Scott Benner 2/9/25 Scott Benner 2/9/25

#1428 Small Sips: Tug Of War

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Meal bolusing simplified (I'm not kidding)

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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, welcome to the sips series.

These foundational strategies were nominated by listeners. They told me, these are the ideas in the podcast that truly made a difference for them. So I distilled them down into short, actionable insights. There's not going to be any fluff or complex jargon, just practical, real world diabetes management that you can start applying today. And I know your time is valuable, so we're keeping these short. Another small sip will come out once a week for the foreseeable future. If you like what you hear, check out the Pro Tip series or the bold beginning series for more. Those series are available in the menu at Juicebox podcast.com and you can find complete lists of all of the series in the featured tab on the private Facebook group. Please remember that nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. The questions you have, I guarantee you there's answers to them in the Juicebox Podcast, and it's all free. You

Oh, it's time, Jennifer, it's time in our little series to talk about the tug of war. Oh, oh, that's fun, okay, but we got to keep it short, because it's small. Yes,

Jennifer Smith, CDE 1:42
the tug of war and, well, this is just, it's easy. Yeah, you think so? Well, I think I hate the word easy in diabetes, because I think when you're starting out, it doesn't seem easy. And then as you move further along with things, easy is a word for some pieces of it, but other parts of it change, and it isn't quite easy until you figure it out. So anyway, tug of war,

Scott Benner 2:04
I always tell people, diabetes is never going to be easy, but one day you might be so good at it, it could fool you into feeling like it's easy. So this has come up in episode 156, 214, and 1220, but, and I know we're trying to do this quickly, I'll do it as fast as I can. I was once on a phone call helping a young mother of a small child with the kids diabetes. And I realized that the mom was not in any meaningful way pre bolusing meals, and I tried to explain it to her, and then she asked why, and then I tried to explain to her why, and I thought I had done a pretty good job. And she said, I'm sorry, I don't understand, Bill, don't get it, yeah. And I was left with a moment of, like, this person, like, I'm, first of all, I'm not a doctor. Like, somebody put me on the phone with this girl, you know, but she was, like, 2021, years old, and she had already had, like, a three year old baby. The baby had type one, and I just felt like, I can't, like, if I hang this phone up and don't find a way to help her, it's gonna be horrible for her. It's gonna be horrible for the kids. Like, I felt very responsible, sure. So I just reached down into my wherever and started talking, and I said, Have you ever, like, been in a tug of war like at school? And she was like, Yes. And I go, okay, so, like, instead of there being people on both sides, and I'm freestyling this whole thing, I'm like, instead of there being people on both sides of the of the of the rope, why don't you imagine on one side is insulin, and on the other side is carbs, or anything else that tries to make your blood sugar go up. And she goes, okay. And I said, now there's that flag in the middle of the rope, right? And at school, you're trying to get the flag on your side to win. And she said, Yes. I said, Well, this game is different. We want the flag to stay in the center. And she's like, okay, so I'm like, just, you know, I don't know what I'm saying.

Jennifer Smith, CDE 3:54
Well, you're trying to find the right way, the simple way to explain that will make sense given you had tried a couple of different ways of explaining how insulin and food work against or with each other, right?

Scott Benner 4:08
I was just, as they say, grabbing at straws. And I had, I launched on this idea, and so I just stuck with it. And so I'm making it up as I go. And I said to her, I'm like, so here's the problem. I said, if we just blow the whistle and everyone starts pulling, the insulin starts pulling one way, and the food starts pulling the other way. The problem with insulin is it's not really super powerful at first, right? Like, it's not at its full power when you inject it, but that food, you know, like you eat, and you see maybe 510, minutes later, you start seeing your CGM go up, right? And she goes, Yeah, I said, so the food's going to end up pulling before the insulin. So if we blow the whistle and everybody starts pulling as hard as they can, the food's going to overwhelm the insulin and win. And then, instead of thinking about this, like east to west, like, you know, pulling the rope, kind of flip it so that the insulin is. Pulling down, and that the food's pulling up, right? And she goes, okay. And I said, so if you let the food pull first, you're going to get higher and higher and higher, and then suddenly, who knows how long into it, this insulin kind of comes online for real at full power, and it just starts pulling. But the problem is, you Bolus for the number and the carbs. Say your blood sugar was 90 when you ballished, and you know it was two units for whatever you ate. Those two units were meant to have a fight at a 90 blood sugar with carbs that were not overwhelming them, that didn't have momentum, that weren't already winning, I said. But the problem is, when you don't pre bullish your meals, the food is not just winning, but it's creating a higher number. The higher number needs more insulin. You suddenly don't have that amount of insulin. The food has momentum, meaning that numbers flying up, and now you're trying to stop it with amount of insulin that was really only meant to keep a 90 blood sugar stable during this eating excursion, right? And then I went through the rest of it about how to, like, you know, put the insulin in first, let it get working, so that that rope is moving in, you know, we have momentum going towards the insulin, not enough to make a low but just enough so that when the food starts pulling, that flag comes back to center. And then you've got the food at full power. You've got the insulin at pull power, they're both pulling as hard as they can, but neither of them can make that flag go left or right and flip that in your head north and south, and imagine that flag rolling along that 90 number for two hours. That's a straight line on your CGM. That's when you see people who like Bolus and have a straight line in their CGM, that's what's happening. And she just goes, Oh, I understand that was like the end of it. I was like, Okay, great. So it works so well for her that I said it in the podcast, and then I said it again. And then one day, and I mean this sincerely, Jenny might not remember this, but one day, Jenny complimented me about it, and it was like one of my nicer moments around diabetes. Oh, you remember that? By any chance? I

Jennifer Smith, CDE 7:07
think so. Yes, you think so. You don't remember. We talk about so many things. I know quite sure that I did, because it is, it's really easy. It's an easy way to understand, because if you were the person who is very interested in looking at all the documentation of every device and every medication, and you pull out the little insert that is inside of your vial of insulin package, you will see a graph of how insulin is supposed to act, how it's supposed to work, what its timing of action is. Nobody, nobody reads that. I don't read it. I think in my 36 plus years of having diabetes, I've maybe opened that little packet two or three times, just out of like, I don't know, curiosity at the moment, whatever. But majority of people are not going to read that. They're not going to put it together with the reason that they take insulin, which is primarily for food coverage, right? And you do? You have to understand it in a way that that marries the two and gets them to work in unison. It is. It's a great description of keeping that flag once the insulin is working where it's supposed to in a timeline, in its action profile of creation, you're getting a stable flag in the middle, which is holding your blood sugar in a good place.

Scott Benner 8:31
If that flag is a stable blood sugar at 90, then the insulin can pull as much as it wants, and the food can try as hard as it wants. You know, if you want to think, I think of the food as pulling the number up, and the insulin is trying to pull the number down, and the balance of the timing and amount of that insulin against the food done correctly, just doesn't allow either side to win their stated goal of making the number higher or making the number lower. But you and I'm going to sound weird saying it myself, but you said to me one day, you said, this is the best explanation of Pre Bolus thing I've ever heard. I really was touched by that. So thank you. Oh, you're welcome. And yes, as you can tell now, I can tell the tug of war thing with my eyes closed, because I've done it a couple of times, but I appreciate very much you doing this with me today. Thank you, of course. Yes, thank you.

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 at. 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

thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple podcast and set it up so that it downloads all new episodes, I'll be your best friend. You.

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Scott Benner 2/8/25 Scott Benner 2/8/25

#1427 Small Sips: Get What You Expect

Find stability, then expect more.

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Scott Benner 0:00
Hello friends, welcome to the sips series.

