#1768 Break the Cycle
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Dr. Ernie Fernandez discusses how sleep, social media, and T1D stress impact mental health, offering strategies to build resilience and break the cycle of generalized anxiety.
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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 (0:0) Welcome back, friends, to another episode of the Juice Box podcast. (0:12) Ernie Fernandez is not just a doctor. (0:13) He's not just an endocrinologist. (0:15) He's also the person in charge at Camp Sweeney, and we are giving away two slots today at Camp Sweeney. (0:23) But first, Ernie's gonna tell you a little bit about sleep, stress, anxiety, and how your cell phones might be messing with you.
Scott Benner (0:31) So we're gonna talk a little bit about that, then we're gonna pull the winners from the contest, and we're still gonna give away four more places at Camp Sweeney in 2026. (0:39) So don't stop entering at juiceboxpodcast.com/giveaways. (0:45) Get in there. (0:45) It's super simple to start. (0:47) It's super simple to enter.
Scott Benner (0:49) You don't have to do anything, and you'll get a chance. (0:52) And by the way, everybody who doesn't win today, everybody who's already entered, I'm leaving your name in for the next drawing. (0:57) What do you think of that? (0:59) Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. (1:04) Always consult a physician before making any changes to your health care plan or becoming bold with insulin.
Scott Benner (1:14) The episode you're about to listen to was sponsored by Touched by Type one. (1:19) Go check them out right now on Facebook, Instagram, and, of course, at touchedbytype1.org. (1:25) Check out that programs tab when you get to the website to see all the great things that they're doing for people living with type one diabetes. (1:32) Touched bytype1.org. (1:34) Today's episode is also sponsored by Tandem Moby, the impressively small insulin pump.
Scott Benner (1:40) The podcast is also sponsored today by Plus Technology. (1:45) It's designed for greater discretion, more freedom, and improved time and range. (1:49) Learn more and get started today at tandemdiabetes.com/juicebox. (1:55) The podcast is also sponsored today by the Eversense three sixty five. (2:00) The Eversense three sixty five has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get.
Scott Benner (2:08) Ever since cgm.com/juicebox.
Ernie Fernandez (2:12) Thanks, Scott. (2:12) Thanks for having me on again. (2:14) Once again, I'm doctor Ernie Fernandez. (2:16) I'm the camp director at Camp Sweeney here in Northern Texas, and I've been blessed to be working with these children with type one diabetes for the 42 here at Camp Sweeney. (2:25) And I know, Scott, we had spoken a couple of months ago about one of the issues that's coming up a lot more and more, especially with the way much of the media has kinda changed in kids with type one and with the kids in general in dealing with stress and anxiety and and especially how it relates to our patients with type one.
Ernie Fernandez (2:46) And I was gonna just spend a few minutes talking a little bit about sort of the normal physiology behind that and ways that parents can can work with their kids, in helping them deal with some of those issues.
Scott Benner (2:57) Okay. (2:58) Yeah. (2:58) Are you seeing that in practice? (3:00) Are you seeing it at camp? (3:01) Or is it something that you feel like you're you're seeing coming from a lot of different perspectives?
Ernie Fernandez (3:07) I see it from a lot of perspectives. (3:09) I see it a lot in practice, not just with with patients with type one, but just in many of our younger and older teens and our young adults. (3:18) Social media has kind of fed into that quite a bit. (3:22) But with our patients with type one, it has really been something that has been magnified. (3:26) And and it it makes sense because when you think about how this starts to develop in these kids, you you know, the normal brain physiology of most children as they enter adolescence and late adolescence and young adulthood is that their that their higher functions of their brain start to develop rapidly.
Ernie Fernandez (3:45) You know, kids when they're 10 or 11 think like kids in a very linear way. (3:49) Know, You kids that are 21, 22 years of age think more like an adult in a very abstract way, and that brings the abilities for them to deal with many, many things. (3:58) But as that part of the brain develops quickly, the two hemispheres, the the need for that part of the brain to be to to be well fueled with neurotransmitters also increases. (4:09) And just in a normal situation with any child and young adult, that always lags. (4:14) You know, the brain's ability to make the neurotransmitter always lags the development of what's being needed.
Ernie Fernandez (4:21) And many things have kinda shifted in our world a little bit that don't make that as fruitful as it used to be in years past. (4:30) Part of that has to do with the fact that you only make those neurotransmitters during your deep stages of sleep, you know, during sort of the the the higher quality sleep. (4:39) And we don't live sort of in a society that kind of promotes that as much as it used to. (4:44) You know? (4:44) Kids of different ages need different amounts of sleeps.
Ernie Fernandez (4:47) Younger kids need more sleep. (4:48) They need, you know, nine to ten hours at night, while young adults need less sleep. (4:53) But it's not just the quantity, it's the quality of sleep and how they enter sleep and how they go through REM into deep stages of sleep. (5:01) And the problem is that many of our youth and even our adults have difficulty adopting patterns to get that kind of sleep. (5:11) You know, so many things are on people's plates, you know, whether it's sports or school or or things that involve them in social ways with their their colleagues.
Ernie Fernandez (5:22) But probably the biggest one that that seems to to be in the forefront is the amount of time that that we all spend on our screens and the addictions that sometimes these algorithms, you know, pull all of us into our screen time. (5:36) And that tends to excite our brain and makes it difficult for them to settle down and to get into deep sleep. (5:44) Now that's in anybody, whether they have type one or not. (5:46) Right. (5:47) And so people tend to go through times, you know, especially during these years where they need the most rest, not getting the kind of rest.
