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Podcast Episodes

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

Filtering by Tag: Glucagon

#365 After Dark: Sex with Type 1 Diabetes (male perspective)

Scott Benner

ADULT TOPIC WARNING

Eric is a married adult with type 1 diabetes and he's here to talk about relationships and having sex. 

Not for children.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon AlexaGoogle Play/Android - iHeart Radio -  Radio Public or their favorite podcast app.

+ Click for EPISODE TRANSCRIPT


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

Scott Benner 0:00
Hello friends welcome to Episode 365 the Juicebox Podcast. Today is the next episode in the afterdark series. The afterdark series began back in October of 2019 and Episode 274, where we talked about drinking with Type One Diabetes. The next month, Episode 283. After Dark we did this show. And then in 2020, at Episode 305 talked about trauma and addiction in Episode 319 sex with Type One Diabetes from the female perspective. In Episode 336, of after dark, we talked about depression and self harm. And today, sex with Type One Diabetes from a male perspective. 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 healthcare plan or becoming bold with insulin. Listen today again, there's going to be a lot of adult language and themes. The curses, you know, like the actual curse words are beeped out. But still, there's a lot being spoken about here that is, you know, not exactly well hidden. So now's a good time to shut this off. If your kids are in the car or if your kids listen by themselves. Usually, you should be running through the house to stop them. This episode of The Juicebox Podcast is sponsored by Omni pod, the tubeless insulin pump, get a free, no obligation demo of the Omni pod sent directly to your home today by going to my Omni pod.com forward slash Juicebox Podcast is also sponsored by dexcom, makers of the G six continuous glucose monitor, check out the Dexcom G six@dexcom.com. forward slash juice box. And if you enjoy the theme of today's show, you're going to enjoy the theme of today's ads. So when we talk about Dexcom and Omnipod later, you know there might be some beeps.

Eric 2:11
I'm Eric Dutcher, also known as chronic super human, and I'm a type one diabetic 19 years. And I'm married to my wife, Heather for seven years.

Scott Benner 2:23
Nice. 19 years. How old? Are you? No,

Unknown Speaker 2:25
I am 45.

Scott Benner 2:28
That's interesting. So you were diagnosed at like, 26?

Eric 2:32
Yeah, yeah, it was, uh, you know, I was running and gunning and a new career and everything seemed to be going okay. And then it wasn't?

Scott Benner 2:43
how did how did then it wasn't present itself.

Eric 2:47
I actually lost about 20 pounds, which I'm 155 160 today and on a five nine frame. So that was pretty significant. And, yeah, just doing the typical, frequent, urgent need to pee and the weight loss. And so it was pretty clear that it was diabetes, although I didn't know that at the time.

Scott Benner 3:14
Yeah, though. It's interesting. I was gonna say that you and I met recently in Dallas, for a brief minute, but I thought 20 pounds must have been Stark on you.

Eric 3:24
Yeah, it was quite a bit. Yeah, there's quite a bit, but it it. Like, it threw me for a little bit, it threw me into either low mood or depression for about 10 years. And really the biggest part of my journey, and my story is really coming on the other side of that depression and becoming who I am today, or actually more appropriately refining who I was before.

Scott Benner 3:48
So let's find out about that a little bit. We always assume, like people guess all the time, right? Like when's the best time to be diagnosed with diabetes? As if there's, you know, a best time but I think most people tend to agree that from a psychological standpoint, it's before you know, about a life without diabetes, is that what three year window a depression, just the sense of loss?

Eric 4:14
Yeah, you know, the sense of loss was a big part of it, but it was just this. You know, the, the weight of everything coming down, you know, you're sitting in that white room, the doctors come in, you stop really understanding what he's saying, and your world is completely changed. So there's the loss, and a lot of people don't grieve the loss. But I think even at younger ages, that loss, that burden of that loss just gets transferred to a parent instead of an adult. And so I always look at it as it's better that I was diagnosed as an adult because the impact is on me as opposed to transferred to my parents.

Scott Benner 4:58
So you had that thought like that. At least I'm old enough where they don't feel responsible for me.

Eric 5:03
Not initially. But as I've grown over the past, you know, decade that's, that's what I've come to, you know, when people ask me that question I say, Well, at least it's me and you know, it's within my control as opposed to affecting, you know, a parent, a parent really having to be that management. And that doesn't even account for what I do a lot with diabetes coaching today of when parents have now have young adults that are ready to launch. But the parents don't know how to do the launch, because the kids are, you know, seeking individuality. The parents are still nervous, you know, I've got adults that that still, you know, wake up every day and texts or parents, hey, I'm still alive, which is a really kind of hard place to live.

Scott Benner 5:54
Well, when you were 26, you didn't live at home, you were on your own.

Eric 5:59
I was Yeah.

Scott Benner 6:00
Did you have any real contact with your parents about diabetes? Or what was that like to be an adult but not so old? That you probably still didn't have a fairly? I would think closer relationship? And?

Eric 6:13
Yeah, well, it was. So it was really hard. I was in a really broken marriage at the time. My ex wife was, yeah, it was not a good situation. I've I've gone through therapy and all this stuff and realize that I was going through abuse and all this other things, as well as the day I called my parents to let them know that I had been diagnosed. They said, Yeah, well, we have news for you as well. Your dad's kidney cancer is back. So they were in the midst of a medical struggle. At the same time, I was in the midst of a new diagnosis. And so I'm sure they were way more supportive. Then I really kind of remember in hindsight, but it was it was a difficult time for the entire family. Yeah,

Scott Benner 7:07
they had their own specific thing going on. And oh, wow, jeez, this is why we have these conversations, because I didn't expect you to say, actually, any of what you just said.

Eric 7:20
Nor did I

Scott Benner 7:22
know, that's something I saw. I'm hearing that your first wife gave you diabetes. I hear what you're saying.

Eric 7:28
Well, you know that you're stressed that is a factor. But yeah,

Scott Benner 7:33
let's just blame her as we move forward. Okay.

Eric 7:38
Okay, so Wow. And I'm sorry, your father. How did that all go? I feel like I have to ask you, although kidney cancer doesn't sound like a good thing in a reoccurrence? Yeah, no, he went, he went through, basically the first tumor he had grew over a three year period, the second tumor that came back, grew the same size and six months. So it transferred into what's called spindle cell carcinoma, which is extremely aggressive. And he tried everything with the best doctors, bone marrow transplants. My parents approach was to exhaust all opportunities. And yeah, he he passed away at 53, which is always kind of a, you know, being someone with a health condition like I am today. And now being 45. There is a little bit of an underlying Healthwatch of Am I going to make it past 53? Even though it's not rational, right, but it's just it's life, and it can mess with your head. Sometimes. I would imagine I found myself wondering how much correlation there is in that or if it is just something that people think about like, Oh, my, my dad made it to this, you know, I'm trust trying to make it there. I wonder if that's really, you know, if the if the data actually supports it, there's anything to worry about there? Yeah, I don't I don't actually think that the data supports it. But it's definitely there's a I, I would imagine a lot of people go through that mental gymnastic hundred percent. We

Scott Benner 9:09
love to set arbitrary, like, milestones for ourselves in the future. It's people love to do that, you know?

Eric 9:18
Yeah, I would, I would maybe put a finer point on it. People love to put arbitrary limitations on themselves. And by thinking, hey, my dad only made it 53. Like, I'm already kind of saying, well, that's a hurdle. Yeah,

Scott Benner 9:31
I hear I did I do the exact opposite thing. I always look around and think like, you know, if I make it to this age, that's good. If I make it to this age, I always think of it as like these little races where you get like bonuses at the end. Like,

Eric 9:43
I love it. I

Scott Benner 9:44
don't I don't know exactly what like, you know, you know, in your 20s you don't meet very many people who have certain ailments. And so you think, well, if I, you know, there, I'll be clear for that. But now we got to just leap over that and there's, again, there's no real common sense to it at all. It's just you know, That's ridiculous. It really is our minds play a lot of a lot of interesting tricks on us. So, so you have been an adult, a sexually active adult, I have without diabetes. And and with it. And so and so Eric, you're on today because you were the You are the lone man, in a sea of women who's who step forward, you were the lone man who said, I will talk about what it's like to have sex with type one. And I appreciate that. Thank you very much. You're welcome. For whatever reason, dudes like sex, but they don't like talking about it. I think it's funny to talk about, so I'm good. Okay. So, I guess we should start in before for a second, like prior to type one. Did you have any? I don't know what to call it. Like, was there anything about you know, being intimate with another person that made you feel like, uncomfortable or, you know, self self? I don't know. Like, like, I big Did you were you were you just one of those people was like, Hey, leave the lights on. I'm good. Let's get going. Or were you under the blankets kind of guy like, how did you start off your endeavors?

Eric 11:12
Well, I'll start with this. Like, I had to warn my mom that I was going to be on a sex podcast, like, my grandfather was a Episcopalian priests. Sex wasn't really talked about, you know, the, the conversation with dad was like, do you know what it is? And I said, Yes. And he said, Great, and get out on the way. So sex was always kind of a taboo talk. topic. So I really, you know, that kind of led into the bedroom a little bit, too. It was, you know, I, I never really felt that comfortable in it. You know, early on in life, and really, at the time of diagnosis of pre diagnosis. I wasn't exactly. You know, I wasn't Casanova out there by any means. But I

Scott Benner 12:03
don't think any of us are, are we were at the whim of women who are nice enough to be kind enough to have sex with us. But it's funny, as you're talking, I realized, you're you're a handsome man, Eric, we've met and you're in good shape. And I'm not in you know what you would? I'm not in your shape. And I could probably have sex in the middle of the mall with 1000 people there if my mom was shopping at Macy's? I don't I don't know if that's just a if there's like, that's the monkey part of my brain like, I don't know exactly. But you'd be hard pressed to put me in a situation where I'd say, huh, no, no, thanks. Not now, that seems wrong here. Or they're not that I would you know what I'm saying? I'm over exaggerating about being a public, but I don't think there's a lot about there's not a lot about that holds me back ever. But as you're discussing it, I realized I didn't grow up in a house where people you know, shied away from it. Or, or, you know, nobody said to me, like, you know what it is right, that thing. Yeah, we don't have to say it. And then it's over. You know, like, it didn't work that way for me. But But okay, so you weren't exactly. You weren't exactly like swinging from a vine like Tarzan prior to diabetes?

Eric 13:15
No, no, no. And I, you know, I wasn't sexually active until college. And so yeah, it was, it was much later in life for me than some others. And, you know, just the fact that I reached out, you know, kind of is a really part of my transformation as well, whether it's through counseling, or really in communication with my wife, Heather, who's amazing. So even

Scott Benner 13:44
doing this was sort of you trying to be a little more aggressive and bolder for yourself?

Eric 13:50
Well, me doing this is really about Look, I run a PG Insta account, all my communication is very, it's it's very PG and maybe even G. And there is not a place where people really talk about especially males diabetes, and sex. And so I've had, you know, I met a guy out in California, just on a whim, I was like, Hey, I'm in town. Hey, you want to talk and we talked and one of the things we talked about was being diabetic men, and how it affects sex just because it's not out there. And there's not a lot of people like you that say, Hey, I'm going to do an after dark series so

Scott Benner 14:36
so what's the first concern like First of all, do you pump you in jack? Do you wear CGM? What do you have?

Eric 14:41
Yeah, so I wear a CGM and I wear a tubeless pump.

Scott Benner 14:46
Okay, so let's guess you have a dex commented on the pod. Right. Okay. And, and you are so what's the first thought you meet your now wife? I'm assuming when you had diabetes, you matter. Yes. Right. So, um, I use that math to figure that out with your age and your diagnosis date. I think everyone should be incredibly impressed. And so the first time you guys decide we're going to move forward here. She knows you have diabetes already. That's correct. Right? Was there any conversation around it was there? Hey, by the way, I'm, I've got some gear on, like, don't bump into my CGM, or what do you do? How do you do you talk about or do you just not talk about it?

Eric 15:28
Well, it at the very beginning, we didn't. But we actually, you know, we talk about diabetes in relation to sex a fair amount, because we sex is part of a healthy relationship. I mean, you know, when I think about it, like sex is what connects you to a partner, it releases oxytocin, it's the same sort of thing that's released in a child that breastfeeding with the mom and the mom gets from that process. So there is a bonding process part of sex, so we talk about sex quite a bit. But early on, like it was just, you know, when something came up, then we would talk about it. But now that the doors are open, and most of the stuff has come up over the course of seven years that we can proactively have those conversations. So did you feel self conscious for her seeing your your gear? You know, it's funny, I said, gear now I think people think I mean, penis, but I mean, like your CGM in your in your pump. Like, did you? Did you feel self conscious The first time you took your clothes off? or How did it make you feel? Do you remember? I'm more self conscious and kind of goofy about my other gear? My diabetes gear doesn't, you know, bother me too much. There's, it's, it is what it is. And it's not me, versus my gear is me. Right. So like, if she doesn't like the diabetes equipment, then it's the diabetes equipments. I believe it's not that I'm ugly.

Scott Benner 17:12
either. So yeah, like so you wouldn't have taken it personally, if, if she like stared a little too long at something or, or something like that?

Eric 17:19
No, no, but I will say that, you know, one of the things that I do think about is your diabetes gear should be in certain spots, and I specifically don't put it in certain spots, so it doesn't get into the way during sex. And I actually I'm very happy that I'm tubeless. Because I don't have to be like, Hey, I'm disconnecting my pump. If you know what I mean.

Scott Benner 17:44
Bow Chicka. Wow, here we come. So Alright, let me try to guess here, right. I've had sex before. I wouldn't want something to be on my hips in the back. If we were talking about missionary. If she was on top, you wouldn't maybe one on your thighs. Am I getting? Am I close? Am I figuring this out? Or how does it go?

Eric 18:08
Yeah, yeah, no, it's, it's true. And then there's certain parts of like, there's optimal placement on your stomach and there's sub optimal placement on your stomach. And then really, it's just a lot of it is her being aware of where it is before we're intimate. So like, where we're touchy feely people, we're always hugging multiple times a day, and so she's pretty aware of where my devices are already before sex is initiated.

Scott Benner 18:38
Now, have you ever gone? This is gonna sound silly, but have you ever said to yourself like in your head? I'd love to go from reverse cowgirl to doggy here but I can't because my CGM is blank or does that not come into your head in the moment?

Eric 18:53
I know typically what happens is something gets bumped and then you go Okay, was that a? Was that a fatal bump or not a fatal bump to the pump and you know, if it if it comes off in the process, no big deal. It's just like anything else, you just reattach it later.

Scott Benner 19:10
So the the passion part of it sort of overtakes the concern part of it like sort of if you were to knock a lamp over, you wouldn't stop and go we have to pick the lamp up now like that kind of a thing?

Eric 19:20
No, I think usually what it honestly it's something like that typically happens and it causes a giggle or something and then you get you get going down the road again right?

Scott Benner 19:30
Do you worry about being low when you're like do you worry about like the exertion making you low?

Eric 19:41
Yeah, so I what guys need to be thinking about a lot and you know, not having the the view into women diabetics. There's also an effect there as well as your blood sugar dictates how Thick your blood is. And because our sex organs are filled through engagement with blood, if you've got thin blood, guess what doesn't happen? erections are really hard to maintain. Although sometimes, like, you know, you finish and you know, you're like, Well, I was 56 How did that happen? You know, but, you know, when you're high, like, you're more likely to not last as long, it's going to feel, you're going to feel more pressure, you're going to feel kind of achy. You may feel sleepy and slow down in the process. When you're low, you know, you, you could have problems, you know, keeping an erection and like I, I remember, there was a time we were, you know, we were active and, and she was manually stimulating, and like, I had nothing and think about, it's not just the low blood sugar that's making it hard to get up. But on top of that, because you're low, you've got this emotional catalyst going on in your brain. And so like, I just broke down in tears, and like, I had a bawling fit on the side of the bed. And it was like, wow, okay. That's kind of not what we planned. When we came back to the bedroom.

Scott Benner 21:28
I gotta tell you something, I assume the women listening are like, Well, nothing sexier than a crying guy with a taffy for a while we're trying to have sex.

Eric 21:37
Yeah, no. And I think like, I think it devolved into, like, you know, something about my father dying and all this other stuff. So like,

Scott Benner 21:45
it was, like, you were so low, you got emotional that that like thing that we all see with our kids or, you know, you know, adults where you get so low that you just really get emotional out of nowhere.

Eric 21:56
Yes, I was a blubbering baby. And and, you know, it took some time to recover.

Scott Benner 22:03
Did she just like back away and pull the blanket up over top of your office? Let's go.

Eric 22:10
Now, I mean, in that moment, I mean, she knew something was wrong, right? I can, it was a it was a, you know, there was a moment that, you know, there are moments that you can recover. And there's moments that you can just and yeah, and what we've learned is like, when you get and you want to have sex, and it just doesn't happen. It's okay if you don't recover. But it's always good for me to let her know, hey, look, I know this didn't happen, right? But, man, if if you wake up in the middle of night, let's try this again or not, you know, just say, yeah, it wasn't you. But like having that communication that she didn't do anything wrong, or, you know, her communicating to me that, hey, it's okay. It didn't work this time. That's an important element. Because when when, when people go and have sex, and oftentimes before it, guys are really good at this, you start building a sex script in your head, hey, this is what sex is going to look like. But as we know, like, you know, when diabetics, write scripts, like diabetes, like come along, and like just crumple up the script, and chew it up and laugh in your face when you're doing it, and

Scott Benner 23:28
so that's interesting. So you just feel like, Guys, a lot of people men are like, I'm gonna do this for five minutes, then I'm moving to this for 13 strokes. And then I'm going to flip it like, do you think like, because I'm, I realized, as you're saying that, like, I have sex the way I live, like, I just, I move in a direction until the other direction seems like, right, I don't think things through like that. That's interesting.

Eric 23:51
Yeah, it's not it's not as specific as that. But it is, it is a clinical thing. And when you go into sex therapy and whatnot, a lot of times there will be discussions around Well, what is your typical sex script? Or what would your ideal sex script be? So it is, like, it's not a, hey, I'm going to do this for five minutes. And she's going to respond this way. And then I'm going to do this for five minutes. It's a more of a general of this is, it's like if you were going to run a race, this is how I'm going to approach the race. And this is how I think it's going to go typically, there's something in that involved especially in you know, in a committed relationship, you tend to form typical sets, grips that work better

Unknown Speaker 24:44
for you. It's interesting.

Scott Benner 24:45
So I have two questions. Before we get too far away. You said two things that made me think of some stuff so before we get too far away from your thought, I want to understand with a high blood sugar, you're saying that no matter how, you know, amazing Sex is that feeling of being high, you can't overpower that. And I come from a place that with that question, I've, I've had sex while I'm ill before, like sick, and you don't feel sick while you're having sex. But that doesn't. That's you can't overcome that high blood sugar feeling, huh? Like endorphins in your fury, it can't mask that.

Eric 25:23
Oh, it I mean, it definitely can mask it. But you can't. You can't not be overcome. Yeah, you can't overcome the physical effects of it. And like, if. So we actually set a thing of like, if I'm over 200, we typically try not to initiate sex, just because you don't know where it's going to go between the start of sex and intersex and over 200, like I could end up at like 300 or higher. And, you know, I've had those moments where you know, you're orgasming and you're over 300. And your heart is just, you can just feel it pushing that honey thick blood through your blood vessels and going, Man, that's not good. This isn't how I want to go out. Right, exactly. And, and being 45. You know, I'm not, you know, who knows what other complications could be around the corner. So you're trying

Scott Benner 26:19
to you also try not to put too much tax on your body in general. Exactly. That's it, which is already being taxed by the HUD, the high blood sugar already. Right? Do you think if you went down in that moment from a heart attack, would you ever were with all to be like, like, clean me up before they get here? Or do you do? What do you think your last thought would be on your way over? Like, ah, I knew this was gonna happen.

Eric 26:42
I don't know what my wife would take care of me for sure. Heather, Heather would know, she would chew

Scott Benner 26:48
up the situation, it would look like it would look like you guys were taking Family Photos when 911 got there. I always hope at my death that I have a minute to realize I'm dying. Like I don't want it to be painful. But I want to be able to cognitively like understand that I'm leaving. Because I want to know the I want to be able to think finally I'm in arrest. Like that's what I want to be. I want to like consciously be aware of like, Oh, I'm not gonna be tired tomorrow. This is fantastic. Yeah, but so. And then I have I mean, this seriously, it's gonna sound like a joke. But when you're low on the lower side, like say your blood sugar's 85. And you're, you know, you're vigorously having sex. I keep saying having sex, I want to say, but I have I keep saying, and so. And do you ever use that as an excuse to not be the more active person in a position? Do you ever say Yo, you got to jump up on top here? Cuz I think I could hold on to this 85 blood sugar? If I'm not the one thrusting? Have you ever. But do you get can you get lazy and use your blood sugar as an excuse? I think is my question.

