#1842 Two Fancy Pill Boxes - Part 1
Diagnosed with T1D 51 years ago , Suzanne discusses her journey with autoimmune stacking. She details a terrifying adrenal crisis that ultimately led to an Addison’s disease diagnosis.
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Key Takeaways
- Early Diabetes Management: Diagnosed 51 years ago at age four, Suzanne's early management relied on primitive tools like medieval-style metal lancets, basic urine tests, and limited dietary guidance, highlighting the drastic evolution of diabetes care.
- Autoimmune Disease Stacking: Suzanne's medical journey demonstrates how autoimmune diseases often cluster. She developed vitiligo and hypothyroidism (Hashimoto's) before facing a severe Addison's disease diagnosis later in life.
- Navigating T1D Burnout: Teenage years and college brought on diabetes rebellion and burnout, leading to a relaxed diet (like eating Pop-Tarts in boarding school) and less frequent testing, a common phase for many growing up with T1D.
- The Addison's Crisis: Addison's disease can present with vague symptoms like low sodium, fatigue, lightheadedness, and cramping, eventually culminating in a life-threatening adrenal crisis requiring emergency hospital and mini-ICU care.
- Steroids vs. Insulin Resistance: Managing Addison's requires daily steroid medications, which directly antagonize insulin. This causes significant insulin resistance, driving up daily insulin needs (from 28 to 40+ units) and causing unwanted weight gain.
Resources Mentioned
- Touched by Type 1: touchedbytype1.org
- Eversense 365 CGM: eversensecgm.com/juicebox
- Tandem Mobi System: tandemdiabetes.com/juicebox
- Wrong Way Recording (Rob): wrongwayrecording.com
- Juice Box Podcast Website & Bold Beginnings Series: juiceboxpodcast.com
- Juice Box Podcast Private Facebook Group (Search "Juice Box Podcast, type one diabetes" on Facebook)
Introduction & Bold Beginnings
Scott BennerWelcome back, friends. You are listening to the Juice Box podcast.
SuzanneHi, my name is Suzanne and I have been a type one diabetic for fifty one years. I feel like I was diagnosed in the dark ages.
Scott BennerIf your loved one is newly diagnosed with type one diabetes and you're seeking a clear practical perspective, check out the Bold Beginnings series on the Juice Box podcast. It's hosted by myself and Jenny Smith, an experienced diabetes educator with over thirty five years of personal insight into type one. Our series cuts through the medical jargon and delivers straightforward answers to your most pressing questions. You'll gain insight from real patients and caregivers and find practical advice to help you confidently navigate life with type one. You can start your journey informed and empowered with the Juice Box podcast.
Scott BennerThe bold beginning series and all of the collections in the Juice Box podcast are available in your audio app and at juiceboxpodcast.com in the menu. While you're listening, please remember that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan or becoming bold with insulin.
Sponsors: Touched by Type 1, Eversense & Tandem
Scott BennerThis episode of the Juice Box podcast is brought to you by my favorite diabetes organization, Touched by Type one. Please take a moment to learn more about them at touchedbytype1.org on Facebook and Instagram. Touchedbytype1.org. Check out their many programs, their annual conference, awareness campaign, their d box program, dancing for diabetes. They have a dance program for local kids, a golf night, and so much more. Touchedbytype1.org. You're looking to help or you wanna see people helping people with type one, you want touched by type1.org.
Scott BennerToday's episode is also sponsored by the Eversense three sixty five, the one year wear CGM. That's one insertion a year. That's it. And here's a little bonus for you. How about there's no limit on how many friends and family you can share your data with with the Eversense Now app? No limits. Eversense. The podcast is also sponsored today by the Tandem Mobi system, which is powered by Tandem's newest algorithm, Control IQ Plus technology. Tandem Mobi has a predictive algorithm that helps prevent highs and lows and is now available for ages two and up. Learn more and get started today at tandemdiabetes.com/juicebox.
Suzanne's 51-Year T1D Journey & Autoimmune Diagnoses
SuzanneHi. My name is Suzanne, and I have been a type one diabetic for fifty one years. I feel like I was diagnosed in the dark ages. I also have several other autoimmune diseases that we will be discussing today. I'm sure that's part of the reason why I wanted to come on here.
Scott BennerYeah. I'm looking at your list here. Suzanne, you got a you got a banger here.
SuzanneI have a banger. Yeah. I do. I do. I have I was diagnosed with, well actually I was never diagnosed technically. I have vitiligo. That was the first thing after diabetes to appear and that was about twenty three years ago. I first noticed it when I was getting married actually. And then I was diagnosed with hypothyroidism when I was pregnant with my first child. I have two kids. Almost a year ago, Mother's Day weekend, I had a fabulous spa trip at the local hospital where I was diagnosed with Addison's.
Scott BennerYou had me going. I thought you were gonna have would were going to have been diagnosed during a spa trip. And then but the lovely wording, Addison's, not fun from what I understand from people.
SuzanneIt is not fun. Yeah. I'll say that was like a slap in the face. Huge slap in the face. I think it's one thing to have grown up as a diabetic, good or bad, and it's got its pluses and minuses certainly as has been discussed on this podcast, I think, many times. That's like one thing, you know, I had that. I it was under control and then the Addison's with the diabetes is not easy. I am still working on that. It is a struggle every day.
Scott BennerSusan, I have to ask you. Your camera was on when you first came on. You've had diabetes for fifty one years. What were you born with it?
SuzanneFour no. I was four years old when I was diagnosed.
Scott BennerFirst of all, you don't look like you're 55. So good for you. Yeah. Congratulations.
SuzanneThank you.
Scott BennerTake that with you.
Suzanne55? Yeah. I had COVID on my birthday this year for the time.
Scott BennerMy god. Are they after you, Suzanne? Whoever they are, what do you think?
SuzanneThey are. But I have to tell you, that was kinda nice because he basically sat in my daughter's bedroom who's in Madrid, and I watched Netflix for five days. Not gonna lie.
Scott BennerYoung people are thinking of having children and becoming real adults. The lady just said, I got COVID on my birthday. What a wonderful gift.
SuzanneYeah. Yeah.
Scott BennerYeah. Yeah. And no one bothered me, and I sat still for a while.
SuzanneYeah. The dogs hung out with me. It was it was awesome.