Ernie Fernandez (5:56) And what that leads to, of course, are are decompensation. (6:00) You know, these these wonderful young adults and, yeah, and adolescents will often just kinda run out of juice throughout the day. (6:07) You know, their their higher functions kind of decompensate, they become much more primal, and their anxieties kinda kinda take over, and they become sort of like they were when they were two or three. (6:17) You know? (6:18) They get unfocused.
Ernie Fernandez (6:19) They get very, you know, upset easy. (6:22) They and they have difficulty, you know, dealing with with many of the challenges that are posed to them. (6:28) But what happens in kids with type one is that they have a whole different level of issues that that decrease that normal physiologic sleep that they they should be getting. (6:40) You know, when you have type one diabetes, as of you know, Scott, you as a parent of a child know this. (6:45) It's it's sort of a hidden world that no one realized.
Ernie Fernandez (6:48) You know, these kids and these parents have a full time job that no one knows is happening. (6:53) You know, it's like, you know, when somebody hurts their foot and their foot is killing them and all they can do is think about their foot, and everything in their life revolves around that. (7:02) Well, you know, when you get type one diabetes, that's kinda like having something like that. (7:07) You know, even as you learn and you adopt to all these wonderful technologies and and pretty prudent protocols we teach our patients, it's still a full time management position. (7:18) And the problem with it is that no matter how, you know, how well you use your technologies, how well you follow your protocols, there's always some uncertainty with the outcomes outcomes each day.
Ernie Fernandez (7:29) Mhmm. (7:30) Because there's so many variables, as you well know, that affect diabetes, and that causes people when you have uncertain outcomes, all that does is it increases that excitability of your brain, the stress of your brain, which then makes it harder for these these kids and quite quite frankly their parents as well to have that deeper sleep because they're always concerned, okay. (7:53) Am I gonna go a little high? (7:54) Am I gonna go low? (7:55) Did I do the right thing here and there?
Ernie Fernandez (7:57) And then that causes them to de deplete themselves a little bit more and and allows them to decompensate into some of these these larger forms of anxiety that, as I said, all kids, but especially kids with type one are much more susceptible to. (8:12) And that's that's really what you know, I spend a lot of my my day talking to patients with you know, yes, I talk to them about, you know, the newest pump and and the newest things that we can be doing. (8:23) But most of the time, I'm talking to them about, you know, how to take care of themselves and and be able to be successful, basically, with their two full time jobs that they now have, which is living their normal lives that they were living in, of course, you know, dealing with with the type one that very few people relate to outside of their their own little world. (8:43) And so that's really what makes kids with type one so much more susceptible to to this kind of stress and anxiety, and there's many ways to to to work with that. (8:55) And one of the things that I'll give as a disclaimer at the very beginning is that it's very important, whether you're a parent or you're a health care provider, that you're looking closely at the big picture because what you sometimes miss in a child who's going through the normal stresses of type one or a family that's working with a child is that some kids will get themselves really in a hole.
Ernie Fernandez (9:18) They they drain themselves so much of of their neurotransmitters that they they don't just go from having anxiety, which all kids with type one have in one way or another, but they go into what's called generalized anxiety disorder where they never surface. (9:34) No matter what they do, they they they never get the rest, and and they get themselves into a bit of a of a cycle that that's hard for them to break. (9:42) And those kids, besides the normal things that we use to to decrease and and to inspire kids to deal with the anxieties, you know, sometimes need additional help. (9:52) They they need to come see somebody, you know, like a professional like myself, a physician that works with kids with this that, you know, they may need somebody to help them with with some specific skills with counseling. (10:02) And and sometimes these kids also, you know, need medication because they've gotten themselves into into such a a hole that that it's hard to get out of.
Ernie Fernandez (10:12) You know, our goal today is just to talk about some of the things that help kids from, you know, putting themselves in into that hole.
Scott Benner (10:18) Are there ways to impact it? (10:20) Because, Ernie, I I you know, I've interviewed thousands of people and I had to stop myself at one point along the way from believing that the whole world was just anxiety ridden. (10:29) But I started to see that I think it's possible that people living with autoimmune issues maybe have a higher prevalence of of anxiety for a number of different, you know, reasons. (10:39) Cortisol, I don't know, gut health, like, kinds of different ideas. (10:42) Right?
Ernie Fernandez (10:43) There's so many components to
Scott Benner (10:45) it. (10:45) Yeah.
Ernie Fernandez (10:46) But at the end of the day, you know, you go from anxiety that everyone has, which is not good or bad. (10:51) I mean, anxiety pushes people to do things. (10:53) And so anxiety is almost, you know, something that that in many ways, you know, pushes us to do well with our things to where you cross over to where you actually have an, you know, an anxiety disorder where you can't see yourself coming out of that. (11:08) Mhmm. (11:08) In other words, you've drained your neurotransmitters to a point, and they they could drain for a variety of reasons.
Ernie Fernandez (11:13) Sometimes it's poor gut health that they're not absorbing the omegas that they need for that development. (11:20) But most of the time, if you look back and you look at all the current data that's come out post COVID, you know, it comes from the lack of the normal sleep cycles that many kids put themselves out of, and it's because people can't settle themselves down. (11:34) They become so rightfully so obsessed on on doing all the little things in their life, not only the normal things in their lives, but also the things that are t one d, then when it's time to go to bed, their brain's going a million miles per hour, and it's very hard to slow it down to allow us to go into natural sleep. (11:52) And then you add you layer on that, you know, being on a a device before you go to bed. (11:57) And many times, know, kids of type one have devices right on them because they're using them, obviously, to monitor their things.
Ernie Fernandez (12:02) And they pick it up, and they're starting they look at their device, and then suddenly they're looking at apps, and suddenly they're looking at social media. (12:08) And so the prefrontal cortex gets more wound up, and when they fall asleep, they end their sleep sort of in the wrong order. (12:14) They start REM sleep and and sort of going into the stage sleep. (12:18) And then the next day, they're back with a low gas tank again, and and it leads to the uncontrolled anxiety.
