#165 Gouda Monkey

Can't you hear the thunder, George is from a land down under....

In this episode we talk about type 1 diabetes, MDI, Freestyle Libre and a lot more. You better run, you better take cover! fyi: The episode title has almost nothing to do with anything.

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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
Ladies and gentlemen, boys and girls, children of all ages. This is Episode 165, the Juicebox Podcast. And as always, it's brought to you today by Dexcom. And on the pod, you have a lot of options to find out more about those two great companies. You can listen to the ads later in the show, which I suggest you do, because I make them fun. You can also go to Juicebox podcast.com. To find links. You can find links in the show notes in your podcast app. Or you can type olden times dexcom.com forward slash juice box Endor and why not end? My omnipod.com forward slash juice box? I'm gonna think of a title for this episode right now live while we're talking. Part of me wants to call it Gouda monkey you'll find out later why part of me wants to call it something simple like George down on earth because George's from Australia. Part of me says though Scott be a little more creative in that a little more creative. And I say to you, I don't know if I can. What else could this one be called? Milk, the silent killer. Again, you'll find out why later. I can't just tell y'all right now if I tell you all right now it's gonna be the whole episode. And then it'll be like listen to the episode where you can just go listen to the episode. Please remember that nothing you hear on the Juicebox Podcast should ever be considered advice, medical or otherwise. I am not a doctor. Always consult a physician before becoming bold with insulin. What about Australian Gouda monkey? Gouda monkey Gouda monkey. Do you love those two words together? They they fascinate me. Let me just warn you now that George's multicultural accent is going to just lull you into a happy spot. Hello, George. How are you? I'm good. How are you? Good here it's like Ilan musk Crocodile Dundee. And James Bond had a baby away. Do you think that should be the title of the episode? What if James Bond Ilan musk and Crocodile Dundee had a baby? That's pretty obtuse and odd. It's not as strange as Google monkey though. Huh?

George 2:19
What did we do like 10 years ago, we like actually phone each other or something, I suppose. And you'd sit there with like a microphone and hold it against the phone. And then I try not to move.

Scott Benner 2:27
I can't even imagine my I listen, I can't even get my son to call people he's known as whole life. You know, like, I said, you guys are texting back and forth. It seems like you're just misunderstanding each other. I said, I think if you spoke for 30 seconds, this would be fixed. But we don't do that as well. I don't know what that even means. Just call him now that you want that they would they wouldn't even consider it. This. This past summer was actually great. Because during his baseball recruiting process, he actually had to call coaches on the phone and speak to them. So that was actually part of his upbringing. I don't even know that. I don't know what he would do. I don't even know didn't know how to speak on the phone if it wasn't for this one thing. So

George 3:07
yeah, I have exactly that nowadays. Like I'm so used to texting, so used to sending emails that I can make. I could actually just phone this company. I could call them and make an appointment and see this person. It just never occurred to me. Yeah,

Scott Benner 3:19
no, it is. It's interesting. I'm very much still a phone call person I like to even when if people contact me kind of outside of the podcast, and they have like this, like specific question about like diabetes, I'll always say just, you know, you should just call me. Because what are we going to do? We're going to go back and forth through email 50 times, you're going to ask a question, I'm going to misunderstand it, I'm going to go through this long explanation that you're going to misunderstand. So we could talk for 10 minutes, you'd understand.

George 3:45
So now you miss all the context and you miss the inflections and people's voices. And I guess we've lost something by going on to text and it's hard to see what you've lost until you realize you've lost that. I guess now

Scott Benner 3:56
that that I think is 100% true. Okay, so what time is it where you are right now? I tend to one in the morning. Okay, so everyone, first of all, we've had people sit in their cars on their lunch breaks in the sweltering heat to be on the podcast. But I don't know if anyone's ever sat up till one o'clock in the morning to do the podcast. So George, thank you very much. I appreciate it. And I appreciate you listening from obviously we can tell from your accent you're from Minnesota, is that correct?

George 4:22
I live in Australia, where I'm actually gonna have to try my really my hardest not to swear just by default we swear about everything. So yeah, not to swear not to throw too many of these lying around, I guess.

Scott Benner 4:34
Well, the the slang is fine, because we can always go backwards and explain it but the swearing if it gives you any hope. And I don't know how much the people who listen to this podcast would or would not believe this, but I curse throughout my day. As if just I don't know I use cursing as joining words, adjectives verbs, it doesn't matter really. There's a lot of cursing, but I somehow I can get on here and I can stop myself. So um I don't know how that happens. Exactly, but I'm hopeful. I'm hopeful that

George 5:05
sounds like you'd fit in here just fine. Oh, I

Scott Benner 5:07
think I'd be okay. Except for. Are there snakes there?

Unknown Speaker 5:13
Yeah,

Scott Benner 5:13
I'm not coming.

George 5:14
Yeah, we have we have lots of dangerous and deadly things. It's quite good.

Scott Benner 5:18
What is that? Like? Listen, we have to take a couple of seconds here. Like, what's it? So around here lately? I am in New Jersey right now the most dangerous thing that is outside? Is? I don't know, I don't think there's any real danger where I live. I mean, I guess a deer could come through my yard lose its mind and crap in my grass. Like, I mean, I guess it's the best that I could imagine that could happen to me. But do you have that feeling like you go outside and think I have to like, are you brought up that way? Like, I can't I have to make sure there's not a spider on me or something like that? Or is it just does it not get funded? Like,

George 5:55
um, probably the most dangerous thing. I live in the inner city. So probably the most dangerous thing that I see is like cars. They're pretty dangerous. They are flying middleboxes not good for your health when they hit you. But, you know, like, I used to live outside the city. And yeah, there's all sorts of stuff that kills you, and you just get used to avoiding it.

Scott Benner 6:16
And it's interesting. Do you actually know a person who's been, like, felled by a animal?

Unknown Speaker 6:24
Ah, no.

Scott Benner 6:27
So that's interesting.

George 6:28
I mean, you you see all the videos on the internet and stuff, right? Like, like when you see the spiders eating birds. I mean, that's, that's unsettling. Right? I don't like that either. I don't live in those places.

Scott Benner 6:41
Okay, so we have some context. You're in a city. You're not. You're not on some large flat piece of sand somewhere.

George 6:50
Yeah, I used to live. I mean, I used to live on a farm. We had this crazy idea that they were going to farm and be great. Until we realized that like, nobody would even deliver takeout to a farm. So that was like, we decided already crap idea and gave up after about a year and a half.

Scott Benner 7:04
You seem like a fairly free spirit from when we go back and forth. So So tell me, let's let's figure out who you are. Exactly. How old are you?

George 7:11
So I'm, what, 3637 years old? I have to do the math sometimes. Because after a while you stopped counting? Of course. Yeah. 36.

Scott Benner 7:20
Yeah. What, what year or how old? were you when you were diagnosed with type one?

George 7:24
So I am actually coming up with my diversity in three days. Oh, wow. So I've had it for about a year.

Scott Benner 7:31
And so 35 years old, suddenly you have type one diabetes?

George 7:36
I know. Right? Um, and yeah, I mean, like, I had all the usual symptoms and just kind of, you know, googling things and going like, No, no, Surely it's not that, like, what are the chances that this is this is no, this is impossible. And then I went and saw my doctor. And, you know, I described to my doctor and said, a few of these symptoms, he's like, looks at me, he goes, Well, you pretty healthy, it's impossible. And then, you know, doing some just regular blood tests, I get my bloods done once a year anyway, because I live on a plant based diet. So I kind of want to check that I have a line minerals and, you know, everything's just running smoothly. So, you know, once a year, I go off and get everything checked. And Saturday morning, the next morning, the doctor calls me says you should come in now, and that's never a good call. You know, like, if everything's okay, they'll wait till Monday, but they did not wait till Monday. Are you a vegan or vegetarian? Or how do you? So I like to I like to say I live on a plant based diet. I'm not 100% vegan. I do run into the occasional animal products and I don't lose my you know, lose my marbles when that happens. Okay, so I don't like the connotations of the word as well. I find sometimes when you say you're vegan, it just comes with a whole boat of other stuff. Okay. But it is a lifestyle. I tried to leave like I don't use animal products. I'm not not big on the cruelty. I think that industry's got got a lot to answer for. And I found myself a lot healthier since I switched off all animal products and just doing a live on pole, the whole food

Unknown Speaker 9:03
cow. How long ago did you make that change?