Scott BennerOh, wow. Okay. Let's let's figure this whole thing out. So I heard you say you have two kids.
SuzanneMhmm.
Scott BennerOne of them sounds fancy because they live in Madrid.
SuzanneWell, she doesn't live there. She's actually a semester abroad. Oh. Or actually not Madrid. I said Madrid. She's in Barcelona. My bad.
Scott BennerI sorry. Why'd you say Madrid, you think?
SuzanneSomewhere in Spain. I don't know. She's somewhere
Scott Bennerin Spain. In Spain. I was in Spain for Yeah. I'm pretty sure. Well, when the fever hits you, what's it even matter?
SuzanneExactly.
Scott BennerHow was COVID five years later? Is it like a cold, or did it hit you hard?
SuzanneYeah. You know, it was really interesting. It was just like a super congested cold. And, like on a whim, I decided to test and all of a sudden I was like positive. I was like oh my god, I finally have it. And it was super super congested. And I did go on Paxlovid because I don't think there's any scientific evidence for this, but the last thing I wanted was another autoimmune disease from a virus because they don't
Scott BennerI don't need more room for them, actually.
SuzanneYeah. I don't. And I and, you know, I know that I was headed in the Addison's direction looking back on everything, but I, you know, it's not a coincidence that the previous year right before my birthday, I got really sick also and it was not COVID. It was not flu A. It was not flu B. It was not RSV RSV. But whatever it was, you know, I had fever. I had chills, and I ended up coughing for, like, two and a half months. And I think that just pushed me over the edge with the Addison's, quite frankly. But I'm not a doctor.
Growing Up With Diabetes in the 70s
Scott BennerWell, listen. What do I know? First of that Paxlovid, what what an ad campaign. I I forget the wording, but it bounced so nicely. Something COVID packs take Paxlovid. Was like, god. Who came up with that? It's awesome. Just really I don't know if it works or not. I have no idea.
SuzanneI don't know. It it wasn't bad. I mean, you know Yeah. COVID wasn't bad. I don't think it was bad to begin with,
Scott Bennerbut yeah. Yeah. And this is the first time you got it?
SuzanneMhmm. Well, look at you dodging dodging all the raindrops.
SuzanneI know. Yeah. And my son has yet to test positive for so I don't know.
Scott BennerFirst time I got it, I, I didn't feel good. I'm gonna be I'm gonna be able to be honest with you. There's an episode of this podcast. It's about using Gvoke HypoPen, and it's with Jenny. And if you find it and listen to it, I am, like, burning up with a fever while I'm making it. And, like, when we got done recording, Jenny was looking at me and she was, are you okay? And I was like, why? And she goes, you don't look okay. And I'm like, no. No. I'm alright. And I got up and walked out the door and my son looks at me and goes, yo, you're all wet. Oh. And I was just like, my shirt was soaked and I if you listen back to that, I don't know how I held it together while I was making that actually. And then I laid in bed and, like, you know, nearly pooped myself and was just, like, feeling terrible for a week. Anyway, I'm glad you got it, later than that. But Yeah. Diabetes, four years old, fifty one years ago. Fifty one years ago was 75?
SuzanneYeah. Yeah.
Scott BennerGod. Now in time for this bicentennial. How nice. Mhmm. Mhmm. Yeah. Tell me what you remember about growing up with diabetes.
SuzanneI remember we actually had so my dad was a physician and there were obviously no blood sugar test kits but he had a blood sugar test kit that he must have gotten through work. And imagine it like some metal suitcase that had foam padding all around it and then it was this machine that looked like, I'm not sure if it's a voltmeter, ampmeter, you know, it had some you would test the blood sugar. The lancets were medieval, square, metal, you know, you'd have to jam it down into a finger. And then this this meter, which is kinda the the needle will go back and forth till it figured out where you were, and that was used for emergencies only.
Scott BennerOkay.
SuzanneYou know? And I remember my mom would have to hold me. Someone, you know, hands would be out. Someone would prick me, and then that was the way we tested. And that was not all the time. Again, emergencies only.
Scott BennerBut you remember that from being four or five years old?
SuzanneMhmm. I remember being diagnosed in the hospital. I remember being in the hospital actually There was a traumatic blood draw situation there. I remember that. I remember getting gifts in the hospital, but I do remember that. I remember advancing to, you know, the urine tests. I I really consider it I'm lucky to be alive today considering how little was known back then. Just huge voids of no information.
Scott BennerYeah. What were they doing giving you, like, one shot a day, or how were they handling it?
SuzanneI was on two shots a day. I was on regular and NPH.
Scott BennerOkay. And do you remember eating a certain way? You ever heard Jenny talk about, like, the the schedule her mom fed her on? Like, was any of that going on?
SuzanneYeah. I don't really. I mean, I remember there was some publication from the ADA that showed a very it was like it's almost like it looked like a calendar format, but, you know, it talked about the food groups and, you know, how you're supposed to have so many carbohydrates and protein and and it was basically fill a plate with, you know, half protein or I I don't know what it was. It you know, images, pictures. And it was not detailed. My parents probably didn't cook like that anyway.
Scott BennerWhat kind of physician was your dad?
SuzanneHe was a urologist.
Scott BennerOh, not not very helpful.
SuzanneNot very helpful. But but what's interesting is that he suspected that something was going on with me and he actually brought home test strips from his office to test my urine and they were faulty and showed up fine. I think not long after that know, he was having an accident and he's cleaning up the urine and he's like, this is sticky urine.
Scott BennerMhmm.
SuzanneAnd that's when we went to the hospital.
Scott BennerFigured out like that. Yeah. Yeah. People in your life, as you're getting older, do they know about diabetes or is it easier to hide when it's just two shots a day? How do how does that work?
SuzanneIt was certainly easier to hide when it was two shots a day. Yeah. I mean, people knew, but no one knew. There was no discussion of what to do, I think, of, you know, crap at the fan. I remember on my date with my husband, my first date, I was still doing multiple injections a day. And I remember kind of, like, trying to hide giving myself the shot. And it was not long after that, I started the pump.
Young Adulthood & Boarding School Rebellion
Scott BennerHow old were you in that on that date?
SuzanneOh, like, 30 years old.
Scott BennerOh, no kidding. And you were still trying to kinda keep it to yourself?
SuzanneYeah. Yeah. It's not what I wanted to reveal on the first date. Right?
