#1117 Bold Beginnings: Medical Team

January 26, 2024Scott Benner

Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.

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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 to episode 1117 of the Juicebox Podcast.

It's been quite some time since we've made an addition to the bowl beginning series. But today's episode is in fact, an addition to that series. Today we're going to be talking about your medical team. And it might be a little different conversation than you're expecting. While you're listening, 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. If you're looking for community around type one diabetes, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, but everybody is welcome type one type two gestational loved ones. It doesn't matter to me. If you're impacted by diabetes, and you're looking for support, comfort or community, check out Juicebox Podcast type one diabetes on Facebook. 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 juice box at checkout to save 40% at cozy earth.com.

This episode of The Juicebox Podcast is sponsored by us med U S med.com/juice box or call 888721151 for us med is where my daughter gets her diabetes supplies from and you could to use the link or number to get your free benefit check and get started today with us met. Hello, Jenny, how are you?

Jennifer Smith, CDE 2:02
I'm awesome. How are you today?

Scott Benner 2:04
I'm awesome, too. Together. We're awesome squared. Yay. Today for the bold beginnings episodes we're going to do your medical team.

Jennifer Smith, CDE 2:16
That's a good topic because it? Yes, I feel I'm curious what and what people have said, Yeah, I am.

Scott Benner 2:26
First one off the bat. First off, find a doctor who listens to you and your worries, not one who tells you it's all in your head and, and are totally not knowing what you're talking and you're totally not knowing what you're talking about. So it's all in your head. Interesting. Your concerns aren't important. Why does that happen? Jennifer? Why would a doctor hear my concern? And just tell me it's not real? I don't know.

Jennifer Smith, CDE 2:55
I don't know. That's a good question. I mean, on all ends of the spectrum, regardless of whether you have a child or an adult, part of being a medical professional is that somebody is coming to you for assistance. Right? And if you can say to them, let's look at this in a logical way. Let's look at this and your concerns. And let's figure the ones out that actually are relative to something that we can change. And what are some of the other ones that we can address in terms of like another avenue of discussion, right? But nothing is nothing is not important. So

Speaker 1 3:39
here's the problem is how do you know? How do you get past that white coat syndrome? Where you look at them? And you think well, they must know? Right? And and how long have you put up with being treated poorly before you make a change? And what if you can't change but if you live in a small town, and this is the endo That's true. That's it, you know,

Jennifer Smith, CDE 4:00
that's true. There are many, you know, places and I'm only talking nationally, but I do know, you know, internationally, it can be an issue to having worked with a lot of people outside of the US. Depending on where you live and what you have access to and what your network providers may be or whatever what you have access to makes, it can make a really big difference. You may not love the person that you go in to talk to. But you may need them just even from a prescriptive standpoint, you may really have to utilize them from that and you may have to outsource in another in another way. And that's that's sad because many times if you outsource, it will be you're paying out of pocket for something else.

Scott Benner 4:46
And keeping in mind that this series is for newer diagnosed people like this is a frightening idea of like you mean all this happened to me and the doctor might not be good. Oh, and how would I even know if they're good? This this person said What should I expect? Back in terms of my support staff, we found that there were many conflicting pieces of information when we were first diagnosed, and they were coming from different doctors and nurses within the same practice. Yeah, so, you know, so you're in a room with one person, they're telling you one thing, and then you come back three months later, and they're telling you something different. Also, no one explains to you that in a lot of practices, you don't see the endocrinologist.

Jennifer Smith, CDE 5:29
Or at least not very often. You're right, because there's there is Amin, if you will, a shortage of endocrine prac, you know, practitioners. And what you may find is that you have a nurse practitioner or a PA, a physician's assistant that you meet with in between the endo visits, you may actually only see your endo every six months, but you may see the other person in between on like, you know, a rotating basis.

Scott Benner 6:02
I used to think that if I used to think the endo had to physically touch Arden once a year so that the billing was legal, because she would kind of come in the room like Mary Poppins just kind of flowed in. She, oh, looked at the chart. Arden. How are you? And then she'd reached out and she would just touch her? And I'm like, Are we completing some legal liability right now? Like I've touched her? We can bill you. Weird. And then she just how are things? And then let me and she she'd lay down rub Arden sites a little bit, ask her a couple of questions. Look at the chart. You're looking terrific. Keep it up and then move up the chin load out the door.