George 9:06
Ah, four or five years. I mean, I've been vegetarian probably for the last 15 years on and off. But then about four years ago, my wife was she was on a mission to prove a point is that you you eat too much cheese. And I was like, okay, maybe you have a point here. And then we started doing some investigations. And after a while, we kind of went Yeah, we do eat too much cheese. And actually, it's not very good for you. So we should probably stop this. And in the process. She actually also ended up on a plant based diet as well.

Scott Benner 9:32
So are you here to say that a plant based diet Causes Type One Diabetes? Is that what this is about this,

George 9:37
this very well might be right.

Scott Benner 9:41
I tell people, like you're being healthy, it's gonna kill you.

George 9:47
being alive is the leading cause of death losing leading cause of death, right?

Scott Benner 9:50
There's a road in Philadelphia that's named after this person. I can't remember at this point, but it's from my childhood and he was this just avid runner and he died running on this road. Have a heart attack. And so the name that wrote after my I always thought it was a, it was a way to warn people against running. I didn't know, I wasn't sure what they were trying to accomplish by naming the road after that this road kills runners is what I always thought. Now, obviously, so I'm joking. Nothing causes type one diabetes, you have a autoimmune disease. So okay, so this is interesting to tell that the more people right, people knew that I don't think anyone's eccentric, I always feel like this, I run into people all the time who don't understand. I always try to go home and think about all the things I don't understand, you know what I mean? Like, so there's a million things that I don't get. And if someone came up to me and had this horrible personal experience wrapped around, you know, I don't know, it makes something out of anything, and you approached me with it, I wouldn't know the your level of how it's impacted you, I wouldn't know how to properly talk to you about it so that you wouldn't feel offended or, or, or just, you know, horrible. I always try to feel that way. And diabetes is just, I don't know, it's one of those things. I wish people didn't joke about it. I would like to not turn on the television and hear somebody make an offhanded joke about diabetes. And at the same time, when I do I don't really think much of it. I wish they wouldn't I know it probably causes a larger misunderstanding. But this is a misunderstanding that is so large at this point that I don't know how you would. I don't, I don't know how you would fix that like, like, you know, this, you know, this giant Slurpee from 711 is going to give me diabetes is is just, it's it's just it's there's throwaway lines to people trying to make stupid jokes. You know, I don't know how I don't even know how you take a person like that, hold them down long enough, educate them about it, and then make them promise not to do it again. I don't know, I don't see a way around it, honestly.

George 11:48
I mean, it's really, really sad actually. Because, I mean, from one aspect, I don't blame people who don't understand and don't know, or I get a bit upset or tired is when I see it coming out of you know, people who should actually know better folks who studied some basic medicine, or, you know, have involvement or have actually some sort of risk factor or something like that, where they've been told by their doctor, hey, you know, you have pre diabetes, and it just doesn't do anything for them. And I think they just kind of shrug it off a whole bunch. And, yeah, that's where it gets really disappointing to me. I mean, I know we're looking more tattoos there. But I guess, there aren't

Scott Benner 12:29
near but I think that's the real danger, too, is that when, and I've I've met people before I've typed too, and they don't even really, no one's really even explained it to them. Like it was just like, it was like someone told them, hey, you have a vitamin D deficiency take this vitamin once a day. And you know, it'll be okay. And they, I've met a lot of people with type two who treat it that way. By the way, I've met people with type one who treat their type one like that, like I just inject, you know, I bring my highs down. And that's it, like people do that. And it's sad, but I don't know if you're I don't I've never really been political on the podcast at all. But it really bothered me last week, and I don't know if it's ever going to be found that I don't think anyone's ever going to call him on it. I was hoping that, that a media outlet would but I guess it's not going to happen. But there's, you know, you know, unconfirmed reports that that in the course of talking about Supreme Court nominees, that Trump when he got the Sonia Sotomayor just said, I forget what the quote was that somebody asked how he was planning on replacing her and he said, her health no good diabetes. And that, you know, if he really said that, you know, forget the political aspects of it. I'm not, I don't care about that side of it. I care about the idea that there's somebody at the top who just looks at someone with Type One Diabetes and thinks, Oh, you don't have to worry about her, she'll be dead soon. You know, like, that's that? How does that when conversations about health care come up? Are you really someone who that person's thinking, hey, if we help these people, they can live better? Is he looking at you like, Well, you know, we'll just, we'll do what's humane until you drop dead? You know what I mean? Like, that's, that would be my fear there.

George 14:12
Yeah, I mean, it really, to me, it indicates a lack of compassion and empathy. And, you know, as soon as we lose compassion and empathy for the people around us, no matter who we are, really, we lose, I think, a critical part of what it means to be human and what it means to live in a functioning society. And then from that aspect, I think it's incredibly sad.

Scott Benner 14:33
Yep. And that I think, is what you were talking about. It's just people who are actually in the position to affect something are when they don't understand and they need to or they should. That's the that's horrifying. Even you hear stories all the time people who go to their endocrinologist and the level of direction they get from their endo sometimes is specious. It's it's a, it's kind of fascinating that you're going to a doctor who doesn't completely get what you're asking them about and they are taking the same approach when you stop and think about it, and I talked about here all the time, like, I think that people get, like, Don't die today advice, sometimes they don't get be healthy advice. And if you really kind of extrapolate that out that you don't have to have your blood sugar here, you know, it can be 200 all day, that's fine. When you when you're getting bad advice, what that's really saying to you is you should not have an expectation of a healthy life. So you have diabetes. So now this is going to happen to you, and it is going to give you long term complications, or it's going to shorten your existence, or whatever it is, that acceptance from a medical person is staggering. You know, not to want to try harder, or try something else, you might be trying as hard as you can, but try something else, you know, make an adjustment, then, then I, that's probably pretty much why the podcast is here, because that that just upsets me.

George 15:51
Yeah, I think it's really shocking in that the way we have our medical system set up at this time, is one that optimizes for really short term outcomes, as opposed to just looking at the rest of your life. And, you know, I mean, I hear these shocking stories about people who've been to a doctor here and a doctor there and a doctor here and a doctor there. And over the years, they've just, you know, sort of accreted medication, and then been admitted to hospital. And then at that point, in time, somebody actually had a chance to look at all the hospitals, or look at all the medication they're on and they're taking, you know, 25 pills, and they slowly wind it all back. And the person, you know, gets better. Yeah. And you kind of go well, it's not really rocket science. But, you know, at some point in time, the, there's a disconnect, like, I think, whole bunch of information is lost between transfer between doctors, but then each doctor does the really, really, really safe thing. And, you know, sometimes they're really safe thing is a good thing to do. But a lot of the time, you don't really get anywhere by stepping in staying inside your comfort zone, you've got to step outside your comfort zone, you've got to engage a little bit more, and you've got to accept that you can die, because you can die. But you know, like, I'm gonna die either way. So am I gonna die, like, I have a small, very small risk of dying, like, in the next couple of days, which I do kind of have anyway, right? Because I live in a city and I go drive cars flying past me. But, you know, also you're gonna do I died definitely, like, really early and young, because I just didn't pay any attention to the management of my disease. And I think what happens is, when you have somebody like an endocrinologist who makes those decisions for you, they never give you the choice, they just kind of go, it's safer for me, if they know you don't die today. So I'm just gonna go with that, right. And then you didn't even know that

Scott Benner 17:32
you could live longer kind of thing. If we can stretch your life out just long enough, when you go, I can say up said complications of Type One Diabetes wasn't my fault. And I don't think everyone even has that. I don't even want to say that. That's the intention. It's just, it's funny, as you were talking just now, I thought, when we started speaking at the beginning, I'm gonna have to leave it in now, where we're just talking about texting versus phone calls, really is the same thing in medicine, like it's the texting is that idea of something quick and immediate. And, you know, gratifying like I did this, and I heard right back, and that was it. But you lose all the context. And the same thing with medicine as you go in for these quick visits. No, it's not a real conversation. It's they're asking you the questions. They feel like they're, you know, the practice tells them to ask you, you answer them, it never goes anywhere. You know, it's meaningless. They're just trying to mine out information. But wouldn't it be better if you could actually sit and talk and maybe through the conversation, figure out what you're concerned about? Or what the doctor is trying to find out? But it doesn't work that way. So