Scott BennerWell, no. Yeah. I I get that. But what was his response? I guess it was a good one because you married him.
SuzanneSo Yeah. Yeah. I mean, he was accepting, you know, that I was a diabetic. He was like, okay. You know, I think he wanted to know more about it, But, yeah, he was fine with it.
Scott BennerYeah. There's someone out there for you is what I try to tell people all the time because there
SuzanneThere's a lid for every pot. That's what he says.
Scott BennerIs that what he says? Which one is he the lid or the pot? I
Suzannedon't I don't know.
Scott BennerI think it's insulting either way if you would no matter what you Exactly. What you are. Exactly.
SuzanneYeah.
Scott BennerWell, okay. Can I ask, like, getting married later in life? Was that to do with the diabetes? Did you find yourself No.
SuzanneNo? That's because I lived in New York City. That was all about meeting a guy.
Scott BennerOh, who wasn't on Coke and acting like a lytic?
SuzanneExactly. That was just living yeah. Exactly. Gotcha. Yeah.
Scott BennerBet you that took a while.
SuzanneIt did take a while, but I don't consider mean, I think for the city, that was probably average. You know?
Scott BennerMhmm. Which people are trying to build careers, make money, stuff like that, hustling around, having a good time, that kind of thing.
SuzanneRight. Right. Right. Working. Working too much.
Scott BennerFinance by any chance?
SuzanneHe's in finance. I'm not. I used to teach, and now I work very part time. I'm a tutor.
Scott BennerWhat'd you teach in the city?
SuzanneScience, AP bio, biology, chemistry.
Scott BennerWow. That's awesome. What led you into that line of work?
SuzanneYou know, I wouldn't be surprised if it's, you know, at some level due to the diabetes. I actually had wanted to go to medical school and in college, that was the goal until one day I decided I did not want that lifestyle So I went ahead and took the MCATs and I think that was the happiest day of my life when I had that chapter behind and I went ahead and took them so that if I ever wanted to go back, the door was still open. But I decided that's not what I wanted to do and I liked science so I went into teaching.
Scott BennerI remember taking my wife to the MCATs. Oh. Man, she was, like, she was young and nervous and
SuzanneOh, yeah.
Scott BennerIt was like a whole day. It felt like
SuzanneI All day. Horrible. Horrible experience, which is why it was the happiest day of my life when it was over. I was like, thank god.
Scott BennerRight? Like, I might have dropped her off and picked her up, like, six, eight hours later or something like that.
SuzanneYeah. Yeah. Very grueling.
Scott BennerYeah. Jeez. Yeah. Oh, my goodness.
SuzanneSo I think I made the right choice.
Scott BennerYeah. Has teaching been fulfilling?
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SuzanneCheesy has been very fulfilling, and, I quit when I had the kids. We, I was commuting into the city teaching. We had moved out to the suburbs at that point in time. And tutoring's been great for me because now I get to choose how many students I want. I still work, you know, one on one with these kids, and I really enjoy it, quite frankly. It keeps me not current too with the science.
Scott BennerOh, yeah. So you're not that person who's like, I didn't know we did math like that.
SuzanneRight.
Scott BennerYeah. You didn't fall that far behind. You know, I just realized my my sister-in-law, she tutors over Zoom with
SuzanneThat's what I do.
Scott BennerStudents in China.
SuzanneI don't teach students in China.
Scott BennerYeah. Yeah. It's a little hard because the time is weird. She's up really early doing it. Mhmm. But she's like, it's really kinda really interesting. Like, she's enjoying it. So, anyway Yeah.
SuzanneI have a student in California this year and yeah. It's it's it's great. I it it keeps me busy. You know? Yeah.
Scott BennerYeah. I like it. Very nice. Yeah. Awesome. Okay. So you've got this diabetes thing. You're growing up with it. It sounds like you were fairly well, like, regulated, meaning, like, you're not upset by it or thrown by it too much. It didn't it wasn't a big It's
Suzanneall I knew.
Scott BennerYeah. Not a big consternation in your life, really.
SuzanneNot a yeah. It it's all I knew. I think, you know, during the teenage years when I rebelled, I did rebel against my diabetes, you know, teenage years and college was definitely not the best control. I had to get buckled down later on. And, when I was living in the city and had good doctors, who could guide me in in ways to get that just to change, I guess, my attitude and how I was handling my diabetes. I think that's pretty typical.
Scott BennerYeah. Can I understand that better though? What Yeah. So there's a moment when you're out of your you're a teenager, and there's that I'm gonna fight against the world feeling. And then you choose well, not choose consciously, but you pick diabetes to fight against. What does that mean? What's your management style right then? Like, what is it you're not doing?
SuzanneHere's what it was.
Scott BennerYeah.
SuzanneI actually went to boarding school, and that was my choice. And when I was in boarding school, I think this sounds kinda silly, but you could eat anything you wanted. You know? I think I had a Pop Tart for the first time in boarding school. Like, I would never have had a Pop Tart
Scott BennerMhmm.
SuzanneGrowing up.
Scott BennerBecause your parents wouldn't have bought it?
SuzanneWe wouldn't have bought it. Not at all. I never even had boxed mac and cheese as a kid growing up. My mom would make mac and cheese but not you know nothing crazy fancy and it was just simple and in boarding school I could have boxed mac and cheese, I could have pop tarts. So I think I don't know if it was so much of a rebellion versus well, definitely it was a rebellion, but also an exploration I would say. As a result of the diet, my diabetes I think suffered.
Scott BennerHow was it tracked then at that time?
SuzanneSo it I feel I I mean, I know in college, there were definitely a one c's, but I don't know how it had been tracked with a one c's. Right?
Scott BennerI mean, you would think blood draws, like, maybe twice a year, something like that.
SuzanneYeah. Yeah.
Scott BennerAnd then your dad had to have been was your dad like involved still?
SuzanneYou know, I don't know how involved he was at that point in time actually. Yeah. You know, my mom was the one who would take me to the doctor's appointments and I went to a really good university, like medical center for my diabetes growing up. So I had great care. I went to diabetes camp, which I think was amazing, probably one of the best things my parents did. But I know that when I was in college, I had to go to, like, a different hospital system because I was, like, thirteen hours away from home. I didn't love that endocrinologist. That probably had something to do with it too, I feel like. You know, you have to I think at that age, it is important to like your doctor
Scott BennerYeah.