Scott Benner (12:24) Right.
Ernie Fernandez (12:24) And so, you know, part of that is, you know, teaching skills, you know, basic mental health skills, having nighttime routines, you know, that get people in in you know, away from their devices an hour before bed, you know, locking down their devices to just have their pump functions or their CGM functions. (12:42) You know, I even recommend some of those devices, you know, like the Pixel device that you can have where you don't have to have your device so close to you. (12:50) You have that to go off if if you need it to go off. (12:53) You go through teaching, you know, kids how how to do things at night that don't require screens, reading things that slow the brain down.
Scott Benner (13:01) Mhmm.
Ernie Fernandez (13:01) But, you know, at the end of the day, it's all about how you deal. (13:05) We have the decompensations. (13:07) You know, how do you deal when you think you have everything put together and the next day something happens and, you know, your your pump has been bad and your your blood sugar is 400 and you're having to deal with that stress. (13:19) And part of that is creating environments that parents you know, and parents do this. (13:25) You know, parents, you know, are very devoted to their kids.
Ernie Fernandez (13:29) My patients, and I'm sure the ones you work with, and I'm you work with thousands yourself, you know, are always wanting the best for their children. (13:36) And, you know, it's all about trying to get kids to deal with the decompensations and to basically get resilience because it's gonna happen. (13:46) You know, they're gonna decompensate for a number of reasons, not just from their diabetes, but other things that go through that. (13:53) And, you know, resilience is the perseverance of getting through something that's tough and being able to start over again, and you start over again. (14:00) And it sounds easy to say.
Ernie Fernandez (14:02) It's difficult to do. (14:04) And so what you have to do is you have to create, you know, situations where the successes are so sweet for these kids that they have that desire to push themselves up. (14:18) You know? (14:18) Many times, you know, we all fall many times every day in our lives, not just with diabetes, but that falls can either lead to the biggest enemy, which is discouragement, which keeps you from wanting to get back up, to falling and saying, I know what it felt like when I was doing great, Mhmm. (14:37) And I want that feeling again, and I long for that feeling.
Ernie Fernandez (14:40) And that's what gives so many of these kids that strength to to make that happen. (14:44) Because the alternative is, of course, is that discouragement and the loss of hope, And then kids just all the king's horses, all the king's men can't get that that kid back up again. (14:55) And so that's what is a key to that.
Scott Benner (14:58) Yeah. (14:58) Where do you think is the easiest spot to break the cycle? (15:01) Because if it starts with, I don't know, poor sleep, and then you wake up the next day and you have diabetes and that's hard and, like, you know, I'm reading about stuff here while you're talking. (15:11) A cytokine storm, when an autoimmune flare occurs, the body releases inflammatory proteins called cytokines. (15:16) These don't just stay in the joints or your thyroid, for example.
Scott Benner (15:19) They can cross the blood brain barrier. (15:21) Once they're there, they disrupt neurotransmitters, specifically lowering serotonin. (15:24) Like, when that's also happening to you and everything else, then at the end of the day, once you've lived through that horrible day and you and you're laying down in bed, I don't know if you've ever tried TikTok or any. (15:35) It's awesome. (15:36) Like, so, like, when you so when you have
Ernie Fernandez (15:38) Flex you right into it.
Scott Benner (15:39) When that's the way you're trying to calm down, relax, you know, turn your brain off, whatever it is, like, where in that cycle because you're gonna have to pick a spot to jump in and say, this is the thing we're gonna do to see if it loosens up the nut for the next thing so that we can try to get this all working better. (15:57) Where do you see people having more success, or is it variable person to person? (16:02) This episode of the Juice Box podcast is sponsored by Eversense three sixty five. (16:08) And just as the name says, it lasts for a full year. (16:12) Imagine for a second a CGM with just one sensor placement and one warm up period every year.
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Ernie Fernandez (18:16) You have to do it in lots of spots. (18:18) You can't just say, I'm gonna fix it in one spot, it's gonna do it all. (18:21) Okay. (18:21) So you start with the sleep first. (18:23) You know, you you do the the conducive thing.
Ernie Fernandez (18:26) You know, people say, what about supplements? (18:27) What supplements help with this? (18:29) Well, you know, a lot of good work has been done on on magnesium and using a small amount of magnesium before bed. (18:35) It's very safe to use the the gluconide of that, you know, for most young adults, adolescents, two to four hundred milligrams, is a great way to help them, you know, have that unwinding. (18:48) Every person reaches for a device to try to unwind because they think if they do this enough, you know, scroll enough
Scott Benner (18:54) Yeah.
Ernie Fernandez (18:54) That that's gonna make them get numb and wanna fall asleep when, obviously, it does just the opposite because the algorithms are so driven to go keeping you there from fifteen minutes to thirty to forty five minutes.
Scott Benner (19:06) Yeah. (19:06) Yeah.
Ernie Fernandez (19:06) Yeah. (19:06) It's And at the same time, it it uses up so much neurotransmitter to decipher the video that it just takes you off. (19:14) So, you know, putting those away from you as much as you can without losing connection to your devices is a critical element. (19:21) But, really, it's a bigger picture item. (19:23) You know, from a parent's point of view, it's about making sure kids have things that they that they can succeed in each day, whether it has to do with diabetes or not, whether it's, you know, something, you know, athletic, something that's, you know, in the theater, something that's wherever it is, creating an environment that they can taste success is critical.