George 18:35
yeah, I mean, I kind of get it as well as right. From one aspect to healthcare as a volume business, we have, you know, however, many hundred million of us and we've got to be kept alive. And so if we all go to the doctor all the time, like there just isn't any time for this. And so, you know, the doctors are overworked? And yeah, it's a difficult solution, a difficult problem to fix, I

Scott Benner 18:54
guess. Well, I think it is that i think that i think what you just said, and what I believe is you're not going to fix it. I think it is what it is, then the rest of it falls on you. And I you know, what are we going to like you said, What? Are we going to go home and try to figure out on our own? What are we going to stand up for ourselves for and push a little harder when we don't like the answer that comes back. And that's, that's what I find most when I speak to people is that they just, you know, I said it over and over again. But there are these, the few people in society that you just you're, you're bred, grown up told not to question them, you know, doctors are smarter than you. They went to more school, they're, you know, somehow they're magical. You don't ask them questions, they ask you questions, police officers, teachers, people, you're supposed to just blindly kind of follow. And I just don't buy into that in. You know, I say it here all the time. Like I don't buy into that in all walks of life, except if a cop asked me to put my hands up, I'm absolutely going to do that. But But that's only because he has a gun. So, you know, I never was once a person who listened and said, well, you're older than me. So you must automatically be cracked, or you know, so when you feel something Inside about your diabetes, you have to speak up. You can't You can't just take this like head in the sand approach, or you know, as my have watched my mom lived her whole life like this, my mom is I will cross that bridge when we come to a kind of a person. And I was like, Mom, why don't we have a plan for when the bridge gets here, when that'd be better? You know? And so, the small one doesn't have to be huge. But let's not spend a month standing at the foot of the bridge going, hmm. Wonder what we should do? You know, especially with your health. That's all. George, why are you on the podcast? I forget.

Unknown Speaker 20:36
Yeah.

George 20:38
I think we spoke, you put out a call a couple of weeks ago, a couple of months ago, I don't remember. And you were saying look, you know, you're looking for people who are on MDI, and who are doing pretty well. And so I said, put my hand up, and Well, look, I'm doing okay. Okay, so I thought I would come on and talk about that for a bit, maybe

Scott Benner 20:53
go. Okay. But before we do that, let's talk about Omni pod for a minute. The world's most incredible insulin pump. And it's tubeless. I've received two separate messages just today, one from a person who listened to the podcast, and began the Omni pod and is just starting today, and the other from someone who began months ago, and was reporting back about their endocrinologist appointment. And I'm not going to give you any other details. But how about the sentence, I've been stocking the sevens and lo aids for a couple of years. And because of the Omni pod and the Juicebox Podcast, I'm now below 6.5. Come on. That's an amazing drop. All you need are the right tools, and the right ideas about how to use them. And I'm telling you right now the Omni pod is 100,000% the right tool, you should go right now to my Omni pod.com Ford slash juice box or click on the link in your show notes or Juicebox podcast.com. And try the free no obligation demo pod today free, no obligation free and no obligation. All you do is fill in your information and on the pod sends you out a demo pod. From there, you can do whatever you want with it, you could put it under a short table like to make it's not rocket if you wanted to. But that would be a waste. When what you really should do is try it on and wear it and see what you think. And after you inevitably love it, start getting the on the pot insulin pump for yourself. Come on guys, Spring Summer is going to be here soon. Get rid of the tubing. I'll tell you what, I'll leave a little extra music here. So you can get your computer right now go to Juicebox podcast.com. Click on the link here. I'll even turn it up for you Samsung.

Unknown Speaker 22:39
Gouda monkey, monkey, monkey, monkey.

Scott Benner 22:43
You know, right away, most people are going to hear that you're on a plant based diet and you're on MDI and they're gonna go Of course you are you don't eat any carbs. But how many carbs Do you take in in the course of a day?

George 22:54
I eat somewhere in the region of it depends on the day, right? Like today was about 100 because I wasn't feeling particularly Caribbean, you know, but other days, I can eat anywhere up to 250. Okay. So it most I realized that for most of my calories I find if I eat entirely carbs, I just I'm hungry all the time. Until I find like if I as long as I have fat with every single meal. So things like avocado or lack of mayonnaise, or nuts or anything that sort of just stretches out the time in between meals where I just feel hungry, I feel satiated for a little bit a lot longer. I don't rely very heavily on Protein Protein Shake in the morning when I've done some exercise. That's about the extent of protein I get. But you know, like nobody ever shows up the doctor with a protein deficiency. So I'm not worried about them.

Scott Benner 23:41
Do you have any diabetes technology are using? I mean, yeah, so I use a I use a freestyle Libra.

George 23:47
Okay, that's what I use as my my. You can't really call it a CGM, but it gives you the data that a CGM gives you. And then I use an app on the iPhone, which I put all my data into. And it gives me predictions of my blood glucose into the future, which is pretty cool.

Scott Benner 24:02
Okay, what's that called?

George 24:03
It's called predict pgl.

Scott Benner 24:06
Is that something it's just about? Is it only available in Australia?

George 24:10
No, I think it's actually globally. And so it's on both Android and iOS. And it's written by a guy who lives down in Victoria, one of the states here. And he's a type one, and his daughter is a type one. And he ended up writing the software because they went on to pumps. And like the software on the pumps, but didn't like being attached to devices, we have a limited range of devices you can get in this country. And so they just weren't, you know, weren't keen on being attached. And, you know, with the tubing and getting caught on door handles and all the various stuff that comes along with that. Yeah, so they switched back on to injections. And when they did so, he wanted the features that you get in the pump. So being able to track bazel rates across the day and being able to track your carb ratios and you know, your correction ratios and then being able to tune for a bunch of different stuff. So being able to put in exercise factors and say, Well, I'm going to go and do exercise now. So for 120 minutes, I'm going to need that percent less incident. So you can plug all of the stuff into that, given your current blue blood glucose reading, give it your carbs, and it'll tell you where it thinks your blood glucose is gonna end up

Unknown Speaker 25:10
how I find it.

George 25:11
I was I was skeptical at first, but I kind of live in the app now. And it's very accurate, like, shockingly accurate.

Scott Benner 25:19
So he's probably got something in that app along the lines of what these artificial pancreas algorithms are going to be like.

George 25:28
Yeah, that's, that's what I expect. And you know, I think, I think quite valuable about the app as well is that you can, it sort of gives you a mental model for how a pancreas works. So you can sort of play around with it. And because it's not a real pancreas, you can also do things you can be like, what if I put a unit in now? What would it do? You can sort of see what it would do? You could be like, what if I ate grams of carbs? What will it do, and it kind of gives you an idea. And so you can sort of poke around without actually doing real things come to a decision. And then you know, make a treatment decision based on that then actually roll back and go and do the treatment decision to yourself, and then have a fairly good idea of where you're going to go.

Scott Benner 26:03
I love that. And so do you find that's teaching you in a way that you almost don't need the app as much as you did in the beginning? Like are you liking? Yeah,

George 26:11
absolutely. I think I think the app help boot me up onto a mental model of how my diabetes worked probably, you know, weeks Foster, like I got, I went through a bunch of apps. When I first started, I started with, I started with my sugar, and I was just logging stuff in, I was logging stuff. And I had them for the pro version, then I was like, Well, why am I logging stuff? This is the most pointless exercise in the world, I get some pretty graphs, but like, what am I doing with this? And then I dug around and I found some other apps and they were the same, I just keep logging stuff. And I'm just like, why am I engaging in all this toil? Like, this makes no sense. And then eventually, I found this app. And then I was logging stuff in was, I was getting something back for my login. And I was like, this is really satisfying. I'm seeing where I'm going.

Scott Benner 26:53
I saw I'm really interested that you said that. Because over the years, I've not to impugn one because I don't I don't have that much knowledge of any of them. But I've had people come at me all the time, like, Oh, you know, we want to talk about our app on your podcast, or can you look at this app for your blog? And, and I always just say, well, what's it do it? Because in the end, it always feels like what you just said, like, so I put in a bunch of information. And then I get a graph, is that correct? And then what do I do? Like, then I have to figure out what the graph means. And I don't know it just at some point. It just seems like so much effort. And it's not like you have an answer. It's just more information. And so I was like, I probably could figure this out without your app, you know, like, and but an app that does something, an app that actually says that what you said earlier is being able to tell it Hey, um, if I did this right now, what do you think would happen? That's fantastic.