Eric 27:54
So this is this is the difference between a diabetic and a non diabetic in that conversation, you actually are more likely to be in a better position to become more active when you're low. Because, you know, if, if I'm, if I've got thin blood sugar, and it's hard to maintain a rec interaction, it's gonna be hard in any position. So when more aggressive than Well, no, what I'll do is is so you switch up what you're doing. And let's say I've taken a glucose tab, which you know, in game glucose tabs is no shame, right? You get that glucose tab in and then you focus on manual stimulation of her or oral stimulation of glucose tabs dissolved, maybe there's and then you've got time to get your blood sugar back up without losing the mood. And actually, it's, it's kind of a good thing, because, you know, as all guys know it, there's more time typically involved for a female to enjoy ourselves. So I hear what you're saying takes forever.

Scott Benner 29:05
Now, I'm, I'm gonna ask you a question that I think it's possible, you might say yes to do you ever incorporate the glucose into the event?

Unknown Speaker 29:15
Um,

Scott Benner 29:16
I know I'm pleased apologize to your wife. If the answer's yes. Because now I feel like I'm asking a question about her too, but she's never, like, hit a tablet somewhere and been like, yo, go get that. Nothing like that.

Eric 29:28
No, no. You know, we could be more interesting, I guess and keep honey by the bedside and like, you know, yeah, put honey on the spot. Yeah.

Scott Benner 29:41
I think people are gonna listen to these after dark episodes and realize that the guy that's teaching them how to use insulin

Eric 29:48
as a problem, it's a no, it's a new side is gone, right?

Scott Benner 29:53
No, I'll tell you. I mean, this, um, if I'm lucky about one thing and my ability to talk often Cough, it's that I think a lot of people are limited when they're speaking to the ideas that they actually firmly believe or, or hold to be true. My brain can go find examples of things that I've never considered before in my entire life. And it happens, like in a split second, so I can say something ridiculous. And most people, you know, will listen and think, Oh, well, he must, um, you know, he must have these thoughts all the time, but I trust me, I say stuff, I do not mean in any meaningful way. Like, they just popped into my head. And I just thought, like, I wonder if maybe his wife could start stuffing like tablets around and being like, yo, you know, piggy go route that out? You'll be okay. And?

Eric 30:40
Yeah, no, I mean, luckily, luckily for most diabetics, like the, the, you know, there's sugar hidden in all parts of the house, and most especially by the bed, and so depending on where you are, you typically have access nearby. And, you know, it doesn't have to be me always being aware of the situation, you know, she can ask a question, Hey, are you low?

Or, you know, how are you feeling?

Scott Benner 31:11
Have you ever been in the act and just seen a hand come up with a juice box? Like the shepherd just be like, Yo, I know what this guy needs like this. In my, my real question is, is that is it on you? Unless it's an emergency situation? Is it on you just to maintain it? And I guess to the secondary part of that question is, How hard is it to be aware of your blood sugar while you're having sex? The dexcom g six continuous glucose monitor is a staple in our house. Being able to see my daughter's glucose trends and values at a glance, is that's irreplaceable. Honestly, right there on my iPhone or your Android doesn't matter which phone you have, you'll be able to see a loved one's blood sugar. And if you're an adult living with Type One Diabetes, you'll be able to see your own right there on your screen. Quick swipe, there it is. The Dexcom shows you your rate of change. how fast you're moving in a direction, right? Am I going up? Am I going down? That wasn't even a pun. Anyway, is it happening quickly or slowly? The Dexcom g six will tell you everything you need to know about your blood sugar. So not only can you know your blood sugar's and their speeds, you can know their directions, which is important. making great decisions about Pre-Bolus thing for meals or, you know, as you're listening to today, being ready to have some fun, what could be worse than getting in the mood, getting into bed and getting too low to perform. With your Dexcom you can see what your blood sugar is ahead of time and make changes that will put you in the position you want to be when you're getting into the position you want to be in. I thought that was pretty clever. I gotta be honest with you. I hope you do too. Go to dexcom.com forward slash juice box to learn more about the G six continuous glucose monitor doesn't matter if you're an adult, or a child. If you're living with Type One Diabetes, or honestly using insulin at all even type twos, the information that comes back from the dexcom g six is life changing. And I mean if it helps you get off better, that's just a bonus. With the time that's remaining, let's talk about the Omni pod tubeless insulin pump. First things first tubeless no tubing don't have to hide in your clothing and isn't a problem when you're not wearing any clothes. Just imagine all of the things that a tube could get caught on I mean a doorknob handle on your dresser someone's I mean, you're gonna have to fill in the blank there, right, but a lot of body parts tubing could get caught on. But with the Omni pod, you don't have that problem. No door knobs or knobs of any kind to worry about tubing getting caught on. The Omni pod is terrific. I believe in it. My daughter has been wearing it forever. And you can check it out at my Omni pod.com forward slash juice box. Now when you get there, ask for the free no obligation demo. They'll send it on the pod right to your house. Right You could be on MDI right now but thinking about a pump, slap that on the pod on somewhere, jump into bed with your significant other and put it through its paces. See if that thing holds on. Eight seconds. Isn't that a bull riding thing? Right? Yeah, to stay on for eight seconds. Well the Omni pod is gonna stay on for three days. Right? 72 hours is how long the Omni pod last night great. You put one on last for 72 hours insulin runs out, pop it off, put on a new one going again, nice fresh infusion sites every 72 hours. All kinds of different FDA approved locations for you to put the pump on. So you're going to have a lot of choice choices. What's important Check out the Omni pod demo to see if it's a good choice for you. And then bring it home and brains out and see if it falls off or not. I bet you it won't vegetal hold on like my Omni pod.com forward slash juice box, get that free demo today dexcom.com forward slash juice box, check out the Dexcom g six continuous glucose monitor. This is the perfect tandem of diabetes devices. My opinion? Get out there, upgrade your stuff.

How hard is it to be aware of your blood sugar while you're having sex?

Eric 35:41
Um, you know, there, there are times that I'm completely unaware. Like there are times that like I said, you, you you're done having sex and below, you realize, wow, I was really low during that time period. And I just didn't realize that. And for whatever reason, the physical response hadn't happened yet. Or I'm high and you know, didn't know that, either. Because you're right. You know, sex is about passion and passion covers up a lot in the moment. So what that means, though, is oftentimes you'll spike higher or lower than you would normally realize. You know, I don't particularly like to have a watch on while I'm having sex, but like, if I do, then, you know, Dexcom can tell me where I am. And I don't always like I I think it's important that I don't let it interfere with our sex life too much. So of course, I generally know where I am from a blood sugar level, but it's not like I I think that's one of the advantages of being tubeless. And all this other stuff is I don't actually have to physically disconnect anything. You don't start going up automatically because you're losing your bazel Right, right. It's not like I'm going to run a race and I have to play in 30 minutes in advance before I have sex I we can you know, we can let the moment take us.

Scott Benner 37:10
I allude to that in some of my Omni pod ads. I wonder if people hear it when I'm like, you don't have to disconnect you know, for whatever you're doing. And I think in this episode, I'm just gonna say it the ad and bleep bleep it out. That's a tagline. I'm sure the pod wants to know, the Omni pod tubeless insulin pump. You don't have to take it off.

Unknown Speaker 37:30
Yeah, really, really

Scott Benner 37:32
tell you what, they might sell a couple of that.

Eric 37:36
Seriously, but like, I I'm lucky. I should point this out. You know, I am lucky in that. You know, my wife has no problem with my devices. Yeah. My ex wife actually, like part of the the control that was delivered by her. I wasn't on the on the pod and I wasn't on a CGM. And that technology, or at least a pump was available. And I was constantly being told, well, you don't want something connected to your body all the time. Like, you wouldn't want that. And what she was saying

Scott Benner 38:17
is I don't want you to where that right. Exactly.

Eric 38:19
And and because of the the mind side of it. And so I don't know the situation of every diabetic out there. And there may be some fear that somebody's not going to accept your method of insulin delivery and blood sugar control. And what I think you know, everybody needs to hear is it is your insulin method and your delivery, choice and your control choice. And you need to be vocal about why you've made that choice. And either the person you're with accepts it or doesn't accept it. But if they don't accept it, that probably a signal of a bigger problem. Did

Scott Benner 39:01
you believe it when she was saying it? Did you think Yeah, I don't want that. Or were you? Were you conscious of the fact that she was subliminally telling you she didn't want it?

Eric 39:10
In the moment? And in the moment, I believe that there's a there's a master manipulator kind of effect to what she had. That led to the the control that was extremely effective. Yeah. Was she Catholic?

Scott Benner 39:29
No. I just think that there's a Yeah. So I've met some Catholics that are really good at the guilt thing. So

Unknown Speaker 39:37
Oh, right.

Scott Benner 39:41
Imagine she was Jewish. Yeah. But there's the two religions that are really on top of guilt. So

Eric 39:47
well, like Yeah, and that's, I mean, look it that was a really dark time, but that was a part of an aspect of it. Like you know, my wife and I, Heather, we have a we have a like group Really free life together, were very open and encouraging. And everything that we do we talk about things in a way like she, she's a change from being a CPA to a licensed professional counselor, she's an intern right now, all based on her ability to communicate and understand relationships. And that's really what inspired me to come on to this is because if you can take the lessons learn from Heather in our relationship, whether you're in a committed relationship or not, when it comes to sex, like you can have a really normal and beautiful sex life, even as a diabetic,

Scott Benner 40:48
I think to it harkens back to something I said on the podcast a number of times, but you need to be with the right person, and a person who can accept that you have a glucose monitor or you know, insulin pump, or that you need insulin or whatever, that's not the right person. You know, you don't want to live an entire life in a battle where you're being manipulated about your your diabetes of all things. That's just, that's terrible. You know, and so I would try to look at it from a more positive aspect, which is, you have an extra sensor on you, that tells you if the person you're with is bad or not, you know what I mean? Like, like, because sometimes it's hard to tell, but this, this thing about the about diabetes, it's hard for them to mask it, if they, if they're not accepting of it, it's easy to see. And so that means it's easy for you to see that you need to be with somebody different, you know, or be treated like, like you don't deserve. And and you don't want to get I think Eric can attest this, you don't want to get caught in a way where you're being treated like that, because it's difficult to break out of because there's still I'm assuming there's other things about the person you like. And so you're ignoring your health to hold on to the parts you do. Like, is that

Eric 42:00
right? Yeah, and I and I think it becomes even more important when you think about it from a sex perspective, because sex is an accelerator, no matter like how much you you know, believe in one might nightstands or whatever sex is ultimately an accelerator in any sort of relationship. And it's physiological, like that whole oxytocin connection, like you will be forever connected to anyone that you've ever had sex with. Or if you're just in a casual relationship, and then you go have sex, like, it's automatically made that more of a thing. And so if you're, if you're already experiencing like, negative talk from somebody about your diabetes, like you need to have the conversation before you need to have sex, just because otherwise, like you're setting yourself up for a bad situation with clinging or being caught in a deeper relationship with someone who is never going to accept you as a diabetic or never accept the it's a much more complicated life to live with someone with diabetes. And families that have kids that are you know, that become diagnosed, they don't have that choice. But we as diabetics, or those that come into a relationship with a diabetic, they get to choose whether or not they want to be with a diabetic, then you want someone that's okay, making that choice. Yeah.

Scott Benner 43:27
And if you've listened to any number of the interviews on this show, when you find you hear it when people find a partner, that is right, it's it's easy. And the diabetes is never an impediment in that situation. You know, now, if you're diagnosed, you know, if you're diagnosed after you're coupled to somebody, and you find out Oh, geez, look, I guess we found their line, this is too much for them. And I don't know what to do. They're like, you know, I've been married to somebody for 15 years, and I'm diagnosed with type one, and then I realized this person is not supportive of this. Like, is that something you end a relationship over? Like? Or is it something you eat? You know, I mean, like, it's, I guess there's a lot of different scenarios where it comes up, but I think the important base of it is, is to, you know, get into a situation where people are respectful of you. I mean, I don't know that that's any different from any other part of relationship, honestly.

Eric 44:18
No, and I think that's where like, I think you hit on it. It's not any different than any part of a relationship, which means we need to use the tools that are available to us and like, therapy is great. And, you know, whether it's therapy because I've now been diagnosed and I need relationship, honestly, in my coaching, like it doesn't even have to be a licensed professional counselor. You can do Relationship Coaching, that you know, doesn't get into deeper mental health issues, but just is coaching on how to talk and educate couples on how to talk about diversity. You know, learning things like asking the question of how are you feeling as, as opposed to where is your blood sugar, you know, things like that, that really help. The same thing can go for sex, like people think about Oh, like a relationship is going into trouble I'm going to have. So now I want to go into therapy? Well, the time to have therapy is really before things go into trouble, like, you know, and there's nothing wrong with having sex therapy, as well as, you know, relationship therapy, and sometimes it can come from the same source.

Scott Benner 45:37
What do you what do you find? thinking specifically about like sex therapy? Like, what do you think? Is most people's blockade? Is it just that it was made taboo to them? Is that like, the worst thing I could do to my kid is make sex taboo to them? I guess, is my question.

Eric 45:56
It's one of the biggest, because when you think about it, sex is a form of communication. And ultimately, it's, it can be a very elaborate or an elaborate dance. And the more elaborate the dance, the more you need better communication. And feeling that shame is going to lead to not talking about things. So like, I don't want to give the impression that we're in the bedroom. And we're always like, Well, do you want me to do this here? Or do this? There is no, like, there's a time for having that communication. But if you don't communicate, like, who knows, I could have something that I'm interpreting that I'm doing that feels great for her. And she's like, yeah, that feels awful. Or it might feel good at, you know, this time, but this other time, like, don't do that. Because that affecting things if you can't have those conversations like that, because of shame, or the privacy of diabetes, or because one party feels like, you know, guy may come in and say like, this is my sex grip, and it feels good to me. Or a girl, same thing. These are the only ways that that are going to work for me if you don't have those conversations, like you're never going to have a fulfilling sex life.

Scott Benner 47:23
On the other side. Oh, yeah. Well, yeah. I mean, if if you've been letting somebody twist your nipple for 30 years, and you don't like it, you know, because they're like, this must be great, right? You're like, I don't know why you would think that. But you know, like, it's not, or if you want that, and nobody would think to do it, the same thing, you have to reach out, maybe the partner is just like that. I don't want to, like, do that. That doesn't make it wouldn't feel good to me. And that really is, by the way, a human thing. We all think that what we like, sex or not sex is what everyone likes. Like, if it works for you, it just makes sense. It's, it's why we push our politics on each other, or, you know, like anything like, you know, like, this makes sense to me. So it must make sense to everybody. And that's just not the case. Yeah, I mean,

Eric 48:11
yeah, that the perfect example is, and it fits here is like the love languages, you know, if I, if my love language is touch, I'm gonna touch my wife a whole lot more, but if her love language is words, like I need to be using more words and less time, right?

Scott Benner 48:26
Yeah, the one person can be tactile one person could be more, you know, intimacy based with, you know, like you said, with, with language, it's just you and you're never gonna know if you don't ask because there's no way that you've unless, I mean, listen, those of you who are lucky, who are just like, you know, animals who bumped into another animal, like good for you, you know, because that must just be like a cage fight. I would assume you just go ahead and start throwing hands until it's over. And everybody's like, yeah, it was perfect. Because I have a question about, it occurs to me that when I'm done having sex, I am frequently hungry. And is it difficult to Pre-Bolus for a post coital meal?

Eric 49:06
Not so much in that there is a there's a natural effect of you're going to have to be higher sensitivity.

Scott Benner 49:19
Maybe you don't need as much of a Pre-Bolus because you've have all that activity. Correct. Oh, yeah, that makes sense.

Eric 49:26
Yeah. So I think like, I think that's one of the things we forget about the most in as diabetes is insulin sensitivity because, you know, even with all the algorithms stuff, you know, loop and whatnot, even bazel iq, whatever it is, insulin sensitivity is determined to be flat unless you tell it's different. But great thing about sex is your insulin sensitivity goes up afterwards. So if you're hungry afterwards, like it takes less insulin or you know, you're less likely to spike because and frankly, sex is worth a spike. Yeah, put that on a T shirt.

Scott Benner 50:05
Is Bolus worthy? Is that what you're saying? Another episode with a lot of beeps I said something in an episode I recorded yesterday, that's just gonna be like nine seconds of beep just no one's gonna know what God said. Fill in the blanks for yourself, you decide what's Bolus worthy? It'll look, there you go, it'll work out for you. Um, I have, are there any things that your wife has ever said to you that you think would be valuable for other people to know, going into a relationship, you know, question she's had or things you've seen her kind of maybe like, pause about, like, the stuff that people could be looking for?

Unknown Speaker 50:53
Um,

Eric 50:55
I'm trying to understand the question

Scott Benner 50:57
like, Has she ever done something, or reacted in a certain way that would make you think like, Oh, this must be common for a lot of people like something I could know, like, might happen, so I could be ready for it or something that you could have done differently, that cause confusion for her or anything like that?

Eric 51:16
Um, I honestly, I think it's more about myself. There is a there's a natural, I guess, fear of performance for males. And, you know, this, the whole expectation of the difference between how long it takes to get a man aroused versus a woman aroused. And so there's already a lot of pressure to perform that you can feel as a man, add diabetes to it. And there is a tendency for me to hold that in, as opposed to share it with my wife. And the pressure that you feel. Yes, right. Not to this? Well, yes. Yeah. So we're like, you know, oh, look, it's you know, tonight's not gonna be online, you know, honey, but like, I still want to be together. Yeah. And I, you know, she's been good about encouraging that communication. Yeah, there's a lot of things that whether it's diabetic, or just sex related, you know, you know, reminder that, you know, sometimes sex can just be physical, we both may not be like, in that romantic place, but we need to physically Connect. And so we have, you know, there's an opportunity to have sex outweigh, like, there's just a lot in a relationship that I guess, if you're married to a diabetic male, chances are that male is not going to be comfortable about talking about it.

And boys are silly,

Scott Benner 53:03
they really don't talk much. And by the way, you just said bang one out in the nicest way I've ever heard anyone say it my entire life.

Unknown Speaker 53:11
I'm married to a therapist. And I say

Scott Benner 53:14
that in the way that a man or a woman could be comfortable with, you could have said that in front of a total stranger, they would have been like, Oh, I know what he means. He means, you know, sometimes you just need to quit real quick. And you put you really were good at that. You know, it's funny, I don't want to brag, but I will for a second. I realized that I your your answer about like time, like the pressure to perform, like when you said pressure to perform. It didn't strike me the way you meant it at first. Because that is just never been an issue for me. Like you could say to me, or let's if we were together, and you said to me, Scott, I want to have sex and I but I only wanted the last four minutes. I'm your man. And if you said to me, Scott, I want to have sex tonight. But I wanted to go 45 minutes, whatever, I'll do that too. Like, I don't have. I can't, it doesn't matter to me. I can do it for as long as you want to do it. And that sounds like it's not even a humble brag. It sounds like bragging. But it's not. It's just what I found in my life. But I realized that that's just specific to me and not to everybody. Like there's no amount of time I couldn't accommodate. As far as I know. I've never I've never gone I've never gone for like you know, you know, three hours or something like that. I'm not saying that. But I'm just saying that within the in the, in the confines of reasonability where a woman would not be like, Oh, god, I'm, you know, this is not pleasurable anymore. Like, you know, I mean, whatever that space of time is, I'm okay. And, but yeah,

Eric 54:37
and I think what what's interesting is, is, in general, comparison is the thief of joy. And we're constantly bombarded with these images of what sex should be. You know what sex is on TV. or, or, you know, pornography, pornographic images that are put out there, right and whatnot and you know, that can put a lot of pressure on anyone, whether you're in a committed relationship or early on in a relationship of what you think the other person thinks you should be able to do from a performance perspective. And there are some people that are like, Hey, I'm gonna go get mine, and I don't really care what happens to the other person. Yeah, there are other people that, you know, a lot of their arousal is derived by the arousal of their partner. And so that becomes a very important part of sex, in, in their relationship. And so, I think there's a lot of angles to it. And I think that's why if, if anything else that I can take, you know, that everybody could take from this conversation is one, remember the physical side of blood thickness, and all of this, but in to communicate, but, but really three, like, don't be afraid to, if you're not communicating in the same lanes with your partner on sex, to get somebody that can help guide you in those conversations, because regardless of whether it's four minutes or 45 minutes, and you know, that can mean a whole lot of things, you could have, you know, two hours of foreplay, and two minutes of of actual penetration, or you could have, like, you know, much longer penetration, depending on what the circumstances are. But it's all sex, whether it's manual simulation, oral simulation, or whatever. And I think that's, I think what you have to do is realize that being diabetic, you've just got to add a little bit more versatility into it and change the script during during the act. Just to make sure that that y'all are connecting in a way that that's fulfilling.

Scott Benner 56:58
Yeah, that's, that's good advice early as I can. Um, I do think that were you saying a minute ago that the access to pornography has given people unreasonable expectations for what sex should be?