Ernie Fernandez (19:46) Mhmm. (19:46) You know, we talked last fall a lot about Camp Sweeney and the four pillars and how that all works. (19:51) And part of that, of course, is creating environments where there's something for every child to touch that success, whether it's something they've never done in their life, something they're trying to do. (20:00) Because once you get that feeling of of sort of glory in you
Scott Benner (20:05) Yeah.
Ernie Fernandez (20:05) You wanna strive for that every time. (20:08) And people that's what makes people want to to break the cycle because you have to have the desire to want to break the cycle. (20:15) Nobody wants to put their phone away. (20:17) Nobody wants to do that. (20:18) But if you know that putting the phone away makes you feel that great feeling, that euphoria the next day, you can start breaking that cycle, and and you have to because it's all interconnected.
Ernie Fernandez (20:31) Yeah. (20:31) You know? (20:32) If you can get more neurotransmitter in your brain, you can make a little bit more serotonin without having to take an SRI. (20:38) That changes everything. (20:40) That changes your ability to compensate with so many things that you produce less stress hormone, and so you make less cortisol.
Ernie Fernandez (20:47) So you have less in you know, you have less of those things that causes to to get back in that hole. (20:53) And so creating those environment of successes is great. (20:56) I work with many, many families, and I think, okay. (20:59) What's the one thing your child, you know, strive can can strive in? (21:02) And you try to put them in those things, you know, whether it is soccer, tennis, or basketball.
Ernie Fernandez (21:08) That's what you know, as I don't wanna go into this right now, but, you know, that's what camp swinging has been driven to do for the last seventy six years is to find things for every child that allows them to just shine.
Scott Benner (21:21) Right.
Ernie Fernandez (21:22) And then you create this community. (21:24) You expand the scope, and you put them in a community that all has that second job, that all has those tough time, and they all celebrate each other's successes. (21:35) That's what allows them to retain the hope. (21:38) I am like you. (21:40) You talk to thousands of people.
Ernie Fernandez (21:41) I've been doing this forty two years, and so I don't talk to thousands of people, but, boy, especially during the holidays. (21:46) I talk to people of all ages with diabetes in their thirties, their forties, their fifties. (21:52) I don't wanna age myself here. (21:54) But everybody talks about you know, they struggle with certain things, and god forbid, you know, when we lose a precious one, we all come together and we struggle. (22:04) But everybody talks about the resilience they have because everybody comes together as part of their community.
Ernie Fernandez (22:11) You know, whether it be the Sweeney community that's tens of thousands of big, but other communities with type one where people are so connected that they care about each other. (22:20) Just recently, and I I won't say this name, I I I heard from a a beautiful young man who was in Sweeney for eight years. (22:26) Last year, he was 28. (22:28) And he's a wonderful guy. (22:29) He's got kids.
Ernie Fernandez (22:30) He's grown. (22:30) He's done volunteer work around the world, and I'm so proud of him. (22:34) But he's had some difficulties with with other health issues that have just hit him hard, but the community riles around them. (22:43) And that's what gives them hope. (22:44) That's what gives them the inspiration.
Ernie Fernandez (22:46) Yeah. (22:46) And that's really what you try to do. (22:49) You try to create every little bit of it that that matters, not just the successes, but the community around it. (22:56) You know, our the Camps Wee PFC life, which, you know, the perseverance, faith, courage, life nights that we do, you know, two, three times a week throughout the country. (23:04) That's all part of that is trying to connect those communities.
Ernie Fernandez (23:07) Right. (23:07) Because that's that's what keeps these kids, you know, going and keeps them from the getting into that cycle. (23:16) But I will say, I do treat so many patients that have true GAD, generalized anxiety disorder, and you have to know when other things are needed. (23:25) You have to know when counseling of this particular type is helpful, and you need to be aware of when an SSRI is needed. (23:33) You know, people say, oh, I don't wanna get on any kind of medication.
Ernie Fernandez (23:36) That would just be terrible. (23:37) But sometimes you have to break the cycle somehow. (23:41) Mhmm. (23:41) Even if it's a short term thing that you do for ninety days or you do for a hundred and twenty days, the cycle has to be broken so that the person has the chance to get back on top and get that resilience, get that push to wanna succeed. (23:55) And that's that's really an important thing.
Ernie Fernandez (23:58) And I I don't I don't want people to think, oh, you know, I should never look for those things. (24:03) There are times when you you need to do that. (24:05) I actually, since the pandemic, I've had to treat more patients with medication than I've had in my entire career. (24:12) And I think a lot of it is because people are using this as a tool to try to break the cycle as opposed to to doing the things that that make more sense and healthy for people.
Scott Benner (24:22) Do you think there are people in better positions to deal with this than others and but yet, do you see it, I guess, across all of those levels? (24:30) Like, I was just having this conversation with someone this morning about, like, work level. (24:35) And today, you and I are it's the day after Christmas, Ernie. (24:38) There are not a lot of people working today. (24:39) Right?
Ernie Fernandez (24:40) Mhmm.
Scott Benner (24:40) And so, like, you and I are working. (24:41) I don't think anything of it. (24:43) I was up this morning. (24:45) I had at some point this morning, I had three devices in front of me. (24:49) On one of them, I was learning audio about something that I like to do for myself recreationally.
Scott Benner (24:55) I had a computer in front of me where I was coding something to put on the website to help people bolus better. (25:01) And on the third device, I was trying to learn about a mattress that my daughter and I are going out to get this afternoon for her. (25:07) And I was talking to a friend of mine at the same time who was helping me moderate the Facebook group, and we were talking about somebody they knew who said, oh, they they needed a break. (25:17) And she laughed, she's like, I I haven't had a break in so long, but I don't even know what I would do with it. (25:22) And so for someone like her or someone like me or maybe you too, I don't really want a break.