SuzanneBecause they have such an important impact on you.
Scott BennerHey. You just said something. I have to make a note to myself. I'm sorry. Hold on one second. I just got done giving away a bunch of spots at Camp Sweeney, And I have an offer to make all the people who weren't chose it's like really like, a really nice offer from Camp Sweeney. I I'm supposed to send an email out. I just realized I didn't do that yesterday. So, I just made a note for myself. I'm sorry. Thank you.
SuzanneDon't worry.
Scott BennerDon't worry. You reminding me. I definitely wouldn't have got that done today. So camp was valuable, but you're pushing back. Are you regular in Miles per hour in college, or are you have you moved up to something else by then?
SuzanneI might have been on seventy thirty or something else.
Scott BennerOkay. But still just you're still just taking a few shots a day. Oh, yeah. What did it look like? You just weren't doing it?
SuzanneOh, no. I did my shots. I did my shots, but I wasn't testing all the time. Okay. You know? Yeah.
Scott BennerYeah. So Yeah. Whether or not those shots were enough for the food you were eating, that was not a thing you were concerned with?
SuzanneProbably not.
Scott BennerOkay. Yeah. Got it.
SuzanneYeah. Or at least not all the time. You know, I don't remember having, you know, crazy lows or and I've never been in I've never been in, knock on wood, as I'm doing right now, I've never been in DKA. So somehow I survived all this. Like, I honestly don't know how.
Scott BennerDo you have long term complications from diabetes?
SuzanneYes. I would say some. I have been treated for diabetic retinopathy in my eyes. My eye doctor was holding off for a very long time on treating them and finally he's like, well, let's just do it and see how you respond. And then I responded beautifully, he said, and he's like, well, let's do the other eye. My eyes have been treated. I see him now once a year. I have had some trigger fingers and some and carpal tunnel surgeries for both of those. Mhmm. And knock on wood, I think that is all of my complications except for all these autoimmune diseases, which I don't consider a complication.
Autoimmune Comorbidities: Vitiligo & Hypothyroidism
Scott BennerNo. No. No. I I wouldn't either. What's the treatment for the eyes? What'd they do?
SuzanneThey just did the laser.
Scott BennerOh, the laser. How was it?
SuzanneI don't even remember, Scott. That was, like I'm trying to remember when that would have been. That would have been pre 2000. It was oh, actually, no. One eye was after. It was totally fine. You know, it's just a weird feeling having your eyes lasered. Yeah.
Scott BennerI'm I I don't know, but I imagine. Yeah. When people talk about the diddles, and they're like, you don't feel it. I'm like, I don't understand what you're saying.
SuzanneYeah. I know. They numb it and yeah. I've also had this is not because of my diabetes, an iridotomy, and that was because of the shape of my eyes. They thought the pressure was just creeping up a little bit. Mhmm. So I had that more recently, and, again, that was not bad at all.
Scott BennerOkay. So what's the next thing that comes? So you have diabetes. You're in college. Do you have something else by then, or when does this no.
SuzanneThe vitiligo is what first appeared.
Scott BennerThe vitiligo. Is it very noticeable?
SuzanneSo in the summertime, it is. But I don't think it's horrible. You know? It's you see it definitely on my hands. It's harder to protect my hands if you're washing your hands as sunscreen comes off. Mhmm. So my fingers are definitely lighter. I know I have it on my face a little bit, but if you were to see me, you wouldn't notice it at all. No one else would notice it. Know exactly where it is. And then it's also on other parts, like, weird parts of my body.
Scott BennerI liked earlier when you said it's, like you said it's not diagnosed. I was like, that's
SuzanneNo one ever told yeah. Like, I don't know when I figured out I had that.
Scott BennerI mean, I'm assuming you looked and went I think there's patches of uneven color on my skin. Right? Is that Yeah. Yeah.
SuzanneYeah. It was no big deal. Like like, it was just like, oh, yeah. You have vitiligo. Like, whenever I eventually found out about it, it was no big deal.
Scott BennerOkay.
SuzanneAnd I don't consider it a big deal. Like, this the vitiligo is the least of my concerns.
Scott BennerSo I wouldn't I mean, putting myself in your shoes, I wouldn't imagine. But at the same time, it's interesting to think, like, you have something. You're like, I don't even need somebody to tell me this officially. I I get it, and there's not nothing I can do about it. So what happens next is the is it the Hashimoto's with the pregnancy?
SuzanneExactly. Exactly. Yeah. Yeah.
Scott BennerAnd that's twenty five
Suzanneyears ago? '21 that was twenty one years ago.
Scott BennerTwenty one years ago. Mhmm. And are you taking medication for it?
SuzanneYeah. I take Synthroid, and my TSH TSH is below two. You'll be happy to
Scott Bennerhear it. I will be happy. Thank you.
SuzanneYes. You're welcome.
Scott BennerI just checked. Somebody told me the other day that they had a TSH of seven, and the doctor was like, well, it's not over 10. You're fine. And I'm like, wait. What? No. Yeah. That's not good.
SuzanneYeah. Yeah. No. And and you might find this funny. I don't even consider the hypothyroidism to be a huge deal.
Scott BennerWell, if it's not impact if you're not you're not tired of
Suzanneimpacted by it. Right.
Scott BennerYeah.
SuzanneYeah. Yeah. Yeah. Yeah. Take my pill for that. Mhmm. And that gets monitored every three to four months. Okay. So I feel like I'm that's controlled. Usually, every winter, my nails just go they're just they're just they're horrible. They just get so bad.
Scott BennerBrittle?
SuzanneBrittle, peeling, cracking. Ironically, this is the first year it hasn't happened. But yeah.
Scott BennerOkay. You know, I think that's an interesting one because if if your energy stays up, I think that's the worst impact from from Hashimoto's. I mean, there's a you could get a goiter or something, but I'm saying, like
SuzanneHere's my thing about that, Scott. Like, I'm a busy person. I'm a mom of, like, two kids. I've got two dogs. You know? My husband commutes to the city all the time. Like, life is exhausting to begin with.
Scott BennerYou think you might not notice? You might
SuzanneYes. I mean, like, so, you know, unless you're so exhausted that you're, you know, bedridden, I don't know if I would notice that.
