at least it's the way they want to talk about it. Maybe just for insurance purposes, I don't know. Maybe it's because of GLP medications that it's starting to come up more. But, you know, they're saying, Look, I have type one diabetes. This is, you know, an immune issue, and I'm really insulin resistant. And if I didn't have type one, you'd say I had type two because the insulin resistance, etc. And it's, it's interesting how they, I guess, how much of the way we think about ourselves, health wise, is dictated. A little bit about the the insurance companies, you know, charting, you know, and what they call things, I don't know, it's a it's a little weird, but so you've been the whole time. You've, you know, basal insulin. You're bolusing for your meals. You don't do that. Your blood sugar gets very high, etc, so on, right? Yeah, okay, I guess let's kind of bounce to, like, stay with your professional life for a little bit, because you listed so many things when you started talking, I was like, God, it's like, you've lived three lifetimes. But EMS, you become an RN, you start working there. How do you get to teaching people?
Jay 21:04
That was a really good look. The good Lord opened the door. I was getting burned out in ICUs, doing, ICU nursing. I started thinking about cardiac resuscitations, the resuscitations that go on when a patient's trying to die in an ICU. My wife was working elsewhere as an RN, and there were nursing students on the unit where she was a nurse manager, head nurse, whatever title, and the faculty member came to her that was supervising the students on her unit, and said, you know, a nurse that would like to teach, we're looking for somebody to teach. And my wife said, Yes, I did. She picked up the phone, called me and said, How fast can you get an over to the nursing school do their application. Because it was a day off, I said, I can clean up and go look presentable. And I ended up teaching, wow,
Scott Benner 22:09
so you just, you couldn't I mean, do you run out of adrenaline at some point? Is it just like it constantly being in fight or flight? Is is that the part that's exhausting?
Jay 22:21
Yes, that that is one of the things, is you almost lose your humanity. Okay, here you are fighting, literally fighting death. It's a tiring battle. You know?
Scott Benner 22:35
It's funny that you put it the way you did, because not nearly apples to apples, but I've mentioned on the show before, when I was younger, got a friend of mine got me a job, like collecting credit card debt. And the same way I would explain to you why I stopped doing that, is what you just said, is like I started feeling like I was losing my humanity, like I didn't it didn't matter that, you know, these people, some of these people, ran up debt with no, you know, visible way to pay it back. But it didn't matter in the end, like, once you were, you know, face to face, over the phone with a person who just can't or won't pay or whatever, and it's there they start telling you about their lives. I just and then it's your job to listen to that whole thing, you know, my husband has cancer, my house burned down, like, you know, I lost my job, and then you're like, I don't care, make the payment or they're going to come take your car. I just, I couldn't do it anymore. It's just like, I can't be a part of this. You know, with
Jay 23:29
your history of being a first responder in your background, you see that, and you know that when they say, my house burned, you really know it's
Scott Benner 23:41
contextual. Yeah, I've seen people lose their homes. I've seen people die in car accidents. I've seen people get maimed in car accidents and then can't work, and to look at them in the face then and say, you have to send money or else. I just one day, I was like, I can't so I can't even imagine literally being there and watching these things happen to them over and over and over again and and then just having to get that energy up to do it again and again and again. What do you know? What's the lifespan of a of an ICU nurse? How long do they usually make it?
Jay 24:09
I've been retired for 14 years,
Scott Benner 24:14
and I don't know. Some people think it's better than others.
Jay 24:18
Some people have better support systems. Some people have tougher skin, and we're all individuals, and so you really can't compare, yeah, one to one, I guess doesn't work.
Scott Benner 24:34
I can just say, if it's hard for you, I can imagine it's really difficult.
Jay 24:39
My Biggie coming off of back to the podcast, is 504 plans, Jay,
Scott Benner 24:46
I gotta tell you, like in your notes, you're like, Why do I want to come on the show? Just those 504 plans. And I, I remember thinking this morning, why does Jay like i with respect? I thought Jay is an older gentleman. Like, what's he talking about? 504 plans. Let me ask you. A lead in question, and then we'll get you to the next one. How does a man in the 70s find a podcast
Jay 25:05
several ways. One because of my nursing background, I would and teaching nursing, teaching endocrine nursing, paling around with the nurse in my indoors office, working with the nurse reps, the manufacturers, reps, the Dexcom, the Animus tandem, I learned a lot about the education of patients in an endocrine office, and then that tied back to something that happened. I guess it was actually the late 80s, late 1980s can I put this story on, on Juicebox a couple of times, but where I got by seed, planted for 504 was much before 504 really had even become an issue. I've forgotten whether this was a first or second grader, but it was a transfer student, transfer at beginning of the year in January. So over the holiday break, child changes schools about 15 minutes before lunch. This child pulls out a little plastic box. This is in the meters had come out. Doesn't finger stick. Meter pulls a vial, pulls a syringe, draws a sliding scale and injects themselves quickly. The teacher was so overwhelmed, they didn't have time to respond before the child was finished, right? They were, they were into, definitely, definitely. The seven year old was independent. The sad part was that the school had just implemented, the school district had just implemented a zero tolerance to drug paraphernalia.
Scott Benner 27:03
Oh, the kid's gonna get in trouble. The kid
Jay 27:07
was taken to the police station for possession of drug paraphernalia.