Awesome. Jennifer, we are going to do for our small sips series the last page, which says extra topics. So there were things that we heard back from people that really had a nice impact on them from the podcast, but they didn't have any deeper meaning or more explanation. So I figured we would try to parse through them here. Okay, so the first one is it was very helpful to me when Scott said to get stable and then increase your expectations. So now we have to figure out what I meant by

Jennifer Smith, CDE 2:01
that. Well, I would expect the comfort level with stability means that you're not having problems with significant drops. You're not having really dramatic rises. Stability offers you a comfort. It does, but if you get stable, and you're stable at 150 we've talked about this before, but you really would rather be stable at 110 Yeah, it's a step wise approach to getting there. You've achieved healthy, safe, stable, and now that stable is leaving you higher than you want. So then it just little inch by inch. I mean, you could do it in increments. Add a little bit more, add a little bit more. Look at your data and see where could I add a little more to get me closer to my desired next, lower target? So

Scott Benner 2:47
who is the person who's helped by this? So like, one of the problems I have, like, you'll hear me say all the time, like, I don't know what the podcast is. I'm not gonna go down a long road on this, but when you do this thing that I do, and you just say, like, here's what I think I don't know, good luck. And then somebody reports back, though this really helped me. It took me a couple of years to realize that they weren't always being helped the way that I thought they were going to be helped. Sure, you know what I mean, because they're not me, but they still took something from it the way I would think about it, like this. To me, seems like common sense, like if you don't know what you're doing. Starting out on day one, looking for an 85 blood sugar all day long is like a weird first hope. You don't mean, like, that's not gonna happen. Oh, I guess that's what it is. So then find stability somewhere, anywhere, and then work from that by increasing your expectations. You can do that, I think probably just psychologically increase your expectations. But I would also think, with your alarms on CGM true,

Jennifer Smith, CDE 3:46
adjust them if you've been comfortable now that you've come down from an average 200 blood sugar. You're wanting to be lower than that. You have stability in the picture. You can adjust again that expectation of okay, know the tricks that I do to hold me here? Yeah, again, it's all about insulin entirely. I'm stable here. I clearly need more insulin in the picture to get me to a stable place still, but lower my expectation is if I add just a little bit and nudge it slowly, I'm still comfortable and I'm reaching the goals that now I've moved on to.

Scott Benner 4:25
But I guess what I'm thinking is, is that if people have found stability at 180 for example, is it that they don't know that more insulin in targeted places would make that stability happen somewhere else? Like, why do you mean, like, yeah, or do you think it's even, maybe it's burnout? Like, maybe they're like, they spent so much time getting to it that once they're there, they're like, oh, I don't want to think about this again right now. Like, I finally got it stable, you know, I don't know I'm interested. And

Jennifer Smith, CDE 4:53
I think that's where the personality and the individual nature of this kind of comes. Comes into the picture, right? You know, when I was like planning pregnancies, I already had had a pretty tight target, so it wasn't hard to adjust my goal range a little bit tighter, and knowing what I knew about insulin to expect to make adjustments to get lower in a safe way.

Scott Benner 5:22
Yeah, the pregnancy is such a great example for this, right? Yeah? Because if you're running a six, and it's a nice, tight ship, and the doctor says we'd love to see at five and a half, you're like, oh, okay, right. If you're running around an eight and a half, and they're like, we'd like to see in the fives, you go, I don't know if I knew how to do that. I would have done it already, correct? Yeah, I see, okay, so get stable, and then increase your expectations. I hope that helps somebody from my money. That means learn how to find stability at one number, then bring down your CGM high alarm so that you don't get above that or see that you act prior to that number. And then, I guess the thing that I would say, that I have said in the past is it seems so childish, but often you get what you expect. And so

Jennifer Smith, CDE 6:05
true. I mean, it's kind of like taking a test, right? You're taking a math test. You don't study really in the back of your head unless you really, really know the subject, and it's not terribly new. You're not really expecting to do the greatest whereas, if you've put the effort in, you've done the work, you know, all the equations and everything, and now you just need to move it up a notch. You're expecting to really have that a on the test. Yeah.

Scott Benner 6:30
And the work is tools. It is with diabetes, understanding basal insulin to carb ratio. You're insulin sensitive. If you have those tools, and you found stability, and you want it to be lower, expect it to be better, like, right? Sometimes your expectations set your self confidence, a lot of other things, okay, all right, awesome. Thank you, yay.

If you're not already subscribed or following in your favorite audio app. Please take the time now to do that it really helps the show and get those automatic downloads set up so you never miss an episode. I know that Facebook has a bad reputation, but please give the private Facebook group for the Juicebox Podcast a healthy once over Juicebox Podcast type one diabetes. The group now has 47,000 members in it. It gets 150 new members a day. It is completely free, and at the very least, you can watch other people talk about diabetes. And everybody is welcome, type one, type two, gestational loved ones. Everyone is welcome. You music. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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Scott Benner 2/7/25 Scott Benner 2/7/25

#1426 Horse Without Wheels

Julianna, a dietitian, shares how her daughter's type 1 diabetes, dyslexia, and ADHD shape their active, travel-filled life, plus insights from her work in food service.

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

Today I'll be speaking with Juliana. She's the mother of a child with type one diabetes. We're going to talk today about dyslexia, ADHD traveling to and from cold and warm climates with a child with type one and much more, 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. I know this is gonna sound crazy, but blue circle health is a nonprofit that's offering a totally free virtual type one diabetes clinical care, education and support program for adults 18 and up. You heard me right, free. No strings attached, just free. Currently, if you live in Ohio, Delaware, Florida, Maine or Vermont, you're eligible for blue circle health right now, but they are adding states quickly in 2025 so make sure to follow them at Blue circle health on social media and make yourself familiar with blue circle health.org blue circle health is free. It is without cost. There are no strings attached. I am not hiding anything from you. Blue circle health.org you know why they had to buy an ad? No one believes it's free.

This episode of The Juicebox Podcast is sponsored by Medtronic diabetes and their mini med 780 G system designed to help ease the burden of diabetes management. Imagine fewer worries about mis Bolus is or miscalculated carbs thanks to meal detection technology and automatic correction doses, learn more and get started today at Medtronic diabetes.com/juice box. 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, are you tired of getting a rash from your CGM adhesive? Give the ever since 365 a try, ever since cgm.com/juicebox, beautiful silicone that they use. It changes every day, keeps it fresh. Not only that, you only have to change the sensor once a year. So I mean, that's better. Hi.

Julianna 2:37
My name is Juliana quarterman. I am a registered dietitian that lives in Louisiana, and I have a 14 year old T, 1d, female,

Scott Benner 2:47
your daughter has type one. How old was she when she was diagnosed? 11? About three years Yep, but you're a nutritionist.

Julianna 2:57
I am, well, a nutritionist and dietitians are completely different things, as I'm sure Jenny has probably told you along the way, but I am a dietitian.

Scott Benner 3:04
I'm sorry. I apologize. I've misspoken. You're a dietitian. I'm making my notes right now. My brain doesn't work. I haven't recorded in like I went on vacation Joanna, so I haven't recorded for 11 days. So fun. I'm out of practice, so

Julianna 3:23
like, you need a vacation from the vacation probably,

Scott Benner 3:26
I'll tell you what that didn't happen. I'm announcing to you and still be, of course, six months later. Really nobody's business. But in the strangest of turns, my father in law passed away while we were on an airplane going on our vacation.

Julianna 3:44
Oh, man, I've had that happen. I was in Mexico when my uncle died, really, yeah, was not fun, but it, you know, it's when it's time, it's time, and then you just come back and do we gotta do? Yes.

Scott Benner 3:56
So we came back and took 24 hours to pull ourselves together, and went to his funeral yesterday, which was cruelly, I guess, on my mother's birthday. Oh

Julianna 4:07
no, so Papa whammy. You know, things happen in threes, so that just means that you got one more thing coming at you.

Scott Benner 4:14
Well, great. I'm gonna put my shoes on stuff my toe or anything like that. I spent the first 20 minutes of his funeral sitting there with a crystal clear view of my mom laying in her hospital bed at the end of her life, and couldn't shake it. And finally, I just was like, Scott, what are you doing? I wouldn't be crying like the widow here in a second. You know what I mean? So like, I pushed it out of my head, and then my memories of him came in, and I was like, this isn't any better. So it was a it was a tough day, but, uh,

Julianna 4:46
how little triggers can be. Can put you down in a hidey hole very quickly? Yeah,

Scott Benner 4:51
I tried my best to, you know, but it just, it is what it is. Anyway, he was sick, and it kind of came quickly at the end. But my wife is her family are together and working through that. So anyway, what an upbeat starts. Liana, let's go. Where do we go from here? Welcome back from vacation. Your kids got diabetes. My father in law passed away, and our vacation had a veneer of sadness just draped over top of it the entire

Julianna 5:19
time, yeah, it makes it hard to have any fun, right? Our first

Scott Benner 5:23
vacation in six years as a family, we were like, okay, all right, anyway, they will have any fun. Oh, it was very sunny. There were times that you just, you know, it was unavoidable, too. I have the best hand that helps I look, I look lovely, right now, perfect. Yeah. So tell me something. When you thought to come on the podcast, were you thinking I'm a dietitian, who's the mom of a type one, I want to come from that angle, or, like, how did it occur to you?