George 27:48
Like that. I mean, that is even better than that. What I find is when when you put a reading in, and it doesn't match what the app expects, then the app will say to you, Hey, I didn't expect that this is what I did expect. Here's some reasons why it could be different. So for example, if I put in a reading of, say, a blood sugar of nine, I'd have no idea what that is an American, either

Unknown Speaker 28:12
doesn't matter.

George 28:14
I actually actually have a chart here so that I could I could look this up. So if I put in a blood sugar of like, say 182, right? And the thing was expecting, say somewhere in the region of 100, then it would say to me, Hey, you know, I was expecting 100, you put it in this? You've got it could be this too many, there's too many carbs, like did you accidentally get your carb count wrong, like might have got got around by this month. Or alternatively, maybe you didn't put enough insulin in. So maybe you You said you put in this much, but it wasn't that it was this much too little. So you need to change your carb ratio. Or maybe your correction factor was incorrect, maybe, you know, you initiate a correction, and it didn't come down. And this is typically what happens to me when my basal rate is off. And I'll see that I'll put in corrections. And I'll tell the app that I'm putting in corrections. And then I'll go and put in a you know, another reading maybe another two hours later. And it'll be the same as the one previously and the app will just freak out and be like, Hey, you know, this, you should have come down by a cup. Maybe 20 or 30 points, but you didn't. Why is this can pops up and gives me a little thing. And I'll be like, I just think you can you can dismiss them. And you know, it's just giving you suggestions, but I just dismiss them and be like, Okay, well I know my basal rates wrong. So it just gives you this really, I guess, good understanding for why something might be out. It's interesting. That's really that's really cool. What's it called again? It's called predict bgl

Scott Benner 29:31
wants to take a look and see what it means. That just sounds like worthwhile. I know, are you how do you make adjustments to like you were talking about basal insulin? No, but you're, you're using a long acting base. All right.

George 29:44
Yeah. So I spent a lot of time playing with this. Because I think, you know, bazel is the, it's the foundation of everything we do. And if you get that wrong, then you just you can't build on anything, right? Like you just don't know where you're at. Yeah. And so, so So many times when I see people that like, my insulin just, it's just unpredictable. I'm probably like, well, you probably find your basal rates incorrect, right? So when you think you're injecting for this food, you're not only injecting for this food, you're also covering some of that with you're covering, you know, your base was too low and you weren't covering that. And you know, your body doesn't know the difference between insulin right? Your body insulins insulin. And so you know, if you've got your basal rate out, then it just throws everything out.

Scott Benner 30:29
This weekend, I managed Arden's blood sugar from halfway across the country. Hmm. How did I do that? Did I talk to her constantly? Nope, actually never spoke to her once. You may be wondering, well, how did you do that? Scott? Did you write messages on small scraps of paper, fold them up, stick them in a pocket of a monkey made out of Gouda cheese and have them swing across vines to get to her? No, I didn't do that. That would not be efficient. And the cheese would melt that I use the world's most powerful diabetes tool in conjunction with the world's most powerful communication soul. That is correct. I use a dexcom continuous glucose monitor and text messaging. Pretty cool, huh? So my daughter Arden is wearing the dexcom g six continuous glucose monitor that speaks to her cell phone, which speaks to the internet, which speaks to my phone, which tells me what her blood sugar is, and where it's going. From there. I can make treatment decisions with her through text messages, just Hey, why don't you post as much. I'll just set a Temp Basal. She can text me I'm about to eat a cupcake, which she was doing at a swim party while I was away. Try to imagine that is that something you'd be comfortable with because it's something that I'm comfortable with? My 13 year old daughter was at a swim party with Type One Diabetes, where she then one of the cupcake text messages, mere moments of time, hardly interrupted what she was doing. definitely impacted her blood sugar. blood sugar's were great all weekend. There are a ton of amazing things I could say about the dexcom continuous glucose monitor. But this time, they don't want to tell you peace of mind. unparalleled peace of mind. That's what you get. I know you want it dexcom.com forward slash juice box with the links in your show notes. Were at Juicebox podcast.com. Do not hesitate. Your body doesn't know the difference between insulin right your body insulins insulin. And so you know, if you've got your basal rate out, then it just throws everything out. If you have your basal is really in check you can make you can manipulate your blood sugar with bazel. You don't even need to, you know there are times you don't even need to Bolus like when Arden woke up this morning, her blood sugar was 140. And I wanted it to come down. So I just increased her Basal for an hour. And now I don't know where it's at. Whoa, I can look. She is 109. So that worked out Yeah. And that was it. But if if, if her bazel was off to light and I start bolusing then I still don't have the bazel The bazel is still not there yet time still moves forward, your your body is still forcing your blood sugar up. Because you don't have this this background and someone holding it down where it's supposed to. It gets lost so easily. Nobody even thinks about it. You know, it's cool that you are actually so are you? Do you want a pump?

George 33:33
Ah, no, no, I mean, so from two aspects. I want a pump because it has 10 phases. And that's the entire reason I want a pump. The reasons I don't want a pump is I do a ton of hot room yoga. And I just think the insulin will cook inside a really hot room. And then also just I'm not huge on things being attached to me. But I mean, the other thing is, I feel like I've got great control. So I mean, I'm just not going to mess with it.

Scott Benner 33:59
And so how much of that do you feel like? Is your basals? Really? Can you hear bazel? He is snoring like crazy today? bazel please? bazel making a podcast? What are you doing? It's just I don't have that dog snores like crazy. I'm sorry. Do you how much of that you put towards the the idea of the plant based diet? Like if you like, do you think if I I don't know, if you weren't eating that way that you'd feel differently? Like how much of MDI is not much of a problem for me. I've got this predictive data from this, this app,

George 34:31
do you think is fun? I think it's I think it's a combination of factors, right? Like, I think you've got to, you've got to set your life up so that when you stumble, you fall into the pit of success. And if you do that, then everything becomes easy. And so like over time, I've just made all these incremental changes and the sum of all those incremental changes has been a great outcome. So you know, I've never done my best All right, that took me that took me so long to you know, changing various insolence and I was trying different things. And there's a whole story behind that. And then, at the same time, like, I'm on a plant based diet, so I eat a diet low in saturated fat. And I did a bunch of research into that, and turns out saturated fat blocks, the signaling pathway between insulin receptors and the glucose pumps inside the cells. And so I see this and I started noticing this, like when I eat junk food that's high in saturated fat, and my insulin sensitivity just goes out the window for about a day. And so I was like, Okay, well, they're great as treats, but maybe I'm going to cut down on that. So I started cutting down on that. And then I, you know, I did a lot of exercise. And I noticed when I do the exercise, my insulin sensitivity goes away through the roof. And I was like, Okay, well, how much exercise do I have to do? And so I eventually settled on, you know, I do Adrien Bikram yoga, Bikram yoga, like once every two days, because if I do it once every four or five days, then everything just becomes all wonky. But if I do it every second day, I just stayed nice and flat and level. And so I think the sum of all these things that I do I just end up, I just don't, it doesn't really feel like work after a while. And then I don't have to pay that much attention. And everything just seems easy. And how do you have?

Scott Benner 36:07
How do you have time? Like, what is your lifestyle like that, that you can do the yoga like every other day? Like if you asked me to do anything every other day, I would tell you, I couldn't commit to it. So how does that like, what do you do for a living that, like you work from your home or like that kind of stuff.

George 36:27
So I'm at the moment, I'm on a year sabbatical, I decided to take a year off, just to figure out how to learn my disease. And I'm in the fortunate position that I work for a software company, and we had a good year, good couple of years. So I decided, like, this is my year that I wanted to take off. But even prior to that, I mean, I've been doing yoga for years. And so I'll typically do you know, get up and go to a 6am class or 7:45am class and do yoga for 90 minutes, and then finish up, have a shower, go to work and work for the day and come home. I mean, I live in the inner city. So everything's on foot that substantially helps my lifestyle I don't ever get in a car. And I have this very expensive hunk of metal that just sits down in a parking space that I pay money every week for and it just gets me I just got the insurance and they're like pay some money for the car, you don't use it.

Scott Benner 37:20
Do you ever, you know just not drive at all, these are just something you

Unknown Speaker 37:23
do once every two weeks.

George 37:25
Maybe we might go do some shopping once every two weeks. But we when we used to live out on the farm, as I was saying like that you just needed a car. Like as I say nobody would even bring you take out. So you just you could not get by without a car. But here in the inner city, it's just too painful, right like so you have to find parking, and you just, you can't do things with cars in inner cities. It just doesn't work. And so we tend to do everything on foot, both my wife and I, we just walk everywhere. And you know, that's been a substantial factor in my health as well. Because now all of a sudden, I'm just getting exercise as part of my day to day routine.