Scott Benner 27:14
It's always fun when people can't think, okay, okay. Now we got the seven year old. Is it the police station. How do you witness this? How do you know about it? Professional
Jay 27:24
channel, okay, and needless to say, the parents sued and said, you know that here? And here's a good word, pneumocephaly. Break it down. P Mo is air. Cephalid head, the El wise condition of so there were some people in that county school system that had Airheads.
Scott Benner 27:50
Isn't it crazy, where people just can't, like, stop and assess it, you know they mean, like, yeah, there's a drug. This is not drug paraphernalia. This is medical equipment. So
Jay 28:00
anyhow, they found Americans with disabilities. Act had come out. They found out that diabetes was protected. So yeah, this kid could do what they wanted to. Didn't even have a school nurse at the time. They didn't have 911 it was so they were still implementing that. But anyhow, I learned about it through the professional circles that had come about. So that's what got me planted the seed. It didn't germinate for a while, until, actually, I was teaching. And then we started looking at lockdowns in the safety committee that I was on while teaching nursing. And we started looking at, well, what about these kids in wheelchairs that are in the school, did need to evacuate from the school campus to the community college campus to shelter while they've got a chemical leak in the building, that sort of thing. So that's what, where I learned about 504, plans. And then started, as I was pumping and getting into Facebook, started realizing, hold, there are a large number of posts my child's school isn't playing
Scott Benner 29:06
by the rule book. Yeah, there's twice a year that it becomes an incredibly popular conversation the lead up to the school year. And actually, when the school year ends and the summer starts, I think a lot of people think, Okay, I have to get one of these ready for next year. And then, of course, people you know being diagnosed throughout the year who come in and eventually will speak up and say something went wrong at school. And somebody says, Oh, do you have a 504, plan? And then that starts that conversation again. Like, I don't know what that is, because why would you know before your kid was diagnosed? We don't do a great job of talking about it. And a lot of schools, not a lot, but a fair amount of schools that you see people talking about will just ignore the 504, plan, or argue with you about what can be in it. Or, you know, sometimes you are with a private school, and they'll, they'll say, like, well, we don't have to abide by that. People run into a lot of different
Jay 29:55
problems. Let me, let me. Let me jump in on that. Yeah, privates, there. Are two sections that come into play on 504 plans. Title two is public facilities, and Title Three is private facilities. And so yes, the private facilities have to accommodate a lot of times they will say we don't have the resources and try to slip the bull between the horns. But yes, there's, there is the title three, and then there is an escape for the faith based organizations. Yeah, I've seen that as well. The only problem is that the faith based organizations are included if they receive government funding. Okay, but now hang on. I just saw this one in a But
Scott Benner 30:47
Jay let me go for a second because I thought 504, plans, they didn't apply to private schools unless the schools took federal funding. Is that how that works? As far as you know, I can look it up, but I think that's what I'm that's, I think there.
Jay 31:01
That's sort of a gray area, because it's like a private business, if it's large enough, it has to accommodate,
Scott Benner 31:11
oh, this side. Oh, yeah, see, it's again, I don't know enough about it, but I don't think anybody else does either. And I do think the schools often do what insurance companies do, they just they turn you down the first time to see if you'll stop, you know, and that does happen a lot.
Jay 31:27
And then, to add insult to injury, state laws impact the action that's local school boards can implement, for example, if the state has in its Nurse Practice, act that a school or a nurse working in a school may delegate certain listed medical activities or nursing activities to an unlicensed purse trained person. That's fine, and so that school can take care of the key 1d the insulin dependent child, and because of obesity, we're even seeing type twos that are insulin dependent in schools. The thing about it is, though, that if the state law says no nurse shall delegate, and it includes certain nursing activities that the child needs to have done by an unlicensed staff member. Then that state has a difficult situation to deal with. They have contradictory
Scott Benner 32:42
laws. Yeah, listen, I just did some Googling around it, and every return almost takes you back to like a lawyer's website. So obviously, there's confusion in the world. When there are so many different states and states have different laws and different rules and regulations to follow. I think it's where all the confusion comes from. Also, when you see somebody ask a question, then somebody's like, no, that's not right. This is right. It could just be right for where you live and not for where that person lives. Even your explanation tells me that it's a confusing, maybe on purpose, confusing situation, because I think the schools don't want, I mean, listen, I only have my own, you know, experience to go from. But I wrote a pretty, I think, reasonable 504 plan for Arden when she was going into kindergarten, and the school counter at countered me with a 504 plan that had like, four or five bullet points on and I ended up going back and saying, like, if you think these, like, four things you wrote down here are enough, I'm like, Yeah, I don't think you're going to be able to keep her alive for a month like this. And you know, oh, plenty of kids that come through here with type one diabetes, and we know what we're doing, and blah, blah, blah. And then you meet those people, and their kids blood sugars are like, 250 all day long. And, you know, and then they've but the school's like, See, they're fine. I'm like, That. Mean, that's not going to be okay for us. Their brains working in syrup. Yeah, right. It's a little hard to think when your blood sugar is high. I mean, let's not do that to people, right? And then later, you know, say, Oh, they weren't good students or they but I'm like, You're not giving them a chance. But that's
Jay 34:10
why, that's why law enforcement is taught to look before they go for alcohol intoxication. They they ask, Do you have any medical conditions I need to know about, right?