Julianna 5:55
So Morgan is my daughter, and when I was thinking about the podcast, like, well, so I am a dietitian. However, even, like, even though anybody who has science background, medical background, sometimes you don't want to be said title. You just want to be the parent. And you don't want to be like, Oh, you've got this. And I looked at them, I'm like, you realize when I first learned this was like, 15 years ago, when I was in college, not to date myself, and it was nothing like it is now. And they're like, it's true, but I also, well, Morgan's a competitive athlete. She also has dyslexia and ADHD, so on top of the T 1d It's like, all these things that make up her I just wanted parents to know and going back to school, because we just went back to school on Monday. So this is my Morgan second day school. She's a eighth grader. So it's kind of all accumulated, kind of all together, of basically as collective group. We got this. We can do this. You can do anything, no matter what is presented to you, whether it's using the information from the podcast or the Facebook page, there's always someone there that kind of can steer you into a different route if you're stuck and don't know what to do. Most of the posts on your Facebook page right now are about kids going back to school and all that fun this that happens along the way,

Scott Benner 7:11
yeah, boy, that turns into a it's a title way for a few weeks, or just

Julianna 7:15
Yeah, and then it comes down. Usually it starts in the south, and then it goes to the north. And I was like, Oh, I hope the people in the North, because people are right now up north, are in vacation mode, like, oh, we have a month, and then we're good to go and and then you're like, oh, I should have done this a couple weeks ago. So that's why sometimes living in I think when you're as you're reading the post, like, oh, I use it as I scroll it away, it's like, Ooh, I could probably use that for later. And I scroll it in my brain, and it comes up again, like, Hey, we're gonna try this. And my husband looks like, did you get that from the podcast? I'm like, yep. So it's just, you know, you just kind of using all the information, all the tools you have in the toolbox, yeah, to not only help your your kid or your adult child, your I call them the itty bitties, the the babies who have just got diagnosed, and yourself just to be able to get through every day because your kids functioning at school, which is awesome, but you also yourself personally, have to function too to make yourself happy on daily basis, because, like, it's really hard as you're helping your child, or children to something else too that I've known. You know, if you know, if you can't function, they can't function. Let's put it that way, yeah. So it's kind of accumulation of everything altogether. I just, I have a bonus, because I have the dietetics background to kind of understand how food works with the body and all that kind of stuff. But sometimes it's just thrown out the window because it's not cooked the same, like you cook it like, you know, when Aaron goes back to college, she's like, Oh, cafeteria food. Oh, boy, this is gonna be fun. You know, it's just, you know, everything all together.

Scott Benner 8:44
Yeah, that's interesting. So how much of I don't wanna, like you said, you know, I don't wanna date myself. But how old are you? I'm 4545 and you went to college, obviously, a couple of days ago or more. Yes, are you still working as a dietitian? So this

Julianna 9:02
is what makes it even more fun. So I was in, I was a dietitian working in corporate dining. Corporate dining for everybody means basically nutrition for older people, you know, adults working in I was in business and industry, so I was where they were at corporate office, and they had a cafeteria, and I would help them. They didn't necessarily use my diet to exp background, because I kept forgetting dietitian. I was like, statistician. I was an operations manager, so I helped run the food service operation. That contract dissolved 15 years later. So I did that basically my whole since I got out of college, and then I always wanted to get into school food service. I always had a passion to help the future generation start eating healthy sooner than later to be able to give them a different approach of how to eat healthy, eating school, food service is very tricky, whether you're in public or private, so I kind of finally got that job, like a dream job for me, but I didn't realize how much went into the whole process. It's that just as easy as heat and. Serve. There's so many different rules and regulations you have to follow. If you are in a public school, private school, they don't have any rules. They can pretty much spend as much money as they want to do whatever they want.

Scott Benner 10:10
So is that the limitation is that financial that like you have to make everything work for everybody, make it as healthy as you can, etc, but that you don't have an unlimited budget to do that with. Today's episode is sponsored by a long term CGM that's going to help you to stay on top of your glucose readings. The ever since 365 I'm talking, of course, about the world's first and only CGM that lasts for one year, one year, one CGM. Are you tired of those other CGM, the ones that give you all those problems that you didn't expect, knocking them off, false alerts not lasting as long as they're supposed to. If you're tired of those constant frustrations, use my link, ever since cgm.com/juicebox, to learn more about the ever since 365 some of you may be able to experience the ever since 365 for as low as $199 for a full year. At my link, you'll find those details and can learn about eligibility ever since cgm.com/juicebox check it out. 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 I let 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,

Julianna 12:20
with the public schools, they have to follow certain they have to follow the the USDA rules for what you have to offer minimally to get a reimbursable meal. If a meal is reimbursable, you get money back from the government, and you can keep going. You can you're going with your food service operation, which means public schools get what they call commodities. They get a big truck of food shipped to them, and they have to figure out what to use it because it's basically free. So what it makes it so tricky for public schools is because they have to combine what they get from the government and what they're purchasing themselves, stay on their budget and also serve healthy food and meet requirements. It's crazy. It's quite intense. And then every five years, they get reviewed by the government to make sure they're following the rules. And the rules change a lot, folks, if they're paying attention to the USDA there, they have released new requirements that are starting next year for the sodium content in foods. They're trying to reduce it, and they're also trying to reduce their sugar content as well. But those are the two big ones that are gonna be coming over the next couple of years for sure. And just makes it tricky, because, like, I work for a company, a food management company, right now. I was a food service director, doing my job I like to do, and then my husband had to get relocated to Louisiana, so I wasn't Wisconsin. And then I moved to Louisiana. And then once we moved, Morgan got diagnosed with very, very intense six months, for sure, I think, happens, learning everything all new you possibly can, and digging into a new job at the same time. Like, oh boy. The world was spinning. It was absolutely spinning.

Scott Benner 13:51
It's interesting to think of a school getting like, a truckload of food. Them saying, like, well, here, make something out of all this.

Julianna 13:56
Yes, and that's why you have to hire the the requirements to be a food service director have gone up. So you have to have actually an educational background to get that job like yet, there's so many years of food management, yet there's some nutrition background, because you have to run a team. Usually it can be anywhere from like two people to like 10, depending on what grade level you're serving, and each grade level has different requirements for portion sizes. You have to serve the kids. You can't just give them willy nilly. Going to give everybody a cup, because the babies, that's way too much food. They'll be like, just thrown half of it in the garbage, which is really hard in the food service environment. So interesting.

Scott Benner 14:35
My grandmother, God, when I was little, she'd she'd get up super early in the morning and go to her job like she was there, I think at like five in the morning, she was home by noon, and she just made hundreds and hundreds and hundreds of sandwiches by hand.