Scott BennerI have to tell you that over the last couple years of my life having lost weight and using the GLPs and everything, I feel a a different level of good than I ever have in my life. Like, now when I'm tired, I think, oh, something's wrong with me. Yeah. Yeah. Because I'm just generally like, I feel the way I feel right now, which is to say energetic and focused and, like, all that stuff. But I was just saying to, Kelly this morning because we both lost weight, and I said, hey. She came in the I was in the shower. Actually, it would help people to know that, when I say I don't plan for the podcast that well, I was in the shower at 09:58 this morning, and this start this started at ten.
SuzanneSo Yeah. Yeah.
Scott BennerSo I'm in the shower, and Kelly's getting dressed. She's gotta go into the office, and she looked nice. She came in and I said, hey. You look great. And she's, oh, I have to go to the office. And I was like, well, at least your butt looks nice. That'll be nice for people who see you. And we were chatting like that, and then she I said, you look terrific. Then she grabs, like, a spot on her, and she's like, well, this. And I said, Kelly. I'm like, go to the grocery store next time. I said, find five pound bag of flour. Pick it up. Figure out how much weight you've lost. Divide it by five. That's how many bags of flour you got rid of. I was like, and then, like, find some perspective because you look terrific. You know?
SuzanneYeah. Yeah.
Scott BennerBut on top of all that, I feel different.
SuzanneThat's great.
The Addison's Disease Crisis
Scott BennerYeah. I mean, I've weight, but, like, it's I don't know that the weight is the greatest thing. Like, visually, it's not my biggest deal. It's it's just how I feel.
SuzanneYeah. But I have to say being well, I was gonna say being on steroids now and being diagnosed with the Addison's, I know there are people who are really struggling with Addison's. They can't get out of bed or, you know, they're so fatigued. I have to say that I feel great on the steroids now. And I don't think even when I just said a few minutes ago, like, you know, what's exhausted? You know, when you have hypothyroidism, how do you know? I do know in retrospect that I probably was a little more exhausted before that diagnosis and just didn't realize it because I just attribute it to life.
Scott BennerYeah. Well, I think when you live with autoimmune issues, if you're tired, you should maybe have your thyroid checked. Yeah. You know? Because it is I mean, in for a lot of people, it is correctable with a pill once a day. Mhmm. Do you ever find yourself not taking the pill, or do you just take it you take it religiously?
SuzanneI take it religiously. Okay.
Scott BennerYeah.
SuzanneYeah. Yeah. And now with the Addison's, I bought this fancy pill box for, you know, dividing up my pills now four times a day. I mean, it's crazy, but there's yeah.
Scott BennerYou're making getting older sound so sexy. You're don't freak. I got COVID and got to watch Netflix, and I have a fancy pillbox, Scott.
SuzanneFancy pillbox. Yeah. Love the pillbox. I love it.
Scott BennerI'm really living is what I'm saying.
SuzanneSad, but true.
Scott BennerHow does the, Addison's, like, rear its head? Like, what is the first thing you notice?
SuzanneSo that's a good story. Let me back actually, let me backtrack this. So I was diagnosed the weekend of Mother's Day. Right? The week before, like a full week plus before, I had just seen my endocrinologist, and everything was great except for my sodium level. You know, sodium is supposed to be in a very narrow range. I'm trying to think, like, the lowest is it's I don't like, one thirty five might be the lowest it's supposed to be, highest of maybe one forty five or something like that, like, it's a tiny range.
Scott BennerMhmm.
SuzanneAnd I had been flirting with low sodium for a while. I had also been on a medication called spironolactone. I don't know if you've ever heard of this one.
Scott BennerYeah. Sure. My wife used it for a while for period pain when she was younger. Okay. Yeah.
SuzanneYeah. People use it for hair loss. People go on it for acne. Yeah. Yeah. I mean, you go on it for a million and one reasons. I actually went on it for hair loss, and I had been on it for a while. It's also a diuretic. So, you know, we the first question was, you know, after my sodium
Scott BennerOh, salt. Okay. Yeah.
SuzanneYeah. Yeah. Yeah. Yeah. So make you go to the bathroom. And I wasn't even on a high dose, but, my endo was like maybe you need to go talk to your GP about this. And so I knew he was going to say go off this spironolactone and I was ready to go off it. I was like fine. So I quit that a few months before and tapered myself off. Went to see her that Wednesday, good week plus before, and my sodium's still low. But everything else is fine. Mhmm. Now in retrospect, there were a lot of other things that you don't think of telling the doctor.
Scott BennerOkay. Like
SuzanneFor example yeah. So workout three days a week when I would do a burpee. Like, if I did a proper burpee when you're down on the ground and you, you know, do the burpee thing and you stand up, I would feel lightheaded. So I had stopped doing them where I would stand up after you, you know, your legs out. You know, I'm trying to explain that. Sorry. It's hard to do that conversation. But if you know what a burpee is
Scott BennerYeah.
SuzanneYou know. So I would just stay down and do them. I also had a lot of leg and foot cramping, particularly in the summer. That had been for a couple of years. So there were these things that were probably signs, but they're so vague. How do you know? Yeah. Right? So, anyway, so then so there's that Wednesday. The following Wednesday, literally a week later oh, wait. Sorry. One more thing. One more detail. I have a frozen shoulder, and that was because I was playing paddle tennis, and I went and got, like, trying to do an overhead shot and something popped, snapped, made a noise in my shoulder. And I remember thinking, great, wonder what that was. But no pain, nothing, and then sure enough, sometime later, my shoulder starts to freeze up.
Scott BennerYeah.
SuzanneSo, you know, look, I'm a woman, menopausal. Yes, I have diabetes. I also have hypothyroidism. That, I don't even consider that necessarily a complication of diabetes. That was probably just waiting to happen. And I'd also had previously another frozen shoulder from moving, like moving all the boxes around, unpacking, all that.
Scott BennerI think frozen shoulder is a I mean, that really could be a complication of the diabetes because you've got trigger finger too. Right?
SuzanneYeah. Yeah. Yeah. It totally could be. Yeah. You know? But I think no matter what, like, I was probably destined to get that with the hypothyroidism, menopause. I mean, like, all of those reasons.
Scott BennerActually, I like your attitude around it a lot. Thank
Suzanneyou. Denial? I don't know if maybe.
Scott BennerI don't know if it's denial or if it's just like, yeah. It happened. And then It happened. Yeah. Right.