Scott Benner 34:22
Yeah, because a lot of things can alter you. I mean, my experience Jay was just that I didn't know what a 504 plan was. Somebody told me about it. I think I found an example that the ADA had. I might have found an example that JDRF had, and I cobbled them together, took the parts out that seemed like they were important to Arden, kind of put it together back that way. I didn't know what it was. I only knew I was doing it because I was supposed to. You get to the school, the school, they don't know why, but nobody knows you know what I mean. And then you just, sometimes you you end up amicably, and sometimes you end up in an argument. And just, it sucks,
Jay 34:59
I'll tell you. And. It, it does. And then, then you get into the Office of Civil Rights, yeah. And also,
Scott Benner 35:04
a lot of people don't want to be involved in all that. You know what I mean? If somebody would have said to me, Oh, you're gonna have to call an attorney for ardent 504, plan, I might have been like, I'm not gonna do that. You know? Like, it's ridiculous that, that we can't agree on some basic ideas about what kids with type one need. And, you know, why can't that just be like, you know, where everyone's rules start, and then you can, you know, change from there. But we're at least going to have people in the in the school that know how to use glucagon, you know, if the kids self sufficient, we're not going to drag them around to a nurse's office if they don't have to be cool, if you want to follow their CGMS, and if you don't, okay, whatever, like, you know, but don't block us from using the Wi Fi and then tell us you're not going to follow it. You know what I mean? Like, just simple stuff.
Jay 35:49
Well, the there are two Facebook groups that support these narrow segments that you're seeing in in the Juicebox group, and those two groups, one of them I actually created a few years ago, is 504, diabetes. And one of your assistants, I can't remember which, which title she has. Nico is always pointing which will she'll drop my name in a one of her comments.
Scott Benner 36:22
I do see you and Nico interacting quite often. That's, that's, she's wonderful, yeah.
Jay 36:26
So yes, Nico and I have a good working relationship to pop up, and usually I'll end up inviting people to either 504, diabetes or one that Carrie Murphy has put together that is really great, and that is following T 1d
Scott Benner 36:46
I think she's emailed me a couple of times, but I just don't never have the time to dig into it. You need to get her on the show. Yeah. Okay, that's good to know, because I also run into the broader issue that the Facebook group is is pretty big. And if we start letting people, you know, for the lack of a better term, pimp their thing all the time, then it just turns into that, then people can't talk. If I told you how many posts get, you know that don't go up because we we don't want people selling their books or their CGM covers, or they, know, telling them about my group that I made, or I'm walking for this company. Can you do this for me? And like, if we can't let all that stuff happen, because it would overwhelm the group with it, would the group ended up looking like a flashing billboard in Times Square, right? So we just have a it's a blanket rule, because I don't know what people think, but like, I'm one person. I have a life, and I make the podcast, which takes most of my time, and then I do my best to manage the Facebook group, which takes a lot of my time. And there's lovely people who donate their time to kind of look over the group and stuff like that. We don't have a company overseeing it like, you know, there's not an army of people looking at every post. So blanket, you just can't pimp, and that's the end of it. And you get, your stuff gets removed. If you do, we also don't want people selling their diabetes supplies, because, you know, we're giving away their diabetes like you think, Well, why can't you let people give their diabetes supplies away like you would in a perfect world, that would be lovely if they wanted to give something away, except then 55 scammers will come in and pretend to be giving something away to steal $20 of shipping money from you and like, it's just it, you know, and it becomes that, and I think it's possible to what you just mentioned, curry, right? I think she just got mixed in with all that in my my inbox, to be perfectly honest, because Pete, I'll email you, yeah, thank you. My day is full of people wanting to sell something or use the platform I have to elevate their thing like it's just, I can't, I don't have time, so I just don't look at any of it. And then I it sucks, because then sometimes real stuff gets lost in the shuffle. You know,
Jay 38:52
I have one that has gotten lost in the shuffle that goes back to my being an educator. Old teachers retire, and they changed their handouts. I changed from nursing to diabetes, but the one that we talked about was the Office of Civil Rights. The problem is that there's several of those in the executive branch of the US, government, education, justice, health and human services. All of them have an Office of Civil Rights. So one thing that would be good for listeners who are commenting, I got in touch with the OCR. Which one? Yeah, it's like when I, when I most of the time, if I'm thinking about it, when I use Ada, I'll put ADA hyphen act or law when I'm referring to the Americans with Disabilities Act, and I'll use ADA hyphen, or when I'm using when I'm referring to American Diabetes Association
Scott Benner 39:47
candy that they both have the same acronym. Oh, yeah. And
Jay 39:51
then we're into more education. And something that I see is that many prescribe. Drivers and users. I mean, watch posts with this set of glasses, the prescribers and users blow off training. How hard can a CGM be to use? Oh, you can slap it on. You can get the wire under your skin. But what does the data mean? Maybe
Scott Benner 40:23
you are too. But I'm always surprised when somebody tells me, my doctor said, My endo said, Oh, I'm not familiar with that pump. I think, Well, how long would it take you to become familiar with it? Just isn't that your job? Like, do it, you know what I mean? Like, What an odd thing to be involved in something like that. And then look at somebody, oh, I don't know that one. Well, I
Jay 40:43
actually had that happen. I imagine one of the pump companies had a layer and share program, and I was a little bit too late jumping on because I needed to get my endo sign off on, because it was prescription material the endo nor there I'm going to use CDE. I get tired of trying to say five letters. Fine with me. But their educator was unfamiliar with the pump also, because they didn't have a boots on the ground rep in the neighborhood. So I knew more about the pump that particular brand than they did. So the prescribers that hand will say, hand a handful of samples to a user and say, Go, try this CGM. And the user then says, Oh, thank you for the new model. I've been using that brand in the old their old system. It can't be, you know, I don't need to know anything. Every time Dexcom has changed models, over 25 years, I've sat through a two hour orientation for every model. It is amazing. What is in the lesson plan of orientation that many users blow off and then in groups dedicated to tandem or Dexcom or pod or even in Juicebox, I'm having trouble with my whatever device. And the first question is, did you go to orientation? No, I've been using that brand for 300 years. I don't need it
Scott Benner 42:31
changes a lot as it goes along. I also don't know, you know, it's so fractured the way people even learn about devices, right? Sometimes your doctor's office just gives it to you and says, Here you use the other one. This will be the same. You'll figure it out. Nobody reads the instructions. You hear people say all the time, like, I was supposed to wait for a trainer, but a trainer never called me, so I turned the thing on. It's just it's such a mess. I mean, people's lives are so busy. Jay, you know what? I mean,
Jay 42:58
did they call the trainer? No. I
Scott Benner 43:00
mean, yeah, I don't know. Sometimes yes, sometimes no, sometimes they just sat back and they're like, I thought somebody was supposed to call me, and then it doesn't happen. And one night, they've got a free hour, and they're like, I'm gonna learn how this thing works. I would imagine that if we all understood the things we were using more completely, we'd have fewer problems with them, for certain. But, man, I don't know how to get to that, but do you have thoughts about it.