Scott Benner 38:02
How long were you married when you were diagnosed?

George 38:06
We've been married probably about five, six years, but we've been together about 15. Okay, so you,

Scott Benner 38:12
you know your wife for 16 years, and you're diagnosed pretty much at the end of that 15 so far, how did how was it for her? Did you notice? Did you notice any shift in your relationship? Or? Did it cause weirdness or strengthen things? or What did you notice happening?

George 38:30
I don't think it caused weirdness. I think it caused, I mean, from one aspect, I'm a bit of a bit of a test tube for her. So she's studying medicine. And so she's been focusing a lot recently on diabetes. Just ironically, actually, at the time I was diagnosed, excuse me, she was writing a term paper on diabetes. And she was like, Hey, I think you have diabetes. And I was like, No, surely not. She's like, No, no, I'm studying it right now. I think you do. So that was that was a good giggle. But you know, I think it had it had the effect on her on her mental health. Just in terms of like this, somebody you love, and now you worry for them. And you're like, like, what are they doing, how they manage this, and she doesn't really get involved in the day to day management. But she kind of gets involved in the day to day worrying if that makes sense. Do you

Scott Benner 39:17
ever wake up in the middle of the night and she's creeping next year with the Libra holding it up against the sensor or? Yeah. Let me just see real quick. And that's interesting. You You said something about the Libra earlier about it not really being a continuous glucose monitor. I agree with you. I think what it does is really cool. I think it's a Do you use it as a big meter? Is it kind of how you say it like a meter that you don't have to poke your finger for or do you have a meter and you use the lever? How does that work?

George 39:45
So there's a little there's actually a little finger prick meter built into the Libra. Okay, so I kind of use that I use, you do use the test strips on that. But I mean I do kind of obsessively scan probably once every half an hour but it Honestly, what what ends up happening i think is and you probably experienced this as well is that after a while, get it, you get a good sense of where your blood sugar is going and where it's at. And so you just periodically checking in and the time for doing a reading is, you know, just seconds. And so in terms of Am I am I just picking up a picking up a device and looking at it? Or am I picking up the device waving it against my arm and then looking at it the difference is not all that big. And what I would like those integration for say, you know, something on my watch, or maybe some alarms those, those would be really nice. But I've gotten gotten pretty talented at the sort of the wake up in the middle of the night scan myself keep the light on underneath the blanket, make sure not to wipe my wake my wife up and then when I know everything's okay, go back to sleep. And like did I actually scan last night?

Scott Benner 40:49
I was explaining to somebody the other day that art was getting braces. And you know, he was talking about it kind of now he has braces and what do you do and she doesn't eat food overnight frequently. But there are times where ardently to banana like in her sleep. And I said it so offhandedly. As I was talking to him, you could see the conversation just brown to a halt. And his look came over his face. And I said oh, I'm gonna have to explain that to you, I guess. And so I you know, I said so Arden can eat a banana while she's sleeping, if I hold it. And that started to make more sense to him. And he goes, I don't understand. I said, I just say Arden, your blood sugar is low, we're going to eat a banana. And then I touch her lips with the banana. And then she takes a bite of it. And then when she's done, she chews and she swallows, I give her more until I've given her as much as I want. I said then we try to rinse your mouth out with some water. And but if you ask her The next day, she has no recollection of that whatsoever. And so I said I guess technically Arden could eat a banana in her sleep. And I even after the explanation, he still sort of just you could tell he was not 100% sure what was happening. It was interesting.

George 41:55
I don't believe this. Like I get that I wake up some mornings. And I'm like, I wonder how many times I woke up last night to scan my blood sugar. And it'll be like four or five, but I don't really remember.

Scott Benner 42:04
Yeah, I'm, I'm, I can't do the wake up go back to the sleep thing. So I'm more of get it definitely right and then pass out kind of got I once I don't know I have a hard time. Like going back to sleep waking up and going back to sleep that kills me, it's almost better for me to stay up sometimes.

George 42:24
Just think I spent years on call working in a technology company with you know, some random service somewhere would go down in the infrastructure and you'd get paged, and you'd have to get up and function. And so over the years, I developed this ability to essentially wake up function for five minutes, and then just go back straight back straight back.

Scott Benner 42:42
That's a pretty good superpower, actually. So George, first of all, you're doing great not cursing, it's fantastic. bazel story has picked up to the point where I'm going to ask the hold on one second, I'm going to get up and move him a little bit. And I'll be right back. He's now distracting me. I don't know if it's if it's even something anyone would ever hear on the recording. But I can't think through it. So hold on one second. When we started to record, the dogs were in separate different beds. And I was like Oh, the one who doesn't snore is near me and the one that does stores way away from me. This is fantastic. And then as we started talking, they switch spots.

George 43:17
So are you recording now

Unknown Speaker 43:18
let's just fix Yeah, how

Scott Benner 43:19
can I mess this up? Hold on, I know. So well. Okay, so let's walk through a little bit of the MDI kind of an idea. So do you have to? What kind of insulin are you using?

George 43:32
Okay, so when I was diagnosed, they put me on nother rapid, which I think you guys will know the log, and lantis. Okay, um, so I kind of started and then you kind of fumble through it and tell how much am I taking what doses etc. And so, you know, you know, typically in hospital, they just give you two pens, and they're like, Well, here's two pens, that's probably enough for the next week, go to your GP get a script and go from there. And so I kind of did that. And then quite quickly discovered that the pens only have one unit doses. And so I quite quickly needed to change up and move to half unit doses because I was still quite insulin sensitive at the time. At the moment, I'm now using novolog whenever appid and Liv Amir and I use it in the pencils. So you'd have three ml cartridges and I load them into an echo pen, which then once I've dialed up the dose and shot it into me it'll, it has a little calendar a little. It's like a counter on the back, which tells you the last dose and how many hours ago it was, which is pretty cool. And then I'll put that into my my app, and that tells me insulin on board. So the app has got a setting for essentially whenever you put in a bolus you put in a URL if you say how long your insulin is active for and it'll you know give you it can track the curve and just say you've got this much left on board. So I don't have to worry about keeping that in my brain because I'm terrible like that. And I ended up on levemir because actually have a random blog. I was chatting to somebody about this today but I was just reading a blog somewhere and This guy was saying, Oh, my kid always hypose on Lantus after exercise. And I was like, Yeah, I have that on this movie Deliver me it would help. And so I chatted to my endo about it. And he said, well give it a go. And that was my main reason for switching. switched from Lantus levemir. I tried splitting my dose I was really wasn't getting coverage with Lantus because I think the one of the way, one of the things about lantis is when you have a slightly smaller dose, it just doesn't. It just runs out early. So they sort of, say 24 hours, but I was sort of getting about 2021 hours out of it. And so I just had these two random highs throughout the day, I was like one one in the morning and one at night. I was like, well, it's sort of when the dose is wearing off, until I moved to Livermore because of all of those reasons. And then it was really nice, actually, the hypose disappeared after moving to live a mere exercise fibers. And so now I don't even hardly ever change my bezel dose like after exercise, I just don't need to find as long as I don't really have any any fast acting insulin on board. I don't I don't know how to exercise

Scott Benner 45:57
live, Amir, are you shooting 11 or once a day now or do still, um,

George 46:02
I split it, it works better. If you split, I've actually now moved to a three way split, because I found the dose action is about eight hours somewhere that eight to 10 hours of peak. And so I get up first thing in the morning, and I'll you know, put a shot in about 630. And then I'll do another one around about lunchtime, and then one just before I go to bed. And then I kind of like that for for two reasons. One, it gives me this this, you know, always I've always got an eight hour peak coming on. But the other nice thing is, when my basil does move around, it gives me three intervention points through the day. So if I'm running slightly higher, my basil are running slightly low, then I can say okay, well in the next one, I'll just knock that down by maybe you know, two. But again, because living here also has a peak, it has a distinctive peak and a distinctive sort of degradation action over the course like once you get to sort of 16 hours in it really starts to go down and it's the dose is not so active, you get these three different peaks you can work with. So I will take less overnight, for instance, whereas with something like Lantus, it's, it's a flatter action. And once you stack them on top of each other, there isn't really much benefit to stacking them in different amounts. Because, you know, over the course of a day, they will just add up to a total daily dose. Whereas if let me add that one actually wears off. And so you can put a new one in and you get it you get a different basal rate. And I find that like super useful because you can then really, really tweak. That's cool.