Julianna 14:52
And they still do that. Still. It's still thing. Yes, most of lunch ladies, they call as everybody knows I'm coming in around six. Dollars, and they leave about 132 o'clock, depending on what's going on. That's

Scott Benner 15:04
something. Yeah, I just remember her doing that. That was great. Also, she brought these great cookies home from school. They were awesome. Does this help you? When you like, I know people were like, oh, it's gonna help. But did it help you? Your kid gets diabetes? You're like, Oh, I'm a dietitian. I know what to do. Or, like, I felt

Julianna 15:21
like it was more like, I should know what I'm doing, and I didn't. It

Scott Benner 15:25
was like pressure. Yes, I see very similar

Julianna 15:29
to like people like you. You've had people on the podcast that like doctors or like kind of stuff. And sometimes like, like them, they don't get a lot of they get training in that global type of sense, right? And then when they get down to the specialty, then they can really dig into So, like, not all these doctors are becoming endocrinologist, so they just give it, they study for it, they pass the test. Okay, next, next thing. It's kind of the same thing with, yeah, yeah. It's like, then you get your feet wet. You're like, holy, symbolic. This is like, I have to do what, I gotta wake up at two o'clock in the morning and check your blood sugar. Oh, my goodness gracious. I want to sleep. Want

Scott Benner 16:02
to sleep. One of the craziest private conversations I've ever had was a person put me in touch with a friend and said, Hey, I've got a friend. Kid was diagnosed, and you know, would you spend 20 minutes on the phone with him, just chatting with him? I was like, Yeah, sure, whatever. So I helped out. I got on the phone, and the person who got on the phone was an accomplished and intelligent surgeon, and, yeah, humbling, isn't it? Oh, were they confused and and, and really scared, like, and that was like, just tell. Like, I did my best, but I was telling for me because I got off the phone, I was like, Oh my gosh, that person's they don't know what to do. Why would you settle for changing your CGM every few weeks when you can have 365 days of reliable glucose data? Today's episode is sponsored by the ever since 365 it is the only CGM with a tiny sensor that lasts a full year sitting comfortably under your skin with no more frequent sensor changes and essentially no compression lows. For one year, you'll get your CGM data in real time on your phone, smart watch, Android or iOS, even an Apple Watch, predictive high and low alerts let you know where your glucose is headed before it gets there. So there's no surprises, just confidence, and you can instantly share that data with your healthcare provider or your family. You're going to get one year of reliable data without all those sensor changes. That's the ever sense. 365 gentle on your skin, strong for your life. One sensor a year, that gives you one less thing to worry about, head now to ever sense, cgm.com/juicebox, to get started, right?

Julianna 17:46
And they're trying to, it's the pressure of like, I should know this, I'm this awesome surgeon. I have all these skills, but when it comes down to something that's not your specialty or your expertise, you're like, it's like, going back to kindergarten again, learning over and trying to make it like I always try to, because of Morgan being dyslexic and all that other stuff, I try to keep the kiss method, keep it simple stupid, like we used to in the beginning. I used to count on the carbs. I was teaching her how to read nutrition labels, and because, because the reading is not the best. And like, I'm like, Okay, this is you. This is what the word looks like. This is what this means. And we were, like, being exact, but that could put me in a bad spot, because I felt like I was constantly having to watch and, like, director and all that kind of stuff. I'm like, You know what? We're just gonna I'm gonna put on the plate, and we're just gonna sway it. We're just gonna Morgan, what do you think? Kind of take out the because her math skills with the dyslexia are the best. He relies, relies on Siri lots. Like, Hey, Siri, what's 10 plus 10? I'm like, Morgan. She's like, whatever. I'm like, Okay, fine. So he's using technology as her tool, which is great. So now, where we are right now, I'm like, she looks the plate, what? I think she's like, she's like, 35

Scott Benner 18:53
I'm like, Sure. Which is, it's pretty close, yeah. So it's

Julianna 18:57
this amazing removing the pressure from her too. We were part of a study, I don't remember the Yale or Harvard or something, where they were teaching us how to talk to each other, to not like, I use the analogy beating our kids over the fat because they're I took blood sugar 300 what's going on? Like, changing your turn. Like, hey, Morgan, what's going on? What the when's the last time you ate? What did you eat? And what did you do? Like, having her tell the story to me, instead of me going through her pump phone and because she's on the Omnipod five and trying to figure her history, you know, like kind of stuff, I'm like, I knew it was making me wacky, like I wasn't able to function outside of diabetes world, which is why I was told in the beginning, like living the dream, because I've now been able to step myself back, take a breath and, like, let her

Scott Benner 19:44
lead the way. Is that? What got you there? Like that, walking her through things over and over again till she understood better what was happening? Yes, yeah, I'm a fan. Because then

Julianna 19:55
when you throw in swim practice, because it comes, like, two hours, um. In the summertime, it's first thing in the morning. It's from 630 to 830 so that's just I prefer. I prefer that because it's way easier. She gives up, gets up, eats if she needs to, goes to the pool, swims, then she comes home and has the rest of the day. But then when you switch it and have it at the end of the school day, at the four o'clock at night, it just your body is not used to that at all. Whether you're diabetic or not, you have to like a time change. You have to like shift to when your your body is ready to do something. So it's being I always consider myself a scientist, being looking at the graph, which I try hard to not go into numbers too hard, and I know a lot, but you can see what they are. You generally speaking, can understand and but you're like, Okay, so we need to make sure that you're at least 200 before you get in the pool. And that gets challenging because she's on ADHD medicine for schools. She doesn't really want to eat. So taking medication in the morning, go to school, don't really want to eat. Having a protein shake for lunch just to get something. Otherwise, she wasn't going to eat all that. You got to eat something. And then trying to figure out what to eat before practice. So you don't take after warm ups, which is only 30 minutes, and you still have an hour, 30 minutes to go. How much

Scott Benner 21:09
swimming happens in time? Like, miles wise, no time even. Just like, how much activity in the water is there? They have it about two hours. Oh, okay, geez, that's a lot.

Julianna 21:20
So she gets out halfway like, usually she'll do the warm up. If she feels fine, she'll keep going. But then halfway through, people get out and go check her blood sugar. Really, she connects her Dexcom, or she does a thing, or whatever she wants to do. It doesn't matter. Usually, when she goes back into the locker room and she connects, I can see her numbers like, it's fine, she can keep going. But there were some times where she was like, 70, going down to maybe 60. I'm like, need a juice box or something. And she's sitting in the locker room, and I'm working out at the gym, because I know that became a pattern after I'm like, I need to know, I there's something going on the coaches, I understand that she has diabetes. Say we were in the when we got diagnosed. First thing, like, most athletes, can I still do this? And the doctor's like, absolutely you can and, like, two weeks later, we were on the bus going to San Antonio, and I was like, Oh my gosh, it was, like, nervous. That was the scariest trip I've ever had. Was that, because we just newly out of the hospital, he was on a Dexcom, thank goodness, but we were MDI, and, yeah, learned a lot that trip.

Scott Benner 22:18
I mean, have you learned yet that without active insulin, exercise is easier, and maybe you're not going to drop as much. Yes, yes. I was wondering, have you ever had the opportunity to roll her out of bed and put her right in a pool without eating, without Bolus thing, without anything? No, I'd be so interested to see what would happen there

Julianna 22:37
from my like dietitian brain, she needs a little bit of fuel to be able to burn it off, because if you don't have any in the tank, you're just going to burn off what's there, then you will potentially drop

Scott Benner 22:47
let me jump in. I'm going to tell you something that I think that fasting blood sugars that don't have active insulin, this is much easier to do with an algorithm that's set up well, quite honestly. But you know, I've seen Arden get out of bed and live five, six hours without her blood sugar moving, Yep,

Julianna 23:09
yeah. And that happened yesterday when we went to first day of school after the first official day that she wasn't super hungry. I'm like, Okay, this will be fun to see what happens. And she was fine. Literally, pelvic. It was like, Yeah, I have her target because of swim practice. We have offers from practice, and it starts next week or something like that. They're trying to get the kids used to school and all that kind of stuff. So I have her target a little bit a little bit higher. I think it's at 140 or something like that. You know, it's on the higher end. But whatever, it works for us,

Scott Benner 23:36
and you're trying, and you're trying to get acclimated to school again, yes,

Julianna 23:40
yeah, yes. Because that way before it was, like, I had it set at like, 110 and because of her not eating at school, and then as soon as she gets on the bus to go through some practice, all the adrenaline were things just kind of coming down. So she had to eat too much to get into the pool, and the exercise mode for her doesn't work. It just makes her skyrocket. So she can't use exercise mode. So she'll eat a little something sometimes, and then they'll be fine. They'll go up to, like 200 then she'll come back down. But meets, that's a whole another monster. A lot of competitive swim parents understand that sometimes you just she'll start an activity mode because it's all jacked up ready to go. And then we take it off, we turn it off, and she just has to give herself, like we manual variety. We give her, like one unit or two units, just to kind of have some active insulin there, to kind of slowly bring

Scott Benner 24:24
her down. Can I ask you to swimming act mostly as aerobic exercise on her impact, or is there some anaerobic feature to it? It's both for her, it is. It all

Julianna 24:35
depends on what they're doing. I mean, every practice is different. It's not the same. So I can tell when it's easy practice, because she'll eat something and her blood sugar won't come down. Or if it's hard, she'll eat something and she'll be like, 80 when she gets to be in the car. And like, All right, we'll see how this goes. And on top of this crazy swim practice, he goes to lift some prostrating right out. Or swim practice for an hour so

Scott Benner 25:01
she can go from aerobic to anaerobic, like aerobic, like Swim, swim, swim, to lifting. All of a sudden, does the lifting push the and the drop from the aerobic back up again?