Jay 43:21
Yeah. And then the training. And then the other one. My favorite one is the tech companies, the tandems, the Medtronic, the insulate Omnipod, beta bionics, Dexcom. They've known for six months that Apple was going to release iOS 18 next week. Why aren't they ready? I don't know. My thought as a nurse is that they are doing malicious dereliction to keep their users safe, because a preponderance of the code in an update, whether it be Apple or Droid or whatever the manufacturer is, the preponderance of the release new software, operating system type stuff is to prevent malware, to prevent malicious code from getting in the door.
Scott Benner 44:15
So the way it always occurs to me is that we look at these companies and we think of them as, like, these giant, huge corporations, and maybe they're not as big as we think they are. Like, maybe they don't have the people on staff to do the testing for the new iOS. Or maybe they have fewer than they you know what I mean, like, can it just be a problem with staff? Like, you know, it just takes them longer, or people are working remotely now. So, I mean, I don't know. Do they work as hard if nobody's watching them? I have no idea. Because I take your point like, how come the day iOS comes out? You're not like, Hey everybody, here's our updated blah, blah, blah that's already been through Apple certification, and we got it off to the FDA already, or whatever they have to do. You know, we've done all of our things, and here it is. Yes, and meanwhile, you get a note that says it's probably going to work so, but we haven't verified it yet, or don't update that one. You know? Yeah, we can't support that. I don't know. Like, I have a hard time thinking that it's a group of people who look at the problem and go, ah, we don't care about that. That's my thought.
Jay 45:18
I think it goes back to one word, thalidomide, to that case?
Scott Benner 45:22
How make your connection? For me, the enabling
Jay 45:25
legislation for the Food and Drug Administration was revamped following thalidomide in the 1959 1960 time frame. There's even an episode or two of Call the Midwife TV show that deal with it in England, and it impacted England and Germany. And I believe the way that things happened in the US, the legislative arm of government said, never in the US. We don't want that. And so everybody is afraid that they have to cross all the t's and dot all the i's with FDA.
Scott Benner 46:05
So you think that the companies are so concerned that they're if they miss one little thing, they're going to be in trouble, that they just don't do anything, or they over prepare when they're doing it.
Jay 46:18
They over prepare, they triple check everything before they even release it for beta testing.
Scott Benner 46:25
They're afraid of their own shadow, where, in this case of the FDA shadow,
Jay 46:29
yes, yeah, or the the court system itself, or that they
Scott Benner 46:35
don't even know what the FDA wants, so they're there. It's hard to figure out what to do.
Jay 46:39
That's another good one. Yeah,
Scott Benner 46:40
now that I that I've heard from people before that you really get into some of these meetings. The FDA almost doesn't know what they're asking
Jay 46:47
you for. No, it's a strange world. Listen to a TV commercial about a drug there's a person standing on the screen visually smiling, laughing, having a good time, and the announcer is reading, this will cause you to grow
Scott Benner 47:07
a third leg. Yes, you're gonna have diarrhea out of your eyeballs. Yes, exactly, maybe, or it scares the hell out of people. I saw somebody the other day, like scared to death about a black box warning on GLP medication. I mean, if you go dig into it a little bit, the occurrence of the thing that the black box was for was very, very, very infrequent, like, just very infrequent. But once it's a black box warning people don't, then go, Well, let me go find out how many people this happened to. They just like, Oh, my God, it's always panic. I have ads with a lot of companies. So I'm going to say something that I think every person who thinks that is going to think it's them, but I have this one specific person who told me, like, half of my job is making sure that we don't do anything illegal. That's what encompasses most of my day, making sure that. And, you know, listen good, yes, but keep in mind, big picture, half of this person's job, two and a half days of every one of their weeks, right? 10 days of a working month is spent just making sure that every word they say, every picture they show, every link they put up, doesn't break a rule, which means that that time, not they shouldn't be doing that, but that time is not being used for other things, like figuring out the iOS device, or, like everybody's so busy. And again, I want to say I'm glad they're following the rules, but it does give you an idea of what happens and why people maybe don't have a lot of you know, vigor at their job to get things hustling and get them done. Do you think about that ever?