Eric 57:14
I think it's, there's a lot of it's and it's not just pornography, but it's it's also just bravado. And or it's really the simple act of comparison is like, if I'm always comparison, it's like, so I, you know, Don, Mattel's running across the US as a type one diabetic. Like, last year, he ran across Texas, I ran for days with them, I ran 110 miles with the guy for four days. And afterwards, I've like spent weeks going, Yeah, but he ran 150. And I'm like, That's stupid. Like, I ran 110 miles, I gotta own that like the same thing. And in insects, like, if my wife feels really good about our sex life, and I make her feel really good, then all of the other comparisons don't matter. And I think what happens is when we see things like pornography, or we see what's going on TV, or we hear people talk about like, I, you know, people get here, you say, hey, like, I could go for 45 minutes, if that makes the website. Yeah. And and it's really, that's not the point. Because, honestly, I'm sure there's some women be like, hey, please do not make it 45 Minute. Oh, yeah, like

Scott Benner 58:37
100%. Yeah. And that, and that's what I was saying to it doesn't need to be that long. It could be it could be whatever, whatever is fulfilling, I mean, my honest interpretation of, of a sexual relationship. I've always just sort of thought that if I concentrate on my partner's pleasure, and they're concentrating on mine, then we both make out, okay, do not need me like, it's like, if you're not going in very, like greedily, I think and thinking about, like, this is what I want out of this, and I'm gonna make sure this thing happens for me, then, you know, everyone should, you know, I'm assuming have a reasonable time, you know, and get and get what they're looking for out of it. Whether it be emotional or physical. You know, we're just recreational, I

Eric 59:21
guess. Yeah. No, that's that's a great way to look at it. There's a there's a great blogger, Dr. Kelly Flanagan that says, he's got a book called marriages for losers. And that's the whole the whole concept there is like if you're focused on giving your partner what they need, as opposed to winning an argument or winning the sex race, whatever it is, if you're focusing on selflessly giving, then especially in sex, then you're gonna have a great sex life.

Scott Benner 59:54
Yeah, it should give back to like I think that's a life lesson. Honestly. It's you know, The other day while we were doing this show that I, that I think the way I talk about insulin really is just the way I think about life. It's it's just common sense. And you know it, there's a weird overlap there that I'm still discovering. But I realized that I didn't come up with some amazing, you know, thing about insulin out of the clear blue, it's just how I think about things, and it happens to work with diabetes management. And I think that there's a way to live that, you know, works with a lot of things. And I think being selfless is one of them, like, just that idea of, if I'm a person who's helping the people around me, and they're helping me, then, you know, we get to think about other people, which is incredibly fulfilling. And, and, and it fills you up, you know, I don't have a, I'm not a religious person, by any stretch of the imagination, but I feel you know, I don't know if you'd call it spiritually or emotionally, like, I feel full like that. And I, it's from this podcast, you know, with in regards to diabetes. And in my personal life, I just came to the conclusion A long time ago, I've been a stay at home dad for a really long time. But I just came to the conclusion A long time ago that my kids had things they needed, I was the one they were looking to, for them, and that I had to find meaning in doing those things. Like, if you can't look at vacuuming the carpet is like this thing that's like, I can't believe I'm the one that has to vacuum the carpet, you have to think of it as I'm providing a clean home for my children, you know, and they'll grow up one day thinking that having a clean home is important. And they'll you know, they'll do the same and I don't know, there's just there has to be, there has to be something in those things that that fills you up, you can't always be looking to climb a mountain or, you know, bang as many girls as you can or like, that's just like a weird way to like live your life, I think. And yeah, you know,

Eric 1:01:57
no, there's, there's beauty in what you're offering. And I think that's the thing is, is if it's important to find beauty in what you're offering, but it's also important that your partner finds beauty in what you're offering. And I think, you know, it's very easy to come out and distance from things that don't feel good. Like if your sex life is not working well, whether it's because you've been newly diagnosed, or you still haven't figured out diabetes and sex, like the natural inclination is to distance. But the real answer to the problem is, is to actually have more sex because it's just like, any other thing. You do, like if, if you're vacuuming and you've only vacuumed once, like watching my you know, kids vacuum for the first time, it's like, what are you doing? Like, you're not even playing to the carpet, right? But like after, over time you learn how to vacu Well, it's the same thing with sex like, and your body. There's actual just like diabetes and exercise, diabetes and sex. There's a physical adet adaptation where your body starts to go, Oh, hey, I know what this is. It's bound to bump over time. And like, I know how to adjust. Yeah,

Scott Benner 1:03:19
no, I hear. That sounds cool. All right. Listen, this was fun. I appreciate you doing this. Dude.

Eric 1:03:26
Did we not say anything that you thought, Oh, we should definitely say, while we're here, uh, just for dudes, you know, because there is something out there around diabetes and rectal dysfunction and fears around that. And I think it's just important to know, you know, there's studies out there that say anywhere from 35 to 75% of type ones will ultimately experience EDI and the type ones are 50%. More likely. It's a good thing to just have conversations with your wife about it, instead of living in that fear alone. Just I think with anything else, whatever your fear is, don't hold it to yourself, share it with your spouse so that she can join you in there. And y'all can plan together for what life looks like at that time.

Scott Benner 1:04:25
Oh, that's a great idea. Well, thank you very much. I appreciate you doing this in the middle of the coronavirus, lockdown.

Eric 1:04:32
Yes. seems perfect time to talk about sex when we're supposed to be physically distancing.

Scott Benner 1:04:38
Yes. Physically distancing nine months from now. They're gonna be 8 billion babies flying out of vaginas all over the world. Yeah. I mean, how long can you stay in your house before you just like I think people who hate each other are gonna start.

Eric 1:04:56
Honestly, though, like there is a certain amount of like, hey, if you Last a diabetic, like if my wife gets sick, like, you know, how much sex should we be having right now? Like, it's actually a thing like a conversation, you know,

Scott Benner 1:05:11
I'm gonna tell you a story, Eric that I didn't think would ever come up on this podcast ever. But when I was like 20 years old, I think I was dating this girl, she was lovely. And I got really sick. I had, I had mono. So I was like, shot, like, I could barely move. I felt like I was dying. And this girl was an angel, she would come over every day, to have sex with me to make me feel better. I have to tell you, that I would live an entire day almost incapable of moving. I was so sick. And for the time she was there, I felt really great. And, and I would say to her, like the first time like, you can't get this. She's like, we'll just keep our faces away from our each other's faces. And I was like, Oh, this girl's applier. She really was terrific. I did not end up married to her just so everyone doesn't think that was my wife and that story, but but she was really like, it was funny. Like she was young. And you know, she didn't have you know, like, you mean, we were young. We didn't have like incredibly deep relationship. And I felt I think that the things she felt like she had to offer me to help me feel better was her body and that's what she did. And I was really grateful at the time. I still think about it. 30 years later is one of the more selfless things anyone's ever done. But having said that, don't get the Coronavirus because you want to have sex? Because this is more serious than mano I? Yes, yes. Yes. But yeah, it gets it's a it's a scary thing, right? Like, because we're talking about, you know, droplets, you know, from your mouth. And then I'm assuming that again, it's funny I talked about I talked about Coronavirus with a doctor the other day he's gonna come back on I guess I'm gonna have to ask him about how a transfer during sex would work. And get and get a real question real answer out of that, because this one with you will go up after that one. So sure, you know, people look back one day and go Oh, I remember hearing that. So you'll know that that question came up here with Eric. And I hope all of you will still listen after hearing just a tiny bit about how I have sex. Figured out like oh, I'm done with this show. Or this was really cool of you to do man. He talked about some stuff that I don't imagine a lot of people would want to talk about and actually from responses from men. There were not a lot of men who want to talk about it. So you did a you did a really nice thing here for a lot of people. So thank you very much.

Eric 1:07:46
Thank you Scott. I appreciate the forum. Absolutely.

Scott Benner 1:07:52
If you want to check out Eric good dot your life.com that's that's your counseling at DOT your life.com also on Instagram at chronic superhuman. Huge thanks to the greatest mother insulin pump on the planet the Omni pod tubeless baby, check it out my Omni pod.com forward slash juice box Get yourself a free no obligation demo today. Stop getting your insulin pump tubing caught on people's. And the next calm g six continuous glucose monitor head over dexcom.com forward slash juice box links in the show notes of your podcast player and at Juicebox podcast.com. Ah, feel good to curse a little bit. I love cursing. I swear to God I could spend all day saying shove it up your mother. So much goodness comes from cursing. Hey, thanks so much for checking out the after dark series from the Juicebox Podcast today, of course was sex from the male perspective. We also have sex from the female perspective, depression and self harm trauma and addiction, smoking weed drinking beers, we got a lot and there's more coming. There's a lot more Actually, I have a couple recorded right now for afterdark you're going to enjoy these things. They're honest conversations about real life issues that everyone has. And you know, people with type one diabetes have them too. We just never seem to talk about them for some reason. Well, not here. On this podcast, we're gonna pick into the deep dark recesses corners of you know, reality and talk about it. We're pretty far from 15 carbs 15 minutes. I think that's right where we need to be. How can you possibly be expected to live with something like type one diabetes, if you don't understand the full scope and impact that the disease can have and ways that you can mitigate those impacts. That's it. I didn't mean to get serious then. Should I curse again? Oh, we how do we want to end? I was just gonna blurt out a curse and now I feel a lot of pressure to pick the right one. And that's something I can't think of one. That's crazy. Thanks so much for listening to the Juicebox Podcast. If you're enjoying the show, please leave a rating and review on Apple podcasts or wherever you listen and of course tell a friend share the show. Please help me spread the word.


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#336 After Dark: Depression and Self-Harm

Scott Benner

ADULT TOPIC WARNING

A 24 year old female type 1 discusses (with clear and frank language) her depression and cutting.

Not for children.

National Suicide Prevention Hotline: Speak with a counselor - 800-273-8255

Crisis and Self-Harm Text Line

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon AlexaGoogle Play/Android - iHeart Radio -  Radio Public or their favorite podcast app.

+ Click for EPISODE TRANSCRIPT


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

Scott Benner 0:01
clinical depression is defined as a mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life. possible causes include a combination of biological, psychological, and social sources of distress. Increasingly, research suggests these factors may cause changes in brain function, including altered activity of certain neural circuits in the brain. The persistent feeling of sadness or loss of interest that characterizes major depression can lead to a range of behavioral and physical symptoms. These may include changes in sleep, appetite, energy level, concentration, daily behavior or self esteem. depression can also be associated with thoughts of suicide. The mainstay of treatment is usually medication, talk therapy, or combination of the two. Increasingly, research suggests these treatments may normalize brain changes associated with depression. If you are struggling with depression, please see a physician immediately. Call them right now. Tell them I'm depressed, and I need help. If you can't do that, ask a family member to help you. If you can't do that, go to Google and type in I am depressed. If you are having suicidal thoughts, call the National Suicide Prevention Lifeline. The number is 1-800-273-8255 and then you'll get to speak with a counselor that will help you the National Suicide Prevention again is at 1-800-273-8255. Crisis Text line.org describes self harm as follows. For some people, when depression and anxiety lead to a tornado of emotions, they turn to self harm looking for release, self harm and self injury are any forms of hurting oneself on purpose. Usually when people self harm, they do not do so as a suicide attempt. Rather, they self harm as a way to release painful emotions. Crisis Text line.org has more information or you can contact them right now. by texting home H o m e to 741741 that will connect you with a crisis counselor text home to 741741 in the United States and Canada, in the United Kingdom, text 85258 and in Ireland 0861800 to eight zero.

Welcome to the Juicebox Podcast. This is Episode 336 another in my afterdark series. Today's episode is called after dark, depression and self harm. When I originally decided to make these after dark episodes, I tried to think about the topics that no one discusses around type one diabetes, and I tell you I had no idea where this was going to go. But back in Episode 274 This all began with a drinking edition. And then in Episode 283 talked about smoking weed with type one diabetes, and Episode 305. We discussed trauma and addiction. Episode 319 was a frank discussion from a female perspective about having sex with Type One Diabetes. And today's show is with an anonymous 24 year old type one female who's going to discuss her depression and self harm. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Please always consult a physician before making any changes to your healthcare plan. You can of course do whatever you want, but I wouldn't suggest this episode for children. This episode of The Juicebox Podcast is sponsored by Dexcom Omni pod the Contour Next One blood glucose meter and touched by type one, you can go to touch by type one.org Contour Next one.com My Omni pod.com forward slash juice box or dexcom.com forward slash juice box to learn more about the good people who support this podcast. Today's episode does not lend itself to breaking in the middle for an advertisement. But the ads will be at the end. If you're interested in a tubeless insulin pump an amazing continuous glucose monitor A blood sugar meter that I find to be second to none. We're a wonderful organization helping people with type one diabetes. There'll be more information about them at the end of the show. And I'm going to start off by telling everybody that we are not using your name. So at no point during this conversation, am I going to refer to you by your name? Okay, and everyone will figure out why. As we're talking, okay. Okay, that seems fair. Now. I do want to know some stuff about you to get some background. So for instance, how old are you?

Anonymous Speaker 5:32
I'm 2424.

Scott Benner 5:34
And how old were you when you were diagnosed with type? 112 12

Unknown Speaker 5:36
years old?

Unknown Speaker 5:38
All right.

Scott Benner 5:40
Hold on one second. Why are people messaging me? While I'm trying to do this? Hold on one second.

Anonymous Speaker 5:46
No problem.

Scott Benner 5:50
It's gonna turn this off. All right. So you've had diabetes for the same amount of time. That you were alive before you had diabetes? You're at your midway point.

Anonymous Speaker 6:06
Yes. And I thought about that. Because it was June of when I got diagnosed. And I just started bawling. Because I don't like it's hard for me to remember before I was diagnosed.

Scott Benner 6:25
Interesting, even though it was 12 years old. Yeah, yeah. Okay. So now, that's it. Not as a strange thing, as you probably think I don't have a ton of like, really strong young memories. To be perfectly honest, I don't have a lot of really strong 20 year old memories, 30 year old memories, or 40 year old memories. I remember, you know, today and a couple weeks ago, maybe. But, but I think some people remember things differently, or do you think that there's a reason that that's the case?

Unknown Speaker 6:55
Um,

Anonymous Speaker 6:58
well, I think I'm really good at shutting things out that I don't want to remember. Because I remember things about like my kindergarten experience, and things like all through elementary school,

Scott Benner 7:12
okay. Remember this stuff? That's pleasant to remember? Yeah. Okay. So let's go into this slowly. So a lot of people will email me and asked me questions about diabetes and things like that. Every once in a while someone says something to me that I'm thinking, Oh, wow. I might not be the right person to ask this question to, but you asked it to me. So okay. And one one that comes to mind is, you know, somebody messaged me and said, I love the podcast, my children passed away in a car accident, but I still listen to the podcast to remember my one son. And that's an email for me that I'm just like, I don't know what to do with this. But I've learned in the past that just sort of being honest, is the best. And, you know, saying whatever it is that occurs to say, and then giving the person the option to talk more if they want to. And sort of how you and I met very recently. So how long ago? Were we messaging? Only about a week?

Anonymous Speaker 8:13
Yeah. A week and a half? Maybe?

Scott Benner 8:16
Do you remember what made you send the message initially?

Anonymous Speaker 8:20
I think just because it was that like, very first initial zoom.

Conference thing.

Scott Benner 8:29
Okay. So we all got together and talked over zoom, like cuz, yeah. Okay, so many people might not know, but there were 70 of you who got together, and we just sort of hung out and chatted for an hour and a half. And people held up their like graphs. And we talked about how to, you know, how to bolus differently and and

Anonymous Speaker 8:46
so I wasn't part of that one.

Scott Benner 8:49
Oh, you were the one where I was? Whoa, no kidding. So you were in the initial one where I jumped on and said, hey, let's do a Facebook Live. I want to try to find a way for us all to talk better. I wish we could all talk and someone said zoom. And I started going yeah, I've been thinking about that. But I don't know what to do. And then I just sort of just threw together a zoom account right then and there and we all jumped over to it. That's the one you were in. Yes. Ah, okay. What did we talk about that one?

Anonymous Speaker 9:16
I think you were like, just randomly choosing, like looking at people and unmuting them and talking to them. Oh, Was that fun? It was it was I just felt not completely alone.

Scott Benner 9:31
Gotcha. Okay. Did you speak during that? I did. You did. Okay. Do you remember what we talked about?

Anonymous Speaker 9:39
Well, because when you were doing your Facebook Live, you were like, how's everybody doing? And I was like, how's everybody doing with, like, COVID-19? And then I said, Oh, I'm like, super worried. And I remember you go, why are you worried? And I'm a student teacher. And just like the fact that Some of my kids don't necessarily get meals when they're not at school. And so you were just like kind of having me elaborate more.

Scott Benner 10:08
Gotcha. And so we're gonna be honest with each other here today. Is that right? Yes. Okay, good. So first of all, you just used your name, but I'll bleep it out. Don't worry about that. And if it happens again, I'll bleep it out. It's fine. Don't don't I don't want you to think about that. So I, from my perspective, when I hear someone, especially a younger person first say, you know, I'm worried about my kids. I'm a teacher. I thought, Oh, that's nice. You know what I mean? Like, that's lovely. And then you expound that a little more. And as you were talking, I thought that you are more closely tied to this feeling than felt healthy to me. Does that make sense? Yes. So that's what I kind of intuitively felt from you while you were talking. I thought, ooh, she's being impacted by this more than, like, if if my kids felt the way you felt, I would feel like I needed to intervene somehow or help them. But I didn't as much as I just was like, oh, tell me about a little bit. But then you sent a note afterwards. And in that note, I don't know how much of the note you want to share, I guess.

Anonymous Speaker 11:19
Um, well, I guess I'll start out, um, I started cutting myself as a freshman in high school, okay. And I've battled with depression for years now. Being able to really like mask it and have this shell, but I'm quote, normal, like mentally normal.

has been really hard for me. And

Scott Benner 11:51
oh, go ahead. Oh, no, I'm so sorry. I was reaching for something.

Anonymous Speaker 11:54
Um, so I cut myself all through high school all four years. Probably three months into it. Me cutting every single day. My mom found out and I told her I'd stop. And I just moved at the placement.

Scott Benner 12:17
Okay, just moved into somewhere she couldn't see as easily.

Anonymous Speaker 12:21
Yes. Okay.

Scott Benner 12:22
So I'm gonna have to ask you a couple of questions. Because I don't understand. They'll probably don't know, please. So first of all, when you talk about depression, can you put words to what it feels like to be depressed?

Unknown Speaker 12:35
Um,

Anonymous Speaker 12:37
I think now, my depression is a lot different than what it was in high school. Um, in high school, I felt

I guess I just felt like,

there was no point, there was no reason to get out of bed. There. Like the only reason I went to school, talk to my siblings talk to my mom. And played sports was

to try to feel something. Okay.

And I think the cutting just went hand in hand because I was in control of it. And I could determine how deep it went, and how much I wanted to feel. Even though after

a week,

that feeling went away, like the pain went away.

Scott Benner 13:45
So if I'm understanding correctly, all the things that most of us think about is you know, average life, going to school, having relationships with people playing a sport as a child, you didn't get any feedback from those things at all. Is that right? Like Like any, like emotional feedback from it?

Anonymous Speaker 14:08
On the inside? No. But on the outside, I mean, I would laugh and smile and have emotion. So I was like completely emotionless but I mean, nothing.

Scott Benner 14:24
So there's like, the impact of it the idea of like euphoria, or just you know, anything that kind of lights you up inside for a second you just don't feel that way. So when you hear people say I feel dead inside or empty or all the different ways I've heard it explained. Like there's just a void and nothing fills it or nothing turns it on.

Anonymous Speaker 14:47
At that point, cutting like cutting is what my whole life evolved around, right. And that's what like, made me feel something inside?

Scott Benner 15:01
Right? So if so you couldn't, you weren't getting feelings from the what they quote unquote normal avenues. So you went to something like obvious like your body can't ignore that you're in pain, so and so is that feeling like, like, do you know what it is you're trying to accomplish by putting yourself in pain?

Anonymous Speaker 15:27
No, no, um, I think it was just something I could control.

Scott Benner 15:31
Okay. And you felt it? For real?

Anonymous Speaker 15:35
Yes. Yeah.

Scott Benner 15:37
Is that does that lead to? Like, I'm thinking it's not a it's not a feeling you want? Like, I guess in the absence of any feeling some feeling is positive. But also it was painful to you. So was that a double edged sword too?

Anonymous Speaker 15:56
Yeah, yeah, for sure. And then, um, my junior year of high school. I started dating this kid. Well, guy. And he was a freshman. And we're three years age difference. We're now engaged. Hopefully, we're gonna get married this summer.

Oh, thank you. You

Scott Benner 16:22
mean Fingers crossed? Like if they let us all outside again to do something.

Anonymous Speaker 16:26
Yeah, exactly.

Um, but I was very open, and upfront and honest with him about my cutting. And then I realized, like, he doesn't know what to do with it. Right? Cuz, I mean, he's a freshman in high school doesn't like, this is his first exposure to it. And that scared me. And so I began to bottle it up again. I went the whole trying to see somebody, a doctor. And that did not turn out well. And so I felt like there was no way of getting how I felt out. Are

Scott Benner 17:15
you comfortable with telling me why the experience with a doctor didn't go? Well?