Julianna 25:15
He's usually fine, because her body's gonna she usually eats uncovered, and then she will go to lifting, and then she'll come back, and she'll eat again, and we half dose, because she's kind of sensitive at that point, because of all the three hours of exercise you just did. Okay, so we had to be really careful at night before she's going to bed. What we do? Because if for her, if she has over five active units on board. She will tank, yeah. And it's like an hour and a half of not fighting the low really, just kind of giving her, like a juice box 15 minutes, okay, not working. Here's another and say, Stop. She think I just want to sleep. I'm like, Dude, you gave yourself too much insulin. So it's, you know, yeah, having to relearn all that over again. And then I'm, you know, and for her, she likes to do her Dexcom fan changes that night. And we're still on the g6 so we, you know, that has a lot of that's always fun, too.

Scott Benner 26:11
I It's the bane of my existence. I'm like, please change the equipment during the day. Please, please.

Julianna 26:17
Do you like to do it the night before? Because so when Morgan wears over patches for swimming, she starts getting irritated by it. So she actually doesn't wear any over patches, and it stays until 10 days. Okay, do I do skin tech or any of that stuff? We just plop it right on there. And keep in mind we live. I consider Louisiana Hot Box, particularly for right now. It's supposed to be like 110 today, or something like that. So, and a lot of people have to,

Scott Benner 26:39
yeah, no, I know the over patches are necessary for a lot of people. If you, if you have the right, you know the right type of skin, and they don't come off you usually, that's lucky. Yep. I just meant when you know if you're gonna put a CGM on, I don't know how accurate it's gonna be in the first handful of hours. Could we not do that overnight? Yep.

Julianna 26:57
And I, we, I beg with her all the time, and she's like, nope. Also,

Scott Benner 27:01
we know how the clock works, right? Like, so, like, let's not change your pump at 11 o'clock, because you know for sure it's going to expire at midnight or something like that one day, or you're going to be up in the middle of the night changing it. Like, just, please while the sun's up, no one listens to me. So that doesn't actually happen. I have a question about your move. She didn't have diabetes in Wisconsin. Is that right? I don't know. She might have, but it wasn't diagnosed in Wisconsin. No, she was not. She was diagnosed Louisiana. That's right. Okay, so you don't have a big like knowledge bed about hot weather versus cold weather?

Julianna 27:36
Actually, we, I do, because I have so we travel quite a bit. We're fortunate enough to be able to do that, and we don't like lot of people. That's why I was saying before living the dream. Because we like, Okay, we're going to go to Costa Rica, or we're going to go to Panama, or we're going to fly to Portland and go skiing for two weeks. So the weather changes. When Morgan goes to the beach, she tends to because of all the extra activity, even though she's very active young lady, when she goes to the beach, there's even more and so she gets even more sensitive. And we were in Costa Rica. It was on the this was before the five came out, and I literally the first four or five days, it was just the basal running in the background. We could not dose her for food, because she would drop to like 60. And so it was, like, amazing. And then the environment, and then we went back to the normal schedule. Was

Scott Benner 28:26
that towards the beginning? Do you think there was a honeymoon happening? Or is that probably

Julianna 28:29
with some honey? There was probably some honeymoon going on there? When we were skiing, we couldn't use activity mode, and it was not super cold. Mean, it's colder than here. That's when we were skiing over Christmas, and her pancreas died, and so we ever like, had to readjust everything to get her into range. There was several nights that it was not the

Scott Benner 28:53
case, yeah, when the when the the honeymoon just suddenly kind of shifted and stopped. Yes?

Julianna 28:58
Yeah, crazy. And then on top of that, she was also getting ready to have her nutrition

Scott Benner 29:03
as well, or what, I'm sorry. Oh, menstruation. Oh, yeah, yeah. So

Julianna 29:08
we, we all could tell, even my husband, like, Oh, she must be getting her period soon. Like, yep, because as soon as he hit that pillow, they would go up. And so we would go and give her a correction, and then she would slowly come back down. But hormones are real.

Scott Benner 29:22
Yeah, they're really something is what they are. Hey, do you have other Do you have other kids?

Julianna 29:26
I have a older son. He is 16. He's a junior in high school, okay?

Scott Benner 29:30
And is there any other autoimmune in your family? No. Anybody else with the ADHD. My mom, my mother in law, okay, no thyroid though.

Julianna 29:42
She actually, she does take um, thyroid medication. So

Scott Benner 29:45
yes, Juliana, is that right? Yes, yeah,

Julianna 29:49
she's, she's quite a funny lady. Sometimes she takes it, sometimes she doesn't, but yes, but it

Scott Benner 29:56
might be why she's a funny lady. Okay. So there's thyroid on your husband's side, ADHD on your husband's side. I just, I don't know. I was having a conversation last night with a group of people. They asked me some of the things that I learned from the podcast. And I said, it's fascinating. How many people, if you dig through their life and their family a little bit, will say things like, oh, there's ADHD here. Or we have some anxiety. People are depressed. I have an uncle who's bipolar, this type one. There's other autoimmune stuff, like, it's all just very, I don't know it's

Julianna 30:30
all connected in some way. Yeah, whether it's genetic or like, I have I'm dyslexic. I got diagnosed when I was in high school, and my biggest fear was that my kids were good dyslexia, because even though I'm very high functioning adult, I helped to run like a $4 million business before I got into this stay at home job. So it just you know you, once you learn how to adapt to your your new you, most people can be highly successful, and you would have no clue that something was potentially hindering how they are processing something. Like, I always tell Morgan, like you were the same as this person. You just take longer to get there, yeah, or you do it your own way, and you're still there. She's like, and she's finally truly understanding that like her. She was in resource for a couple classes. Her goal was to be back into gen ed, and this year, she accomplished that. For math she made she made good grades she was in. They had resource, and then did inclusion, which is some kids with learning disabilities or exceptionalities, is what they call Louisiana. And then then they have some gen ed kids, and they combine it, and they have a helper, and now she's fully immersed back into Gen Ed this year. Yeah, that's excellent. They they get there. Just takes them longer. You just gotta keep trying to be positive as much as you can.

Scott Benner 31:45
Learning different skills too is really valuable. Yeah, I

Julianna 31:49
never really know what she tells her classmates, because every year you have students with some of the same classmates and some new people, and she does not hide her her gear, she people can see it. So I never either. Was one little kid that asked her, our neighbor kids like, what is that? So that melts in my heart. I'm like, oh, because it's hard to explain to a six year old. Yeah, what that is. I was talking

Scott Benner 32:11
with these people last night, and I said somebody said something about, like, I don't understand why. They just don't, speaking about a person with ADHD. And I said, if you knew somebody was born with a limp, would you say to them, like, I don't understand why you don't just walk without a limp? There's this interesting thing that happens when you're things happening in your mind. People sometimes look at it and say, why don't you just stop doing that? It's not easy. It's not even not easy. They don't know it's happening. It's like anything else, like, it's a function of your body. You don't understand it's even going on. Maybe you see outside, you know, reflected back at you, and you realize, oh, maybe, you know, I have ADHD, or I don't see myself the way other people see themselves, or that kind of, like, you know what I mean, like you see it reflected back at you, but you don't know internally, what's happening is, you're just you. I was fascinated that they couldn't. People are having trouble wrapping their mind around that, like, I'm like, that person's not being flighty on purpose or because they don't want to try harder. This is just, this is how it works for them, you know. So when my

Julianna 33:11
daughter is on her in Asia medicine, she's very she's gonna, I equate it to her kind of being stoned, you know, she's calmer. She when she's not on it. You can tell, because she's constantly bit firing questions. My brother in law called her the pistol because it's constant, like, one question, I don't know. Let's do this. Let's do that. Like, there's no, like, calmness, no, it's just it's kind of intense, if you're not used to it, yeah, she does not take her medication on the weekends or in the summertime. We kind of let her be, let her be her,

Scott Benner 33:41
to her. So interesting that conversation moved on to other things later, but I just can't I can't wait to see how some some of the newer medications maybe end up helping people where they didn't expect. But that's not for this conversation. Let's see you talked about in your notes to make sure you take care of yourself. You were talking about being a parent of type one.