Jay 48:40
Yes, every once in a while it depends on if I'm thinking left or thinking right. You can almost tell when my comments come whether I'm thinking sort of left brain or right brain. Okay, that the there are times that this person really got left, hung out to dry by their care team. They were handed technology and said, Good luck, or they were they weren't told how to learn or where to seek how to use their technology. And so yeah, those people, you need to go back to your team and get educated.
Scott Benner 49:26
It would be nice if the companies put out more user friendly, you know, videos and educational tools. But then you realize that those those tools, also go through an FDA process, and that every word is in there, and it's what, you know, it's funny. We had this conversation recently, but a person asked me why they thought the podcast was valuable for people. I said, that's because I'm just on there talking people tell their stories, and you pull out what you can from them. But moreover, it doesn't sound like I don't know a doctor who just spent the last seven years researching something is now. Reading either a research paper, word for word, line by line. It's not boring. These people are like, Well, can you educate me better? I said, Yeah, we made you a video, and then the video is boring, and the first three minutes of it are like, you know, legalese. And then somewhere in the middle, there's a vague description of what to do, but it doesn't get too specific, because if it gets too specific, it might not be right for everybody, and then it ends up being useless, and then the company sees that nobody uses it, and probably takes the air out of their balloon. And you get that kind of apathy on both sides at that point. I don't know. It just seems like such a I understand why the rules are in place, and I want everybody to follow the rules, but when you do something that specifically like that. It becomes just not a reasonable way to communicate with people. There's
Jay 50:47
one company that has in their literature, actually, it's in a user manual, and in the very back of it, it says something to the effect of no person can modify what is written in the warranty. Okay? And then you look about five pages in front of it, and it says, this book is the warranty, and you must do everything. You must do thing. You must use our product according to the User Guide. Yeah,
Scott Benner 51:25
that's a disclaimer to protect them in case you mess something up or or even if something goes wrong, they can say, Oh, you didn't do it exactly like this in the book. And yeah, like a lawyer put that there Right?
Jay 51:36
Oh, yeah, that's exactly what it is. It's legal ease, clear and unambiguous, but then on the company's website, it contradicts the User Guide. Oh, yeah, right, because you know so the webmaster, hold it, is the webmaster a person, so no person can change or offer any other information other than what's in this user guide,
Scott Benner 52:01
do you imagine, like being like, stepping back and looking at it, that's a misunderstanding between the person who wrote that and the person who wrote the other or maybe they just didn't understand, or it's, I don't know, even just wrong, but not on purpose.
Jay 52:15
I think that the company's checks and balances are inadequate.
Scott Benner 52:21
Listen, they all got so many people working for them. Like it's interesting that it's, I don't know it's interesting that it can't be done. But is that that's a is that a shortcoming of a company, or is that a human shortcoming?
Jay 52:32
I would say that it is a procedural shortcoming. One of the things in television production is a continuity editor,
Scott Benner 52:43
yeah, yeah, like an eye in the sky who sees the whole thing and is in charge of making sure one thing agrees with the next.
Jay 52:49
And for example, they make sure that the actor in one scene is leaning up against the left side of the door. And then there's they switch to a different cut, and they splice the the video at that point, and here they are. Instead of leaning up left, they're leaning up right, because all the script said was leaning against door frame.
Scott Benner 53:13
Jay, are you a football fan?
Jay 53:16
Not really, no.
Scott Benner 53:17
How about sports in general?
Jay 53:18
Uh, I spent many times on the sidelines dealing with medical emergencies, okay,
Scott Benner 53:24
but not playing or being involved watching as a specter, okay? So what I was gonna say is this, I am 100% for people having the ability to go get new jobs and do the best for themselves that they can. But what ruined the NFL for me, was free agency, because you take this time to build this cohesive unit right, these people who knew each other backwards and forwards, the guy to the left, you the guy to the right, you knew what you were going to do. You were a well oiled machine. It took years to get it that way. And then all of a sudden, players, you know, and again, no one's arguing with people having, you know, the freedom to go look for another job. I think it's the right thing to do, but it's what hurt football, is that now you get this person who's like, well, I'm going to leave now. I'm not part of the team anymore. I'm going to go over here and be part of that team. That team gets a better player, but might not be any stronger, because their team cohesiveness is not great. You've just lost a piece of yours. Now you got to bring in a new person. I think this happens in business too, right? Like somebody's good at their job, and everybody goes, Okay, the Department of XYZ is being handled masterfully by Beverly. Okay? And so we don't have to think about that anymore. And then two years later, you realize Beverly left, she got another job, and you know, the next person came in and was like, What am I supposed to do? And no one knows. Like, everyone's just doing what they think that they're supposed to be doing. You come in, you find these rules, like, you know, punch people sit around you and even tell you, if there's a training, this is what we have to do. They often don't even know why they're doing what they have to do. You know, that's something I've learned years and years talking to my. Wife about how many people are doing functions every day. They're getting them done, and they're they're correct because they're following the rules that are written down. But if you ask them to tell you why they're doing it, they have absolutely no idea. Like they don't know why they're pushing the it's it's the show Lost. They're pushing the button every day, but they don't know why they're pushing it.