Scott Benner (25:27) I like doing things. (25:28) I like going. (25:29) I was just sharing with her today. (25:31) This is almost apropos of nothing and yet fits right in here. (25:34) I created something that works really well.
Scott Benner (25:38) It's a physical thing in my house. (25:40) And all I've been thinking about for the past three months and what any free time I've had is doing it better and throwing out the old one and trying again. (25:48) So I don't feel that way. (25:49) But there are other people whose brains are just not wired like that. (25:52) And they also have autoimmune issues and stress and they live through COVID and they're 10 and somebody's making fun of them.
Scott Benner (25:58) Like, all that other stuff is going to. (26:00) My question is is could someone wired like me fall into this? (26:04) I believe yes. (26:06) And could someone not wired like me fall into this? (26:09) I also believe yes.
Scott Benner (26:10) Is the path pathway out the same for both of us? (26:12) Do we both have the same chance of breaking the cycle and starting over, do you think?
Ernie Fernandez (26:16) Absolutely. (26:17) But Yeah. (26:17) Don't get me wrong. (26:19) Doing nothing doesn't help anyone. (26:21) It just increases people people's anxiety.
Scott Benner (26:24) Yeah.
Ernie Fernandez (26:24) You know, doing the things you're good at. (26:26) Like, I have multiple jobs. (26:28) I'm here in my office right now seeing pediatric patients start back in about twenty minutes.
Scott Benner (26:31) Mhmm.
Ernie Fernandez (26:32) You know, I work at Children's Health, and I'm taking care of kids with diabetes once a a week. (26:36) And then, of course, I run Camp Sweeney, which is a year round thing that I spend every night where I probably spend sixty, seventy hours a week in addition to these two jobs doing Cam Sweeney. (26:45) Yeah. (26:45) And you're thinking, how are you preaching, you know, normal, good mental health? (26:49) Well, that's good mental health because I'm doing things that that fulfill things that that that I I'm passionate about.
Ernie Fernandez (26:56) I'm passionate about, you know, trying to make sure the kids with with type one, for example, have tremendous opportunities to be able to get out of these threats. (27:05) Not just when they're kids, but, like, as adults, you know, when they they fall many, many times.
Scott Benner (27:10) Right.
Ernie Fernandez (27:10) You know? (27:11) I like, a young man just called me about three months ago. (27:14) He's 32 years old. (27:15) Okay? (27:16) And he yeah.
Ernie Fernandez (27:17) I haven't seen him in fourteen, fifteen years. (27:20) And he just said, doctor Ernie, I just called. (27:22) He just because I just have one question. (27:24) Does it ever get any easier? (27:26) And I said, what do you mean by that?
Ernie Fernandez (27:28) And he goes, well, you know, my diabetes. (27:29) And I said, well, you know, it doesn't get easier. (27:34) You just learn how to do hard better. (27:36) Mhmm. (27:36) Because people of type one, as you well know, are pretty much stronger than most anyone else.
Ernie Fernandez (27:42) You know, they have the super strength to take something and just, you know, and do a great job with it. (27:51) Yeah. (27:51) But the problem is they all can run into the pitfalls of the little pit that we were just talking about, where suddenly that word that I can't stand, d, comes in, discouragement. (28:02) They just get discouraged for one reason. (28:04) They forget what it felt like, you know, in that time of success, in that time of this, and that's what leads the you know, sadly, with many of our older patients, sometimes a loss of hope.
Ernie Fernandez (28:15) And all the stuff I've been talking about here this afternoon, how do you avoid those pitfalls? (28:20) We're all gonna hit them. (28:21) We're all gonna get discouraged sometime in our lives. (28:23) I mean, that just happens because just the fact of how our lives go. (28:29) But how do you steer away from them?
Ernie Fernandez (28:31) How do you overcome that? (28:32) How do you get that resilience? (28:34) Well, part of it is the adversity. (28:35) I mean, just the adversity itself makes you stronger. (28:38) But what keeps you on top of it is that longing of what what it feels like to be on the other side.
Ernie Fernandez (28:45) Yeah. (28:45) And that's what I I remind every person, you know, what they have. (28:50) You know, I I know this it is Christmas time, and you always think about, you know, these these movies like, you know, it's a wonderful life and, you know, the the the poor man who got you know, was so discouraged by all the things in his life, but he he forgot those things on the other side. (29:04) And that's how it is with type one. (29:06) Everybody does have a different path.
Ernie Fernandez (29:09) It all comes down to having the strength to get back up. (29:13) And, you know, last year, I had a long podcast where you're talking about the four pillars of how camp Sweeney works. (29:18) And every one of those pillars is designed to and I I believe me. (29:23) I've spent my entire life obsessing on how to kindly adjust those and adjust those and adjust those year after year to try to get people to have that not when they're 15, but, like, when they're 35. (29:37) And when they're 45, they can fall back on something that that's that bedrock for them to push back up on because that's what it's really about with type one.
Ernie Fernandez (29:47) Yes. (29:47) The technologies are gonna change. (29:49) You probably your podcasts are wonderful. (29:50) You're talking about this and that and all this wonderful stuff. (29:54) But at the end of the day, it's just the same thing.
Ernie Fernandez (29:58) Type one is type one. (29:59) And the the challenges are gonna be there whether you have the most sophisticated system or the simplest of systems. (30:07) And the real challenge is avoiding the discouragement and and pushing oneself through these these things I mentioned that that help you produce more serotonin, trying to get the deeper sleep, you know, trying to avoid the pitfalls of getting sucked into those algorithms. (30:23) You know, you say you use screens all day. (30:25) I use screens all day too.