Jennifer Smith, CDE 6:45
Or away on her umbrella or

Scott Benner 6:48
movies right now. I've never seen Mary Poppins.

Jennifer Smith, CDE 6:50
Oh my god. Oh, you are missing out. It's such a good movie. Both of them actually. The new one and the really?

Scott Benner 6:56
She cleaned the chimney or did she go up the chimney? Or was it the guy that cleaned the chimney?

Jennifer Smith, CDE 7:00
That's the chimney sweep. Oh, Scott.

Scott Benner 7:03
That was right.

Unknown Speaker 7:05
That was Dick Van Dyke. Nobody

Scott Benner 7:07
listening to this knows who Dick Van Dyck is. At least I got that right? Well, if they've seen

Jennifer Smith, CDE 7:11
the newest Mary Poppins returns, Dick Van Dyke does show up in it at the end. And he is very well. He's very old. He still does his little jig dancing and everything. So yes, I actually looked at my husband. I was like, I am super Rami is that his dancing ability? Like,

Scott Benner 7:30
you know, he was sitting in a corner and they were like, alright, in five minutes, hit deck with the adrenaline. Out here he's like, do the dance. Do the dance. Then he was done.

Jennifer Smith, CDE 7:43
That's funny. Yes, I'm that makes me sad that you have not seen Mary Poppins. Come on Scott up a spoonful of sugar. And you're talking about diabetes? No, I'm

Scott Benner 7:53
just kidding. I saw I saw I saw the first episode of She Hulk last night. This might not this.

Jennifer Smith, CDE 7:59
Probably. I don't even know what that is.

Scott Benner 8:03
I wish I had known how to advocate for myself. When you don't know everything. Especially in the beginning, I knew there was more. And I knew it could be done differently. But I didn't know the words to say to create the partnership with my Endo. Instead, we often felt like opponents looking back, I can see how a change in language and better questions would have helped in our relationship. I struggled in that place of knowing I didn't that I didn't know everything, but not sure if our endo was going in the direction that we wanted. She said spoiler alert, they are actually amazing to work with. But in the first six months, we were in constant battling. Right?

Jennifer Smith, CDE 8:42
I think there it sort of defines to the the underlying lack of the right kind of explanation at diagnosis, right, all of the things that get sort of spilled out to you. And you only you only can absorb so much, especially with now this turned around in life, right? Something that's bringing something in you didn't plan to have to manage and take care of. So things like you know, all of the language around diabetes management, anything from going into a clinician, it's really just being very upfront and saying, You need to explain that better. I don't know what that word means. And you have to step back and just pretend that you are saying I just don't get it. You're not saying that you're not a smart person. It's just that this is new. I don't get that or I've bring in some of the things maybe you've done the online community kinds of investigating and you've seen some things talked about and you're like, that's what's happening for us, but I don't know, is this right? Should I try? You know what I've read about? Go to your clinician and bring it up and say I've seen this too. Scott started seeing this product or whatever. You can open doors in terms of discussion, too. Because you know that doctors aren't mind reader's either. They don't know what you don't know.

Scott Benner 10:12
It's an absolutely interesting situation because you're 100%. Right, like, well, it's easy to blame the doctor for not saying everything they should have said, right. They don't know what they should also they don't like when you when you're a doctor, and you use the word Bolus 800,000 times a day. There's no world where you think this person doesn't understand Bolus you don't even think about that Bolus is the to them. It's a word that they just use, which is why and I will absolutely without embarrassment, pimp the the defining diabetes series in the podcast because

Jennifer Smith, CDE 10:45
I was gonna mention it too. So I'm glad you brought to it.

Scott Benner 10:49
There's simple terms that we explain simply so you can listen through them. They're short episodes. And when you leave the episode, you go, Okay, I know what Basal insulin is. Now, I know what a Bolus is. Now, I know what an algorithm is. Now, I know what you know, there's so many people that come on this podcast that will say things like, I didn't know, I was MDI until I heard defining diabetes. Like I knew I gave myself shots. I didn't know anybody called an MDI. So then when the doctors talking, and they say MDI very quickly, you're and you're sitting there going, I don't know what that means. But I don't want to say, I don't want to say anything, right. And then quickly, that feeling can turn into animosity. You're like, why are they talking to me in ways I don't understand. And so, you know, it helps if you help yourself too. And if we're being fair, the doctor shouldn't assume you know those words. Correct. Especially in the beginning, correct. I

Jennifer Smith, CDE 11:38
mean, the random, you know, time, I might take a pause with a friend at a mealtime where I, you know, they don't have diabetes, they know that I do, obviously, I'm like, I just have to Bolus, you know, for my food. It's, it's kind of like the deer in the headlights sort of pick. Jenny's just doing her thing. Like, I don't know what she just said. But we're gonna go back to our conversation about whatever, when she's done with this thing.