Jay 55:18
It brings to my mind a good book that I read leadership principles of the Navy SEALs. The author was cannon, and it's a team. Everyone on the team needs to know what is the mission and how is it going to be executed. And this same thing is true in the diabetes device technology, everyone on the team needs to know, what is the mission, what is the exit strategy, that sort of thing. Yeah,
Scott Benner 55:52
I wish I could tell a story that I can't tell, because I think it would be wrong. But, and if I just say it the generalization, everyone's going to apply it to some, some other company. And the truth is, none of you know which company this is, but just keep in mind, if you think you know who I'm talking about, you definitely don't, because that's somebody I never ended up actually doing business with. But I sat in a meeting with, you know, God, five or six people you know supposed to be professionals, and they look at me and they say, Well, what do you think we should be doing? I was like, you're asking me. I was like, I make a podcast. You're trying to buy an ad on a podcast. You know, you want me to write the ad. And it wasn't just that. It wasn't just like, tell me what you think people would like to hear, like, that kind of thing. It was we have this thing to accomplish, and we don't really understand what it is, and we don't really understand how to get to where we need to go. Do you have any ideas? And I'm like, Oh God, if you don't know, aren't we in trouble? And that is why I ended up not doing like. I didn't follow through with them, because I was like, these people are out there in the world trying to talk somebody into something. They don't know what it is or why they the person might want to use it. They don't, they don't understand it at all. And, I mean, there's a group of people, and not one of them, like said something that made me think, oh, they understand. I don't know, man, it's, it's everywhere. You know what? I mean,
Jay 57:17
I think you and I have seen, we've we've been to the mountain. The thing is that the healthcare team needs to educate the users better, and the 504, plans need to be more accepted. And the whole thing is that the technology needs to be congruent. I mean, it's it's training, education and technology, and it comes across everywhere you You and I are two good choir boys on this one we
Scott Benner 57:51
I hear you say that, what I think is, there's the kid who needs the help, there's their parents or their guardians, there's the school at the administration level, there's the school at the teacher level, there's a school at the nursing level, there's your doctor, who you don't have direct contact with, so you're probably talking to a nurse practitioner or your CDC, CD CES, and then maybe the doctor. Now I don't know what we've we're up to, we're up to the kid, the parents, the administrator, the teachers, the nursing staff, the other staff at the school, the doctor, the nurse practitioner. I got nine people now involved in this right hand doesn't know what the left hand is doing. Is the saying, for a reason. How do you centralize what needs to be done? Do you need somebody like the ADA or the JD? It's not even JD, ref anymore, breakthrough diabetes. Like, way to go with that one. Like, do you need somebody at one of those big organizations to put together, like a, you know, a blue ribbon team of people who understand all these different aspects and put together an actual document that would work for everybody, and then let those people build off that document, so that at least the institutions would know the basics. Is that the answer?
Jay 58:54
I think that's part of it. And I think that I may be speaking out of school on this one. Well, it's
Scott Benner 59:00
a podcast, Joe, we're all speaking out of school. Go ahead.
Jay 59:04
The Assistant United States Attorneys, the A us as the a USA in Connecticut, did a marvelous job of educating the Connecticut school system. I have reason to believe that that movement may be spreading, okay? And that once that happens, all of the US, District Court, US attorneys, the A us as we'll be getting a memo to read them in on 504 particularly for CGM monitoring in schools, and that that needs to be a part of 504 plans. And so you carry that forward, hold it. That's part of a 504 plan. Then the doctors got to put in the diabetes medical management plan, the DM, MP has got to put it in there. And so it's going to be a dog chasing its tail. Not realizing it has a mouth full of fur. But once it gets once the dog wakes up, I think we're going to see a change. Wow. It's
Scott Benner 1:00:07
the only thing that makes sense to me is that that it's centrally dealt with. I mean, everybody has to have their, you know, everybody has to have their voice in the process. It can't take forever. You know, you can't let it get all caught up in an ego and and fear and everything like these. These kids need, these kids deserve, for there to be a basic understanding of the medical devices that they're using, the dangers that they're in, and the things that will help them both from, you know, emergent low blood sugars and being asked to walk around with a 250 blood sugar all the time. Like, people should know that basic amount and And don't you think, I think you could explain it to someone in 10 minutes, right? Like, I don't think it would take a weekend course or something like that. You could explain those things. Here's these devices. This is what they do. Here's why it's important. Here's why it's important to them today. Here's why it's important to them tomorrow. And you know what? Here's a little bit of background on what it's like to live with type one diabetes. It isn't as easy as you might think. Okay, now, you know, here's the things we're going to do for these kids. These things get done. They happen. We don't argue about them, we don't ignore them, we don't forget them. And if you don't do them, there's going to be some sort of a repercussion we're done right? Like write that down and make that the rule for everybody. And then if states, like, I don't know, like, you know, I don't know what we're talking about exactly here, meaning, you know, should this be a federal thing, or should it be state by state? But I think if you make it a federal idea of the basics, and then tell the states, look, if there's other things you want to add on to this. You know, come back to this office and tell us what you think why that's important, and we can make an amendment for you specifically if you think that's necessary. But just giving these kids the basics would probably, probably fix 90% of the problems.