Ernie Fernandez (30:26) I walk around with this laptop right over here from room to room constantly. (30:30) But, you know, they did a good neat little study back in the COVID days when people were were co, you know, co learning on on screen. (30:37) When you're just using the screen as a tool, you're not sucked into it. (30:41) You're not so focused that you're looking at all the pixels that it's draining the heck out of your brain. (30:45) Right.
Ernie Fernandez (30:45) What makes you get sucked into screens are things that you're having to constantly interact with, like a video game or or these algorithmic things that are on all of these these social media things where suddenly time just stops where you go from ten minutes to an hour, and you've been staring at one little screen as opposed to using your your screens because you're writing on a chart or you're working on coding this or you're working on looking for this. (31:09) That's a totally different level of engagement with your brain and the screen, and that's not harmful. (31:14) And and that's why kids that have the screens on their on their the buy on themselves, where they use them for their CGM, where they use them, you know, obviously, for their pumps or whatnot, that doesn't drain them because they just use it as a quick little tool. (31:25) Their brain doesn't have to engage and try to de decipher what's happening on the screen. (31:30) So there is different levels there.
Scott Benner (31:31) Right. (31:32) Yeah.
Ernie Fernandez (31:32) And, you
Scott Benner (31:33) know You basically have been given a slot machine, which is, you know, been designed decades ago to put you down and and in in a seat, make you not wanna move, and somehow dull you enough that as you're losing money to it, you think, no. (31:49) This is still a good idea. (31:51) Right? (31:51) There's going to be there's something's going to happen. (31:54) I don't know if anybody's ever noticed this.
Scott Benner (31:56) Online gambling is very prevalent at this point. (31:58) Right? (31:59) But if you've ever sat in front of a machine or done something on like that, you can put a dollar into something, lose 80¢, and the noises and the sounds make you feel like you're you won something. (32:09) It'll say you won 20¢. (32:11) It'd be like, no.
Scott Benner (32:11) I put a dollar in there. (32:13) I lost 80¢, but it doesn't feel like that. (32:15) TikTok does the same thing. (32:17) Right? (32:18) Like, all the apps are designed that way.
Scott Benner (32:20) There's a great documentary. (32:21) I don't know the name of it. (32:23) Go find it. (32:23) It's by one of the people who who designed what do they call it? (32:27) Like, forever scrolling.
Scott Benner (32:29) Like, do you remember you used to scroll to the bottom of something and eventually would say, you're out
Ernie Fernandez (32:32) of Stop.
Scott Benner (32:32) Yeah. (32:33) You're out of content now. (32:34) Now it just it just uses what it what you paused on the longest. (32:39) So the thing that you're more likely to look at again, it just regenerates and gives you more. (32:43) You know, people call it doom scrolling colloquially, but there there's an actual name for it.
Scott Benner (32:48) And it's so devastating, Ernie, that the man who designed it has publicly apologized for it. (32:54) Yeah.
Ernie Fernandez (32:55) And and I know we're we're out of time, but I will tell you that it is not just what it's doing to your brain and draining your neurotransmitters. (33:02) It's also like we talked about last year, you know, when we talked about the four pillars. (33:06) It it's teaching people what to value. (33:09) Mhmm. (33:10) It insidiously tells you that if you're like this person, you're valuable in society.
Ernie Fernandez (33:16) If you're like this person and you're taking this substance abuse substance or you're following this thing or you're good at at hurting yourself in this way or tearing other people down, that's valuable. (33:28) Mhmm. (33:28) And so people lose their own value. (33:31) I mean, that they devalue them. (33:32) So that's why the third pillar of Sweeney is all about, you know, what we possess or what we truly possess, you know, the true virtues we have.
Ernie Fernandez (33:39) Because you get to believe what's on that scroll. (33:42) I mean, you believe what's on that scroll like it's it's it's truth. (33:46) And as a result, kids devalue themselves tremendously, and that leads once again to them to not having a want to get back up, and it leads to that discouragement again, which is the biggest enemy I think kids with type one have in in my opinion. (34:02) It's not just the pump side going bad. (34:04) It's something much greater.
Ernie Fernandez (34:06) And so that's that's really what I spend my year doing is trying to to empower these kids.
Scott Benner (34:12) Right. (34:12) Well, I appreciate you coming on to talk about it. (34:14) You're actually also here because we are gonna pick winners. (34:18) So Ernie and I are giving away six spots at Camp Sweeney in 2026. (34:25) And I have the first, I think, 50 people have put in their their entries.
Scott Benner (34:30) By the way, you can enter it juiceboxpodcast.com/giveaways. (34:34) Now I wanna tell everybody that everybody who doesn't win today, we're gonna pull two today. (34:38) Everybody who doesn't win, their name stays in for the next drawing where we're gonna pull two more, and then we're gonna pull two again so that it we've given a total of six spots away at camp, before the twenty twenty six season starts. (34:50) We'll be doing that through the winter here in 2026. (34:54) But, Ernie, they do have to pay something.
Scott Benner (34:56) Right? (34:56) So not only do they have to get themselves there. (34:58) So travel's not included, but there's a $500. (35:01) Can you explain that part?
Ernie Fernandez (35:03) That's that's the deposit. (35:04) And, you know, it, you know, it costs $6,100 for us to have somebody go to Camp Sweeney. (35:09) We're we ask families to to to pay 4,900 of it, and I we we fundraise the rest. (35:15) And then we have we do have scholarships for kids that that are financially need as well. (35:19) About half of our kids come on something.
Ernie Fernandez (35:22) But for the people on this giveaway, we have them pay the $500 deposit. (35:27) And the reason we do that, Scott, is simply because it's occupying a spot. (35:31) Yeah. (35:32) And sometimes when people get something for free, they'll occupy a spot that someone else could have had Mhmm. (35:37) And then it doesn't mean anything to them.