SuzanneYeah. And I knew the funny thing was I knew as soon as I had the first one, and I went to the doctor like months after it first started, I knew I'd get the second one. It was just a matter of time. And sure enough, that one stroke on the paddle court. So I had been dealing with this frozen shoulder and starting that Wednesday before I went to the doctor, following weekend I hadn't slept well and I was blaming my frozen shoulder because why not? You know it's uncomfortable at night sometimes so I wasn't feeling great. Monday I go work out and in retrospect the person I work out with and the two people I work out with they were like, Yeah, you didn't look so great. Go have lunch with my mother-in-law and she told me I didn't look so great. I was like, okay. Tuesday I have dinner or lunch with a friend, not really hungry, kind of a loss of an appetite. I decide that night just to have a peanut butter sandwich for dinner. Then Wednesday I wake up and literally my husband is walking out of the house to go to California until, I guess, Friday night.
Scott BennerOkay.
SuzanneAnd I crossed paths with him to walk into our powder room to vomit. He turns around and he looks at me and he's like, Do I need to stay? I was like, Nope. I got this. Because I don't know how many diabetics are like this, but when I vomit, there's a very good chance I'm going to get ketones.
Scott BennerOkay.
SuzanneSo I start to play what I call the ketone game where I take Zofran and I try to hydrate with electrolytes and try to keep some carbohydrates in me of some sort to prevent the ketones and to stay out of the hospital.
Scott BennerMhmm.
SuzanneSo that's that's like the normal protocol.
Scott BennerYeah.
SuzanneSo I just tell them, nope. I got this. I was fine for the rest of the day. I even picked up my son for something, drove him, went into takeout because I wasn't feeling good enough well enough to make dinner and didn't really have an appetite to eat that. And I would say by around 08:00, I'm like, yeah. I'm not really feeling well at all. And I called my dog sitter who also happens to be a type one diabetic.
Scott BennerI was like, why are you calling your dog sitter?
SuzanneWell, husband's away. I've got my son here. You
Scott Bennerknow? Okay.
SuzanneHe's gonna have school. And I called her, and I was like, are you available if I have to throw on the towel and go to the hospital? Like, I just needed to know, like, is she available?
Scott BennerYeah. Yeah.
SuzanneThat's it. She's like, yep. Any anything you need. And sure enough, by the time my son goes to bed, I get sick again. So I, like, I managed, like, twelve hours plus not getting sick. And I feel like this always hits the van at night. Right?
Scott BennerYeah.
SuzanneAnd I'm getting ready for bed, and I throw up again. And I'm like, you know what? Like, this isn't right. Like, there's something going on, and I had no ketones.
Scott BennerRight. So do you start thinking at that point maybe this isn't what I think it is?
SuzanneI didn't know what to think, Scott.
Scott BennerOkay.
SuzanneI did not feel well.
Scott BennerOkay. Well, you're starting to get dazed and not really I don't know.
SuzanneYeah. But, like, I just I didn't feel well. And I called I called Jackie up, my dog sitter, and she immediately came over. And then I'm, you know, ready to take myself to the ER and she's like, no. You're not. So she drives me and as a diabetic, you get in pretty quickly. Usually, it was I think it was also a slow night.
Scott BennerMhmm.
SuzanneBut this is, like, the local hospital and they do blood work, and they tell me that my sodium is one sixteen. And that's really low. Like Okay. That's severely low. Like, I could have confusion, seizures, coma, like, bad stuff. And they immediately sent me off for a CAT scan to make sure my brain hasn't swollen, and lucky enough, it had not. And I think oh, go ahead.
Scott BennerNo. That's just horrifying. That's all. Also, your husband's about to do a round trip over to California is what I just heard too. But
SuzanneYou did not hear that, by the way.
Scott BennerOh, he didn't come back?
SuzanneWell, we'll get to that.
Scott BennerBut Okay.
SuzanneDidn't know how bad it was, Scott.
Scott BennerOh, okay. Okay.
SuzanneYou know, so they tell me my sodium is on 16. I don't know what that really means. So I'm like, okay. I have low sodium. They do the brain scan. And then next thing I know, they're admitting me. And I didn't know they admitted me to the mini ICU, so I have no idea.
Scott BennerOkay.
SuzanneAnd I didn't know until, like, I was practically being released, the day I was being released, that I was in the mini ICU.
Scott BennerWhat's mini ICU mean? Is it are
Suzanneyou medical? Like, that's what they called it, but it's like the the wing opposite the ICU so that if they have to admit you to the ICU, it's a step up or step down from the ICU, basically. Okay. Yeah. And they wanna be there, I guess, because if they couldn't raise my sodium correctly, properly, or had any issues with it, I'd have to be in the ICU. Geez. Yeah. So they had no idea why my sodium was low either at this point in time. They just know that it's low. I think they get nephrology involved because, yes, it could be my kidneys. I didn't know all of that at the time, and I wasn't confused. Like, I was very
Scott BennerMhmm.
SuzanneCoherent. It was it's kinda weird.
Scott BennerHow long are in the hospital for?
SuzanneI was in the hospital for four days. I will say they handled the Addison's very well. Oh and another symptom that I didn't realize, my blood sugars were really low beforehand and I remember commenting on that. Was like, Gosh, I can't get them up. I wonder what's going on. And it was kind of weird that that had happened and that continued in the hospital for a few days too. But they diagnosed me with Addison's. My husband did stay in California. I didn't say come home. I had girlfriends and family who were here. Think had it been known that I was in the mini ICU and perhaps how serious it was, obviously, he would have come home.
Scott BennerYou know, like, we've been married a long time, but not that long. Yeah. Yeah.
SuzanneYeah. Yeah. Yeah. So I'm glad I listened to myself. Right?
Scott BennerLike Yeah.
SuzanneIt definitely was the right thing because I'd hate to think about what would have happened if I hadn't gone in when I did. I think my body was so used to having to work at a lower sodium level to begin with that a sodium level of one sixteen, I was not having any complications from that, which I feel very fortunate. But they didn't do such a great job with releasing me with the steroids and the meds. And within a few hours of being released from the hospital, I was not right. Oh. And there were I was confused. I was hearing noises, and my legs felt like there were weights in them, and they were pulling the weights were pulling me down to the ground. And I knew something was wrong with me. Again, like, I knew this is not right, and I knew I was confused. And the worst thing you can Google or do is Google. Right? Like, you shouldn't Google when I don't know. Maybe you should. I don't know. I did. And I think part of it is like my because, you know, I I can Google something and understand a lot of the science behind it to a certain extent. And I was convinced that they had not raised my sodium correctly, and they had caused nerve damage to me. Like You
Scott Bennerand Google figured this out together?