Jay 1:01:55
Ah, yeah, Jay, I
Scott Benner 1:01:58
don't know. You've been alive 72 years. Man, how do you make stuff like that happen? You've
Jay 1:02:01
got to remember to grassroots level and and that brings up another one that my timer just went off, so I'm going to have to get this one quick, and that is the Americans Disabilities Act and refuse handling of the in the US Constitution, Article Six, clause two, is known as the Supremacy Clause. And there the states, local governments, local businesses can't overstep federal law, so this is where, when schools say 504, plans are federal, they don't apply to state law. Supremacy Clause just got them, yeah, but
Scott Benner 1:02:37
you're gonna need an attorney to do that if you get into that conversation, you're beyond your own personal understanding for most people, and now you're good.
Jay 1:02:46
Hold on. How many times have you heard the saying in the world of law in these United States? Quote, ignorance of the law is no excuse.
Scott Benner 1:02:57
No, no, but you still need somebody to hold them accountable. So if they're ignorant to it, as the school, for example, you don't just get to walk in with a tin badge you got from, you know, Kmart is Kmart, the whole place, Walmart, and say, hey, you know, you broke the role. You believe me. Now do the other thing like you. Somebody has to come in officially and say, you've, you know, these people have asked you for this. You've said no, you're not legally allowed to say no to that. We're compelling you to do that. You have 30 days to comply. But, like, it turns into that thing, you know what? I mean? That's true, man, the
Jay 1:03:28
thing, the thing about it, is that what the the teacher line comes back and that is, show your
Scott Benner 1:03:36
work, yeah, well, you want them to do the right thing, but
Jay 1:03:39
right and I've used that a few times to say to someone, okay, you you're telling me the law says ignorance of the law is no excuse. Tell me the law I don't
Scott Benner 1:03:50
know. Man, then you get back to like, the person doing the job that you're talking to, who doesn't know what they're doing. They're holding on, you know, by the skin of their teeth, hoping nobody notices. They don't understand 45% of their job, and everybody then the ass covering starts, and then other people realize, uh oh, if they figure out she doesn't know her job, then they're gonna figure out, I don't know my job. And then, you know what I mean, like it just, I don't know, man, all this stuff always feels like, it always feels to me, like people who are not, they're not well oriented. It goes back to education, they don't know what they're supposed to be doing. And if they do know, sometimes they're not motivated enough, or they're burned out, or whatever else, and they don't end up doing everything they're supposed to do, plus companies. I mean, listen, this is you can make the argument the other way, these schools, and you know, they've got these teachers and administrators doing more than probably their fair share of work, and you know, there's a lot of work, and it gets thrown on everybody, and I don't know, it just I like, it's funny, because you feel like you're talking about a 504 plan, but at the same time, I feel like you're talking about everything. Does that not feel that way to you? Like, most things end up going like this, yeah,
Jay 1:04:55
because it the 504 plans. Do it the show. Parks disposal, does it so it well,
Scott Benner 1:05:02
I'm talking about beyond that. I'm talking about the lady at the register doesn't know how to make discount card works at the grocery store. Like, if you don't know, you know, like, then, then who does
Jay 1:05:11
if that's right, it goes, it goes back to take this back to your trainer. Take this back to your educator.
Scott Benner 1:05:20
What I keep thinking though, Jay, is that if I keep taking it back to the person who's like, if I keep doing that, do I end up in a room that nobody's in? Is that too metaphysical? Like, if we keep going back to the person who was supposed to tell me how to do this, and then I go to the next person, I said, Well, who told you this? And I go to the next person like, it feels like it's a nebulous thing. There's not a person in charge. There's these ideas. I'm going to be unclear about this, but there's these institutional ideas that we follow, and there's norms that we've heard. Because the last guy that had the job told me this, the last girl that had the job told me that. So I this is how I do it. I don't really know why I'm doing it. I just know I'm supposed to, it's Tuesday and I'm supposed to push this button, so I push it on Tuesdays, then you realize that it's completely possible that all of these rules came from places and times and people who don't exist anymore, and so nobody really knows why they're doing anything, which is why sometimes things need to be looked at with fresh eyes from the people who are involved now and put together something cohesive that everybody can agree that they can do and that's protecting the people it's supposed to be protecting
Jay 1:06:25
you have said it well, and looking at the other side of we've always done it this way. Oh, it's the worst. Yeah, yeah. This
Scott Benner 1:06:37
is how it's always been. This is what we do. Listen. Forget all this with the 504 care plan. Most of these people listening. Your health care is based on that too. Oh,
Jay 1:06:45
it is health care. Health care is, is it? And you need to be taught, and you need to be taught about your insulin, you need to be taught about your administration. You need to be taught about your profiles. You need to have protocols for half a dozen different things. I mean, yeah, it's timeless. I think this is the stuff
Scott Benner 1:07:07
that when they talk about, you know, there are things in the world that we just do to keep people busy. That's what a lot of this is. I mean, anyone who's ever signed a mortgage, I mean, my God, you'll spend a half an hour, 45 minutes in a room with somebody signing documents
Jay 1:07:22
and ask them. Reduce this to 25 words,
Scott Benner 1:07:25
what is this? You know, what is this? I'm signing here. Oh, it's the blah, blah. No one knows. No one knows anything. I just it happens constantly. No matter what you're doing. People like, Oh, you just have to sign that. Or, I had this one company, they're like, we want to, like, direct deposit. You know, when you send us an invoice, we'd like to just deposit it directly into an account. And I said, Yeah, that's fine, whatever. Here's, you know, here's the information that you need. And they came back and they said, Actually, we need you to take this document to your bank and have it certified by the bank manager and the and I responded back, and I went, No. I said, No, period. Send me a paper check. And that was the end of it. Like I couldn't believe what they wanted. It was ridiculous,
Jay 1:08:04
you're right. And there's one more that from education, the one thing to keep in mind is the mind can only absorb that which the tail can endure. So if a person's listening, they they need to look at how much information can a person absorb in what in one session?