Julianna 34:06
So what? When Morgan first, before Morgan got diagnosed, I was trying to take care of myself, because I usually let make sure my husband and my kids are doing their thing being successful. That the move here was rough around my son at first, but then he finally kind of turned the corner, and now he's thriving and doing great in high school. My daughter was supposed to butterflies. She met everybody, and I'm like, Okay, now it's my turn. And I was like, started doing more exercising I like to do. I found a trainer who was doing Olympic training. I'm like, Sure, I'll try it. And I was doing great losing weight, all that kind of stuff. And then she got diagnosed. It all fell off the wheel. I fell off the horse. Then I was started getting depressed on my end, because, like, oh, I can't take care of her and do this and some finally, what, three years later, trying to get back into a routine for myself, to make myself in a better head space. But it does take time. You just have to. Kind of I would like this morning. You just gotta breathe. You just gotta work through it every day. If you have a friend who, lot of times, when you have a kid with a medical condition, you have friends but they don't truly understand it, I've been fortunate enough to have people like, tell me about this. Like, what can I help you? Can I follow numbers? You know what you know? So it's trying to slowly introduce them into what we have to deal with. In the beginning, it was very bumpy with the honeymooning and trying to figure out carb ratios and all that jazz. It has much calm down so you wouldn't even know she is a diabetic until you saw that she was had her technology on her. Can

Scott Benner 35:37
you do something for me? Can you explain to me what your life was like before, and what it was like when you realized I'm in trouble here, before diagnosis, yeah, like, where? What is the thing you were trying to get back to? And where had you where did you start? Where did you end up? What were you trying to get back to? For

Julianna 35:53
me, I was just wanting I was not happy. I was in a place where I didn't know anybody. I was working out of the house. But then I kept getting fur load because of the times that were going on, and I really couldn't get out of the house. I was basically I called this my prison. And jokingly call my house my prison, because I work here, live here, sleep here. I do everything out of here. And I get very nervous in social situations because I have a My call myself. I have a very funny personality because I don't have a filter. I've been doing a very good job here. I usually just say what I think, and just usually what other people are thinking too, but usually comes out of my mouth and they're like, look at me, like, I'm a crazy person. And then I'm like, Oh yeah, I was thinking the same thing. Like, well, I'm the one who just said it. So I was struggling to find that a new group of friends or acquaintances that I could just get out of my prisoners talk about life and make me realize that I'm not the only person who has a kid who's having trouble making friends or, like, I can't figure out how I need something more crock pot recipes, because we're constantly go from, you know, that kind of thing, right? And so I started doing, like, Okay, I put myself out there, and I was incredibly nervous, because I don't didn't want to say anything wrong that would offend somebody, because I'm a Yankee trying to live in the southern world. Took some time, and then I was finally felt like I was going out with friends. I was we're going to dinner party, like on double dates and all that kind of stuff. And then Morgan got diagnosed, and I decided my husband travels a lot, so I basically became the de facto lead on the management in the beginning, my husband does a great job when he is here. He follows her, like, when he's traveling, he'll call and say, Is she okay? Like, all this stuff, but I'm usually the point of contact for school, swimming, everything is me, because it's easy when I'm working out the house.

Scott Benner 37:38
Yeah? So that was exhausting and isolating, yes,

Julianna 37:42
okay, very depressing. Was not in a good head space. Felt like I sucked. Not gonna lie, you felt like you sucked. Yeah, it's like, I don't people want to do things that being it like is because I was putting my my kids, my daughter's management first, like it was consuming me, like I was she went back to school. We're very fortunate in Louisiana, in the beginning, like most places, and nurses were rotating between schools, but then three weeks after Morgan, so Morgan got diagnosed in June, and we started school in August, so we had some time to kind of kind of figure out, maybe potentially, the nice thing was that when the paperwork got back to the schools, the nurse called me instead of me trying to get ahold, like, Hey, I saw your paperwork. We got this, we will get back to school. That kind of was a little bit more relieving that, okay, I don't have to be sitting at school making sure everything's going because I was really worried that I had to be the right amount like, I because they're

Scott Benner 38:34
like, you just have to sit outside for the rest of her life and wait for something to go wrong.

Julianna 38:40
Yeah, just like, kind of sit there figure out that. I'm like, Well, I'm not so I'm like, Okay, this is not, you know, that wasn't the case. We and then three weeks after her she got diagnosed, they made state law that there's a nurse in every school in Louisiana, in Louisiana, can you believe it? That's awesome. I was like, No way. So, and we've been very fortunate to have some very fabulous nurses, and as people are going back to school, just give them some grace. This is a teaching moment for you to teach them how you manage. Keep in mind they also have lots of other obligations to help other kids too, not just your kid, and that it gets easier as your kid gets older. Like, this is Morgan's told me before, especially, like, I want to be independent. We had an endocrineologist appointment before getting all the paperwork ready. And she's like, well, I can't fill out. There's nothing in my paperwork that will that I can do to say that, but there is something for school. And I was reading the school paperwork, and sure enough, I clicked independent talk to the nurse. She's like, Yep, she's good. She doesn't have to come here. Like, I'm like, okay, there we go. Morgan Sophie, you have to you're independent, and go back to where she's Yep, you're independent. Sunshine. And that's like,

Scott Benner 39:46
we checked the right box. It's all okay now.

Julianna 39:50
Well, I mean, it's every school district is different. Like, there's a lot of places like you have to be no matter what, you have to go check in at lunch. And there are some right middle schoolers that say that they're good. They got this, they know it better than you do, and then they'll just make a roll. But they're also going to have times where they're all wackadood, like they have a test, or they're sick, or their gym class got switched before lunch, and it's just there's so many things that can potentially happen. But as you give your kids the confidence to speak up for themselves, because Morgan really struggles because she doesn't want to call attention to herself. She's not the leader. She likes to be led, but she also likes to do it the right way, not break the rules. Like she said, I remember, she's like, Oh, am I going to get in trouble? Like, No, we're just kind of talking about this. I had

Scott Benner 40:32
a question. Where'd it go? Jesus, let me dig it out of my head. This is my first day back in a while. How about that?

Julianna 40:37
I'm like, I'm kind of rambling too. So I apologize. No, no.

Scott Benner 40:40
Listen, you are who you are. Do you have ADHD? No, okay. Has anyone ever said to you? You do? Nope, yeah. Well, I'm

Julianna 40:52
pretty good at focusing. I have an office upstairs. I'm in the guest bedroom, and once I get down and sit down and start working, I could, like, work to five o'clock. I'm like, oh my goodness, it's already five o'clock. I gotta do my I gotta do my family thing. So no, it's more of me with the sex, because I process things a little bit differently. I have some high level people that I work with, and I'm like, You need to dumb that down just a little bit. You don't make any sense to me. But we all learn from each other. Like, I kind of re approach it a different way. Like, do you mean like this? And they're like, yes, like, Okay,

Scott Benner 41:24
does that impact like, because you just used the word rambling. And so, like, does that impact that for you? Like, do you feel like, do you feel like, do you feel like you're all over the place right now? Or no, no, I don't think you are. You jump around a little bit, but I do, yeah, but you jump around within the within the topic, Yep, yeah,

Julianna 41:43
I somewhat circle back to the home conversation. I never like for for taking care of yourself. You just have to find the five to 10 minutes that you can do something for you. For me, my kids go to school earlier in the morning before I start work, I do a little workout routine, video thing that I follow, where I go for a walk every morning and walk every night. Like, that's, that's what I do. So

Scott Benner 42:07
that's a good example of, I don't know why you're telling me that in response to what I just said. Like, so I'm missing something. What you do that to help what

Julianna 42:17
well you were in. You asked me a question, like, like, where I started, what happened, and then where I ended up, and I never told you where I ended up.