Ernie Fernandez (35:39) And so we asked for the deposit because of the fact that it it's secure you know, we're not turning someone else away Sure. (35:47) From it. (35:48) And so we feel it's a small amount of the entire value that they get from from going to Sweeney. (35:54) This year, it's magnificent summer twenty twenty six, and I'm more excited this summer than you know, I I keep saying this every year. (36:01) You know, it's my forty second year.
Ernie Fernandez (36:03) Every year is a totally different thing at Sweeney because we you have no idea how purpose driven we are. (36:09) You know, our group of program directors meet every Monday night for a couple of hours from September through through May to constantly titrate how these pillars work and how we make that better for each child. (36:23) And every Tuesday, our medical directors meet constantly working on the algorithms and the data. (36:28) It's unbelievable, the data that they did this year. (36:31) We had a big conference in December where they took hundreds of thousands of blood sugars from the summer, and they looked at every modality, whether it was an Omnipod five or it was a Moby or whatever it was for every age and gender, and looked at every aspect of all eighteen days that the kids are at camp.
Ernie Fernandez (36:48) If there were a 12 year old boy on the sixth day in the morning, how did a Moby do compared to an Omnipod five? (36:55) How did it do compared to a Medtronic device? (36:57) And they constantly are changing our internal protocol so that we can maximize the time on control. (37:03) Because our first pillar is getting the kids to feel normal while they're at camp. (37:06) And I am very proud to say that if you take the entire aggregate of all the kids that went to Camp Sweeney in the 2025, no matter if they were on shots or MDIs, whether they were on any kind of modality, and you look at all of their blood sugars for the summer, and you look at what their time and range is as an aggregate, remember, this is people from all over the world, all over the country that have hemoglobin a one c's that are either in their fives or unfortunately pretty high, our time and range was close to 69% Look at that.
Ernie Fernandez (37:34) Which is unbelievable. (37:35) I mean, not for one person, you think, well, that's a pretty low time and rate. (37:39) But when you take an aggregate get and you put people through a program like this with all these different modalities and you can accomplish that, let me tell you, it takes an entire year of work to make sure that you're ready for that for the next summer to try to enhance the best you can with those kids. (37:54) And so we have a lot of wonderful things in in 2026, and I'm excited to have two two people coming on board here today.
Scott Benner (38:02) Alright. (38:02) We're gonna pick their name, but let me agree with you for a second. (38:04) I think surrounding yourself with people who are all have a common goal of, you know, living a healthier life is the secret to this. (38:12) You have to have good tools. (38:13) You need to know what you're doing, but you do need to be supported all the time.
Scott Benner (38:17) I'll share with you this morning. (38:19) I got a little frustrated. (38:20) I saw someone post something in my Facebook group. (38:22) My Facebook group has 78,000 members as of today. (38:26) And someone said, hey.
Scott Benner (38:28) Did you know look at this. (38:30) This is crazy. (38:31) If you cool pasta off and eat it reheated, it doesn't impact your blood sugar as much. (38:35) And I thought and I I almost drove my head through the countertop because I've said that about a thousand times in that podcast. (38:41) And all I could think was, if you were listening to the podcast, you would already know this.
Scott Benner (38:45) And I but I don't feel like don't get me wrong, like, Ernie. (38:48) I'm like, I don't feel snarky about it. (38:49) It's just it's hard as a person who puts it out there all the time just goes watch somebody's realize that they've been struggling unnecessarily, and they've made their way all the way to the place, didn't take the last step of the podcast. (39:00) So I made a post about it just saying, hey. (39:03) Listen.
Scott Benner (39:03) Imagine what else might be in that podcast that you don't know. (39:06) Get together. (39:06) And people started coming and talking about it. (39:08) This one guy named Matt, I'm gonna use his first name, because he comes on and said something that just indicated to me that he was a listener. (39:16) It wasn't even anything deep.
Scott Benner (39:17) And I responded back, and I said, Matt said something in his reply that indicates to me that he listened to the podcast. (39:22) I don't know who Matt is, but I'm gonna guess right now that he's got an a one c between 55 and six 5. (39:28) Right? (39:28) And he came back on and said, oh my god. (39:30) My my a one c is 55.
Scott Benner (39:33) I was diagnosed at 13. (39:34) I found the podcast. (39:35) It's 55 now. (39:36) And that to me, I was like, look, guys. (39:38) There.
Scott Benner (39:38) There's your review. (39:39) Surround yourself with people trying to do good for themselves. (39:43) Good will come for you. (39:44) You know? (39:45) Anyway, we have two winners.
Scott Benner (39:47) The first two winners, you're gonna have to pay the $500 deposit, get yourself to Texas, and get yourself home. (39:52) And this is an interesting split, Ernie. (39:53) We have somebody who has been to your camp for three years and loves it. (39:57) So Hampton Madison Madison, excuse me. (40:00) Congratulations.
Scott Benner (40:01) Your child, Cooper, is going. (40:04) Contact me. (40:04) Cooper has attended Camp Sweeney for three years. (40:07) The family flies all the way. (40:08) Boy, talk about a review.
Scott Benner (40:09) The family flies from Colorado Springs to Texas for it. (40:13) That's how much they love it. (40:15) Talks about the immense relief of the eighteen day break, that that they experienced. (40:19) That's the other thing. (40:20) Ernie, you're you're inviting those kids out for nearly three weeks.
Scott Benner (40:22) It's not a not a short thing. (40:24) The second winner, Michael Gambrell. (40:27) Congratulations. (40:28) Your daughter, Newt, has won. (40:30) Michael wants to experience a deep sense of belonging and community that Sweeney offers.