SuzanneYeah. We did.
Scott BennerYeah. Yeah. Yeah. Did you Google and see I I think about AI so much now, not Google. Like, I would have been like, I think I'm confused and I think AI would have been like, how do you know? Know You what I mean? And then you would have got caught in an existential conversation.
SuzanneWell, part of it I know. Part of it was that they said they would do another CT scan on my brain and make sure everything was okay and they didn't. And then I I started going down that rabbit hole. Oh. I mean, I was not right Scott.
Scott BennerYeah, no I hear you.
SuzanneI should have been this confused when I went into the hospital, not when I came out. And you know my husband knew something was not right and I was like we have to go back to the hospital. And for some reason we called my endo. I actually had her cell phone number because I've done a lot of studies with her practice in the and I had her cell phone number and she's like yeah, you need to go back to the ER. And it was like, we go to New York City or do we go to another university hospital that's close by? And we decided she thought New York would be too much of a mess in the ER, and we went to the other hospital. I thought I was having a stroke in the ER, Scott. My husband's like, you were not having a stroke. Oh, yeah. I mean, was not myself, and he's like, she's not right. I know she's not right. I was like another person, like a crazy person.
Scott BennerYeah.
SuzanneI mean, I can look back and laugh at this now.
Scott BennerBut It's scary at the time.
SuzanneAt the time, it was scary. Like, I was convinced I was having a stroke.
Scott BennerHe's too old to date. You know what I mean? He's got a there's he's got concerns as well.
SuzanneStuck with me.
Scott BennerYeah. He's like, I got this lady's gotta hang in there. I don't wanna do this again.
SuzanneExactly. He's got kids. That messes it
Scott Bennerall up. Yeah. The kids seem to like her. I don't this is bad. We gotta figure this out. God, I don't wanna do the laundry.
SuzanneRight.
Scott BennerSuzanne, wake up. But you felt like you were having a stroke?
SuzanneI did. I was convinced I'm having
Scott Bennera stroke. Okay.
SuzanneI mean, it probably didn't help that I saw the signs for stroke, like, right across from me. But, I mean, like, I, like, I felt like my mouth was getting swollen. I was having trouble swallowing, like, all this crazy stuff.
Scott BennerRight.
SuzanneSo they actually ended up doing a CT scan of me, my brain, I guess, I don't know, in the ER. And actually, that was one of the most psychedelic experiences I've ever had and that is the only way I can explain it. It was not like my first CT scan a few days prior. It was the psychedelic light show. I don't know what was going on. They ended up admitting me and this is also a little weird. I had had to transfer me to another one of their hospitals within the system just like on the And other side of my only experience with that other hospital was that I knew someone's dad who was a psychiatrist and that was his hospital. That's where he saw his patients. Okay? So that that's important because when once they got me transferred to the other hospital, and this is like late at night, by the way. Mhmm. I wake up at this this this other hospital. You know, they they set me up. There's a a woman who I'm sharing the room with who is I can't see her. The the screen is between us, but she's talking about fentanyl patches and all this stuff, and I'm like, okay. This is really interesting. And I hear screaming noises from the hallway from patients. Okay? And for a minute there, Scott, I literally thought was Mother's Day, the way.
Scott BennerPut you in a psych ward.
SuzanneYes. And I was like, I'm not crazy. Like, I was like, I'm not crazy. But how would you know if you are? Know.
Scott BennerYeah. This is the worst season of Sex and the City I've ever heard.
SuzanneI thought I'd woken up in a cyborg, and it it became very clear soon enough that, obviously, I had not. The woman next to me had she had a tumor in her pancreas. I mean, so, like, they were gonna have to do, you know, whipple and all this stuff on her. The poor woman, she was super nice. I talked with her. The screams from the hall were the patients with dementia. You know?
Scott BennerMhmm. You're like, I could give you some insulin advice, but I am tripping balls right now, so I don't think I should tell you anything.
SuzanneI was fine.
Scott BennerI was fine. By then, you were okay? Okay.
SuzanneYeah. So they actually said there were two things they said. They said one thing that they thought I was having a panic attack.
Scott BennerOkay.
SuzanneMaybe. I don't know. Probably. Could've. It could've have been
Scott Bennersteroid to me a little bit, but go ahead.
SuzanneRight. Right. So, you know, I've had one panic attack before. It was not like that at all. Mhmm. That was during COVID when I had to fly for the first time to go visit my sick parents. So that was something totally different. And then when I've been in the ER, you know, they were trying to figure out if I was in DKA, and I remember flipping out in the ER because, like, I was like, I've never been in DKA. What are you talking about? You know? Like so I don't know. It there was just a lot of confusion. I think I was in. My endo now says she thinks I was having a crisis. She had connected, unbeknownst to me behind the scenes, connected with other doctors at this hospital, and this lovely doctor came to visit me. She was pregnant with her second child on Mother's Day. I, you know, bless her for coming in that day. And she was like, you're fine. She's like, you have to eat. I think I had some ketones, but nothing crazy. She's like, you just need to eat. And she's like, you need a week, and you just need to deal with this new diagnosis. She's like, you're gonna be fine. We finally made it home for dinner. That was the beginning of Addison's except for the fact that I came home. So that's Sunday night. On Tuesday, I had a Zoom call with my end up, and I asked her if I could be readmitted. I was like, can you can we just start this all over again, please? Because at this point in time, I had two different hospitals telling me what steroids to take when. Like, it was such a mess, Scott. Yeah. And she was so amazing. Like, you know, I met with her 08:30 in the morning on Zoom. She told me what to take, and then she hooked me up few months later, it took with an adrenal specialist in her practice.
Managing Steroids, Insulin Resistance & Conclusion
Scott BennerI was gonna say, who manages the the Addison's?
SuzanneSo I see two Endos now.
Scott BennerYou have an Endo for diabetes?
SuzanneI don't know if I need to, but you know what's crazy is that I I asked my Endo. I was like, so how many other Addison's patients do you have? And she looked at me, she's like, just you.