Scott Benner 47:25
I know that when Arden was first diagnosed, we used Lantus, but it burned. Yeah. So we moved. We moved to love Amir, and then so you've tried to imagine, you know, that many years ago, the internet wasn't really as like so I found through googling. This web space where pharma people, the sales, people were talking about their drugs. But it wasn't private. You didn't need a password to get into it. And I found this one spot where these salespeople who were selling Lantus, were talking about how they feel bad telling people that didn't last for 24 hours when they No it doesn't. And that that made me go, oh, okay, that makes sense. You know, like, that makes sense. That's why we're seeing this hire right here, because it's gone. She doesn't have any bazel right here. And that's when I started splitting it just every 12 hours, which ended up working fine for Arden, but I wasn't looking into it at that time, as closely as you are now. And so I imagine if I would have figured out what you figured out, maybe I would have gone to two more injections of it to that makes a lot of sense. But

George 48:36
I find that I find that like works really, really well for me. I mean, the other thing is I looked into the insulin action. And so as you say what you know, Lantus you you get the burn. But the way Lantus works is it sort of it's a it's an acidic substance that then sublimates under your skin in the fat into a little ball of insulin that sits wherever it sits right. And then there's there's two interesting things about that. The first thing I found is that, and I think this is why I have I have no evidence to suggest this. But I think this is the way I had to hypose is that that ball is going to break down at whatever rate it breaks down. If I go into a hot room yoga class, I've just heated up my body that's going to break down slightly faster. And so what I found is that on days, I would do our dream yoga, we'd get this hypo after exercise, and then later in the day, I'd have the tie and I'm just like, why is early what without why did why did this happen?

Scott Benner 49:24
But yeah, but yeah, so you know, it crystallizes under the skin and then it basically just melts away slowly giving you giving you insulin slowly. And I've always thought you can tell it's working faster now. Or it's, you know, it's you can just have

George 49:40
like there are moments but the other thing about that is that it creates this little ball of insulin right? Now if you think about a bowl, the bigger the bowl, the bigger the surface area of the ball, right? And so the bigger the surface area, the more insulin there is to create to like sort of sublimate out and just sort of break down into the into the surrounding tissue. And so I think this is why they have now Gone with their new incidents, they've gone with higher dose insulins to make the ball smaller again, because if you're injecting a big ball of insulin, then you just by definition got much more surface area, like a bigger ball has more surface area. So you get more insulin into you at any one point in time. And then as it shrinks in size,

Scott Benner 50:17
there's less, it gets less. Yeah. And then your tie, yeah, there's

George 50:21
less, but then you also sort of had a peak. And so you know, it's just not even. And I think they've done a lot of a lot of work on this. But I'm still not too keen on a little ball of insulin somewhere in my body.

Scott Benner 50:31
Just We'll see. It's funny. I've broken things down into overly simplistic statements. But in the end, what we just said was, if your blood sugar is high, you probably miss timed or miscalculated the amount of insulin you have not enough insulin. And if your blood sugar is low, you probably have mis timed it or have too little. And it really is it's all about what I there's a thread I was looking at on Facebook before I started talking to you. And it's all about what do I do? How do I get my blood sugar down? Why is my blood sugar high, you don't have enough insulin. But that it's really not more difficult than that that basic concept. Now how you how you get the correct amount of insulin at the right amount of time gets to be a bigger idea. But in the in the very beginning, if your insulin, your blood sugar's high, you don't have enough insulin. That's it. It's that simple.

George 51:20
It's exactly that it works exactly the same way for bagels as well. And I think, you know, as soon as I put two and two together with that, that's when you know, that's when I really started to make progress.

Scott Benner 51:30
All right, juice. Okay, so plant based, I diagnose you probably out of your honeymoon period. Now you were talking about needing a half unit? And yeah,

George 51:39
I mean, I was I there was one point where actually, I was trying a keto diet just because I wanted to see if it worked. And I was actually not having any insulin because I was just typing. But that came to a swift end. And, yeah, last couple of weeks, it's just been, you know, it's been a bit of going down and increment slowly. But surely, in the last couple of weeks, I've been like, what the hell is going on here? I'm injecting like, for a horse.

Scott Benner 52:02
Yeah, it is how it starts to feel, especially when it makes that big shift, where you're like, Oh, I used to use this little bit. But now it's so because it does seem like, it's funny, too. I think, when you're injecting it, when you can really see it, it's a little more impactful. Like when you tell a pump to give you 15 units, it's just a number. But when you look at 15 units in a needle, it's a lot of insulin. You know, like, like, physically, when you look at it, you're like, Wow, that's a lot of volume. But here, so it's a little more impactful. I think when you see it going to be perfectly honest. So plus you feel it because you're injecting quicker, where pumps kind of like the Omni pod, for instance, if you take a big bolus, the only Patil take, it could take a minute or so to put it in it goes in much more slowly, as an example. But that's interesting. It really is. How's healthcare in Australia? What is uh, what's your, like, what falls to you, I'm already fascinated that you were able to take a sabbatical. That's so unAmerican, that's incredible. You wouldn't get a year off here, if you had 16 babies, they came out your ears, they'd be like, get back to work.

George 53:16
I kind of feel that. But now I mean, healthcare is good. So I mean, let me give you an idea of what my typical my typical experiences. So I live in the eliminator city, I picked a GP who has a practice near my work. There, they're everywhere. I particularly look one look for one that who does does what we call bulk billing. So by being an Australian citizen, I get free health care free access to Medicare. We call it Medicare here. It's not it's sort of the the single payer health care system that we have. So I'm not Australian by birth, I moved here about 10 years ago. But yeah, as I once I, once I became a naturalized citizen, they go cool. Here's your Medicare card. And so there's a bunch of reasons many ways you qualify. But ultimately, if you find a GPU does bulk billing, and what they're saying is that the rebates that you'll get from Medicare will cover their expenses. So I found when it does that, that means I don't pay for any of my GP visits. Like, I can go to them as often as I want in my GPS, like, Oh, hey, good to see you again. And then yeah, Medicare will will pay for that. Typically, most labs are on Medicare, so I don't really pay for those, I guess, and, you know, less, I really get out of hand, but you know, I go and get a couple of lab tests per year. And that doesn't seem to doesn't seem to touch sides. I've never noticed the ball. You know, DGP gives me a piece of paper, I'm making a point with a nurse and she takes the blood out of me signs a piece of paper, and then I come back a day later and I've got some results. And so that's I don't don't see a cost to that. For my end, I've registered with a public health hospital here that has a great Diabetes Center. And so I see my endo. I was seeing him once every three months. I now See him? He said, he looked at me right now you're doing fine. I'll see you in six months. But I don't pay for that either. That's again, belt build. So I've got a bug called endo endocrinologist as well. And then that that diabetes clinic has an attached or that that diabetes clinic has an attached set of educators. And so they actually run in a separate group at a Diabetes Center. And they have, they have, you know, some nurses and some dietitians, and psychologists, and essentially, I can go and see those those people for free as well. And it's just basically finding them up and going, Hey, how are you going? I'd like to talk to you about x and they go, Okay, great. I got a space on my calendar here. Let's talk about that. Then. If I go and do some more complicated stuff, so let's say going and seeing a specialist, or maybe going and seeing a psychologist or maybe going and getting some surgery, that's where you start to encounter costs. Emergency healthcare is always free. Like, if I just if I get sick, I just walk into, I walk into a hospital now. And they'll just be like, Oh, hey, you're sick. Okay, cool. Let's sort that out. And you generally won't see a cost about that. But when you get admitted to hospital, then it gets complicated. Like, have you got hospital cover? They're kind of they kind of push you into into having that. Are you in a private hospital? Do you? There's a whole bunch of like rules and regulations and conditions. But you know, for most stuff, like if you're willing to wait, you can get away with no cost. And so it sort of becomes a trade off of like, Do I want this done faster? Or is this sort of a more optional treatment? So stuff like chiropractors and yeah, pretty much just the more, the more not would you call them I guess? Yeah, like not

Scott Benner 56:45
annoyances. Yeah. Well, what about the insulin? Does the insulin cost money?