Anonymous Speaker 17:22
Yeah, I'm so

I'm from a very rural town. Okay. There's there's one stoplight in the whole county. And the county is the fifth largest county in the state. I'll

Scott Benner 17:35
tell you, that would depress me Just so you know.

Anonymous Speaker 17:37
Yeah. If you, if you're, if you're not an outdoorsy person,

Scott Benner 17:44
you're kind of screwed.

Unknown Speaker 17:45
Yeah.

Anonymous Speaker 17:49
So really, there was really like, only one doctor you could see. And even when I got diagnosed, I had to travel three hours away, because that was the nearest endocrinologist. Okay. But I'll talk. So when I first went in, saw the doctor, I was beginning to open up and find ways to cope that were better. Mm hmm. And then right after the meeting with him, because it would just be him and I, after the meeting, my mom would be like, what did you guys talk about? What's going on? and scare me? Because she's not the best person that handles delicate things.

Scott Benner 18:42
And also, if I can, you know, assume for a minute, she's probably super worried that whatever troubles you're having are her fault. Oh, yeah. And she either doesn't want that to be true, or doesn't or knows it's true and doesn't want anybody to say it. Anybody else. It's, you know, there's her humanity is, isn't on his playing defense at that moment. It was this doctor, by the way, a therapist or a psychologist or a psychiatrist, you know,

Anonymous Speaker 19:09
I think he was a children's psychiatrist, specifically. Um, and so I probably saw him for two months, multiple times a week. And then all of a sudden, I learned that he committed suicide.

Scott Benner 19:28
Yeah, that just sounds like the end of a bad joke doesn't. And, and so I'm trying to figure out how old were you at this point?

Unknown Speaker 19:38
Oh, boy.

Anonymous Speaker 19:41
Probably

almost 16.

Scott Benner 19:44
Okay. Now, let me ask you when he committed suicide after talking to you for two months, what's the feeling? Or what's the interpretation from you? Do you feel at fault or are you just like, I can't believe I was finally getting help. And now that person Gone. Like, what was that? experience?

Anonymous Speaker 20:04
I felt that

my only outlet was gone. Yeah.

I knew it wasn't my fault. Good.

And I now like, looking back on this whole experience, I realized, like, Wow, that is something that I was right about.

Scott Benner 20:25
Well, you know, what you're really proving is that living in a place that rural with one stoplight is not just depressing to one person. It's apparently depressing to a lot of people. Oh, yeah, I'm certain we don't know his Was it a male or a female doctor? I'm sorry. A male man. We don't know his his issues. But, you know, you know, he was obviously having trouble. No differently than a lot of other people. Exactly. You know, and, but the biggest concern is, is that you had found a place to learn coping skills. But they weren't ingrained in you yet. I'm assuming, and then your sounding board was gone, and your teacher was gone? And then there was just no one else to go to? Is that right?

Anonymous Speaker 21:04
Exactly. So then I just sunk back in to what I knew what to do. And what I, at this point, quote, unquote, enjoyed doing.

Scott Benner 21:13
What? What were some of the changes that you were seeing? While you were speaking with the, the psychiatrist, like, what was? What were some of the improvements you were getting?

Anonymous Speaker 21:24
I remember my mom making a comment. Like, one Sunday morning at breakfast.

She said,

you have a twinkle in your eye. And I was like, wow, I want like issue dress. Trying to tell me what I want to hear? Or do I have like, light again? Yeah. And that was really hard to accept, because I had felt this way for so long. And then I realized, like, this is what she wants to see from me. This is how I can be normal again. And so I was able to just take that timestamp of how I looked how I felt, well, not necessarily inside, but on the outside. And that was what I looked like, at all times.

Scott Benner 22:30
Now, did you feel like that? Or were you pretending

Anonymous Speaker 22:34
I was pretending?

Scott Benner 22:35
Yeah. And so so this is really interesting for people who don't have these feelings. You were probably progressing. And you saw a little bit of like, you know, you might not even have noticed that at that point. You know, sort of like the beginning of a diet. When you're three pounds down, you don't really know it, but you're so you're on your way to something, but you're not even aware of it, somebody else looks at you and goes, Oh, wow, you look good. And that reminds you, I'm heavy, and light. And here's what I don't like about myself. And here's all the things that are wrong, like and so this very kind, you know, statement from your mother, which is, you know, if it's a sparkle in your eye, it sends you down a rabbit hole of her concerns and feelings like you don't think about yourself in that moment. Like, I think a person who's not struggling, might think, oh, wow, I'm working on myself, and I'm making an improvement and other people can see it. That's fantastic. I'll keep going. But you transferred yourself right into her head and said, she sad that I'm not happy. She wants me to look like this. This is what I should be doing. This is what normal looks like. And instead of continuing that thought with, so I'll continue to do what I'm doing because it's working you thought I'll This is where I'll put myself out. This is the picture I'm gonna paint on my face because it makes my mom happy and probably makes other people happy. And it makes me look quote unquote normal. Am I understanding that correctly?

Anonymous Speaker 23:55
Yes.

Scott Benner 23:56
Wow. That's stop I'm sorry. I've seriously, I am sorry that you feel that way. Any tragedies in your life as a young person? Any? Any? I were you abused at all? Like, is there anything that we can point to? Or is that you have a family history of depression? Is there anything you can look back to and say this is where this came from?

Anonymous Speaker 24:24
I don't think so. Um, I mean,

before I was 10, my, when I was three, my parents divorced. My dad is on his third wife, and my mom, married and divorced. Before I was 10, so or so. And so I've been I've been through three divorces as a kid and I'm with my father's current wife. You He has clearly chosen her. And that has been a struggle. Um, but that was also Well, I started cutting before because I lived with them for a shorter period of time. Okay? And

Scott Benner 25:21
so does it make this seeing your dad happy? Instead of making you feel like you're happy for your dad make you feel like, he wasn't happy with me or my mom, but he's happy with this person? Does it always shift back to you like that?

Anonymous Speaker 25:35
No, I, cuz she was she was always very nice to my brother and I, um, and then I just, I moved in with them. On my birth day, I don't remember which one. But one of my uncle's got me this like really cool. Like Swiss Army knife. And none of them knew that I was going through this whole phase.

And then I remember,

like, just getting the urge to cut myself.

Unknown Speaker 26:15
And

Anonymous Speaker 26:17
I remember going into my room, closing the door, getting out this brand new Swiss Army knife, opening it and just slashing my thigh.

And then I realized

it's not stopping. And so I just grabbed a T shirt and like, tied it around my leg and went to sleep. Because I felt better. But I was worried like, Oh my gosh,

Scott Benner 26:46
now you're wearing a wound. You feel better. You feel better from cutting, but now you're worried about the actual wound?

Anonymous Speaker 26:52
Yeah, right. And so the next morning, I wake up, and it's still bleeding.

Scott Benner 27:00
How deep? It was.

Anonymous Speaker 27:03
Um, I didn't see bone. But I'd like this is one thing that I haven't thought about in years, because

it's painful at times to think about.

Unknown Speaker 27:20
Um,

Anonymous Speaker 27:24
but I don't really know if

Scott Benner 27:26
it was, but it was a bad enough wound that overnight it didn't it didn't heal over or clot. Yeah, what do you do then? Because it can't be mistaken for something else. Right? You can't say I walked past that table. It's it's

Anonymous Speaker 27:40
no than that. Right? Like, at that point, I took off that like bloodsoaked t shirt, and just went told my dad like,

Unknown Speaker 27:50
I have a problem.

Scott Benner 27:53
And then how did he handle that? I mean, beyond the wound, I'm assuming you got that dressed and taken care of. But did he? Try Like what? I guess my question is, what's that reaction like from a person who I'm assuming up until that moment, had never thought about something like that in their life? And then all of a sudden, you know, his daughter standing there saying, Hey, I cut myself to feel something. And I don't know that I would know what to say is is what I'm getting at. What did he say? Yeah. Can you understand that? Like from an academic point of view?

Anonymous Speaker 28:30
Now I can

Scott Benner 28:32
write I'm not at the time. No, I wouldn't have met your kid. You're looking for your parents that have the answer?

Anonymous Speaker 28:41
Yeah, yeah. Um, but I've like we sat down and talked. And he instantly took it as like, my hobbies. were causing me to do this. Ah, so he he whatever he could see he thought was, Do you listen to the podcast a lot? I, it's hard for me to get through a lot of episodes because I just, well, I commute to college. And it's a 30 minute commute. And I can't get all the way through. Well, that and I just, like 10 minutes into it. Whatever were you guys are talking about I just ball and cry.

Scott Benner 29:27
So no matter what someone's talking about, you take on their pain.

Anonymous Speaker 29:32
For the most part, like your first

two episodes that you put out were the hardest for me.

Scott Benner 29:42
Because I was being really honest about how I felt about raising Arden.

Anonymous Speaker 29:47
Yeah, yeah. And

it took me two weeks to get through. Like those two episodes. Why did you keep trying

Unknown Speaker 30:02
Because

Anonymous Speaker 30:05
I think it's interesting to hear a point of view of somebody that doesn't have diabetes, but wants what's best for their child. Like my parents wanted for me, but, and this isn't really like diabetes related, but they want what's best for me.

Scott Benner 30:28
Right? So it's nice to know that there are other people in the world who are trying to do their best for other people and for their kids. Yeah, but the content is really hard for you to absorb. So yeah, you're getting some good from it, and some and bad. So. So like, try to like, Listen, I record all these podcasts. And I know, they're emotional. And I'm an emotional person. And so when I'm hearing them, you know, I'm doing my best to shut them off. But feel them enough that I can have the conversation. For instance, if you and I were just talking on the phone, I'd probably be crying by now talking to you about the things you're saying. But I'm trying to be academic and thoughtful, and listen to you, and tell you how it makes me feel. Hoping that you're going to find your way to some sort of a thought, like we're recording right now. Because your note made me respond to you and say, you should really, you know, I can't tell you what to do. But I think you should find help in the form of, you know, a doctor, and you said, Yeah, I tried that at my doctor killed himself. And then I was like, I looked at my wife, I'm like, What am I gonna do? I was like, I can't just tell this poor girl. Oh, sorry, goodbye. And so I said, Well, maybe if we talked a little bit, we could find our way through to some sort of an answer for you. Maybe just saying it to somebody else who's you know, you know, there, but not there. You can't see me, right? You're not reading my face, you don't know, if I'm upset for you while you're talking. Maybe that'll help. And, you know, we're gonna try it here and do it. And at the very least, you're going to help a lot of other people. And so you get to have that feeling. You know, when when this is over. There are a lot of people who feel like you who are hiding it just the way you were hiding it. And they're gonna know they're not alone. I imagine that's going to be helpful for them. So I appreciate you doing this. I hope it helps you. I definitely expect it to help somebody else.

Anonymous Speaker 32:27
All I can do right now is just sit and cry. Because for the most part, I haven't thought about these thoughts for a long time. And so it's just kind of opening old wounds up

Scott Benner 32:38
course. But you when you say you haven't thought about them? You mean you don't give voice to them, but they still impact your day. Is that right?

Anonymous Speaker 32:46
Yes. Well, I think about cutting myself

at least half a dozen times a day.

Scott Benner 32:54
Is there anything else that you found so far, that can take the place of that need?

Anonymous Speaker 33:02
I cry, and I sleep?

Scott Benner 33:06
I have to tell you, I like doing both of those things. I really do. I love a good cry, but not the way you're describing. And sleeping is terrific. And I definitely don't do enough of it. So you're either letting it out. Or shutting it off by being a voice. Gotcha.

Anonymous Speaker 33:21
And I just well, growing up, I I was never the kid that took a 10 minute nap. I took a three hour nap. And so now that I'm a quote, adult, and I can decide when I want to take a nap. I usually like in a 24 hour period, I will sleep for 20 hours. Wow. And that includes like two naps, and sleeping for eight to 10 hours.

Scott Benner 33:53
And then in the four hours you're awake, you're crying.

Anonymous Speaker 33:59
Usually I'm well. I'm working on schoolwork usually.

So it at least takes my mind off of it.

Scott Benner 34:08
So when you're busy, it's better.

Anonymous Speaker 34:12
For the most part, um, now that I have chosen a field that I'm dealing with children, um, because I'm student teaching in a kindergarten classroom, so I hang out with five year olds all day. Yeah. And I know that none of them some of them do have like, like not the best lives but they are not developmentally where I started cutting myself, which, thank goodness.

Unknown Speaker 34:44
But

Anonymous Speaker 34:46
it just

takes a toll on like my empathy has grown so much that it is so hard for me To come home on a bad day, and not like, act on my urges.

Scott Benner 35:08
Gotcha. Is I'm trying to understand the idea of choosing to be around small children is it is, is there comfort in their innocence? Is there comfort in the fact that they haven't had problems yet. And so when you see them have that problem of not having a meal, now you realize that there, they might have problems too. I'm trying to figure out why you were drawn to this line of work.

Anonymous Speaker 35:36
In the beginning, um, like when I could decide if I wanted to teach primary or secondary. I chose primary because I'm taller than kindergarteners. But I'm a short person. And I didn't want to deal with high schoolers.

Because I thought I'd have to be a bitch.

Scott Benner 36:00
So you thought Oh, so you thought if you were physically smaller than someone, you'd have to assert yourself in a different way? And do you think, did you not? Or are you a bitch, and you didn't want to be one? Or that's aside? Like what? I mean?

Unknown Speaker 36:14
I

Anonymous Speaker 36:17
thought, I still think this, but high schoolers know better. And kindergarten will like primary for little people. They're so innocent, and they are they don't understand. And I have a lot more patience for a five year old than a 16 year old. Because kindergarteners, they don't know how to do school. And so it's a learning curve for everyone.

Scott Benner 36:48
Yeah. Have you ever thought about your location, being part of this I this, I might be 100% off on this. But I think of this sometimes. In Ireland, the potato famine was so terrible for so long, that it created a lot of depression, alcoholism, schizophrenia, mental illness, like all kinds of stuff in the Irish population, that some people believe still sticks to them to this day. And, and you really you live nowhere, like as you're talking, I think you should save up a couple of thousand dollars, get on an airplane, fly to some great Island and get a job carrying drinks to people on the beach. And just, you know, go somewhere interesting and, and relaxing, and do something that doesn't require you to be around people long enough to start taking on their pain. Because I mean, you're doing that. And listen, I am nowhere near where you are. But I am at my core. You know, I am a person who's a caregiver at heart. I think I'm happiest when the people around me are taken care of. I don't like to see people upset. And I will put a lot of myself into helping them feel better. It's probably why I understand Arden's diabetes so well. And just other people, you know, they can be big problems or little problems. The people I love, I want to be I want for them to be okay. But you know, if you dig into that a little bit, I'm adopted. So I've been abandoned once. I don't think of it as abandonment but it's true, right? Like, there were people who had me who were just like, Scott, yeah, somebody else can take care of them. And then I find out later that that is not what my birth mother wanted. She was forced by your family to give me away. And that gave me some comfort. But, you know, it doesn't fix whatever it happens to you that you're not aware of. And then my adopted parents split up when I'm 13 on my birthday, by the way. Wow. So and you were shipped from one house to another on your birthday. So there's little things about that that are hard to ignore. Even so, you know, subconsciously. You know, my father went to work on my birthday took me with him in the morning dropped me at my grandmother's house. I had a lovely day. He picked me up in the afternoon said what do you want for your birthday? I wanted this cartridge and floppy disk that went into your Commodore 64 that made your Commodore able to copy a floppy disk. These are probably a lot of words you don't know. Okay. And I and my friends had a mass mafia like setup where we were copying video games on on flop By the way, when I say floppy disk, I mean the big ones that were five and a quarter inches square. Like do you even know the ones? I mean? Yes. Okay, so you put this cartridge in the side of your Commodore 64 head like it literally on a toggle switch on it. Then you'd put this floppy disk in run this program. At a certain point, you had to yank the floppy disk out, flip the switch on the cartridge stuff in the game, let it run, pop it out stuff in a blank one, and it would actually make a copy of the disk. And I wanted that. So I asked for it. It was $100 $100 in 1983, for my dad that worked in a rubber molding plant, and my mom who didn't have a job, and we were broke. $100 was all the money in the world. And my dad just goes, Yeah, sure, where do we get it. And we drove home stop the dislike CD computer store, bought this thing, he bought it for me a big smile on his face, he was as happy as he could be to give me this thing. I'd never actually seen him that happy before in my life. We got home, we had dinner that I got to choose. My dad got up, took a shower, came back downstairs, said he was going out and never came home on my 13th birthday.

And I gotta tell you, hard not to feel like that's kind of your fault. When you're 13. You know what I mean? Now, when I look back on it, now, I see it differently. My dad was cheating on my mom for a long time. He obviously wasn't happy, he didn't like being broke, he had more responsibility than he knew what to do with. And for a split second buying me something that wasn't going to hurt him because he knew he was probably going to file for bankruptcy after he got divorced. He was like, Oh, this is what it feels like to give my son something he wants. This is nice, he was so happy. This had nothing to do with me. But for a long time, it felt like I was the reason they got divorced. I didn't know any of the other myriad of like, you know, reasons behind any of it. And as an adult now, I know it's not my fault. And I don't have any, like lingering impact from it as I talk to you today. But there's no doubt in my mind that I try really hard to keep my family together because I know what it feels like when it falls apart. Right. So I have this extra empathy that I have for their problems. Because when they're upset, I know there's a path out of being upset. And I have also seen people give up before they get to the end of the path. So I just take on the book comes with it and disperse it so that they have time to get through it. So that whatever they're feeling in that moment doesn't bounce around inside of my home, the way I saw it bounce around inside of my parents home, like had my parents just gone to neutral corners, do you know they mean or relaxed a little bit or had better communication skills or whatever it ended up being that they needed? They could possibly have worked out their their issues. And so I think a lot of people can work out their issues, if they have enough time. And don't blow things up in the middle of the argument. And so yeah, and so that ends up being who I am. And I don't know if the people around me know that about me. I don't know if they appreciate it or would want it not to be the case. I have no idea. But I just know that that's how I feel. I feel like we're a good group, the four of us, we'd love each other and something that's both should not derail us. So I think we should have every option and opportunity to not let that happen. Now don't get me wrong. You know, if I came home tomorrow, and I found out my wife had been cheating on me for 30 years, I'd be like, Oh, you know what, this didn't work out everybody out, you know. But but but I'm saying for the little day to day things. And so I know what it feels like to look at somebody see them sad and then feel sad. But I probably have 3% of what you have. You know what I mean? Yeah, yeah. So listen, a good, it's a pleasure, sir.

Anonymous Speaker 43:55
Oh, just you telling your story.

Reminds me because even though I was three, I remember like my dad leaving. And it's the most vivid memory that I have.

Scott Benner 44:14
Yeah, I used to go downstairs in the middle of the night. And I found in the back of a coat closet, our family portrait, which was probably in a frame that was maybe, I don't know, a couple feet wide and three feet tall, you know, used to have to go out and have a picture taken and it was melted and all this stuff in my mom didn't get rid of it. She put it all the way back at this long, narrow closet. like you'd never and I found it one day and I used to come down in the middle of the night. First I would go into the bathroom on the second floor and look out the back of the house where the driveway was. And I would sit there and every time car lights would come up. I would allow myself to be excited that my dad was coming home until the car passed by my house. So So probably not for nothing. Not exactly the Same, but that's cutting a little bit. You know, they mean like I'm opening, like, I'm opening myself up to this excitement that I know, intellectually is not real. But it felt so good for 20 seconds while the car drove by to think my dad was coming home. Yeah, right. And then I would get horribly upset. And then go downstairs, dig the picture out, sit on the sofa, hold the picture, cry, get tired, put the picture away and go to sleep. Yeah, that sound familiar with different words?

Anonymous Speaker 45:32
For the most part, yes, yeah.

Scott Benner 45:34
So I think we need to find a way to get you from all of this to some of it. Because those feelings that I describe in small doses are really valuable part of being alive. You know, like that empathy. I love that you're empathetic. I think that's terrific. You know, but how do you get from there to there? Is it a rewiring of your brain chemistry that's going to help? is it changing locations, like other people you need to get away from? Is there a place you need to get away from? Like, I don't know what the answer is. But you can't just keep doing the same thing over and over again. And hiding it because at some point, that's gonna, it's gonna short circuit you, you know what I mean?

Anonymous Speaker 46:20
Yeah, yeah, well, and because I lived in rural, for 18 years. And then I moved six hours away to the state capitol.

Unknown Speaker 46:40
And

Anonymous Speaker 46:42
just like, it's a culture, shock, Holy moly. Going from, like, 2000 people in a town or less, to your state capitol, and then trying to figure it all out. And finally finding a place like, student teaching, being with the same 25 kids and having great support, in that sense, has been very positive and negative with me.

Scott Benner 47:15
How's it been negative.

Anonymous Speaker 47:19
I, my mom works in the school district where I grew up. And she was the librarian at the middle school when I passed out and got diagnosed. So she was with me from day one, in the school system. And I knew just from knowing some of my peers that kids didn't have, some kids didn't have the best home life. But now being an adult, and being

a co teacher in a classroom.