Scott Benner 12:05
She needs a bowl. So somebody got her up.

This person says, I was constantly told not to adjust my own insulin, or my insulin to carb ratios, or my basil. And if I did, I got in trouble. And several times, I got in trouble for doing it without permission, which this is an adult who's now being told, you can't do things. I felt bad at first. And then I stopped asking for their help. So to this day, they are always surprised at how the settings look when they get the pump information. But it really is. Okay, so to adjust things for yourself, so there's this thing. I don't know the movies getting old now at this point, but you remember the Madagascar movie? The Yes, the animated movie. So there are times when I tell people, you just have to act like those penguins. You just smile and wave. And wave? Yeah, I won't touch it. Don't worry. Do you have any idea how many people send me notes that say the doctor took my pump for me changed my settings, I thank them walked out of the office, put them all back and kept going. Right and it but again, if you're newly diagnosed, and you hear that, that is not comforting. Like you mean, I know better than the doctor? Or what if I don't like then there's that indecision like should I go with what this is what I see from newly diagnosed people most often is the uncertainty. And it all stems. My best estimation, it all stems it's easy to say, like the, you know, the gaps in our healthcare system. But it's the gaps in what's reasonable. Like you can't see your doctor constantly. You can't see your doctor once a week, that's not going to work. Right? Right, every three months is too often they don't know you, you know more than they do. They're trying to go off of a static piece of information that you bring to them. They might not even be that good at it. You're bad at articulating what's going on. Because you get in there and you clam up a little bit because they're the doctor and you don't want to say anything and blah, blah, blah. And so it's it's bad communication. It's all it is. It's bad communication. The same reason you have trouble in your marriage, you have trouble with your kids, you have trouble with teachers, you have trouble everywhere, you are not communicating well. And it's a two way street. And so if one of you is doing a good job, and the other one isn't, it's still not gonna work. It's a tough position to be

Jennifer Smith, CDE 14:28
in. Oh, and I think from a standpoint we're talking about, you know, medical team, right? You should have a team approach in which you are a team member. You're not the stand back, let the team do it for you. You are a piece of this team, which means that you may have an endo you might have an endo and maybe a nurse practitioner or PA. You need to have an understanding of what can our communication be like how often Can we kind of check in with each other everybody, for the most part has an electronic medical record with the ability to send a message and get a response. It may not be as quick as you would like it to be. But you may get a response. But also, that team should be made up of not only an endo, but also an education partner. Yeah, right. I endos are an over the many years that I have been working as an educator, I only just really like thought about the fact that endos are not educators know, you may you may find a really good Endo, who does talk you through things and does explain things and really does the work kind of collaboratively with you. But I think real education comes from an educator who you can sit down with in a more lengthy visit. Yeah.

Scott Benner 16:00
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Jennifer Smith, CDE 18:23
think another piece within that is take take some of what the doctor or you know, clinician might be telling you newly diagnosed, a lot of it is a little bit more experimentation than it is with lengthy years with diabetes and some understanding behind that, right. So take some of those things. But the next time you check in, bring back and say we applied these things that you told us should be working. This is what happened, whether good or bad, or you know what you wanted to happen or not. You have proof to be able to say we did try this. We next tried this, this seems to work better for us. And somebody should work with you then. Yeah,

Scott Benner 19:06
and I think there's a there's a technique and conversation where you don't you don't put somebody in like a power situation over you. But you do act a little referential towards them a tiny bit. You know what I mean? Like you don't want to come in overpowering the doctor, because they're gonna they have a personality too. They're either going to push back because they don't like the power structure or they're going to be a timid person. And now you're not going to get their thoughts anyway because you're just kind of going at them. There is a way to center yourself. Say what you need to say stick up for yourself without being aggressive. And there's a there's a middle ground in there. This this person said try to find a doctor that works with you and doesn't boss boss you around. The first doctor I saw after diagnosis, walked into a room this harsh and told me that I had to eliminate carbs or else I would risk In amputation, if my certified diabetes educator, mom hadn't been in the room, I might have actually believed that. So my mom yanked me out of there and told me that I needed a doctor who didn't use scare tactics. And who would teach me instead?