Scott Benner 42:24
That's interesting. So I can we go back for a second? I said, Is there something about your dyslexia that makes you jump around within conversations, and you then told me the end of the original story? I did? Yeah, not the, not the answer to my question. So is there something about dyslexia that, because I There might not be, but I'm just asking, like, is there something about

Julianna 42:47
not, for you, me being it's just, it's just me being nervous. You know, are

Scott Benner 42:53
you nervous still a little bit? Yeah, people come on, and I know they're nervous, but sometimes it clears up for them. But yours, yours hasn't cleared up at all. What do you think you're nervous about saying the wrong thing? Interesting, so you said earlier about you didn't want to say the wrong thing being a northerner in the south. And I was going to ask you, did that ever end up being a real problem? Is that something you still think about?

Julianna 43:17
I think about it all the time, making sure that I'm being respectful of the climate, the environment, the State of the Unions going on. You know, you just gotta, you have to be able to read the room and know what is appropriate and what is not. And sometimes, when I'm with people that I can trust, I can truly like, just let the guard down and play it

Scott Benner 43:38
in conjunction with a geographic change, you're aware of that, and it's still, still something you're aware of. Now, in the specific example of making the podcast, you're nervous about saying the wrong thing to who,

Julianna 43:51
when somebody listens to a podcast to get ideas about something, you can give someone like, oh, this lady said this, I'm going to try this, and I'm just trying to be informative. Oh,

Scott Benner 44:01
you're worried. You're worried that you're going to say something is going to lead somebody to do something that isn't correct, potentially, yes, yeah, that's interesting. I thought you meant that you didn't, you just didn't want to offend anybody. But that's not a that's not a concern. And

Julianna 44:17
with with your group, I don't think that's truly possible because you have such a wide net. I mean, maybe, of course, someone's always going to get potentially ruffled. Are you always going to

Scott Benner 44:28
say something that somebody's not going to like? That's every word I speak, by the

Julianna 44:33
way, but you also, for me, I tried to filter, not filter, really, just kind of and not hold back. Just be respectful. I guess I try. I just want to be liked. Who doesn't want to be like? That's it.

Scott Benner 44:46
Don't make a podcast. I got myself in so much trouble over and over again at some point. So I don't know if you're aware of this or not, but I make this this series about my weight loss thing. So I started, I started using a GLP. Weight Loss, like, I mean, God, it's, it's been, like, a year and a half now, I think maybe, honestly, don't even know. It's a long time. And I thought, Oh, I'm gonna sit down and record a couple of minutes every time I inject the medication once a week. And I'll, like, reflect back on the week before, talk about what's in my head, or something. Inject the medication, move on. And after I do this, I don't know. I make an episode say I do it like four or five weeks in a row. You know, the episode ends up being 2025, minutes long. It's five or six injections. I'll put it out as an episode. And I guess at some point in one of the episodes, I was starting to lose weight and seeing like a real difference in a lot of different aspects of my life. And I said, and I don't even know the context, I promise you, I don't know because you're just talking. And anybody who's never done something like this, like, honestly, like, shame on you for, like, thinking you know what this is like to sit down, flip a microphone on and just start talking without a script. You know what I mean? Like, you don't know what it's like. And I guess at some point in one of those episodes, I said, Nothing tastes as good as skinny feels, which is just a thing I heard someone say at some point in my life, right? It's not contextual, like whatever. My goodness, do some people have a problem with that sentence, and I don't actually know why, but I also well, it could

Julianna 46:25
potentially be that they're gonna unfilter myself. They could potentially that they're jealous that you're actually on the GLP one, because it's hard to get on, hard to get and can be very expensive.

Scott Benner 46:35
Oh, it could be a million different things. I had one person tell me it's triggering. One person started talking about their body image problems and like and I like. I am not indifferent to how everybody feels, but I just can't imagine that people don't understand that if a person, anybody forget me, but if me or someone else who's putting their voice out into the world, if they made sure not to say anything, yeah, that potentially, anyone could have a problem with what you would hear is a lot of nothing. There'd be dead noise. Yeah? Because that's not possible, but it's, it's super fascinating. I think, even to take it away from that example, for someone to think, you know, I have the right, the moral the just opinion about this, and anybody else who's different than me, You're offending me and you're wrong. Like, what if we all did that to each other? Like, it just, it's such a strange thing to me. Like, I can't I'm not doing a good job of articulating it, but it's a big part of my life. You know, where, where you get, I mean, no, I'm not kidding either. Like, you know, 98 of 100 emails that come or, like, oh my god, the podcast was so helpful, or Thank you, or what, you know, whatever, that kind of stuff. And then there's two of them where, like, you know, you might think I started, you know, a World War. And, you know, I'm a horrible, horrible person, but that's

Julianna 47:59
what makes your group so great is from the varying difference of opinions. That's how we learn together. No, yeah, I understand. I just nobody's nobody's perfect, and, you know, that's just, and it's unfortunate some people have to vent there. The

Scott Benner 48:13
crazy thing Juliana is that overall, I think most people, you know, whether it's this conversation or, I mean, even probably politics or anything really, like, most people fall into the middle, like, somewhere, into, like, a reasonable pot of like, yeah, like, do you you know what I mean? Or like, you know, even if you heard me say nothing tastes I don't know what the hell the saying is. Like, I don't even know where I heard it. You know, years ago it just, I was talking freestyling, and I just It popped into my head and I said it, you would think that I went to, I don't know, an outpatient facility for people with eating disorders, and yelled at them and and said mean things to them. I'm just telling you that I what I figured out is, is that there's some foods I used to eat that I'm now able to avoid, and as good as they tasted in the past. I'm enjoying being healthier more. Yeah, it's amazing. It's amazing thing. Yeah, it's also not a crazy statement that, Nope, it's fascinating. Like, so anyway, my point to you is, I would just say whatever you think and come to the conclusion that not everybody's going to agree with you, and that's going to have to be okay, because that's because I don't I feel, I feel like you're slinking around Louisiana trying not to say anything, to pick anybody upset. Okay, I'm good, good, good, yeah, because I have a an exploded view of that problem, like my life is more, I don't know. I have a bigger scope of of understanding on this one, and you just can't, like you know, all the sayings that you know throughout the years. You know. You can't. You can please some of the people, some of the time, whatever. I don't know if Lincoln said that. I don't know who said that actually, but I can tell you right now that by referencing it, I've just pissed off some Lincoln historian, and I'm. Certain they're gonna leave a horrible review about how I'm getting Lincoln's quotes wrong on this terrible podcast. I don't know. I think it's mental illness if I'm being completely candid. I don't understand the desire to like I've heard so many things in my life I don't agree with and I have never once thought I have to go track that person down and let them know they're wrong. I don't get that part. But anyway, sorry, I took, I took a left turn for you. You talked about in your note, we got pretty much to everything, but you talked about, and I'd like to see you dig into this a little more, trying not to be too rigid in your parenting.