Scott Benner 48:04
You can really say

Anonymous Speaker 48:07
yes, and seen making those hard calls to the parents and making, like having a little kid come up and say that, like they slept in the car all night. And then have but they don't tell me that even because I'm a mandatory reporter. They don't tell me that they tell the aide. So it's not up to me. Like I with mandatory reporting. It's who that the first person that the child says it too.

Scott Benner 48:39
Yeah. Well, I have a couple of questions. So first, I want to ask you a little bit about does all of this impact your type one diabetes care?

Anonymous Speaker 48:53
I think the mental part of it does. Because I usually go days without eating. Or like in high school, when I was at the height of it. I would just because I had for the first from 12 to 16. I had a pump with tubing, I can't remember. And then I've been on the Omni pot ever since. Okay. And at the height of my cutting, I would just like slap on the Omni pod with no insulin in it. And I would just go like I would just have a show of like, yeah, I have my insulin on my my pot is on so I must be taking insulin. So I would call my mom down because on top of it all, you know, me having these struggling issues mentally I'm also diabetic, it's not something you can't take lightly. And so, um, I did a lot of things that I look back now. And I'm like, I hope to live like, till I'm 70 because I really thought my body up. Okay.

Scott Benner 50:26
Well, how are you doing now though? Are you? Are you in a better space with it?

Anonymous Speaker 50:32
Yes, um, I've been, I still have my Omni pod. And I actually give, like, have insulin in it? Um, I've been on the Dexcom. Since August.

Scott Benner 50:47
Cool. is it helping? And? Yeah.

Anonymous Speaker 50:51
Pretty all through high school and into Well, up until last last August, my a one C was over 11. Wow. Like, consistently, between 11 and 13. And I haven't, I think the last time I went to my endocrinologist was in January or February, and I was down to 7.8. Very good for you. That's really cool. And so I feel like

I can.

I mean, it's a big step. But now that I'm gonna get married, and like we've talked about, like wanting kids, someday. Now, I feel like I can't think about me anymore. Since I'm the one that has the child. And like, now, I'm like, well, 7.8. I can't do anything with 7.8. So I feel like it's just like, maybe not 12. Again, well, it's not

Scott Benner 51:56
it's a it's an amazing leap. It's this, that's the sparkle in your eye that somebody notices. It's not it's not a reason to, to go backwards. It's a reason to be hopeful and keep moving forward. Also, it's interesting, where you place your hope and where you don't place your hope you want to be 70 you want to have kids. And those things seem reasonable to you. You don't you don't imagine yourself 70 cutting yourself Do you know, and you don't imagine yourself with children and being in the situation you're currently in or worse as it's been in the past. So you are hopeful. So there's a feeling you have that you're in complete control of that's working for you the way it's supposed to? Yeah, I think that's really, you know, encouraging. You got your agency down significantly. You're paying, you know, obviously much better attention. Are you eating more now that your blood sugars are better? Were you not eating because you were trying to keep your blood sugar's lower?

Anonymous Speaker 52:55
Well, pre covid 19 quarantining myself, ask, um, I, well, I've never been a breakfast eater. I don't. Well, I take thyroid medication and other medications in the morning. And that's pretty much my breakfast.

Scott Benner 53:19
Is your breakfast?

Anonymous Speaker 53:20
Yep. I don't

Scott Benner 53:21
think that has any nutritional value. No. So I hear what you're saying. So he throws off your timing because you're supposed to take that medicine on an empty stomach because being there for like, a half an hour or something like that before you eat and that throws off your morning. Yeah, and take it before bed. You can do that.

Anonymous Speaker 53:44
Yes, I've just never ate like even

when I was younger, I don't remember eating breakfast. So

Scott Benner 53:52
you don't have to apologize to me. I'm not a big breakfast eater. At all. Like when I'm trying to eat more, I kind of forced myself to have an egg in the morning or something like that. But I don't wake up and think the eat right away.

Anonymous Speaker 54:04
Yeah, and I'm an extremely picky eater. Mm hmm. And so it's very hard for me to find breakfast type food that I will eat.

Scott Benner 54:16
Which ones do you do you like?

Anonymous Speaker 54:20
Well, I'm a big potato person. And I've pretty much stopped eating potatoes.

Because it's just

it's not too hard for me with my diabetes, but to me it's just not worth it. Um, but I don't eat eggs. I don't like there's the list that I don't eat, or I don't like outweighs what I do like

Scott Benner 54:47
Well, I mean, I don't think there's anything wrong with sticking to a simple diet. I there are a lot of people who do that but find the one thing or the three things you do really like and you know have them around the house. See if that helps you eat breakfast like Imagine if you just move your Synthroid to the night and get up in the morning. And there were always three things in your refrigerator that you liked for breakfast. Like, I wonder if that would make a positive step for you.

Anonymous Speaker 55:11
Yeah, and we've

since moved into the valley.

There's so many more you pick berry farms. And so we spend pretty much all summer picking gallons of different berries. And so now that we don't, I don't really go outside, well, I don't go public places, we've been doing a lot more smoothies. And that has been something that I have really started putting into my diet, which has helped. I feel like that has helped me.

Scott Benner 55:53
Let me ask you a question. Do you have the empathy you have for those kids? Do you have it for yourself?

Anonymous Speaker 56:05
My initial responses No.

Scott Benner 56:11
I get that. I think that, um, it does worry about yourself seem selfish.

Anonymous Speaker 56:21
Yeah, and I feel that

in high school, I was consumed with myself that like, when I needed to do things when I needed to act on my urges. And so since then, I, I don't really like, stop and reflect on my happiness or my feelings as much as I probably should.

Scott Benner 56:53
So if I asked you how you, like, if you if you allow yourself to go into your hope for a second, how, how do you think you would like your day to go? Like, what what would you want your life to be like, if I gave you a magic wand that I was like, just turn yourself into exactly the picture of what you're looking for? Like, what are your days look like?

Anonymous Speaker 57:21
Me being a stay at home mom, and not having to worry about like this whole, getting an education and getting a job and being able to like love my kids and or my future kids. And

Scott Benner 57:39
so why are you doing? Why are you doing the things that you don't want to do?

Anonymous Speaker 57:44
x because it's not financially.

It won't work financially.

Scott Benner 57:52
Okay, well, but you've got this guy, right. And he loves she's thinking about marrying you guys thinking about getting married? Right? So? I mean, would there be anything wrong with him working and you at home in a small place? And you had I don't know, a pet instead of a person? Or do you mean like, Why? Why? I'm being serious for a second, like, Why? Why are we all trying to put ourselves into the mold that we think is right, like, I don't think there's anything wrong with you being the, you know, the wife of your husband, who, you know, takes care of their house, people did it for generations and decades, you know, and and it's also cool if you don't want to be that, but it doesn't sound like that's what you want. I don't think you want the job. I definitely think that being around people who your empathy is so strong for that it's it's causing you trouble is it's problematic for you, at the very least. I don't know why. I don't think it's wrong to put yourself in a situation that's good for you is what I'm saying. But

Anonymous Speaker 59:02
yeah, and I do think that my bad days are really bad. But I mean, three out of the five days of the week, I come home. And I'm like, Oh my gosh, guess what one of my kids did today. And I'm so excited. Like I feel like deep down. Like, you won't believe the shit that happened in my classroom today.

Scott Benner 59:31
So how come when I gave you the magic wand? You didn't want that to be your life where you just feel good every day doing what you like doing? It seem scarier that it might not happen.

Anonymous Speaker 59:50
I just I don't know.

Scott Benner 59:52
Yeah, no, I don't imagine you do. Um, so I have questions about what you've tried to help this You tried this, like, the psychiatric route, and it does sound like you're in a different location now, like maybe a psychiatrist would be a good thing for you to do again, and you might have better access now. But aside from that, I mean, have you ever been on medication? Ever smoke weed? Like, is there anything you do to alter yourself to try to make this different? And have you had any success with it?

Anonymous Speaker 1:00:23
I, well, since moving away, I haven't tried any antidepressants or anything like that. Um, I've tried, like, drinking, till I'm numb, or just drinking to the point of passing out.

And I don't really like myself.

Really, I don't like the hangover. And I would

Scott Benner 1:00:54
like to say that I want for you not to do that. Okay. So I think that's, I get that you tried it? It's not a viable long term solution. So So, and it did any of them. And I'm not saying the medications are either, did you? But did you have any benefit from them? Or not? Particularly?

Anonymous Speaker 1:01:14
Not that I remember. Okay.

I've tried, like edibles. And those just make me cry. Like, I don't get the munchies or anything. You don't

Scott Benner 1:01:28
get the fun stuff that people talk about?

Anonymous Speaker 1:01:30
No, I just get, like, so emotional, that I could do that. I can cry when I'm completely sober and clean.

Scott Benner 1:01:40
Yeah. Is it a sad emotion? Or is it just like, do you cry over? Like, would you look at a wooden tabletop and think about the dead tree? Like, isn't that ridiculous? Or? Like, it doesn't take you into your thoughts?

Anonymous Speaker 1:01:53
it? My thoughts? Okay, especially right? So

Scott Benner 1:01:56
no, let's put a line through that. That's a no. All right. And the medication you didn't listen, if I'm, if, if, if you put me in the situation where I'm your father for a second, I and I've listened to this last hour talking to you. And we're not done talking yet. But I would say you have to find a competent, skilled, licensed, well reviewed and thought of psychiatry psychiatrist, an accredited psychiatrist, not a psychologist, not a therapist, you need to go talk to a psychiatrist who can really diagnose what, you know, these things you're saying, and make sense of them. Because if you think you're going to wall off this part of you forever, that seems highly unlikely to me. And I think you deserve whatever it is, you want. You know, being 70 having a great day one, see, having a baby, if that's the way you want to go, being married, not being whatever it is you want, you deserve that. And I think that you should find the best option out there to try to get to that, you know what I mean? Because I just don't think that I don't think hiding, it's gonna work. And, and you're, you're just and try to, you know, I don't even want to say try to imagine but if you had a baby, and the cutting kept going, the guilt you'd feel would be immense. Because you're going to, you're going to, you're going to feel this, this connection to this baby and this desire to do good things for it and appointment in the right direction, you're going to feel like you're not doing that for it. And then that's going to be a huge problem. So you don't want to do things that are going to create new problems, you want to do things that are going to alleviate existing issues. Yeah, you know what I mean? And I know you know that and that's also the strange thing about depression or these feelings you're having it's, you're not unaware. Like, right, you don't have that knife in your hand going, this is a great idea. Birthday Cake time, like you're not thinking that you're thinking, this is my last best option. This is cutting is jumping out of the window of the World Trade Center, right? Like, I'm gonna jump so I don't burn to death to by myself five more seconds. But get right.

Do you have any luck looking at the world or yourself or anything in more of a macro way, because everything you're talking about occurs to me. And I've been thinking a lot about macro and micro thinking lately. So this is maybe why my mind's going there. But everything you're talking about is very micro like you are right down on top of every little thing, seeing the granular issue, like these kids. You know, there's a kid who sleeps in his car. Well, if you pull yourself back 100 miles, you know, the world's full of people who don't have a home to live in. And it's incredibly terrible and horribly unfair. But in reality, and I don't mean to sound harsh. doesn't have any real, today impact on you. Right? Like I can see if you want to help that child or do something to curb, you know, homelessness. That's all really cool to work on a macro or a world level, but you can't feel it on a micro level. Like that's just not sustainable. And so, you know, sometimes I get notes from people were like, I don't know how you talk to I got a note from Sony. I was like, I can't believe you talk to Donnie about his problems like that. And you weren't all broken up the whole time. I was all broken up the whole time. A lot of the things that he was saying was horrible. You don't even know what I'm saying right now. And trust me, don't listen to Johnny's episode, it'll kill you. Okay, but you know, but like, when I was talking to him, I had to pull myself back. I couldn't be in the, in the granules with him. I had to be back, looking at him through binoculars. Does that make sense? Yeah, yeah. And, and it just you're so into everything. Like, on that level, it's hitting you too hard, you just don't have enough of a force field. And I don't know that I don't know how to create that force field, I don't even want to sit here and guess about it. I don't even know that we should be talking about it. Like it's a force field, I mean, distance, like enough distance, where you can make the statement, you know, there are children starving in, you know, XYZ place. I know, that's bad. I wish that wasn't that way. But in reality, I have no sway over that I can't really affect that I can send a couple dollars to an organization is trying to help. You know, I can, you know, there's all kinds of things you can do that are big picture things. But I mean, but if I get into a plane to fly to, you know, the middle of some country where everybody's starving thinking, I'm going to hand them out food, that's not gonna work, I'm just gonna be in no time flat, I'll be in their hell to. And now I can't help them anymore. I'm, I'm involved in it. Like the people who help are a little distance. And I wonder if there's not a way to apply that idea to your everyday life to the things you say? And I don't know. But I think there's probably somebody who could help you figure it out. I'm probably not that person. But I think there probably is somebody. And and by, I mean, you sent the note to me. So at some point in that day, you felt enough of a connection with me that you were like, maybe this person can help me. Right? Because that's the only reason you would send an email like that.

Anonymous Speaker 1:07:39
Don't Yeah, right. Yeah.

Scott Benner 1:07:42
Yeah. So here we are doing it. Now we got to do the next part, which is, you know, find somebody way smarter than me who understands this a lot better than I do. And get you involved with them. Because Do you feel any better now than you did when we started talking?

Anonymous Speaker 1:08:00
Good tears have steadily rolled down my face. But yes, good. See? Short answer. Yes.

Scott Benner 1:08:12
Great. So that's really cool. So you know, you need another person to talk to, that you can have these conversations with over and over and over again, even if it's just a pressure release. And maybe, maybe for years, it'll be that for you. Maybe you'll just go a couple of times a week, and talk to somebody and let off enough that you know, you can keep moving until the next time you get to let off a little more. And then find some, you know, plateau at some point, ascent. And and, and keep yourself in a situation where as you make small improvements, you can hold on to them. Right, I want to see you get a twinkle in your eye, and stay at that level, and then get a brighter twinkle and then stay at that level and get a brighter one and a brighter one and a brighter one not get a brighter one, feel the pressure and then backslide. Because that's you're just caught in this like, slippery slope. And then once you realize that's your loop, you're shutting down and pretending it doesn't exist. And that's not fair to you. You know what I mean? Like you should get to make those improvements and keep moving unfortunate. I don't think that that's not possible. You're a bright person, you're thoughtful you understand what's happening to yourself. You know, maybe you can get past that and you know, maybe there is depression that you need to you know, address with something. I mean, obviously, listen, I don't want to get you something's wrong. You know what I mean? Like, you're not you're not you're not in the same situation that the person next to you is in, but that doesn't make your situation not controllable. You know what I mean? Like, like, there's, it's probably the wrong word. But I think that there's you're not alone. lost cause? Do you know what I'm saying?

Anonymous Speaker 1:10:02
Yeah, yeah. And I feel that like, this whole COVID-19 thing has just, like, amplified it. Because I don't like, we go outside we have a bocce ball court and basketball and things to do outside. But I choose not to, like, it's easier for me to stay inside and dwell and and what could happen just? Yeah, well just like,

like not

removing myself from the whole situation.

Scott Benner 1:10:48
Let me tell you how I think about this, this specific idea. And we're gonna add a date to this, which I don't usually do, but it's April 1 2020, just because we're talking about the Coronavirus so that people can keep up. So listen to what I'm going to tell you here. And I'm trusting you because I think you are, I think you're you're a smart person. And I think you're gonna understand what I'm saying. This is going to be okay. And if it's not, it'll just kill us all. So one way or the other. You know, it's all right. Do you see what i'm saying by that like, like, this is a, this is a virus. These things have happened over time and space, multiple, multiple, multiple times, you know, you can point to the Spanish flu, or any other number of things that have happened over history, there are going to be a certain amount of people who get sick, and then get better. There are going to be a certain amount of people who get sick, and they're going to die. If you want to sequester yourself so that you're not a person who gets sick. While hospitals are overtaxed. I don't think that's an unreasonable thing at all. And you should absolutely do that. But in a month or two, this is going to be passed. And you still might get the coronavirus, you know, six months from now. Or maybe you know, I'm here and j&j might have a inoculation brewing, maybe you you know, because your diabetes, you'll be at the top of the list to get an inoculated, maybe it'll never happen, but you're not afraid to die of the flu, right? Have you ever? No, of course not, you don't think the common cold is going to be the thing that knocks you over and doesn't let you get back up? again. The problem with this virus isn't that it exists, it's that we don't have any natural immunity to it. And that it's overwhelming the healthcare system. It's not the law. It's it's that's your concern. And so sorry, for texting me, don't text me. And so. So that's the real concern. So when you look at that, realistically, you're either going to get it now later, or never, it's very likely not going to hurt you significantly or a young person. Right. And this one doesn't seem to be getting young people there's been, you know, there have been outbreaks throughout history that have targeted population centers, you'd never believe I don't know what one of the flus you know, hundreds of years ago, mainly killed young men who were really healthy. Like, who knows why that happened? I don't know why, you know, but the truth is, is the world kept spinning, we're all still here. And the ones that are behind are, you know, going to move on. You have to think of it that way, in my opinion, my opinion is is is no different than riding in a car, or walking down stairs, people dying all kinds of weird ways. Every single day, there are people who are going to die reaching into a soda machine. I know that sounds ridiculous, but it happens, they get their hand stuck, and then they panic and the damn machine falls on them and kills them. It only happens to one person a year, but still, five minutes before it happens. That guy wasn't like, you know, what's gonna take me out? Probably a falling soda machine, you know? And so and so. In the in the, in the short term, dude, stay inside, if that makes you comfortable? Do it. You know what I mean? But you gotta understand it's gonna end. And yeah, I gotta be honest with you. I'm lucky. First of all, I can do my business from my home. My wife can work from home. I've got my children with me. You know what I mean? Like I'm in that position. I don't have an essential job that I although By the way, podcasting has been deemed an essential job. I don't know if because of like, I guess because of media. But anyway, I don't have an essential job. I'm not going out and collecting someone's garbage or making sure you have food or anything like that, you know, so I'm lucky. But I'm kind of treating this like a vacation. You know, what they used to call this a staycation? Like there's no expectations, right? You don't have like there's, you know, all the doors aren't being knocked on. You know, every mortgage company in the world is not going to take somebody's house like this is a pause. Like it's not set up like that yet, but it is the world is paused like it Enjoy it. Like, just be like, whoo, this is nice. There's not a lot to do. I just cleaned my bathroom. What a beautiful, deep clean, I just put on that bathroom. Because I was like, I'm not even a rush. If I don't do the other bathroom today, whatever, I got nothing but time. And so, you know, in this time, what are you gonna do with this time? But I think you could be finding a really competent clinical psychologist or a psychiatrist that could that could maybe start talking to you on the phone or by zoom or I don't know how they're gonna do it. You could be a different person by the time you know Coronavirus is over, make make another ascension. You know, I mean, like I get a little brighter sparkle for yourself. Yeah, any of that seem reasonable? Where am I?

Anonymous Speaker 1:15:50
I feel that, like, Yeah, sounds great. But then my, like, underlying thoughts creep in. And I'm like, I have trust issues with like, I'm not saying you're gonna go and kill yourself now that you've talked to me, right? But it scares the hell out of me. Like I people commit suicide all the time, for whatever reason. Yeah. But that, like, I had seen him that day. Okay. And it was just like this out of nowhere. thing that happened. And so I just have like this very underlying trust issue.

Scott Benner 1:16:35
Alright, so listen, I promise you first of all, I'm not going to kill myself. Okay. There are plenty of people listening to me right now. Like, that guy's a narcissist. Because that's what they think. And they're gonna be like, he never could hurt himself. Well, a You're right, I could never hurt myself be I don't believe I'm a narcissist. But that's exactly the kind of thing a narcissist would say. Talking about narcissism is so funny. But let me say this to you. Until you can find a person. Right? That you feel good with. I could absolutely committed to talking to you on the phone privately every week. I could be your friend through this. And, or it could be someone else. It doesn't need to be me. Okay, but I would 100% do that. You're lovely. And I'd like to get to know you better. And if, if we, if we could have a conversation that would continue to get to your to get you to a point where you'd be comfortable enough to reach out into the world and look for a competent person to help you. Because let's be clear, I am not a competent person that should be helping you with this. Okay. But But if if if you need to see me not dead for a month, or a couple of, you know, months or whatever, if that's what makes you comfortable. I'd be thrilled to be a little part of why you're, I guess the sparkle. You know what I mean? Yeah, yeah, you let me know, I'm down with that. But if it's the voices coming in and telling you it's all going to go wrong, blah, blah, blah. To me, not knowing much about anything. That seems like that seems like something chemical. That's, you know, they mean happening because I think I'm right about this, like you're there's depression, where the chemicals in your brain are just mixed, Miss balanced and, and giving, you know, have it letting you have these feelings or thoughts? And then there'd be actual insanity. And you're not insane. Right? Do you know that about yourself?