Jennifer Smith, CDE 20:14
Yeah, absolutely. There's,

Scott Benner 20:17
I think, I think it's possible that doctors can become jaded. I have a friend who has been a police officer for a very, very long time. And he has to battle against the idea that every person he sees, is trying to get over on him lied to him, or is breaking a law. Sure. And I wonder how many people you see ignore their diabetes before you just think I'm going to come in with a club and just beat this into their head? Right? It's just it's how it that's my expectation, like, how many people did that doctor gave good advice to before they just gave up? You know, right, right.

Jennifer Smith, CDE 21:00
And I think you know, what's a little bit different, age wise, is that, for the most part, while there are kids with type two diabetes, as a child diagnosed, majority of the time, it's going to be type one. Right. And so within that is an endocrine practice that has a little bit more specialty and understanding specific to type one diabetes. Whereas those who are diagnosed as adults, even young adults, oftentimes need to do a little bit of homework about the endo that they're going to be seeing or working with. One of the big questions I always have asked, whenever we've moved, and I've had to change practices, is I call the office and I ask, how much of your practice or who in your practice, sees the majority of people with type one diabetes, you know, if you're going into an office space, where 10% of the people that they work with have type one, it may not, it may be a really, really awesome Endo, your first experience might be that this person is really willing to work with you. So don't certainly turn away from them. But they may not have the experience of an endocrine practice that more so specializes in type one, right? So doing a little bit of your homework, if you have the ability, early on, that can help to

Scott Benner 22:37
add on to that this person said don't assume that your pediatrician or your primary care doctor even knows anything about diabetes management. And that's probably not as common nowadays. But there are still places more rural places where there's no endocrinologist or I. Because when I interview older people, they'll tell me all the time, like Oh, an internist took care of my diabetes for 20 years, I never saw an endo, you know, like, or my general practitioner writes me prescriptions for my insulin or stuff like that. And it's, it's some people just aren't in the position to see. And I don't, I also don't want to paint a picture that all doctors are going to be like scary or bad at their job or anything like that. I'm sure there are plenty that are absolutely terrific. But the terrific ones aren't going to lead you to this podcast, where you're like, What the hell is happening? You know, like, it's, it's, it's going to be in these situations. And these are this is real feedback from people. I had to figure out that my doctor was being super conservative with guidelines. And they weren't telling us information because they thought it was too complicated to tell us. So this is an interesting scenario. I've talked about this before it's hurtful to hear. But the doctor makes a snap decision about your intelligence. It just happens. They look at you, and they think what can this person handle? And it's they're not always going to be right, they're probably frequently going to be wrong. I don't think it's a medical thing. I think it's a human thing. And then they can find themselves in a position where they're doling out the information on a level where they think you can handle it. And sometimes you have to tell them, I need all like, some people want it all right now, like, if you're one of those people that tell me everything, I'll let me deal with it. Right? And if you're a person who's not put your hands up and say, Hey, can we go a little more slowly? I'm overwhelmed by this a little bit, right? Like you can tell them who you are, instead of letting them decide who you are. Because I think I've seen it happen in both directions. I've seen like very kind lovely people get overwhelmed by information and I've seen people who are voracious to have information who have held back from them. Right.

Jennifer Smith, CDE 24:49
And I think that also goes with doing a little bit of homework on your end, honestly, to be aware of what it is that's important to discuss knowing time constraints of the visits that we have with clinicians these days, your visit will not be three hours long, despite the fact that you came in with a list of 100 questions and you're the person who wants them all answered right now, a guarantee as much as the doctor may want to, they don't have, they don't have time for that. And it's unfortunate. So come in with the top priority of I need to address this, this and this especially nice, newly diagnosed where it is a little bit up and down, you're learning you're navigating through things like insulin needs and changes and all that kind of stuff. So what are your priority, you know, needs right now that you want answered that you want clarification around or you know, those things that you just need to understand? Because that can help direct the course of that visit, as well.