Julianna 50:38
Oh, if you're constantly on. In my opinion, if you're constantly on your your kid, like I was, I had instance with Morgan, where her she was constantly eating, that seemed like all the time because she was hungry. She's an she's an athlete, she has to eat food, all that kind of stuff. But she was just constantly either bored and did something in her mouth because he was bored. So I'm like, Did you dose for that? Because she wasn't coming into range, okay? And she was like, my dad stopped leaving me alone. And she'd be like, be sneaky, and she would shut off her follow and all that kind of stuff. Like, well, that is loud, sorry. But the endocrinologist too is like, okay, Morgan, you need to space out. Space Out. You're eating. You can eat. Just make sure that you're eating more food less frequently. So instead of eating like, cheez, its every two hours, have have more with it to give a little bit more substance, so you're not hungry all the time. You know, I just say I was just being able to teach her, like, hey, you know, we just got to let go. Don't need to keep eating all the time you can. You just need to space it out. And then she eventually did it. She figured out. She's like, Okay, fine. I'll eat every two hours. I'll do it for it, and then keep going. And she actually did that this summer. And her her range went up, and the endocrine was like, oh, that's the first time she actually said, Good job to my daughter. Keep in mind the endocrine dollars, ladies, I find her. She's very clinically. I don't know how else to explain it. Good job, Morgan that I last visited, so I was excited about that. Excellent. Okay,

Scott Benner 52:05
a lot of type ones can experience kind of like insatiable hunger. It's not crazy. Have you ever heard of Amylin?

Julianna 52:17
Okay, well, like a lot of times it's what they're eating as well, if there's no protein involved, like makes you feel fuller, or having some fiber that they're going to be

Scott Benner 52:27
constantly eating. So being able to round about weight teach them what to eat. Yeah, let me give you another perspective on it. So I've been talking to chat, GPT while you were talking for the last 20 seconds. Amylin is a hormone that is CO secreted with insulin by the beta cells of the pancreas and type one diabetes, where the beta cells are destroyed by autoimmune process, both insulin and Amylin production are deficient with type one so the way that could intersect is regulation of appetite, slowing gastric emptying, glucagon inhibition, impact of Amylin deficiency in type ones, because people with type ones have little to no Amylin due to the deconstruction of beta cells, they often experience issues with appetite regulation, faster gastric emptying and more significant blood sugar swings. These factors can contribute to insatiable hunger as the body struggles to achieve a balance in blood sugar levels and appetite regulation. So there was a time, I don't know when, but there was a time when doctors were giving Amylin to type ones, but it's a daily injection, so I guess it's the thing people end up not doing. But you're seeing a lot of people now get some regulation back with these things, with GLP medications. So there's a ton of reasons why somebody could be hungry. I mean, your daughter could have just been growing. You know what? I mean? Like, yeah, yep, but, but it's important to point out that that if this continues for people, that they should maybe fall down this rabbit hole a little bit looking for an answer. That's all. That's the only reason I brought it up. But bigger picture, rigidity, not a great way to parent, one way or the other. No, it's not. It's

Julianna 54:08
not good for you and it's not good for your kid, because eventually you want your kid to go to college, be able to function on their own, be able to drink alcohol, have relationships, have a baby like all this, all this stuff, is you just using as because you're they're guiding you as much as you are guiding them, and not, not every kid's the same. So you kind of have to, you know, figure out what works best for you as a as a team, because that's exactly what you are. As you are a team. You have

Scott Benner 54:36
to figure out the difference between parenting and lording over.

Julianna 54:41
I think the best thing for me is when Morgan switched from the OmniPods omnipot Five, where I can no longer see, like when she was dosing in middle school, it was great, like a hey, because she was honeymooning, trying to figure it all out, I could see when she gave her correction with that follow thing that Omnipod have with omnipot Five. 1000s, and I was really upset in the beginning because I couldn't hold her accountable. But as she's getting more savvy with she uses an Apple watch because she hates sticking out her phone at school. She uses the Apple Watch and she can feel her lows. She doesn't feel her highs at all. She's good at associating a number with something, whether it's good or bad, or in range or whatever. So that's how she's, you know, this is she's doing her he's figuring it out every single day.

Scott Benner 55:26
You're happy with her progress over the over the years? Yes, yeah.

Julianna 55:30
I mean, she's not like her ANC is not the best. Her time and range is getting better. But like everybody says, it's like, it's a marathon, it's not a sprint. They got to live with us their whole life. You know, you don't diabetes. I was getting diabetes burnout myself as a caregiver, and so that's why I had to back off a little bit. So that way he could, I mean this, I can't. I kept having time myself. This has car disease. She has to live with it. I just have to make she stays

Scott Benner 55:53
alive. It's a lot, is it's just a lot. It is a lot.

Julianna 55:57
It's very overwhelming. But if you take it day by day, which is why, when everybody, anybody asks me, no matter what, I always say, I'm living the dream. We're all alive. We're functioning. She's thriving. She's doing great in school. She has friends. What else can I ask for?

Scott Benner 56:11
Do you see slow progress with like, a 1c with like, time and range, that stuff? It's very slow. Yes, yeah,

Julianna 56:18
okay. I know it's important and it's but sometimes in my head, I'm like, it's just, it's okay, we'll get there. Like, do I want to be in the fives and the sixes Absolutely, there was one time where you wouldn't see was 6.8 Yes, but that's also when I was being rigid with her management, like I was constantly correcting her, like, doing all this. I'm like, can't keep doing this. It's

Scott Benner 56:38
going to kill me. Why do you think that blood sugars get high. What do you think is happening? Yeah, with when her blood sugars get high. Why do you think it happens eating and not dosing correctly, not dosing at all, skipping insulin or just getting the carb

Julianna 56:52
count enough, not dosing, not Pre Bolus. Okay,

Scott Benner 56:55
so she's bolusing while she's eating. Kind of an idea, yes, and you think that would put her a 1c, into the sixes, if you would do it? Yes, is the ADHD. What stops her from doing it? Do you think her age? No, she just doesn't want to do

Julianna 57:09
it in the beginning. For her. She was nervous about seeing that number on her and some of the how much. And since she already had working in her body, no, I already have, like, eight units on board. I'm like, well, that's from the past, reporting in the future. And it actually this is showing a whole nother curve ball into this conversation. Is she's been going to diabetes camp. There's a lion's camp here that is fantastic. And she came back from that camp this year. She's like, I'm no longer afraid of the number. I just have to dose

Scott Benner 57:36
for it. Yes.

Julianna 57:38
So nice. Now that she's finally over that hump. It's gotten that's where the time of range went up. Good,

Scott Benner 57:45
good. Oh, good for it. Well, she said, Listen, you guys sound like you're doing well, honestly, do you feel like you're doing well? I Yes, good. Some

Julianna 57:53
days are better than others, of course, but that's just life in general. For anybody, you have good days and you have bad days, that's

Scott Benner 57:59
excellent. Oh, I'm glad for you. That's wonderful. Wow. Can you give people any kind of like advice about like things that have been valuable for you so far?

Julianna 58:08
Patience, make sure that you have, if you can find someone that if you need to vent, vent to somebody that's not necessarily within your your family, but outside of it, to get a different perspective and just take time to take care of yourself, because you're in it for the long haul, just like they are.

Scott Benner 58:26
All right, that's excellent. Thank you. Is there anything we haven't talked about that we should have? No, I think we're good, excellent. Are you still nervous? No, good. I'm glad. How do you think this went? I don't usually ask people while it's being recorded. But how were you with us? You liked it. Didn't like it. Think I'm an idiot. Now, what do you got?

Julianna 58:44
Like you said, sometimes when you're talking on on a microphone, it's kind of like a talking journal. I guess you could say you don't have an audience, that's just you and me, but yet, at some point it might get posted for the whole world that is following you to hear it. So it's, you know, it's good, it's it's kind of weird, but cool at the same time, I'm glad.

Scott Benner 59:03
Can I ask a question that has nothing to do with diabetes for a second, do you like it better in the south, or did you like it better in the north? I

Julianna 59:11
love the South. It's fantastic. The people here are great. Everybody. The everybody's very helpful. The common saying here is, like, I know a guy, whether it's male or female, to help you with something. We were fortunate enough when we got diagnosed that I have a neighbor who's a type one diabetic. He's older, he's almost 60, and then we have met multiple families that have two type ones and their families that live close by two. And you know, when you get into the club, it's you kind of get steered to a different way. But the weather is great, the people are nice, the food is great, you know, and there's constant sunshine, which has helped overall, everything

Scott Benner 59:47
that's excellent. Good for you. All right. Um, I'm glad you're happy, and I'm glad things are going well for you. I appreciate you adding your voice to the podcast. If you hold on for just a second, I will say goodbye to you when you're not being recorded. Okay? You.

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