Scott BennerIt's just you, me, and Google, baby. We're gonna get it. Don't worry.
SuzanneRight? And then I asked the adrenal specialist. I'm like I was like, so how many other type ones do you have? And she's like
Scott BennerJust you.
SuzanneYeah. Maybe one, but I mean, maybe one if you don't know is just you.
Scott BennerYeah. Right.
SuzanneAnd, you know, look, they're both in a med school university setting, so they don't see patients every day. Right? They see patients two to three times a week, then they're teaching, they're, you know, doing whatever they do behind the scenes with the research. So they don't have a full patient load, but between the two of them, it's almost a full patient load.
Scott BennerRight. Right. Right.
SuzanneAnd I was just like, I feel like the balloon popped when I heard that. I was like, oh.
Scott BennerOh, it's it's just it's just us. Have you found there's some people in the Facebook group that have Addison's have kind of
Suzannefound each actually a type one Addison's Facebook group.
Scott BennerIs there? Okay. Good. Yeah.
SuzanneFacebook has been amazing, I have to say. Yeah. You know, between
Scott BennerSomebody doesn't yell at you about your politics. It's awesome.
SuzanneNo. But, like Yeah. Yeah. Right. But it's like, you have to take everything with a grain of salt.
Scott BennerSure. And then filter through. It's a great starting point. You know what I mean? Like, people can
Suzannegreat starting
Scott Bennerpoint. Yeah.
SuzanneAnd I think early on, that was so important for me, at least with the Addison's, and there are so many adrenal insufficiency groups, and people have adrenal insufficiency for different reasons, different kinds. So that's really take everything with a grain of salt. That side of
Scott Bennermy health. How much more are you having to bolus for the steroids?
SuzanneIt kills me. Yeah. So that, I'm learning to get over. So I used to be on maybe twenty eight units a day, you know, maybe a day of a lot of eating or not a lot of exercising, maybe 32. But now it's around 40 something. And this is what I also hate. I feel like I have a belly now. Like, I was so proud of myself that with the diabetes, I was, like, making it through menopause and doing so well, and now I put on weight with the steroids, like, about 10 pounds. But I'm a short person, and so 10 pounds is a lot.
Scott BennerWell, I knew you were short because they put you in the mini ICU. It's a joke I made earlier, but you didn't hear it. I just wanted to do it one more time. That's all. I love that, by the way, before we started, you said you were nervous. You don't even need me. No. I could say, hey, everyone. This is Suzanne. She's gonna tell you about her life. I'll be back in an hour.
SuzanneSorry. I'm probably talking too much.
Scott BennerNo. You're doing great. I just like, you set me up for me having to prompt you, and then you were just you don't need that. So Thank you.
SuzanneThank you.
Scott BennerYou're not nervous now. Right? Mm-mm. Okay. Good. Good. Good. No. Chicken So what are you gonna do about the weight? Is it
SuzanneI wanna buy a treadmill, first of all.
Scott BennerI'm gonna buy some
Suzannestuff, Scott. Joking.
Scott BennerSo Are you gonna run the treadmill on your belly? How's that gonna work exactly? You do all what do you I don't know.
SuzanneI don't know. But here's the thing. Like, you know, I said I feel so much better on the steroids, and I do. And I feel so fortunate that I can still work out three days a week with my trainer. I'm still back doing pilates one day a week, so I'm really trying to work out.
Scott BennerMhmm.
SuzanneI make sure I do that in the morning after I take my biggest steroid dose. But with the insulin resistance, if I could just hop on that treadmill at night for even fifteen, twenty minutes, go for a walk, do it after lunch, I think it would make such a difference. At least it would make me feel good if nothing else.
Scott BennerRight. No. You do. You get nothing wrong with getting moving. That'd be awesome.
SuzanneNothing wrong with getting moving. Yeah. And, you know, I I often think about GLP ones because I feel like I am such a prime candidate for that now.
Scott BennerI wonder if it would lower your insulin needs if the Addison's would combat that the other way.
SuzanneNo. I think I think it would combat the Addison's because that's combating you know, the the the steroids and the insulin are fighting. Right? They're antagonistic, so they're fighting. And I think the GLP one that's what I think. But and there are Addison's type ones on GLP ones. I think it would, you know, reduce the it it would let the insulin work better. I really think it would.
Scott BennerWell, why are you not trying it then if that's what you wanna help?
SuzanneThat's a great question.
Scott BennerSo Because let me say this, Suzanne. You have a reasonably comfortable life. You there's things you wanna do. You do the things you wanna do. I'm you're not being stopped by insurance or money or anything like that is what I'm saying. So, like, why at least that's my my take from this. So, like Yeah.
SuzanneYeah. Insurance will not pay for it, and it is expensive. Money. Hey, that's why I tutor. Right? So what's stopping me is that it is another drug you're dependent upon. That's just one more.
Scott BennerRight? Why does that matter? This episode was too good to cut anything out of, but too long to make just one episode. So this is part one. Make sure you go find part two right now. It's gonna be the next episode in your feed. This episode was sponsored by Touched by Type one. I want you to go find them on Facebook, Instagram, and give them a follow, and then head to touchedbytype1.org where you're gonna learn all about their programs and resources for people with type one diabetes. Are you tired of getting a rash from your CGM adhesive? Give the Eversense three sixty five a try. Eversensecgm.com/juicebox. Beautiful silicone that they use. It changes every day. It keeps it fresh. Not only that, you only have to change the sensor once a year. So, I mean, that's better. Head now to tandemdiabetes.com/juicebox and check out today's sponsor, Tandem Diabetes Care. I think you're gonna find exactly what you're looking for at that link, including a way to sign up and get started with the Tandem Mobi system. Thank you so much for listening. I'll be back very soon with another episode of the juice box podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend. And if you leave a five star review, oh, I'll probably send you a Christmas card. Would you like a Christmas card? If you're looking for community around type one diabetes, check out the Juice Box Podcast private Facebook group. Juice Box Podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational, loved ones, it doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort, or community, check out Juice Box podcast, type one diabetes on Facebook. If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. Listen. Truth be told, I'm like 20% smarter when Rob edits me. He takes out all the, like, gaps of time and when I go, and stuff like that. And it just I don't know, man. Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired Rob at wrongwayrecording.com.