Scott Benner 25:51
Yeah, man. It's interesting. I'm reading through some of these and we've talked about some of this stuff. And I just sort of made a point that I just wish I would have waited to see this person's thing because she just says I wish people would have stopped telling me what I could handle. Yeah, that that was a big one. Because

Jennifer Smith, CDE 26:09
they don't know you personally. Like you said, You Are you were Joe Schmo. Nobody knows anybody. Yeah,

Scott Benner 26:19
this person makes the point when you have questions, you can call your end out, day or night leave messages, there's services they can get back to you. There's other support at the hospital like social workers, child life specialists. Jenny used to work at a hospital right? Doing nutritional stuff, like there's people there you can talk about nutrition with Yes, ask for the services, don't just assume they're going to give them to you. Correct. Let's see what else we have. I think a lot of people don't realize they actually do have a say in their care. It was difficult for us because my husband is an ortho. He was leaning towards doing everything by the books. And I was reading and listening to all the podcasts and all sorts of things. And I wanted to derail this train quickly. And he thought we were being told truths from the hospital, we came to a common ground after a little while. So I read this one, because this is a common thing that people with diabetes have said to me when my daughter was diagnosed. And then I say to other people, there is an amount of time and it is not a long amount of time, where you will know more about this than the people who are helping you. And maybe you'll get lucky, it's a weird thing to say and have a practitioner who has type one diabetes, and thinks about it the way you want to think about it. If that's the case, you're probably really going to have a nice smooth time of it. But if you're just talking to a lovely person who wanted to help people and found themselves in endocrinology and are reading from, you know, books and charts are supposed to follow, there'll be a moment where it's not because their knowledge is lacking. It's because you're in it all day long, and they're not. You're gonna know, right? And then what's the, then the hard part is to make that leap to actually trust yourself, like trust your gut, like this is wrong, I need more basil, or I you know, my carb ratios, not right, or this shouldn't be happening this way. Instead of just asking a disembodied voice on the phone a year into your diabetes, what do you think? Because I mean, Jenny, you do it for a living and I see a lot of people's stuff. You can make an educated guess when you see a couple of graphs, yes, but you are still guessing. Absolutely.

Jennifer Smith, CDE 28:40
Without details, you're still guessing. And that's where, you know, when you say, at some point, you will know more than your clinician knows, I think it's you will know more about your navigation of diabetes, then your clinician knows because your clinician isn't living it for you. And you those are some again, from a communication standpoint, you have to communicate that to your doctor. Let's say the doctor is the one who said to just this way for soccer every single Saturday morning, and you tried that, and you tried it and you're like that didn't work. This is what's happening. So let's try this. Let's do something different. Then bring it in and proof again. Say we did we tried what you told us to try. It didn't work. But it's working this way for us. We figured it out. So in that case, yes. Do you know more? Absolutely. You know more, because you are living your diabetes?

Scott Benner 29:43
Yeah, there's a moment where you know it's true. And you just have to believe it. And there's a moment where you have to remember the old adage it's easier to ask for forgiveness than permission. So because then you're going to get caught into situations where Are, you come back in and you're like, look, we made our basil point five. And it was point three, and the doctors gonna be like, well, who told you to do that? And you're gonna say, my kids blood sugar told me to do that when it was sitting at 150 all the time. And now, by the way, look, it's 95. So I figured this out, say thank you. I always, I always think that sometimes when people are giving me crap, I'm like, what you can just say thank you. And let's move on, like I did your job. Like, like, just right, be cool. Do you think there's, this is sort of an unfair question, because I don't know how comfortable you'd be answering this. But do you think there is that, that God Complex with doctors, that they don't want to be wrong? Or they don't want to appear to be wrong? Because then you lose faith in them? Like, what is that? What stops a person from going? Wow, I can't believe you brought your agency down three points without me great job. Like, you don't

Jennifer Smith, CDE 30:53
right. And I think it in a way it's it's that god complex kind of term is, it's a harsher way to say what I think is a doctor has gone to school for an awful long time has really learned has applied in a clinical sense, all of this book information, right? And it's not that they're displeased. I think on a personal level, they're not displeased with success, at least a good physician is not in fact, they should be praising you and saying, Hey, how did you do this? You know, let me learn a little bit because it may help me to help others who have similar, you know, but I think they're disappointed that not that they don't have diabetes. They're like, geez, give me diabetes, that I can learn about this better. But I think they don't have the personal experience. So that there is a little bit of sense of feeling like, but I know, because I went to school for all of this. Right?