Anonymous Speaker 1:18:30
I feel like I'm not insane. Good.

Scott Benner 1:18:32
Well, listen, you know what insane people don't do? They don't consider they don't consider their sanity. Now. They couldn't admit it. There's just no way they could even consider it. Listen, crazy. Don't know. They're crazy. You understand what I'm saying? So you're aware that this is weird, which means you're not crazy. You're not insane. Alright, so you're probably depressed. You haven't said anything? Like bipolar ish? You know, you're not you don't see manic to me. Unless you're not. You get manic at all. No, yeah. All right. You're probably just the pressed SOS like a bazillion other people. And it's I'm telling you, you put me in place. It was a one stop sign. I'd grown up depressed to parents get divorced. And then I get the diabetes. How much of this do you think the diabetes pushed you? Like Did you feel any depression from that? You haven't mentioned it once as being part of this.

Anonymous Speaker 1:19:27
Um, I was well, for the longest time I was just in denial about my diabetes. Yeah. I'm

probably for

eight or 10 years.

Scott Benner 1:19:43
Yeah, that's a long time and plus then your your blood sugar is all out of whack which does not help how you feel how you think? Serious now? Yeah, high blood pressures are tough. Look, I got something here. National Institute of Mental Health. Estimated 16 point 2 million US adults had at least one major A depressive episode in 2016. This represents 6.7% of the US adult population. This is four years ago. Depression is most common in ages 18 to 25. Listen, you're 24 you're almost out of it. I'm just kidding.

Anonymous Speaker 1:20:17
I wish it was that easy.

Scott Benner 1:20:19
Just got to make it a 25. But But you know, how much of getting through stuff like this is setting short term goals? Right? Like, like, I just got to make it to Tuesday, you know, I'm gonna, I'm gonna have a conversation with somebody, because that's really what psychiatry is, right? It's somebody who has a conversation with you on a regular schedule, who, if they're a psychiatrist, understands the, the reason why what you're saying is happening, like, you know that when you're talking, you don't understand why it's happening to you, but really good psychiatrist. They know right away when you're talking, like they can, I'm not that person, but they can, they can pick through it in two seconds, they will say something or relate a story. And they'll know, this applies to, you know, this theory about mental health. And then they'll know how to direct you into a better place. Yeah, you know, I just put, I don't know, like, it's up to you, obviously. But let's be honest, we can't put you in charge of this decision. You'll get depressed in the middle of having a thought, and you'll stop doing it. So you have to listen to me and go, go find that person. And until then, it can be made, we can chat whenever you want. It doesn't have to be recorded. I don't want it to be, we'll just talk privately. Okay, am I empathy will be all sorts of happy about that. Right? And let me tell you something else, too. I really do want you to think more about having a pulled back. Like view of things I don't want you to like get so far away from things you don't feel them at all. I'm not saying that. But you need to feel far enough away to realize that that kid that can't find a place to sleep, that's not your fault. You don't have you don't hold sway over that. It's not your responsibility. It's sad. But you have to be sad about it intellectually. Do you know what I mean? Like I'm sad about hunger, intellectually about homelessness, about the border problems, like that stuff is. To me, it's real. It needs impacting. I help with things like that when I'm able to. But I also recognize my limitations in a global problem. You know what I mean?

Anonymous Speaker 1:22:41
Yeah,

Scott Benner 1:22:42
yeah. It's just It's not your fault. Let's go over things. Your parents divorce isn't your fault. Your diabetes isn't your fault, that kid not being having a place to sleep isn't your fault. When you listen to this podcast, other people's problems are not yours. They're not your fault. You didn't do it. Everyone's got problems. You know, if we felt bad for everybody, we'd be, we'd all be in one level of swimming in a puddle of our own tears or another, you know, like, it's just not reasonable. Now, if that's happening to you for a chemical reason, then that you got to find a way to change that, like anything you can do to change that. And not drinking, by the way, it's not what we're talking about. Right? If it's conversations with people, it maybe it'll end up being medication. I have no idea. But yeah, no, you. That's not none of us could handle that. So that's what I'm trying to say to you is that if you gave me your feelings, I'd be in your exact situation. Did I mean? Like, if you gave me your feelings or gave them to anybody, we'd all be right where you are. So yeah, yeah. So it's like it would be like blaming a person with a broken leg for not being able to run a race. Right? You're, you're struggling with the things you're struggling with. Because, you know, there's a part of you that's not doing what it's supposed to do or it sounds like it's doing it too much to be perfectly honest. Like you're getting way more than you need of like concern for other people and and the idea of like drilling down on problems and thinking about things like I've never once I've spoken to my mom a million times in my life and and not once in one of those conversations have I ever thought like oh, here her her needs in this I'm gonna blow up my life because of it like I see my mom's needs but I see it at a at what I would consider to be a healthy level. And there struggles My mom has in her life that I can't help her with. And they don't make me feel bad about myself.

Anonymous Speaker 1:24:46
Oh, hold on me.

Scott Benner 1:24:48
I know you're there. Okay.

Yes. Don't go anywhere. I know why I can't hear you. I just I'm having trouble getting it back. Okay, one second. I'm gonna, Okay, I'm gonna hang up and call you right back.

Anonymous Speaker 1:25:08
It was for an art education class. And we created like, we painted individual feathers and created that wings. It's

Scott Benner 1:25:17
really pretty. I'm sorry, we're recording again, we're just a small glitch for a second. But I was talking to the person you're hearing about something in their, in their profile picture. It's really pretty. No, people never get to know what it is. that's their problem. Okay, so it was a weird place for there to be a technical problem. But I need to know, I, you know, I'd like to know where you're at before we say goodbye. So what do you think you're like? What do you think? Because I think if you go start thinking about it, your your beer, unpleasant thoughts are going to overwhelm the clarity you have right now. Is that right?

Anonymous Speaker 1:25:57
Yeah, I'm extremely anxious right now.

Scott Benner 1:26:01
Okay. Because of the idea of doing something. Yes, yeah. So listen, do

Anonymous Speaker 1:26:09
one, if it's talking to you,

Scott Benner 1:26:11
again. You know, I'm not gonna force you to do anything you can do absolutely. Whatever you want. No one's gonna make you do anything. So I'm just telling you, it's an option. And if you want to take that option, it's there. And I'm happy to help you. And any way I can. And if you don't want that option, then that's cool, too. You know, I just think I think it's important to know that there's probably a good path out there for you. And, you know, I think you need somebody to help you find it, because you're having trouble finding it on your own. That's all. Okay, anything you want to say? Are you good?

Anonymous Speaker 1:26:54
I am okay.

Scott Benner 1:26:58
With this boy, you're talking about? He? Do you guys live together? Yes. How much of what you just told me this he know.

Anonymous Speaker 1:27:10
He everything but how I feel currently? Like all the thoughts, probably in the last

year.

Scott Benner 1:27:25
So does he think you're in a good place right now that you're not in?

Anonymous Speaker 1:27:29
And I think he knows I'm not

where I should be. But not how deep it goes.

Scott Benner 1:27:38
Gotcha. Do you think he could be the person you talk to? No, you don't want to is that a part of you, you don't want him to see because of your, your relationship.

Anonymous Speaker 1:27:53
He is completely opposite of me in the sense that I am very outgoing, and opinionated. And I wear my heart on my sleeve. And I like, with him, he knows my feelings every moment of the day. And I can he's completely opposite, he won't talk about his feelings to me. Or if I open up, he just kind of like, gives me a hug, because he doesn't know what to do.

Scott Benner 1:28:34
Yeah, well, your situation is unique. It's hard to know what to do. That's for certain. But I don't think that you need somebody to do something, I think you need to keep talking it through. I think that's sort of like the, the key is for you to continue to like, let the pressure out. Do you know what I mean? Like, like, so that you you don't turn into a, you know, a steam pot that just pops its lid, you got to just keep letting it out. And if it's not him, like, I don't know, like, you know, if this is the odd psychological parallel to not wanting to poop with the door open in front of your, you know, your boyfriend, is just some stuff about yourself that you would be hard to share, I would get that I would 100% understand that. But that then again, makes it even more important for you to, you know, to find another person to talk to because right now, what you're describing, is, you just, you know, you're standing on thin ice and it's going to get warm at some point. So, you know, you can't, you're not going to be able to keep the ball up in the air of pretending you're okay. And painting a picture for him that he wants this that you think he wants to see which by the way, I don't know that he wants to see that picture. Like maybe he really wants to know what's happening to you. And you know, that's up to you about whether or not you can show it to him. But maybe if you spoke to someone else you could get to a point Where you wouldn't be able to share to them? Like, how cool would it be to come to them and say, Listen, I had trouble sharing this with you. But I spoke to a doctor, I've been talking to them for, you know, six months, I am in a different place right now. And I want you to know that, you know, I'm good. And in the past when you thought I was, I might not have been as good as you thought. Like there's, you know, a lot of ways to traverse this. But listen, not on this level, but I've been married a really long time. And what I can tell you is that not saying something never ends? Well. Yeah, you know,

Anonymous Speaker 1:30:32
yeah. And from, like, my diabetes standpoint, he takes better care of me, than I take care of myself. I mean, he, because

Scott Benner 1:30:47
he understands that,

Anonymous Speaker 1:30:48
yes, and he, like, he wants to go to my doctor's appointments with me, and understand as much as he can. And I mean, there are more times than I can count, when I've been passed out from drinking or whatever. And he changes my pump knows how, like, gives me a shot, because, or whatever.

Scott Benner 1:31:16
So then Aren't you describing a person who would be willing to help you with an issue? Like the one you have?

That feel different? Because it's in your it's, it's your brain? Is that white? feels different? Yeah, yeah. It's not it's there's no difference. There really isn't. There's, there's no difference between what you're going through. And, like I said, a person with a broken leg not being able to run a race or a person who has a pancreas that doesn't work, not being able to, you know, make their food go through their system properly. There's, there's no different. It's a part of your body that's not doing what it's supposed to do. It's creating a deficit that needs attention. And when you give it that attention, look what happens. Look, what happened, your one seat when you gave your diabetes, that attention? You know what I mean? Like, like, I think you just need to do that for this. I mean, he sounds like a really decent guy. You know, I'd hate to see you hide something from him for so long that he felt like he was being kept in the dark. Like, I think it sounds like he wants to be in this with you. That's hard to find, you should lean into that if you can.

Anonymous Speaker 1:32:33
Hi, I'm trying. I know you are,

Scott Benner 1:32:35
I think you're doing a really good job. By the way, you also have to give yourself credit for reaching out to anybody, you really did reach out to me. Like that's a thing you did. And it worked out great for you.

Anonymous Speaker 1:32:48
Well, since we have talked,

every Well, my life is full of just me thinking or like lately, just me thinking. And I don't know, several times a day, I'd be like, just think to myself, like, this is a mistake. I have nothing to say. I don't know it, like, just all of these negative things. Yeah. And then I was like, Oh, my gosh,

Scott Benner 1:33:16
I just need to cancel it. You but you, are you happy You didn't?

Anonymous Speaker 1:33:23
In tomorrow, when I think back, I'll be happy that I didn't. But right now I'm very like, on edge.

Scott Benner 1:33:34
You have to you have to believe that you're being lied to by your brain sometimes. And I don't know if that's something that you can cognitively do or not. But, you know, that the the the thoughts you're getting are not matching what's happening. You know what I mean? Like, it's, you're, you're, you're kind of being lied to by your feelings sometimes. And, and it sucks because you, you know, they're not coming from, you know, they're not coming from Amazon. You can't just refuse the package. Like it's coming right through and you're you're feeling it no matter what. And I, I think that what I just said is probably completely unreasonable to expect for you to stop. But I think you I think you just owe it to yourself to look beyond a guy who does a podcast or a 24 year old girl who's you know, been struggling with it. Like you don't know, you know, you don't have the answer. If you had the answer. you'd actually be a psychiatrist. yet. I mean, if I had the answer, I could be charging like $400 an hour to have this conversation. So it's not me either. But the one thing I can be 100% certain about is that your feelings are lying to you. And you need to go talk to somebody who can help you stay clear about that and move you in a better direction. When you're not able to help yourself. I think that's like flat out. The only thing But we've really talked about it that that, that makes sense to me. 100%. And I think you agree with me. Yes. Right. So before your thoughts lie to you involve another person in your life in this decision and get them to help you find someone so that when you want to stop looking, it doesn't happen. Like that. You know what I mean? Like, you gotta you gotta you never, ever heard like, the idea of like, you got to tell people, you're on a diet. So you can't like quit, like, you need to like, take this clarity you have right now find a person. And whether it's your, it's your boyfriend, or it's somebody else and tell them look, I want to I want to go take this step. I need you to help me get to it, because I might, I might sabotage myself before I get to this appointment. And in the meantime, I will hold up my end of the bargain by not ending my own life. Okay, I promise. Hundred percent. Okay, you can trust me. Definitely not doing that. Okay. Yeah, I mean, listen, I bet there's too many bathrooms to cleans. I got laundry to do, I gotta put this podcast up, I sold ads to the end of the year. I have to put the podcast up. I already spent money. You know, so I already sent that money to my son's college. And I and and that's it, like, I think small digestible steps, short goals. You know, lean into this guy who sounds terrific. And, and and let them know, let them know that they're going to be times where you're going to be clear. And they're going to be times where, you know, what you think is depression is going to stop you from, you know, falling what you intellectually know to be right. And that you need to get past that. I think there's a way for you, I really do. Blow is if you can't pull Time will tell. See, right away, you're negative there. There's and see. And so now being serious. There's nothing lost with just, you know, hoping for hope sake right there. But, you know, enough has happened to you that you're thinking Oh, it's, it's more likely This is gonna go wrong. And it's gonna go right, buddy, you know, you can try to be upbeat if you want. But, uh, you know, little kids don't have a place to sleep. And I'm depressed. And you might be right. But that doesn't make me wrong.

Unknown Speaker 1:37:32
Yeah, you know,

Scott Benner 1:37:36
I gotta tell you something. I have never spoken to somebody for 90 minutes before and wanted to tell them that I love them. But I, I, I feel like I would like to say that to you. I love you. I am sure there are other people in your life who love you a lot more than I do. And, and so I think that I think you got to go find those people. You know what I mean? And stay around them. Okay, so now you've told somebody else empathic about your life. So now I'm gonna, I'm gonna, I'm gonna keep you in my heart while we're talking. All right, okay. I don't think stop recording.

I want you all to know that I did keep in touch with this young lady. And we've been talking now for a couple of months. And she's doing much, much better. She'll be back on the show at some point to tell you how. But I think it would be unfair for you to leave here not knowing that she talked to her doctor is seeing a therapist has found medication that is helping her. And honestly, when I spoke to her yesterday, I double check to make sure that it was okay to share this with you. She felt like a completely different person today. She'll come back on at some point and tell you how that'll happen. But for now, I didn't want you to leave without knowing that. I know we've been here for a while but I appreciate the sponsors. They bring this kind of content trust me when I tell you that not every organization and company would put their name on an episode about depression and self harm. If you're looking for an insulin pump, a glucose monitor an organization to stand up for or new blood glucose meter. You can check out touched by type one at touched by type one.org. It's an organization dedicated to helping people living with type one to live better, healthier, happier lives, touched by type one.org. And if you'd love to see the data that we see through Arden's Dexcom g six continuous glucose monitor dexcom.com forward slash juice box. Find out what direction and speed your blood sugar is moving. Share your information with a loved one or friend through the cloud. Get back to the Information about how foods impacting you, that will allow you to make a better decision with insulin next time. Those of you who are looking for a new insulin pump, or want to start using one today, you just have to check out the Omni pod tubeless insulin pump tubeless is the really amazing part. But equally cool is that on the pod, we'll send you a free, no obligation demo of the Omni pod directly to your door. This way you can try it on, decide for yourself what you think you don't have to take my word for it or anyone else's, my Omni pod.com forward slash juicebox. And if you go to Contour Next one.com. Today, you may be eligible for an absolutely free blood glucose meter. The blood glucose meter that Arden uses right now, the blood glucose meter that I find to be more usable, friendly, and accurate than any pardon has ever used in our entire time with Type One Diabetes. You can find these links right here in your podcast player, or at Juicebox podcast.com. When I say links, I mean of course, on the pod Dexcom touched by type one, the Contour Next One blood glucose meter, as well as the phone number for the National Suicide Prevention Lifeline and the self harm Crisis Text Line. When the person you heard today on the podcast sent me an email, I didn't know them. I didn't know what I was about to find. All I knew is that she seemed like she needed help. And I did not have the heart to ignore her. There will be somebody in your life that will help you to a friend, a neighbor, coworker, family member, somebody. And if none of those people are available to you. That's cool. Crisis Text Line can help the Suicide Prevention hotline can help. There is someone out there who not only understands what you're going through, but can show you the path back. It happened for her. Hi, I'm sorry, I can't use her name, but it happened for her. It could happen for you. You're never as alone as you think you are. Thanks so much to everyone who listens and supports the show shares it online. And of course, the sponsors for making all this possible. My family for allowing me to do this. I am very emotional today. Having listened back to this episode during editing just reminded myself how far that today's guest has come in such a short amount of time. halfway into this episode, I thought I made a mistake. I don't know what I'm doing. I shouldn't be involved in this. But then I realized just just need somebody to talk to who can help her get to where she needs to go. That's all I did. She was just a little lost and needed to find our way back. And she's doing that. It's very exciting. I'm gonna go now want to remind y'all to be kind to each other. Wash your hands and take care


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#327 Dr. DeSalvo has T1D

Scott Benner

Dan DeSalvo, M.D. is a Pediatric Diabetes Endocrinologist

Dan DeSalvo, M.D. is a Pediatric Diabetes Endocrinologist at Baylor College of Medicine and a person living with type 1 diabetes. Dan shares his story and talks about how the Dexcom G6 is being used in hospitals for Covid-19 patients. 

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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 Episode 327 of the Juicebox Podcast. Today's show is with Dr. Daniel disalvo. Now, Dr. disalvo is a pediatric diabetes endocrinologist at Baylor College of Medicine and Texas Children's Hospital. He also has type one diabetes himself. Now, you know me, Dan came on the show to talk about how decks coms were being used in hospitals during the current coronavirus. But then I started talking to him. And I think we got to that part eventually, just I enjoyed Dan's conversation. So we didn't, you know, I don't make a bullet list and be like, talk about this, then this then this. I don't know how to do that. If you want that, go to another podcast, which I'm betting will be boring. Anyway, this one is interesting and fun. And you'll still learn about how Dexcom is used during the current Corona crisis in hospitals. So you know, all the information gets out. But you're not put to sleep by a boring host and stagnant questions that have been written down on a piece of paper. This episode of The Juicebox Podcast is sponsored by the Contour Next One blood glucose meter by touched by type one Dexcom and Omni pod. Now you can go to Contour Next one.com right now to find out if you're eligible for an absolutely free meter. Why would you want to do that? Well, one reason is, it's absolutely the most reliable and accurate meter that I've used in well over a decade. So that's a pretty good reason to check into it. I'm also going to ask you to check out touched by type one.org. In these trying times, organizations that are doing good work for people, they need your help. So check out touch by type one.org. And of course, you can get a free no obligation demo of the Omni pod tubeless insulin pump at my Omni pod.com forward slash juice box. And to check out the people who put these continuous glucose monitors in the hands of the people helping those who are suffering from COVID-19. Check out dexcom.com forward slash juice box.

Podcast something here. But first, let me remind you that nothing you'll hear today on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan or becoming bold with insulin. I'm going to read to you now from Dan's professional statement. It says Dr. disalvo joined the faculty in pediatric diabetes and endocrinology at Baylor College of Medicine Texas Children's Hospital in July of 2015. Previously, he was a postdoctoral fellow at Stanford University, where he was an active researcher in diabetes device technology, including closed loop artificial pancreas systems. His overarching goal is to provide compassionate and comprehensive treatment to children entrusted to his care, and to advance the field through clinical research. It says some more here, but what I'm going to tell you is as a serious guy who knows how to have a good time while he's given an interview. And now, Dr. disalvo.

Dan DeSalvo, M.D 3:35
My name is Dan DeSalvo. I'm a pediatric endocrinologist at Texas Children's Hospital and I'm on faculty at Baylor College of Medicine. And I have been pediatric endocrinologist for I guess about seven years now. And my inspiration started when I was 19 years old as a sophomore at Baylor University in Waco, Texas. When I was diagnosed with Type One Diabetes, it was through that personal journey, and his desire to help others that I sort of had this epiphany about halfway through my sophomore year, where I realized I wanted to become a doctor for kids with diabetes, not realizing the journey that would lie ahead. I switched over to pre med and never look back. And here we are 20 years later after my diabetes diagnosis. And now I have the incredible joy and privilege of being a pediatric endocrinologist where I can walk with and Shepherd families on a diabetes journey. And I feel like I learned as much from them as they probably do for me. And you know, I'm really glad to talk to you Scott because a lot of my patients actually listen to your podcasts, read your blogs, and I've really found a lot of inspiration, hope, practical kind of tips and tricks, and also community so thank you for the work that you're doing.