George 56:52
Yeah, so I pay $35 for a PBS script. So the way it works out here is that I will get a script from my GP. And then all the medications that we have are on a scheme called the Pharmaceutical Benefits Scheme. And if the medication is on there, then it's it's covered in a script. So a standard script costs 35 $37, Ozzy, and there are ways to get that cheaper. So like, if you don't have a job, or you don't have, like, if you earn less than a certain amount, etc, there's like a whole bunch of conditions you can get out, you can get a concession card, and then it cost like eight. And then it just you go to your pharmacy, and they give you whatever the standard doses. And so with my insulin I get whatever it is, I think it's a five ml cartridges. So I get five boxes of five. So I'll get five fives, what's that

Scott Benner 57:41
35 cartridges for about $37 about $1 a cartridge. And if your insulin needs went up and double, they would still be the same mount or with the mount go have also?

George 57:50
No, no, I just that's the standard script. So I'll get a script for that much. And if that last me as long as it lasts me and I got one repeat. And then I go in the lab that repeat, I'll pay the $35 again. And then I'll go to my GP and get another one. That's pretty good. Was the LIBOR free? Or did you? Unfortunately not No, I have to pay for that. Although there's, there's a consultation going on at the moment. So the way the diabetes stuff works is slightly differently. So insulin is obviously medication that's covered on PBS just as basically all the medication that you can get. But for diabetes stuff, they run a separate scheme called the ndss. So when you when you become a diabetic, like you're sitting there in hospital, and you're like what the hell has just happened to me and you get a stream of people coming through it, one of the people that come through is a an educator who comes and registers you with a scheme called the NDS s, and they kind of validate that you actually have diabetes, and that you're this type, and that you get a card and it kind of register you. And then you can take that card to any pharmacy or you can go online to their website, and that gives you access to diabetes supplies. So using that card, I don't pay for needles, but I can just have an endless supply of needles if I want, I get access to subsidize test strips. So instead of paying whatever it is 50 bucks a box, I pay I think 17 if I'm always on a pump, I'd get access to my pump supplies at a reduced cost. And like so basically all of the all of the management tools for diabetes are covered under the ndss. So CGM has been made available to under 20 ones in Australia. So if I was under 21, I could just go and get a CGM, and they would give it to me, and that would be free. But they haven't yet approved funding for anybody over the age of 21. So about six months ago, they kicked off a consultation as to whether or not they're going to find the Libra but they haven't yet made a decision. And so we're hoping, hoping holding thumbs

Scott Benner 59:38
were without the the lever without the without the you know, the alerts. It really is. It's a really great big meter. You know, to me like where you don't have to poke yourself because you even said like I have to wake up and look or you were talking earlier about how like every half an hour you look, I believe that if the if this isn't a sales pitch, but if you were if you were on Dexcom you You had your, your your level set, you would get to a comfortable place where you'd never think to look at it unless it was beeping at you. And so and so that's the difference. I think LIBOR is really cool. I just don't think it's a CGM. Like it's Yeah. Right. I

George 1:00:13
mean, it's what's good going for it is it's got the cost. And I think it's also got, and I don't have to calibrate it.

Scott Benner 1:00:19
So you're managing Well, with type one with with injections, got a Libra plant based diet, which I applaud you on. Did you was that hard to get into a plant based diet? Or were you always a healthier eater to begin with? Or was it a big transition for him?

George 1:00:35
No, actually, I mean, so ironically, this is this is 20 year old me like 21 year old mine, my brain. I don't know what I was thinking. But anyway, I was, I was living in London at the time, and I was looking at what I was eating, I was like, I'm eating a lot of junk food. If I turned vegetarian, I'll eat less junk food. I don't ask me how I thought that I thought at the time. And so I said, Okay, well, I'm going vegetarian. Until I became a vegetarian, and that kind of forced me to cook my kind of my, and brain logic said that if I don't eat meat, I'll be able to eat less take out the side. I don't know, I had, to me that I

Unknown Speaker 1:01:12
just had to believe.

George 1:01:15
Like, anyway, it worked for me. And I ended up learning to cook and, and you know, like, over the years, like, you kind of just eventually lose the flavor for me at some point in time. It's just, I'm just like, Yeah, no, not my thing. But also sort of the same becomes I think the biggest one was like sort of dairy and cheese, because it's so addictive. Like, literally addictive. is a is a castle, morphine is like a morphine analog in cow milk, which keeps the baby cows happy, but also has the side effect of getting you addicted to it. As a human

Scott Benner 1:01:49
cheese is one of those things that you don't think of as being unhealthy, but it's not particularly healthy. It just but it is one of those, it falls into a category in your mind, for some reason, where it's very, it feels natural. So you're like, Okay, cheese,

George 1:02:04
but I remember I was I was in Amsterdam at the time on on a, just like sort of a I want to say working holiday, but I was working for the company I work for. And they have a they have offices in Amsterdam, and I was just kind of out there for three months working and like, like, do you think Americans like cheese, like the Dutch are just like, everything is cheap. Like life is cheese, if you live in Holland. And it's all like just, it's none of us like processed cheese is just like it's these all these really these boutique cheeses that have aged and you just kind of crazy. And I'd been eating all this cheese. And then at the time, that was when my wife was like, we should eat less cheese and go vegan. And so I watched a you know, I think I watched the milk documentary or something like that. And I was just like, okay, that's me. I'm done overnight. And so I just went cold turkey and cheese. And actually went through like morphine withdrawal. Like I remember like, lying in bed shaking, sweating, the most horrible thing I've ever experienced, really. I was like this from cheese.

Scott Benner 1:03:02
You had the Gouda monkey on your back. That's

George 1:03:05
literally withdrawal symptoms. And I was just in bed shaking, like for about four days. And then it just went away. And I was like, Oh, thank god that's over. That's

Scott Benner 1:03:14
crazy. And George, don't be surprised if this episode is called Gouda monkey. butt. I'm, I'm somehow delighted by the idea that you had withdrawal from cheats, but it's just not something that would ever have occurred to me that a person would have said, so that is really that's fast. And you say because there's what's in the milk that

George 1:03:34
they kind of get is a cup. So camo has a thing called castle morphine. It's one of the proteins that's in Carmack. And but it is literally morphine. And so it binds to the same receptors in your in your brain. And that's why when you eat a piece of cheese, you feel warm and fuzzy. You have a glass of milk, like oh, that's really good. I feel warm and fuzzy from that. So you're getting the most Yeah, you're literally getting a morphine head.

Scott Benner 1:04:00
Well, I don't think that's going to take over the opioid crisis in America. But I think at the same time that is really interesting news that I didn't I never seriously That's insane. Wow,

George 1:04:12
I didn't know about this. And I was like, what, what? What? What? Well, even milk doesn't have that.

Scott Benner 1:04:17
I don't think oh, you're making me wonders what else I don't know. Which I'm assuming is a huge amount of things to be heard. That's Um, so

George 1:04:26
when that happened that was when I was like, I became like, yeah, pretty anti dairy but now it's sort of backed off and like everybody's got their own path. Like you want to have dairy. That's cool. You can have too arrogant like but you know, I just don't think it's particularly healthy. And one of the interesting things I noticed when I cut out dairy out of my diet is just my weight started dropping away like excess water attention, and little bits of puppy fat I was holding on over the years but also my hunger satiated and I think that was related to the growth hormones that are in in cow milk. Because I mean, I didn't really think about it this way but you know, as well I was watching this documentary and they're kind of like, what's the purpose of milk? Right? The purpose of milk is goes from a mother car down to baby cow. And it says the baby cow, you

Scott Benner 1:05:07
should get really big, fat. Yeah.

George 1:05:10
Yeah. And so we, you know, we drink this as humans, are we, you know, what happens? Well, we get bigger,

Unknown Speaker 1:05:16
or, you know,

George 1:05:16
so I stopped having it and like all of a sudden, like, I just my weight normalized. And I was like, wow, I'm certainly not just putting on that extra half keto, a year that you just, you know, you just do as you get older, and you just kind of accept it. And it's my weight stabilized, and I kind of got a whole bunch more energy back. And I was like, wow, this is actually pretty good. I'm gonna go with us. Well,

Scott Benner 1:05:38
where did you like we're over an hour, but I wanted to ask you for so you can hear in your voice like, sure you're from where are you from? Originally? Where were you born?

George 1:05:46
I was born in South Africa.