Scott Benner 31:58
Yeah. You know, I used to tell people in the, in the past on the podcast, if you listen to older episodes, I'll tell you don't go into the doctor and tell them you learned this on a podcast. It'll make it easier for you, right? And you think about it, right? How do you become a doctor, you get an undergrad degree, you have to pass the MCAT apply to medical school, complete your training in medical school pass like, I think there's parts one and two of like this medical licensing exam, you have to get into a residency program, complete your residency program, and then you have to graduate from medical school, you've done all that. And I come into your office and I go, Hey, Scott, and Jenny said, Who the hell are Scott and Jenny?

Jennifer Smith, CDE 32:38
What do you mean? Do you see my awards on the wall? Right? And for a specialty specialties go beyond right? I mean, an endocrine fellowship is at its two years typically. So that if they go into school to be a doctor, now they've gone to school to specialized in what you walked into their office to talk about. So I

Scott Benner 32:58
do think that like that, on that very human level, sometimes like somebody must sit there and think, Oh, well, yeah, I'm a doctor. But I guess you could listen to a podcast if you wanted to, like I think a podcast is the new Dr. Google to people, you know what I mean? Which, by the way, back in the day, when the when the internet was first getting going, I get it. But at this point, no kidding, you can pretty much diagnose anything with Google. You can be you can be right about it. Like the old joke is that you know, you can find out anything you think is wrong with you. But if you're really thoughtful about it, I figured out some significantly difficult things about people in my family by just thoughtfully going through the the details I knew and Googling the things I didn't understand. Absolutely. Yeah. But I have I listened to those doctors, I'm sorry. I can't imagine. Like if someone walked in here and was like, You know what you should do? I'd be like, shut up. I have this I know how to do my job. And so I think there's that. I also always wonder about the fear the doctor must have, like, how did you do this? I don't understand what you did. And how do I help you moving forward? If I don't know what you did to get to this point, like I see both sides of it, you know, right muscle. And that's,

Jennifer Smith, CDE 34:15
that's where the communication part really, if you want a team, if you want a team, that on the back end of everything that you navigate and have figured out, something's going to come up where you're going to need your team. Yeah. And you want that collaboration. Some of it may be educating them. Like I said, You figured out that their strategy didn't work, then explain what you did. Because that may, that may bolster what they're doing in terms of or they're learning to help somebody else and learn you better. There

Scott Benner 34:49
are also countless people who come into the Facebook group and you answer these couple of questions and one of them is how did you find out about the podcast and more people than I ever imagined? and saved from my, from my doctor, my doctor. So it's great. There are plenty of people out there who are open to it. And you know, again, if you find those people just rejoice and move forward, you know what I mean people, because you might, you might get the exact opposite, it's I almost feel like this conversation is a lot like the one about putting your kids in school with diabetes. There are people who have terrible experiences with schools, and there are people who have amazing experiences with schools. Now, here's the last thing I want to say about this. You know, when you ask somebody about how's it going, how's your agency, and they go great, but then they don't tell you anything else. And then later, you learn the array, one sees like, 8.2, but it used to be 10. So it seems great. It is great, right? But you lack the context, when you ask the question. Sure. How is it at school? Oh, it's great. The nurse is terrific. Sometimes that just means I don't get pushed back, or we don't fight. It doesn't really mean they're doing great. And I think people do that with doctors a lot, too. I hear them say all the time. I love my doctor, you have no idea how many people I've interviewed whose health is tenuous at best. And when they speak about their physicians, they're fantastic. Oh, they're great. Sure. Oh, we love her. She's wonderful. You're a one sees nine and a half. Oh my god, she's salt of the earth, you have no idea. Big hug every time I hear you judge your doctor any way you want. I'm judging your doctor, by your health. Okay, so, you know, so if your health is not optimal. I know you're a good person, and the doctor is a good person. But it's okay to expect better, I guess is what I'm saying?