Scott Benner (40:34) So, thank you so much. (40:35) Everybody else, keep going to that link, juiceboxpodcast.com/giveaways. (40:40) It's super simple to enter, and we'll pick two more. (40:43) Yeah. (40:44) I I won't drag Ernie out for the next one, but we'll pick two more maybe in a month or so and do it again a month after that.
Scott Benner (40:49) And six of you will, will have a great story to tell sometime later this summer.
Ernie Fernandez (40:53) And I I will mention to to Scott that people that live far away, if if they don't want especially if their kids already come to camp once or twice, you know, we we offer a service called point to point. (41:03) They pay an additional fee, and they can just we have if they take a direct flight from Boston or from wherever they're coming from, Florida, wherever they're coming from, we our medical staff meets them at at DFW Airport, picks them up, brings them up on a charter bus, and and gets them enrolled so the family doesn't actually have to make the trip both ways. (41:22) Basically, there's a one way or both ways, sometimes they'll bring them down to meet all the staff, but then we send them back on point to point Mhmm. (41:29) So they don't have to come all the way down to Texas. (41:31) To that.
Scott Benner (41:31) Ernie will FedEx your
Ernie Fernandez (41:32) families use that.
Scott Benner (41:33) Ernie will FedEx your kid to camp. (41:35) Look at that. (41:36) Yeah. (41:37) Get him in a nice box. (41:38) It'll be comfortable.
Scott Benner (41:38) They'll be fine. (41:40) You do amazing work, Ernie. (41:41) I appreciate you sharing this with me. (41:43) I don't know if there is an answer that's strong enough to break how awesome Instagram Reels is or whatever, but I can tell you this, and I hope you you find this to be helpful. (41:52) As a person who makes content, I'm seeing it all shift again.
Scott Benner (41:57) So for a number of years, the algorithm's been beating on my head. (42:01) Make your stuff shorter. (42:02) Make it simpler. (42:03) Make it fancier. (42:04) And I've avoided that.
Scott Benner (42:05) I've ignored it, and I haven't done it. (42:07) And right now, I'm actually seeing some of those algorithms. (42:11) I think they've depleted how much they think they can ring out of people twenty seconds at a time, and longer form content is starting to come back. (42:18) So hopefully, maybe more thoughtful ways of sharing things will be coming through people's screens in the future.
Ernie Fernandez (42:24) That is wonderful.
Scott Benner (42:25) I got
Ernie Fernandez (42:25) my fingers great work, Scott. (42:27) Thank you.
Scott Benner (42:27) You're welcome. (42:28) You're awesome. (42:29) Happy New Year. (42:29) Merry Christmas. (42:30) It's it's lovely to see you.
Ernie Fernandez (42:32) Thank you. (42:32) Yep.
Scott Benner (42:40) Okay. (42:41) Head over now to juiceboxpodcast.com/giveaways and enter your child in the drawing to win one of those remaining four slots at Camp Sweeney. (42:50) You're not gonna wanna miss it. (42:51) Check it out at campsweeney.org too if you don't know what Camp Sweeney is, but you gotta join the giveaway to have a chance to win. (43:00) The podcast you just enjoyed was sponsored by Tandem Diabetes Care.
Scott Benner (43:05) Learn more about Tandem's newest automated insulin delivery system, Tandem Mobi with Control IQ plus technology at tandemdiabetes.com/juicebox. (43:15) There are links in the show notes and links at juiceboxpodcast.com. (43:21) Are you tired of getting a rash from your CGM adhesive? (43:25) Give the Eversense three sixty five a try. (43:27) Eversense cgm.com/juicebox.
Scott Benner (43:31) Beautiful silicone that they use. (43:32) It changes every day. (43:33) Keeps it fresh. (43:35) Not only that, you only have to change the sensor once a year. (43:38) So, I mean, that's better.
Scott Benner (43:42) Touched by Type one sponsored this episode of the Juice Box podcast. (43:46) Check them out at touchedbytype1.org on Instagram and Facebook. (43:51) Give them a follow. (43:52) Go check out what they're doing. (43:54) They are helping people with type one diabetes in ways you just can't imagine.
Scott Benner (44:00) Thank you so much for listening. (44:02) I'll be back very soon with another episode of the juice box podcast. (44:05) If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple Podcasts, please do that now. (44:13) Seriously, just to hit follow or subscribe will really help the show. (44:17) If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend.
Scott Benner (44:24) And if you leave a five star review, oh, I'll probably send you a Christmas card. (44:28) Would you like a Christmas card? (44:40) If you're looking for community around type one diabetes, check out the Juice Box Podcast private Facebook group. (44:47) Juice Box Podcast, type one diabetes. (44:50) But everybody is welcome.
Scott Benner (44:51) Type one, type two, gestational, loved ones, it doesn't matter to me. (44:56) If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box podcast, Type one Diabetes on Facebook. (45:05) I created the diabetes variable series because I know that in type one diabetes management, the little things aren't that little, and they really add up. (45:13) In this series, we'll break down everyday factors like stress, sleep, exercise, and those other variables that impact your day more than you might think. (45:21) Jenny Smith and I are gonna get straight to the point with practical advice that you can trust.
Scott Benner (45:26) So check out the diabetes variable series in your podcast player or at juiceboxpodcast.com. (45:33) If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. (45:39) Listen. (45:39) Truth be told, I'm, like, 20% smarter when Rob edits me. (45:43) He takes out all the, like, gaps of time and when I go, and stuff like that.
Scott Benner (45:48) And it just I don't know, man. (45:50) Like, I listen back and I'm like, why do I sound smarter? (45:53) And then I remember because I did one smart thing. (45:55) I hired Rob at wrongwayrecording.com.
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