Scott Benner 1:05:48
Okay. And then Have you lived in a number of different places? It feels like Yeah, yeah, I've

George 1:05:53
lived in. I've lived in the UK. I've lived in London. I've lived in Edinburgh. I've lived here in Sydney. I've lived in Amsterdam. I spent three months backpacking Thailand. But also,

Scott Benner 1:06:04
I think that's about it. Do you feel like you'll stay in a city? Where did you meet your wife?

George 1:06:08
I met my wife in Edinburgh. I think, Well, I think we'll stay in Sydney. I really like Sydney. Actually, it's, you know, it's just, if you can imagine a place that is just basically perpetually Sunny, as good health care and good work. And it's easy to get around to just kind of comfy, it's only downside is that it's expensive. One of the most expensive cities in the world. But like I like that feels like everywhere nowadays. So I don't know that I can count that as a downside.

Scott Benner 1:06:34
I don't know. I mean, so far, I haven't been able to find a place that wasn't expensive to live. That was anywhere you'd want to be for any amount of time. You know, you know, sometimes you just get dark, rural places, you know, this is cheaper. And now I live here forever, like, nowhere to go and nothing to do. And I'm too far from everything. That is the one downside, I guess I'll show you when you leave. It's a long flight to almost everywhere you go. Is that right?

George 1:07:00
Yeah, I mean, I sometimes go home to my parents, and you're kind of you fly over the Arctic, like the Antarctic, whatever the one at the bottom is, you fly over it. And it's like this 14 hour flight. And it's during the during the day. So it's not even like if you fly to the States, at least, you know, they have the good sense to put the plane into the air at something like two, three o'clock in the afternoon so that you watch a movie for two or three hours. And then you have a nap and you wake up in America. Great, cool, I'm refreshed. But to fly to South Africa is just the opposite way around, they leave at 11 o'clock in the morning, and they fly essentially through the day. And then they drop you off or whatever it is four o'clock in the afternoon. You're just like, I couldn't even sleep. I was awake. So hold that whole flight for 14 hours. And like, do you have any idea how bad your movies are? Yeah, so it by the same token, you also just get used to sitting on a plane for 14 hours. And so at some point in time, I kind of went, I you know, I'm gonna tall guy so I get emergency x rows whenever I can. And at some point, I was kind of like, wow, this is only an eight hour flight. I don't need an emergency exit.

Scott Benner 1:08:02
Man, that's something that really that sounds listen. We're at my house here talking now about if we should be moving or what should we should be doing and our minds never go to like it was just really fascinating to hear all the places that you've lived. Were you always following work? Or were you following just whimsy, or how did you end up moving around so much?

George 1:08:23
Mostly random, random reasons. Right? Like, when I first left London, and moved to Edinburgh, it was just a friend of mine was like, Hey, you should move to Edinburgh with me. And I was like, Well, okay, yeah, let's do that. And so I just ended up there. And then, you know, over the years, it's mostly been about traveling. like Thailand, oh, and my wife wasn't my wife at the time. But it was my she was my girlfriend at the time. She said, I am going to go and live in you know, I'm gonna go and backpack Thailand for three months. So it's like, oh, okay, that sounds like a good idea. Let's go do that. And then she was kind of the reason we came to Australia as well. We've been living we come back from Thailand. We've been living in London for a few years. And after doing that, we kind of went she went, I really want to live somewhere warm. Let's go live in Australia. I was like, Well, okay, let's go do that. And so she we moved out to Sydney. And then the rest is sort of just places I've always wanted to visit for extended periods of time to sort of soak into the culture, but never really had the opportunity to and then you know, fortunately the company I work for has offices all over the place. And so I've kind of managed to squeeze a you know, 234 weeks or five weeks or even up to three months. Just go and sort of find a job at that office for a couple of weeks and just go and live there and live in the culture and go do stuff. I think the only really big exception to that was when I we bought a car and drove around Europe for three months and that was just insane.

Scott Benner 1:09:45
It's just it's George's incredibly inspirational. I don't know if you realize or not that just the freedom that you feel to do that is I'm jealous of it. To be perfectly honest. Also, you don't have kids. Is that right? Yeah, I don't have you don't make that as you'll just be wherever You are after that happens.

George 1:10:02
Yeah, we are now Yeah,

Scott Benner 1:10:03
yeah. Right. Oh, that's something a church I this time went by so quickly. I really appreciate you coming on. I had such a great time and you have to go to sleep I would imagine also, is it about to have now I know I'm like thoroughly awake now you're all awake.

George 1:10:17
Now I might as well like go for a run or just like go see what's on at two o'clock in the morning. And today? I think actually almost nothing because government is shut down or fun, fun. And is not. There's a time when defined ends. Yeah, they're like a after I think 12 or 12am. Or like 1am. Like, this is when the fun stops. No kidding.

Unknown Speaker 1:10:36
That's interesting. Yeah, you

George 1:10:37
literally get ridiculous things like they won't serve you. I don't drink alcohol. But like if you do drink alcohol, like you're not allowed to leave a bar after 1am because they won't let you back in or, like after midnight. They're not allowed to serve you spirits without a mixer. And so it's the funniest thing. You let people go into bars. And they're like, I'd like an 18 year old scotch please. And they'll be like, sure. Which which makes it Do you want that with maybe like, what?

Scott Benner 1:10:58
I don't, please. So did

George 1:11:02
you have to now put a Coke into your 18 year old scotch after midnight is just ludicrous.

Scott Benner 1:11:08
Like, listen, this sounds like it. I hope I can visit sometimes that's really something. But I have kids, so probably at Georgia,

George 1:11:18
I keep them entertained before you know, it's not

Scott Benner 1:11:20
even that it's that yours. They have things they have their own lives and you are the facilitator of their lives. And there's just no time to be a god. This is an indictment of parenting. But it's hard to be you and them at the same time, which is ends up being what's going on as you're trying to facilitate their situation. And at the same time, work and make money to pay for things and sleep. And you know, like there's just not you run out of time like this. You know what I mean? It's,

George 1:11:49
I completely understand. And I think that's also the kind thing about parenting right? that your life is no longer yours. You're giving so much to somebody else. I think that's something wonderful parents do. In

Scott Benner 1:12:02
the least manly thing I've done in a while. I watched this football game last night while folding laundry. So that's like, there's a there's a clear delineation between my masculinity and my femininity. Last night, I was just folding laundry, trying to look up at the television to see if deals were going to win. Football being American football. But, but church, thank you so much. I really feel like I could talk forever. I think you've lulled me into a into a feeling of happiness, but your multicultural accent which is delightful. So not only do I have to thank George for coming on the show and sharing but I have to thank him for a follow up note he sent me many weeks later. I'm gonna read it to you. Soon as I find it. Did I find it now here it is I got Hey, mate, I wanted to message you quickly. And let you know that it turns out I am actually still honeymooning. To my surprise. I had a C peptide test. So we could go in and showed I still have some pancreas function. I've been using 35 or 40 units a day, which for my build age and exercise level i thought was about right, given what multiple books said I should be expecting. Anyway, I figured that my good control is assisted but not caused by this. But it would still be unethical of me to claim no honeymoon when I know that not to be true. So I just wanted to let you know, so you could decide how to handle it. So while I want to applaud George for his courtesy and his transparency, I don't think it changes much other than to tell you that you may not know exactly when your honeymoon is over. George is still controlling his diabetes exactly the same way as he spoke about in the episode, nothing's changed. He just needs more insulin. Now. I just want to take a moment to point out who brings the podcast to you, I do the interviews, I set everything up, I write I do the whole thing. But without DAX comment on the pod, I would not have the time to do it. So again, thank you very much to both companies for your generous support of the podcast. It really does help me bring all this information, these people's stories, and anything else that you find valuable about the podcast, it really would not exist without the ex comment on the pod supporting me. I also want to thank the listeners for sharing with friends, family, loved ones, doctors, everyone you tell about the podcast, I know you're doing it, I can see it growing and I get your notes. So thank you very, very much. I really appreciate it. You guys know you can listen to the podcast anywhere including Juicebox podcast.com, or on any podcast app. But did you know you can also listen on Amazon Alexa, don't worry. I won't say the thing that makes your Alexa do something. And you can also listen and you can also listen on Siri with home pod at home if you have that speaker. There's so many different ways. I'm going to see you guys next week. Hey Siri, play the Juicebox Podcast.

Unknown Speaker 1:14:49
You here's the Juicebox Podcast type one diabetes,

Unknown Speaker 1:14:53
where in South America there's so

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