Jennifer Smith, CDE 36:50
Absolutely. And if you're not getting, again, you've tried what you know how to try. And you're not really giving getting any additional feedback to improve what you know, isn't quite right. It's time to potentially look for something better. Yeah. And

Scott Benner 37:09
I would suggest interviewing those new Doctor candidates, by phone or in person, if they will, before you switch? Yes. Because I've seen people switch from one to the other. And I also want to tell you, that there is a moment when you're going to have to look down deep in your soul and make sure that it's not you. So maybe you're I hate to say this, but maybe you're difficult and you don't know it, you know that crap? Right? It could

Jennifer Smith, CDE 37:41
be absolutely. And it's actually a reason that I really and I love the fact that on your website, you've got some endocrine resources. And I look at it every once in a while. I'm like, Are there any new ones in here that I've like missed any new states that actually have somebody that somebody's commented, because from a new standpoint, while there, there are a lot in there, there are not as many as I think need to be there. Because people with diabetes are all over the place. And there is not always going to be an endo. Doctor who fits. Yeah, this person is great.

Scott Benner 38:22
It's juicebox docs.com. And when you go there, you can click on a link, it'll generate a little email for you. And then you fill in the information it asks for. And if you think you have a great doctor, then we add them to the list so other people can find them.

Jennifer Smith, CDE 38:35
Yes, that's it's a great, it's a great resource.

Scott Benner 38:40
I wish more people would would make submissions, because it really is difficult to find a good doctor.

Jennifer Smith, CDE 38:47
It is absolutely and there are some cities in there that are not the typical like New York City or like Chicago, you know, there's some some smaller places or some areas around bigger places that have some good recommendations. Jimmy,

Scott Benner 39:03
I have to tell you at the end of this if you have a second the Yeah, going through and living with diabetes with my daughter, and then thyroid stuff. It's taught me stuff that has helped me in other parts of my life. It's helped me advocate for myself. It's helped me help my mom, I'm gonna tell you right now, my mom is alive today because of what I learned from Arden having type one diabetes, because

Jennifer Smith, CDE 39:29
because you know how to dig for more information and to find the right resource. And

Scott Benner 39:33
I know I know what's happening in front of me, a doctor told my mom that she would not live through a surgery she needed to remove cancer. And he was telling us, we're just going to manage your mom's pain until she dies. That is exactly what we were being told. And we kept looking and kept pushing and found another doctor who gave my mom the surgery she needed and that was it. Two months a year ago, my mom was given a clean bill of health, she is finished with chemotherapy, and she is back living her life again, she would have died about five months ago if I listened to the first doctor, right? That is exactly the truth. I needed an iron infusion. And nobody believed me. But I kept pushing, and I came with facts. And I was persistent without being a pain in the butt. And, and I got it, and it saved me, you know, over and over again, these things happen. My mom's blood pressure got wonky last week. And I called the doctor and I said, What are you doing? And he goes, Well, we're upping her blood pressure medication. And I was like, well, that hasn't helped, what else you're gonna do? And he's like, Why can't try giving her more I said, You know what else you could try? And he said, What's that? I said, you could try calling a cardiologist because you're a GP. And let's go. And he gets the cardiologist in with her. And my mom calls me two days later, she goes, Well, I'm dizzy today. And I'm nauseous. I'm like, why she was good reason. They got my BP down. And I'm adjusting to it. She's like, it's gonna take a couple of days, I think. But my mom was going from a top number of 180. And they got her down to like, 120. Why? Because the cardiologist knew a different medication than they knew about.

Jennifer Smith, CDE 41:21
And you know what I, I hear as you explain that, as well. I don't know how old your mom is. But she could explain why she was having the symptoms she was having. She wasn't just thinking, Well, I just have to live through this. The cardiologist did a good job of explaining that to her and saying, these are some of the things that you're going to go through until the meds are adjusted. Right. And your body has kind of come to the level that's appropriate. Yeah, that is a really good doctor, my mom,

Scott Benner 41:51
who said, yeah, she didn't know that in Iran that she definitely didn't somebody shared. Somebody explained it. Yeah. Well, anyway, so good luck. I hope you get a great doctor. If you don't pick up for yourself. If you stick up for yourself, do it nicely, because you're building a relationship with this person, trust your gut. Understand, you're going to know more than them at some point. And smile and wave when you have to be the penguin. Yeah, that's my advice, which is not advice, medical or otherwise. See you later. Bye bye.

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