Scott Benner 4:49
diagnosed in college. What were you thinking of majoring in before you made the switch?

Dan DeSalvo, M.D 4:56
So I was actually a political science major and I was thinking that I Maybe he wanted to go to law school, didn't know exactly what I wanted to do. And really, it was through my my diabetes diagnosis that sort of led to this, as I called it an epiphany. My best friend, or one of my best friends growing up was Eric paslay, who I think has been on your show before. So Eric paslay is a country music singer now. But growing up, he was just a good friend of mine who had type one diabetes. And so I learned a little bit about diabetes from Eric, and, but really had no idea that that would be what I would want to do with my own life until my my personal diagnosis, it's kind of a funny side story is that I had, I had for a moment, I thought maybe I wanted to go into medicine. And when I was a senior in high school, there was an internship where I spent about a week in a pediatricians office. And at the end of the week, I decided, you know what, medicine is just not for me. But, but I'm happy to say that, you know, through my personal journey, I've decided to go on this path. And I cannot be more grateful for the opportunities that has provided me in terms of being able to edify my own knowledge, but mostly just be able to, through my clinical practice, pass it on to others, and also, as a clinical researcher, helped to really advance the field of diabetes.

Scott Benner 6:16
Before I asked my my big question, was type one. A surprise? Like, were there people in your family who had it? Or did it come out of nowhere?

Dan DeSalvo, M.D 6:27
Scott, it was a total surprise. I, you know, I was that kid who never miss a day of school, always won the awards for for attendance, no family history of type one that we're aware of, in my family, some type two. But no family should type one. And yeah, I bet the summer after my freshman year of college, I went on a medical mission trip to Africa actually was just a mission trip, not a medical mission trip on a mission trip to Africa. And on the tail end of that got really sick. And when I came back was just continuing to lose weight, had to excessive thirst and urination, this similar story to so many have the diagnosis of diabetes, but was kind of in denial. And finally, it was my roommate, who was a really light sleeper, who every time I woke up was waking up. And finally I said, Dan, I don't know what's going on. But you've got to go find out what's going on, you know, what's wrong with you. So I went to the Student Health Center at Baylor was diagnosed with diabetes, and spend a couple of days kind of learning how to manage diabetes had a sister who was in college, about two hours up the road in Dallas, who actually came down to Baylor where I was, and such an amazing advocate would actually come to my classes with me, because she was so worried about me, you know, having a low blood sugar, this was all brand new for us, and would help me kind of talk to my professors about this in diagnosis and what to expect. So having advocates like my sister, Sarah was was really impactful. And it wasn't long before I became my own self advocate and develop my own knowledge base. But, you know, to answer your question, this was totally out of the blue. And while initially shocking, really led to, you know, learning so much building community with other people at Kent on campus who had diabetes, and ultimately leading to this sort of career calling for me

Scott Benner 8:20
so what would you How would you describe your, your goals for patients? I mean, we talk all the time here it's interesting the threw me off a little bit by saying that you knew the podcast but you know, we talk all the time here about giving people great tools, good information, so that they can make better decisions so they don't get caught sort of in the backsliding vortex that is being confused by diabetes. And and I hear back from a lot of clinicians who are like keep talking about this please this is how we do it. You know, we share the podcasts with people but I hear back from far more people who have successes after listening go back to their doctors and then are honestly yelled at like scolded in the office, even when they show data, even when they pull out a Dexcom graph and say look, no I don't have meaningful lows. You know, I've only been under 65 2% of the time you know in this 90 day period I'm getting this a one c you know legitimately the doctors you know what I always surmise is either they don't understand or they're just scared and they've never seen anybody with a good a one c before someone make a change that quickly and and that does happen people will listen and in the span of one a one c measurement sometimes dropped their their number a point or some people too, and it scares Is that what it's happening to them? Can you can you kind of put yourself in their shoes if you see somebody with an eight nine who all of a sudden has a six nine, and they tell you I heard this on a podcast. What would that sound like to you as a doctor if somebody came in and said that

Dan DeSalvo, M.D 9:59
Yeah. So a couple of things on that, Scott, first of all, you asked about sort of my my personal mission for caring for patients. And it's really, to help empower them to live well and die with their diabetes, to really take ownership of it. And I'm not only looking for improved clinical outcomes, but also less burden of diabetes. And I think part of that is, is being really tight in the community, and having a sense of purpose. And I think that's where the diabetes online community, your blog, your podcast, has really helped inspire them. I also think it's those nuggets of truth in terms of being able to have the self initiation to manage diabetes, having the confidence and the skill set that comes with time. And I think hearing other stories, what you've done with art in with so many of the parents who brought on what so many of the young adults, living with diabetes, their stories, I think, is really helping helping to empower others. You know, I think my sense, as a, you said, at the, at the onset and a younger physician, it all kind of takes the the what how I view this, for maybe some of my really amazing experience overheard colleagues, I think were from where they stand is that the diabetes control and complication trial was published in 1992. And at that time, you know, which really was in many ways, now, the Stone Age is a diabetes, having a lower a one C was associated with a higher risk of having a severe hypoglycemic event. having a seizure or loss of consciousness passing out, right to be clear with the tools that technologies that we have now, that is no longer the case. In fact, if you look at the T Wendy exchange data, which is sort of a cross sectional look at a one sees and the US, having a lower a one C is not associated with a higher hypoglycemic risk. In fact, those with the highest day onesies have a higher risk for having severe hypo, probably, because in many ways, they're managing their diabetes in the dark, maybe they have a lot of struggles with, you know, maybe their adherence and sort of where they are in their diabetes journey, it could be from a tough place, maybe it's the social determinants of health that don't allow them to have access to technologies that others may have. But you know, what I've heard on your podcast, but I've certainly experienced in my, in my clinical practice, is that so many families who have a one sees that are dropping, dropping, at the same time having less hyperglycemia on their CGM, that's sort of the holy grail diabetes, right, there's, I think, three things. One, a lower average glucose associated with the low re one C, two more time and range, the percent of I use in the 70 to 180 range, or 70, to 140. And then three less hypoglycemia, percentage values below 70, or below 54. And that can be achieved that can be done with a dynamic approach today to diabetes, with the technologies and skill sets and the self initiation. So in my personal practice, you know, my goal is really to help help to lift up and inspire my patients and their families. And really, to be sort of, in many ways, a coach and a guide, my hope is, is that they'll reach the point where they're just as self empowered and self initiated, as you and Arden are. And I do see that with so many of my patients, and it is a journey, everybody's on a different pace of that journey. And for some, they require a little bit more guidance and coaching. But they do often reach that sort of Zen state and diabetes, where they've got it, and they've got the confidence to do it. And they reach a place where it's less burdensome. And it's just so amazing to see the kids living well and thriving as students, as athletes as musicians. without diabetes getting in the way,

Scott Benner 13:42
I honestly the feet, you know, I've been doing this now for quite some time. And what I'm seeing coming back from people is that it doesn't really matter, your level of education or social status, or any of the ways we you know, quote, unquote, measure people, everyone can figure this out. And it's not as difficult as we make it seem, or you know, as others sometimes make it seem I'm not saying that taking care of diabetes is simple. I'm just saying that there's some basic kind of tenants, if you follow them, through experience trues are you know, on earth, and all the sudden you see them, and then it doesn't matter the situation I always kind of chuckle sometimes when people are like, Hey, what are you talking about on the podcast? Would that work during a soccer game too, and I was like, it works doing everything. It's it's the idea of putting insulin where it's needed. It really is all it's about I joke all the time. If you all figure it out, I'm not gonna have a podcast anymore. It's timing and amount, put the right amount of insulin at the right place. That's it. It doesn't mean there's not much more that there's other variables. Of course, that can impact those things. But you start to experience those variables and then before you know it, when something goes wrong, you just know what to do. I don't know another way to put it like when something happens with Arden's blood Sugar, I don't stop, put my hands on my hips and start thinking, Oh, okay, well, you know, I guess so she was outside, actually, I just, I can look at that graph on that Dexcom screen, I think for a brief second about what's going on, and I know what to do next. And that just comes with repetition, you just have to get your 10,000 hours. And once you have them, it's I hate saying this, but it's kind of easy, at some point and easy, not that it's not impactful and horrible. And you know, all the other things that diabetes is, it's just your time involved in it becomes so much lesser that it's sort of just a throwaway to me like it. We don't really talk about diabetes around here that often. You know, it's just something happens. We adjust, we keep moving, we don't look back. I don't know why that can't be. Well, I'm gonna I'm gonna rephrase, I believe that can be taught to anyone. But I think it's the same thing. I think the reason the podcast works is because of the repetition, the conversations around the ideas, because it's not something you can just sit and tell somebody, you know, one time how to do and write them down a rule, which is, you know, everybody wants, you know, tell me when tell me how much that's that's not how this works. So given that, I believe you believe you believe in that, too. My thought on this end always is if I can do it here, right? Like if you've ever you've never heard me speak live somewhere. But I guarantee you, I can talk for an hour an hour and 30 minutes, and a large percentage of the people in that room will leave and their agencies will go down by a point a month. So what if I can do that? Because Doctor, Doctor it Can I call you doctor Damn. Doctor Dan, I'm almost a more like an idiot. I know college barely got through high school. Okay. If I can do this, why can those even those silver hair doctors? Why can't they like were anybody like, why is every wire? Why are there a mass of people just going with you didn't die today? And that's a good day. Like, why is that the? Why is that the bar we're trying to get over?

Dan DeSalvo, M.D 17:04
Yeah, so. So you know, one is, is I think I think you're exactly right that your life experiences and sort of learning from cause and effect is something that can really help to inform the next way you do it right. So using CGM is what I call it heuristic learning tool, meaning something where you can sort of learn from cause and effect. Yeah, so with the breakfasts that you eat, or the activity that you that you do, or the you know, your favorite meal at your favorite restaurant, once, you know God willing, we can all go back to doing that, again, you know, really paying attention to it. And and the approach that you took with your insulin, the timing, how is delivered, you know, the adjustments you make with your temp basals are the carbs that you take, before exercise, make taking mental notes of that, and the next time trying to do it just a little bit better, and eventually reach that sweet spot where you can do it really well. You know, one of the joys I have is to be able to sort of watch families as they progress through this process. And you probably remember it well from monogamous first is when she was a little one and how daunting that was and how you wonder how you can ever do this. And then you start to gain a little bit more knowledge and a little bit more skill. And you eventually reached that, that that sweet spot where you realize I've got this, and I can do this, and I can really become an expert, I think with physicians, I you know, I think there, there are so many also who are nimble, and who do change and who were here during dcct, way back in the early 90s. Were before and who really had advanced, so to where, you know, we are now with leveraging technologies and taking an emic approach to diabetes. I think the nature of medicine, though is is that there are others who may be a little bit less resistant to change. They're still practicing the way that they were trained. And I think the other thing is, is as providers, we can all have the humility to sort of learn from our patients as well, you know, maybe there's a new tip or trick that they've learned. And if we kind of step back, and learn from that, it might be something that we can help to impart to another family as well, in the case of diabetes, and so i think that i think that's just a matter of being, you know, willing to sort of change to have an open mind to really advance one's knowledge and to be able to take the learnings from others. And you know, if it makes sense to help to realize that everyone is different, to be able to help to take those special tips or tricks or pearls so that others can can use those to improve their diabetes improve their quality of life as well.

Scott Benner 19:41
Yeah, well, I I just listened. I I agree with what you're saying. I I would like to put myself out of business here right Joe quit, you know, after I put my kids through college, but I would like to put myself out of business. I would like it that one day. This is how doctors across the globe talk to people about diabetes and I've had private comment sessions with some who will say, Well, you know, there's some people who don't get it. And I'm just thinking, I always think, no, you just, there's a way to explain it to them. You know, I, I fall back to a conversation I had a long time ago on the phone with someone, someone online connected me with this young mother, and she was struggling helping her daughter. And I got on the phone with her. And I was like, Oh, I can help her. And I started talking. And it became kind of evident to me that I was speaking with someone who had to drop out of high school to have a baby. And that maybe wasn't on track to go to college to begin with. If that, that, you know, I'm trying to be kind. And, and she just wasn't the she wasn't the brightest person I'd ever spoken to in my life. And I was explaining Pre-Bolus thing to her, the way I explained it to everybody forever, and she just wasn't grasping it. And in that moment, I had this horrible kind of dire feeling like, I have to get off the phone, I can't help her, I'm going to put her in a situation where she's going to hurt this kid, and you know, blah, blah, blah. And then I stopped and I thought, how am I gonna do that? How am I gonna just tell her Oh, well, good health isn't for your daughter, and and get off the phone. And so in that moment, I made up a story about a tug of war. And I put insulin on one side of the rope and carbs and body function on the other. And I started telling a story about this tug of war. And now I sometimes get notes from people who say, Hey, I was in an office the other day, and my doctor explained Pre-Bolus thing to me. And I said, Do you listen to the Juicebox Podcast? And the doctors said, Yes. And I thought, that's just such a wonderful thing. But it's because I didn't listen, I'm not trying to give myself credit, I'm trying to say that you can't give up on people that everybody has the ability to understand this, this is, it's not that difficult to understand. You just have to find the words that they need. And I think that, you know, Jenny and I were talking the other day on the podcast, and I said that sometimes, you know, it's not that we're bad students, sometimes you're not a good teacher. And and you know, that, that should be it, and I get the rest of it, man, like, I get the office hours, and you got to get people in, you got to get them out. And there's this minimum amount of time. Like, I can't imagine that that seems like a heart to me. But I don't think this is, um, I don't think this is how we're going to end up helping people with diabetes, I, you know, 15 minutes at a time every three months, I think the conversations where it happens. And and, and I think they can get it. I think everybody can get it at some point. I just I'm very excited by the idea that you heard about the podcast, and that you've apparently listened to it. That's really cool. I appreciate that. It's made it out like that to people. It's a very, it's very encouraging. When someone sends a note and says, Hey, I went in with my agency, I showed my doctor my graph, he looked at the graph and said, quietly, they always whisper for some reason you listen to the Juicebox Podcast, it looks like you do buy your graph. Like that's weird, man. You know, they mean like I, it throws me It gives me chills, you know. But anyway, I just think that people like you being out there, I find it very encouraging. I really think this concept of talking to people, like they can understand should just be commonplace.

Dan DeSalvo, M.D 23:18
Anyway, I agree. Yeah, no, I agree with that. I mean, I one of my favorite parts about my job is I get to interact with such an amazingly diverse group of people from so many different backgrounds, cultural backgrounds, races, ethnic backgrounds, education, socio economic status. And I think you're right, and I think everybody can get it, I think it might take a different approach, and really meeting people where they are. But if we take the time, the effort, the energy to do that, then then we can get there. I mean, everyone, you know, all these parents, they love their kids, they want their kids to be healthy and safe and to thrive. And if we take the time as a team to teach them how to do that, it's helpful, I think, something that you hit the nail on the head with is, is that it can all happen in the walls of a hospital. So finding community, and whether that's online or with with a podcast, or, you know, we have a lot of different community groups at our hospital to get families together, I think there can be shared learning there that can really help with others so that, again, we can transport this knowledge and we're not just keeping it with one family, but we can really share it, among others. I think it's also helpful for the for the providers, so the diabetes care team, and it can be there as well. Because again, we learned so many tips and tricks around diabetes management around how to use which adhesive to keep the CGM on or, or the pods or you know, how they you know, whether it's Pre-Bolus seeing or managing diabetes and exercise. And we all have a lot of learning there. And again, that knowledge can be transported to the masses

Scott Benner 24:51
being agile like that is so it's incredibly important. It's just like you said if forever allowed to travel again, I'm supposed to head out west to talk to a group of doctors About how I talk to people about diabetes. And that's, that's a cool thing, because they're those are a group of people who are going to leave their ego behind, get in a room, and, you know, stupid maze gonna walk in and say, Look, here's what I've learned about how people hear this. And that's, that's very, very exciting to me. Because, you know, listen, I have friends who are doctors, and one of them told me once he put an age on it, and he said, I'll never go to a doctor over that age. He's like, because they just stop learning. And, you know, now all the sudden you're being, you know, you're being treated 25 years ago, and that's, you know, not valuable for people. And I'm like, Wow, so everything we you know, but are plenty of doctors who are older that keep up to and that's just,

Dan DeSalvo, M.D 25:48
I don't know, man. Absolutely. Yes. In fact that a lot of my mentors so people like Bruce Buckingham at Stanford, who I trained under, people like Laurie lafell, at Joslin build terrible in at Yale, who have been doing this for a long time are not only incredible mentors, but they are, you know, at the cutting edge of diabetes. And there's so many who, you know, might be might have started this journey a little bit before me, but are way advanced in their knowledge and constantly have that agility to change and are really at the cutting edge of this. And so yes, I mean, that I wanted to specifically call out a few of those who've had such an impact for me and my training and mentoring me my career. But there are so many people like that who are out there,

Scott Benner 26:34
it can't get lost if we're talking about the problem where you know, but it can't be lost in the conversation. There are plenty of people who stay behind didn't mean they learn this thing, and then they don't run forward and keep it for themselves. They stay behind to share it with somebody else. And that's how the idea. Yeah, you know,

Dan DeSalvo, M.D 26:51
yeah, and I think that that gets back to being one's advocate, as a patient as a parent, where if you have an interaction with the diabetes provider, where you don't feel like you're learning where you don't like they're supporting the, what you're doing and managing diabetes, when you know, it's working. There are others out there too. And I don't think it's always an age thing. I think it's partly just an openness, and being really adept at taking cutting edge approach to diabetes care, a dynamic approach with Pre-Bolus. Seeing and, you know, dosing based on trend arrows and leveraging technologies like CGM and closed loop systems, you know, that that's what you want to learn from, that's you want to be in your corner, so to speak. And so if you don't feel like you're getting that, then you know, there are others out there, hopefully, depending on where you live, who can can who can be of more support to you.

Scott Benner 27:47
I just want to be a cheerleader for organizations who are out in front and thinking in a modern way. And for the rest of them who through fear or whatever. The reason is that they keep good information from people, you know, Shame on them. You know, I just I don't have any time for it. Okay, yeah, we had you on for a reason. It wasn't this, although I'm really enjoying this. I wanted to talk to you a little bit. If you have type one diabetes, you need a blood glucose meter. Even if you're using the Dexcom, g six, or another CGM, you still need a reliable and accurate meter. It's easy to transport and use. And that meter for me, is the Contour Next One blood glucose meter. Now there are links right here today in your show notes, right in the podcast player, where you can go to Juicebox podcast.com, to find them. But what I'd like you to do is to go to Contour Next one.com and check out the meter. I mean, I know it's a blood glucose mate, and you're thinking what could it possibly do? Scott, you put a test trip in it, you poke your finger. I mean, they all do that. Yeah, they all do it, but some of them do it better. So right out of the gate, the Contour Next One, accuracy is insane. Top of the level, right at the top, right there, right at the pinnacle of the mountain. If you picture a mountain and up the side of the mountain, there's different blood glucose meters, in order of how great they are. Contour. Next One, right at the peak. I think you understand it's good because of my amazing description. Now, test trips offer a second chance, which means if you hit the blood and don't get it right, you can go back in, try again without ruining a test trip. It's got a great light that works at night. It's small and easy to hold on to without being so small or slippery. You don't mean that you can't handle it. I just love it. Absolutely 100% the best meter I've ever used. Contour Next one.com Check out the link at the top of the page. You might be eligible for a free meter. When you're done there, please check out touched by type one org wonderful people doing amazing work for people living with Type One Diabetes, they need to now more than ever touched by type one.org. And of course, if you'd like to check out the Dexcom g six dexcom.com forward slash juice box, and to get a free no obligation demo of the Omni pod tubeless insulin pump, go to my omnipod.com forward slash juicebox. All these links are in the show notes of your podcast player. We're at Juicebox podcast.com.

You know, I was talking to Dexcom. And they were discussing with me a little bit about how the sensors are being used during the current coronavirus crisis. And I found that idea in chanting and I wanted to know a little more about it, and they said you were the one I should talk to. So can you tell me how cgms are helping during this time?