Scott Benner 1:08:27
I Yeah, and the answer is not a lot, right? The answer is not a lot. I'm not saying I'm like, magical, and I could do it. I'm sure if you put me in one of those jobs and hit me for an hour with information, I'd walk out of there like, Oh God, I don't, I don't, okay. And then, you know, it's not like you, by the way, get to go back to your desk then and spend 15 or 20 minutes going over these ideas, and, you know, looking at your notes and and saying to yourself, Okay, this is you get done that meeting. You run up, you run back and go into another meeting. People are meeting all day long. I don't know how anything is getting finished. It's
Jay 1:09:01
time sensitive, any way you want to, want to do it like Jay. You're used
Scott Benner 1:09:04
to working in a world that's on paper, but now I'm telling you, nowadays, my wife will someday start working at five o'clock in the afternoon, and I'll be like, what'd you do all day? She goes, I had six meetings. So she gets up at six, she gets dressed, she sits at a computer. By seven o'clock, she's in a meeting. I see her when she runs to the refrigerator to grab a cold drink or runs to the bathroom, back and forth, back and forth, back and forth, meetings, meetings, meetings, meetings. Then at the end of the day, she's exhausted from absorbing all this information, and now she's like, okay, now I have to go do my job, and you work till 11 o'clock, and you sleep for five hours, and you get up and do it again, and then we're over here, like, you know, in the real world, getting the short end of the stick at your 504, you know, with your with your school or something, and you're like, do a better job. But then that cascading, I mean, the thing we've been talking about for the last hour, like, that cascading problem of, why is this really not happening, opens up, and the answer is, there's, like, 1000 And different reasons why this and other things aren't happening. And, you know, I don't know how to stop the world long enough for everybody to reassess and and start over again. So I don't know, like, like you said grassroots is, like, somebody's got to get pissed off and make it happen. But the truth is, is that even those people are going to get tired. You know what I mean? Like, I remember one of the diabetes groups that was really popular for a while and kind of fell off. Now, can't think of which one it was, but they had this, like, great idea, we are going to contact every pediatrician in the country and tell them the importance of checking with a finger stick when you see these flu like symptoms, because you're going to find people who are heading into or in DKA, and it's going to look like the flu, right? And we're going to save these kids from not being diagnosed by type one diabetes. A pretty big organization. I thought, Man, this is a this a good use of their effort, you know what I mean. And they started, and they were going, and then it got hard, and then they lost some of their support from, you know, people who were, you know, volunteering, and the next thing, you know, just fizzles out and it's gone. So I don't know, man, is this just how things work? Is this as good as it gets? In over my head on that, am I bumming you out? Jack?
Jay 1:11:16
Not that you're bumming me out, but, but I think that, I think the my statement about the mind can only absorb that which the tail can endure. I'm going to have to
Scott Benner 1:11:25
go back to that one. Yeah.
Jay 1:11:29
So look at look at the chat and see what we got.
Scott Benner 1:11:33
So what I would say to people, if they've listened to this entire thing, because we've been going a while, and I need to wrap up with you, but like, what I would tell them is, is that you should expect pushback from people who, at sometimes might seem like they're villains in your story, but they're probably not. They're probably either lost or confused or doing what they think they're supposed to be doing. This is where you have to branch off, find a quiet space and decide this is the thing that I have to get worked out, and then you have to put that effort into that. And if it's not something you have the space for, then you might have to say, All right, well, I guess I gotta do what they're saying, or I'm gonna fight or, you know, you, but you gotta figure out what this is. And I think if you're looking for an entity, whether it be the school or an org or somebody else, to come in and stand up for you, I mean, that's not as easy as said. Is done. You can probably get legal representation through American Diabetes Association that they at least they might know somebody to like, point you in the direction of right? But then you got to decide that that's what you're going to do. My point is that life's full of roadblocks, and just because diabetes sucks doesn't mean you're not going to find some here too. Amen. Look like, yeah, those roadblocks look like all kinds of different things, paperwork, misunderstanding, people, institutions that are not trying hard enough, institutions that aren't even doing they don't even know what it is they should be doing. So, man, I don't know this bump say out of me. Jay,
Jay 1:12:58
Hey, aren't you retired?
Scott Benner 1:12:59
Why don't you stop thinking someone else's problem.
Jay 1:13:04
Why don't, why don't we wrap this one up? Then I think, I think we've, we've, we've beat this dog, beat the fur off the dog, every way we can. Yeah, it's really
Scott Benner 1:13:12
enjoyable speaking to you. I love watching you online, because if I can, it's interesting watching a person from another generation say, I see this is how people are talking now, and I'm going to be involved in it, but it's really cool that you're there. You know what?
Jay 1:13:26
I mean? Hey, thanks. Thank you for having me on the show. No,
Scott Benner 1:13:30
it's a pleasure. Absolutely. Hold on one second for me. Okay.
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