Dan DeSalvo, M.D 30:56
Absolutely. So you know, I think the main reason why CGM why the FDA is allowing CGM to be used during this unprecedented time with the public health crisis of COVID-19 is that it came out of the need to really preserve personal protective equipment or PP, and also to reduce the frequency of staff exposure with COVID-19 positive patients. So you can imagine without CGM, if someone with diabetes who also is connecting positives, you have to have pretty frequent blood glucose checks. And every time there's a bug, because check, the staff is having to dawn TP to wear peepee to walk into the room to check a glucose, that's another that staff exposure to the person with with COVID-19. And, and furthermore, you know, of course, with with blood glucose, it's just snapshots in time of what the blood sugar is doing as well. As opposed to CGM, which really is the full, comprehensive picture also with the trends and the alerts. And so in step CGM, with this ability to have this cloud based technology, where if the person with diabetes, who asked COVID-19 is using CGM, with the Dexcom g six system, the transmitter can transmit up to 20 feet. But also, if it's on a cell phone, which Dexcom is supplying Android phones, for the user to have the patient who's hospitalized via x com share a follow feature. Those CGM data can be tracked remotely by the healthcare team so that the nurse who's no longer at the bedside, can receive an alert for low or high glucose on her phone or her hospital issued device to that that the doctors, the medical assistants, whomever are part of that care team can receive those timely alerts. And also, depending on hospital protocols, you could use CGM, in some cases to supplement or even in place of a normally scheduled blood sugar depending on where that that level is. So again, you're reducing the need for PPV, reducing the staff exposure to patients. But you also have this this real time CGM, which can aid in glucose management medical decision making. So that's where it came was really out of the need to limit PE and staff exposure with patients. But I think that there will be a lot of lessons learned on how CGM as a tool can really help with keeping one safe and healthy during hospitalization. For someone with diabetes,

Scott Benner 33:34
that's a second thing. I thought when you were saying this, the first thing is I wondered what the process was like. And, you know, I guess the the FDA had to say yes to this in a quick fashion. I guess that that is interesting. But I'll I'll bug Kevin about that when I get him on. But the idea that all of a sudden, nurses and doctors are going to get to see this technology that they maybe don't know about. And I know it's easy to think of course they do. They're doctors, they live in hospitals, you know, this is this is their life. But Arden had a cyst removed, you know, just a little cyst. This is a short surgery she had to have a number of months ago, and you know, had all the conversations in the world with the surgeon. This is what Arden wears. we'd like it to stay on her while she's in there doctor was like, Oh, yeah, sure, sure. I got yesterday. That's no problem. I get to the hospital on the day of the nurse comes in the room to prepper the prep nurses like oh, yeah, that's no problem. If the doctor said it was okay, it's fine. Well, then the nurse, the next nurse comes in the one who's going to be in the procedure. And I start you know, now at this point, I've set it to the doctor, I've set it to the prep nurse, everyone's Yes, me to death for a month about this. So I'm now I'm just talking to the third nurse and I say, Hey, you know, this is great that you guys are doing the shoes. Oh, that's not hospital protocol. We can't do that. Just like that. I was like, Wait, what? No, no, I've been talking to the doctor and I started explaining it to her, showing it to her and she's like, Yeah, it's great, but we can't use that. a nother nurse walks in the room. And I just I wish you could have seen me down I pivoted right from the one nurse to the other Other ones, like the first one wasn't there anymore. I was like, Hi. And I started explaining again thinking like, let me take another stab at making this clear to somebody. Well, that nurse says, Oh, my friend has type one diabetes. That's cool. Let me see. Oh, she has this too. Oh, yeah, yeah, we'll use this. I'll keep her phone with me. Just like that. The tiniest bit of understanding, when I made that conversation go from, oh, no, there's a hospital policy. We can't do that to no problem. Give me your daughter's phone, I'll take him to the operating room with me. And that's the understanding that this kind of technology needs throughout the medical community, because a podcast shouldn't be one of the main ways that people find out about Dexcom. Like, why that hell does that have to be the case? Do you know what I mean? Like, and by the way, don't don't get me wrong, Dan, I need my ads. Okay. But, but I, but what I'm saying here is, what I'm saying is, is that this should be something people just think of not something that they're scared of, or say I don't know about this. So this is a great, it's a great opportunity for them to see it live fire, and really help spread the word to other people with type one. Because until it's thought of like that, you're still going to run into situations where insurance companies say stupid things like you're a one sees too low for CGM, as if those two things in any way have anything to do with each other. You're going to get me upset, Dan, I want people to have Dexcom. So so that that is that is very cool. So what you're saying to me is now we're keeping we're saving equipment or saving exposure, and probably giving people I would think greater care than they were going to receive. The other way. I've seen friends in the hospital with type one it it doesn't normally go very smoothly. Well, have you ever been in the hospital and been hospitalized with your diabetes and have the experience of having to manage like that?

Dan DeSalvo, M.D 36:48
No, but you know, there was Adam brown from diatribe wrote a really, really interesting piece on this his experience in the hospital, somewhat diabetes, I've seen and you know, you're right, it's it can it can be there can be some challenges there. You know, that's one of the things that Dexcom is doing here is since Dexcom has or CGM has not been approved by the FDA for in hospital use previously only for in home use. There may be less knowledge or experience with it. So they're really doing a nice job of of providing training to those healthcare teams who will be deploying it. The other thing that hospitals are doing is looking to who are the experts, for example, diabetes educators, or maybe the the diabetologists, or their teams to help train the trainer so to speak, to help to teach and empower the the hospital staff to use these systems and also how to sort of set up and operationalize what that remote monitoring would be like. And then also, it requires a little bit of a new protocol. Right. So since in many cases, this will be the first time that CGM is being used by those care teams. What do you use for your low and high alerts? And what do you use for low and high alerts in a hospital setting may look a little bit different than it would be at home. For example, a hospital might decide that they would use a low alert of maybe 90 or 100, so that they can intervene in a little bit more timely manner, or a high alert of something more like 200 or 250. There have been some studies that have looked at sort of health outcomes as it relates to blood sugars. And actually in a hospital or especially an ICU setting, having a blood sugar that's more in the 100 to 100 to 100 range is associated with improved clinical outcomes, as opposed to running really tight like you might, when you're otherwise health and safety, health and safety in your own home. And so developing the systems and protocols is something that a soldier having to do. We've been talking for a while just as a industry about how we really need disruption in health care, right, so that we can do things a little bit more and a little bit more efficient. And I think technology forward way. And while COVID-19 has been such just a terrible tragedy for our country, the countless laws lives, lives loss, the impact it's had on our economy, how it's impacted almost every one of us personally in some way or someone we love has been so horrible. You know, one of the one of the silver linings, I think that may emerge is that we will see things like the plane these technologies and a a smarter, safer, more efficient way and move to telehealth where we can you know, instead of having families being disrupted from their their normal, you know, job or education having to do with traffic be able to do things by telephone, and diabetes, where we have cloud based CGM technology, where families can in some cases, download their pumps from home or at least provide a log of what their doses have been, actually lends itself nicely. So my hope is is that many of these lessons learned from this really horrible crisis can be used going forward too. deliver healthcare deliver medicine in a much smarter and better way for patients.

Scott Benner 40:06
It is normally in emergency times that medicine leaps forward, it's, you know, it's hard to think about, but wartime brings all kinds of revolution to medicine, because you put doctors in a situation that isn't perfect. You give them, you know, you give them less tools than they might normally have in a hospital. And all of a sudden, they've got to be MacGyver, and they figure something out. And some of that stuff ends up, you know, becoming commonplace in in practice. And I'm just, I'm excited about this, I'm, I'm imagining a nurse, getting an alarm on a CGM at 100, like you're saying, and intervening, and then watching the blood sugar bounce back up, and having that thought, like, wow, maybe I didn't need as much glucose drip as I thought I did here. And maybe next time, that'll stop them from driving some poor patients blood sugar to 250. Because, you know, because of fear, maybe you'll it'll teach the the fine tuning ideas around diabetes to them, you know, and, and then who knows where that goes from there? Like, where do they take that information? And where does it spread to next? This is the stuff to me, that's macro very, very exciting for people with diabetes. If you have no idea what's going to happen to that, that nurse in that, you know, made up situation, goes home becomes a, you know, the parent of a kid, but Type One Diabetes five years from now. And then that kid becomes a doctor like you 20 years from now, and blah, blah, blah, and where do we end up because of this? You know, I, I just I can tell you that where I am now, in my understanding of Type One Diabetes was held back by the direction I was getting from my daughter's doctor, I was seeing things. And I was having thoughts and desires about changing practice. But everything I heard on the doctor's office side, was telling me I was wrong. And I had to break out of that feeling that Oh, no, I am doing it. Right. This is just what diabetes is. I don't know man, like I'm very excited for people to not live the way some people do now in the way my daughter did for a number of years when she was first diagnosed, I just don't think there's a need for it. And I think that anything that moves us towards that is exciting. And this is particularly interesting and how it came about. Do you happen to have any numbers on how many people are actually wearing it? Who were infected with? COVID-19? Do you know?

Dan DeSalvo, M.D 42:30
I do not know how many it is. And I can tell you I've been hearing from a lot.

Dan just disappeared.

Hello, this is Dan. I'm back. Yeah, what happened? I'm wondering as zoom kicked us out, I don't know.

Scott Benner 42:44
I sang while I was waiting for you to come back, which I'll take out. Because I can't say

Dan DeSalvo, M.D 42:48
you were slacking picked up with your last question, which was in regards to how many people are using it right now? And I don't know the answer to that I can tell you from speaking with my colleagues, from all across the country, we're all eager to use this in our hospitals just because of the reasons we mentioned, in terms of being able to preserve PP to reduce staff exposure, but also to have that helpful tool for aiding diabetes management. You know, to your earlier point, one of the things that is helpful with CGM, in addition to having the comprehensive glucose stream to having the the alerts, it's having the arrows also, and in many cases, this will be the first time that some of the hospital staff will see that. So you know, I always describe glucose as being like a vector or an arrow has both a current level, but also direction. Yeah, glucose that's 150. And headed down is different from a glucose that's 150 and double arrow up change by more than three milligrams per deciliter per minute. And so to be able to kind of, you know, and in the case of daily management, you know, and leveraging those trend arrows for daily diabetes decisions is so important. And I think that that can play an important role in a hospital setting as well with managing insulin doses, or insulin drips, or IV fluids and dextrose, concentrations, and so on. So it's another one of the things I think will be born from this. This use of real time CGM during the covid 19 pandemic.

Scott Benner 44:17
That's a great point I talked about stopping the arrows I consider not just the, you know, the direction and the speed, I call it the momentum, like you have to stop the momentum of the blood sugar. And you know, you know, talking to people about I don't know about a Pre-Bolus idea. I'm like, you know, you you count your carbs, your blood sugar's 90, you put your insulin in, but you don't Pre-Bolus now all the sudden the food starts impacting your blood sugar before the insulin has a chance to before you know it, your blood sugar is 180. It's 190. It's 200. It has momentum, you only have enough insulin in there to cover the carbs if you're if you're lucky. And you know, the glycemic load of this food actually matches up with your carb ratio that's set up Right. And so now, you're staring and watching this, this number go up and up and up, you don't realize you need the insulin for the carbs you need to be, you need the insulin to stop the momentum, and you need the insulin to bring the number back, you know, you're sitting on one third of the insulin now that you need, you know, one third of the picture. And, you know, most people stare at it and stare at it, they think, Oh, I counted the carbs, right, like they're back at that point. That's not, that's not even a tiny bit of the picture. It's, I couldn't do what I do for my daughter, and what she does for herself, and what the people listening to the podcast end up doing for themselves. Without the data that comes back from the Dexcom. Like, it's just it's no bowl, you know, like I, I, there's a lot of people I could have, as advertisers on the show, there's a reason I chose the ones that are here. I was wondering about your management, do you have like, like, what are your goals day to day for yourself?

Dan DeSalvo, M.D 45:55
Yeah, you know, I think for for me, it's, you know, I live a pretty busy active life, professionally, but also as a father of two young kids. And so, certainly, for me, being able to watch my glucose and trend arrows closely is important. And, you know, I aim for pretty tight control. And so I have pretty tight thresholds on my low and high, you know, that works for me, it may not work for some of my patients, depending on where they are, and their diabetes journey. And so, you know, I pay, I pay pretty, really close attention to the trend arrows and a lot of what you're talking about in terms of, you know, stopping the glucose in its tracks, looking at the momentum of whether it ties or lows with insulin or carbohydrate, respectively. And really trying to sort of guide the glucose and, and sort of hone in on on that, that maintaining the time and range, and you guys seem strange that the range of, you know, for me, I'm aiming for 70 to 140, typically. And I also, you know, I do a bit of, you know, nutritional approach diabetes, for me as an adult works, you know, it's not, it's not necessarily advocate for my patients, but I tend not to eat breakfast on weekdays. And so I need to sort of ride my basal rate, usually, and within range glucose in the morning. And then for lunch, I usually fairly low ish carb lunch and get most of my carbs at dinner. And so I don't have to worry about blusher quite as much during the day. And then in the evening time is where I tend to have my largest meal. It's also when I exercise and so that can present some challenges with management. And so just like, the patients I care for, I'm always learning in my own diabetes on how to how to best manage it.

Scott Benner 47:39
Have you ever taken information from a patient and applied it to your own life?

Dan DeSalvo, M.D 47:44
Oh, yeah, I mean, absolutely. I mean, they're their little tips and tricks that I pick up from them that I might use my own. You know, I'll give you an example. Sort of a concrete example is with the adhesive that I use for my Dexcom you know, I run cycle and swim, I lead a pretty active life. And I have two kids who like to wrestle with me. So, you know, for a while I was having some challenges and keeping an eye out for 10 days. And, you know, some patch, this was a while ago, but some patches adhesive that's available on Amazon and other places. And it's also hypo hypoallergenic. And so that was something I was able to use to really buttress down the CGM, the sensor transmitter to prevent it from coming off. And, you know, I've really not had any trouble keeping it on for 10 days. And I usually wait until it starts to maybe on the edges start to come up just a little bit, and then apply the adhesive. Okay. And with that, it's really works well. And so that's something also for my patients who, you know, they may be athletes, or, you know, Texas, it gets really hot in the summer, people do a lot of swimming, using these sort of things can be really helpful. So that's just one of many examples I can I, you know, I can share, you know, that I've learned from from patients,

Scott Benner 49:01
I just thought you have a even interesting, you know, opportunity for yourself. Do you think that having Type One Diabetes is a benefit for you in what you do? Or does it give you an advantage? I mean, if I'm looking for an endo what I I want them to have diabetes.

Dan DeSalvo, M.D 49:22
You know, I think I think anyone can do this. And I think I think it really takes having a passion, but also having the kindness and just the the willingness to go the extra mile in terms of having the knowledge and skill set and diabetes management. I don't think you have to have diabetes to do that. I do think that living with diabetes does give you a way to really connect in a really powerful and impactful way with patients and families. And so I i do some time and I do oftentimes share that I have diabetes and and i don't really talk about how I manage my own diabetes as much But I do try to convey a message that, again, you can live well and die with your diabetes, you can become absolutely anything. You can become a professional athlete, a movie star, you can become a US Supreme Court Justice, a lawyer, a doctor, really whatever it is that you're passionate about, you know, I used to say there's only two things you can't do. One is become a commercial airline pilot. And the other is join the military. Well, the FAA has now a law now allows with a doctor's letter, the potential for someone to become a commercial airline pilot with diabetes. That was a huge win.

Yeah. And yet with Yeah, go ahead.

Scott Benner 50:39
I'm sorry to mean to cut you off. I had Owen Lieberman on the other week, and he was talking about this. And now I'm starting to see people holding their letters from the FAA. All of a sudden, in the last couple of days on social media. So it's happening, people are getting their their pilot's license back, and sometimes for the first time who have type one,

Unknown Speaker 50:57
it's super amazing.

Scott Benner 51:00
And, I mean, honestly, that's in no small part to Dexcom as well. I mean, that that's a that's a an ability for someone who doesn't understand diabetes, to be given a visual way to understand it, and then be able to make that leap like, Oh, you know, we just, you know, the government just thought people randomly get low. And that's what we were talking about earlier, doctors 20 years ago, we're telling you keep everyone see higher, you know, keep your blood sugar higher. You don't want to randomly get low. And now there's, there's real concrete ways to stop that. Listen, last night. Last night at 1130 Arden's blood sugar started to trend down. And I couldn't figure out why. So we're talking and I was like, hey, it's holding, but it's like it's at 70. And I'm like, if you look at the line, I don't think it's going to, I don't think it's going to hold up for us. So we started taking bazel away to see if we could get it to rise and it wouldn't rise. So we're talking, I'm trying to find out what's going on, she see she pulls out her period tracker, and there are days prior to her period where her blood sugar, just that she just doesn't require that much insulin. And so this is where we're at, right? So from 1130, last night, no light or three in the morning, I kept Arden's blood sugar up using the dexcom. And without it, I can't tell you how low I think she would have gotten because I was able to, with confidence, take away the basal insulin in a way that held her up in the 60s, which is, by the way, the best we could do for a couple of hours, even with food intervention and everything else. I'm just trying to imagine if we were blind there, I would just see a low number I would treat her and then that, you know, I think oh, it's gonna come back up again. But for for four hours last night Arden's blood sugar just didn't want to come up. And I had the comfort of knowing that that was true and being able to manage her through it. And, you know, eventually, obviously, it started to move again. And then we were able to re add the insulin and bolus with confidence. After four and a half hours of not eating any insulin, I was able to look at a trend and say, whatever that was, is over now. And you need your insulin again. And so because we were able to bolster confidence, she didn't get high, you know, all the sudden when her body had different needs. And she had a, you know, a reasonable period of time where she didn't have very much basal insulin. It's just It's magical man. Like, it just is, you know, so?

Dan DeSalvo, M.D 53:25
I don't know I love Yeah, I think it's essential. I mean, yeah, for people who have busy professional lives, no matter what it is having that real time data on your phone or on your wrist. And I only know where you are, but where you're headed, so that you can actually, you know, as Wayne Gretzky said, it's not enough to know where the puck is, you got to know where it's headed. And really think 123 steps ahead. I think that that is absolutely essential for being able to do all the things we do to have that that information that helpful data, you know,

Scott Benner 53:55
the genesis of that story was Wayne Gretzky.

Dan DeSalvo, M.D 53:59
His father was something he was his dad, right? I don't remember the exact details.

Scott Benner 54:03
His dad was teach him to play. And he always seemed like he was behind the game. And he told his son, you got to skate where you got to skate where the puck is going, not where it is.

Dan DeSalvo, M.D 54:12
And it's just an analogy.

Yep. So So, you know, perfect for diabetes management, right?

Scott Benner 54:21
I tell people all the time, the insulin you're using right now is for later, it's never it's never for now, nothing you're doing with your diabetes. In this moment is for right now. It's always for later and more importantly, and it's a weird distinction that might seem like it's not a distinction, but it is if you really think about it, it's not so much the insulin you're using now is for later it's the insulin you used in the past is for now, and I know that seems like the same thing. But if you really kind of like really go into a Wavy Gravy plays and think about it for a minute then it's um, it's different. It's, it's more about it's about controlling the energy of the inside the power of insulin that's coming at you. It's about it's about being in It's, I know, I don't know, maybe you'll have to wrap your head around it. And other people will too when they're listening, but it's not so much about now for later, it's about before for now. And if you can wrap your head around them, this is kind of easy, you know? Anyway, Oh, dude, I'm really thrilled you did this, I didn't expect to have such a great conversation with you. I thought we were going to just be like, Hey, COVID-19 Dexcom That's cool. And then you'd be gone. But uh, but this turned into an excellent episode. And I'm really excited that we did this. I might have to ask you to come back on again sometime, and maybe talk more about your personal story, if that's something you might be interested in?

Dan DeSalvo, M.D 55:37
Absolutely, I'd be more than happy to. And Scott, thanks again for the work that you're doing to advance the cause that people living on thriving with diabetes for the community built and for getting this message out there. You know, again, it's it's so I think important for using real time CGM in this area of COVID-19. And I think that there will be many lessons learned from this, both in the hospital setting as well as with telehealth that will be propelled forward as we one day reenter normal life. It's hard to imagine that right now but we'll all be there and so my thoughts and prayers for everybody out there and hope you and your family stay safe well, and I'm adding sane to that list because it can be mind numbing sometimes to be stuck at home, but you know, my my best wishes for for all your listeners as well.

Scott Benner 56:23
I really appreciate that. Then, you know, we last weekend ended up I staked my entire family and we played poker. I played poker to get my own money, just to just to try to pass the time. I said to my kids, I'm like, Here's 25 for you. 25 I gave my wife $25 I took $25 like Alright, this pots worth 100 bucks. We played for seven and a half hours.

Unknown Speaker 56:45
No one wanted to give the money away.

Dan DeSalvo, M.D 56:48
Yes, we need distractions these days. Absolutely. I saw

Scott Benner 56:52
a woman online say that she spent four hours yesterday watching a truck get towed out of some mud. She said it's the most exciting thing that's happened to her. So Alright, man, wash your hands stay safe as well. I really appreciate this. Huge thanks to Dr. Sabo for coming on the podcast and sharing his story and telling us more about how the Dexcom g six is being used in hospitals to aid with the Coronavirus fight. Huge thanks also to the Contour Next One blood glucose meter for sponsoring this episode. Don't forget also, sponsors like touched by type one.org Dexcom and Omni pod. They make the podcast possible. So check them out, use the links support the show. I'm still here. I'm so bored. I don't know what to do. I mean, once I finish this, I'm just gonna go downstairs and like clean something or make something or put something away. All my options. Here's my here's my day. I sleep and then I wake up and take a shower and work on the podcast. cook something clean something. cook something clean something. Take out the recycling. cook something clean something. Watch Ozark and go to bed. That's it. It's the whole thing. It's my life. It's your life. It's our lives, but not for much longer. Hang in there people. Stay strong. Wash your hands. Cover your cough. You know what I'm saying? Don't be disgusting. Say


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