#1922 Teen Factor
Teen Factor
Cold open & sponsors 0:00
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Testing. Testing.
Awesome. I used to say and I ask you to say testing, then I get quiet. And then I realized people are waiting for me to literally say, say testing. It messed me up. You are being recorded.
Take a breath. Talk to Jesus. Do whatever you wanna do. Then introduce yourself. We're gonna start talking.
Meet Kari — pharmacist, mom of four 2:53
Hello. My name is Carrie. I'm the mother of four children, wife of eighteen years. I have a daughter, my second daughter with type one diabetes. I'm also a clinical pharmacist, work in the hospital setting.
Yeah. Nice to meet.
Nice to meet you.
Nice to meet you too.
Thank you. Four kids. What's the age range?
So my oldest is 15, and then we have a 14 year old. That's the one with the type one diabetes.
Mhmm.
Those are daughters. And then we have a son who's 12 and another daughter who's 10, almost 11.
Wow. They're all very, very close together in age.
Very close in age. Yes.
Are you stealing drugs out of that pharmacy to buy pay for school college later? No. No. No. No.
No. I know you're not, but I just saw an episode of, of The Mentalist yesterday where where a hospital employee was stealing drugs for themselves. And I think that's probably why it's in my mind also.
A good episode.
Underrated television show, if you don't if you don't know. Anyway, let's find out more about you. So how long have you been married? You said eighteen years?
I was trying to figure out how many years before we started. I think it's been eighteen years. We got married in 2008. So this August will be eighteen years.
Okay. Awesome. Yeah. Okay. So is there other autoimmune stuff in your family, or is your daughter like an outlier?
Her mom’s diabetes, never named 4:19
So okay. So where to start? So my mom had diabetes. She was diagnosed around the age of 45. She's passed away.
And, you know, at the time, we didn't really discuss type one type two. She lost a ton of weight in the beginning, and that's how she was diagnosed. And she immediately got put on insulin. So to me, felt like a very type one kind of situation now looking back, but at the time, we never really talked about it. And, so How did she ever call it type one?
No. But I think that's probably what it was.
How how old are you at that time when she's 45?
So I would have been I was let's see. Let let me do the math here.
Go ahead, please.
If she was 45, she was born at '45. So that would have been '90. 1990. So I would have been 20 no. No.
No. 14. Oh, you're
a kid.
Yeah. 14.
You're a kid when she's how old what old was she when she passed away?
She was 63.
Was this from the diabetes?
So she had breast cancer about ten years before she passed, went into remission after surgery and radiation. Toward the end of her life, she started having a lot of what felt like kind of heart failure kind of symptoms, but I don't know that she was ever technically diagnosed with heart failure. But, know, she's having trouble, walking long distances without getting short of breath. Mhmm. And then she started just kind of downhill.
She had some problems with her voice for a while.
Cardi.
She was in the process of getting a diagnosis for possible return of the cancer. Like, they were doing a PET scan. And during the PET scan, she coded and ended up in the hospital and never made it out that. So that was so we never really knew if this cancer came back, but we were suspicious because I think she had had some coughing up blood, and that was obviously concerning. So
Yeah. No. I'm so sorry. That's terrible.
She lived a good life, though. She raised six children, and she yeah. She lived a good life. She she had lost my dad when I was 16. So she lived many years as a widow and yeah.
That that's hard. From having sex
so did he die from having sex so much? What happened to him?
He died from lung cancer. So we have, like, a lot of cancer in our family.
Live next to one of those big electric poles or what's going on?
I don't know. I'm not sure why we got what why we got that.
But Is the cancer in the family? Do you do you look back in other, like, family lines for cancer?
Not those particular types of cancer. Okay. You know, I think we have some GI cancer in my one of my grandparents had some stomach cancer toward the very end of their life. You know, they were in their eighties. So Yeah.
But no. I mean, none of like, you know, I have sisters and brothers and none of us have had any problems with any of these types of cancer. I have another brother that has it's either CML or CLL. I can't remember, but he does have a cancer, but it's, you know, like a chronic type cancer that you you can live with for a long time.
Do you do you get checked for breast cancer more frequently than other people? You do?
Absolutely. Yeah. Yeah. I started mammograms earlier than the typical just because of my mom's cancer history and yep. Wow.
For sure.
A lot. Okay. But how about autoimmune stuff? Anybody have a thyroid, celiac?
So my grandmother had took a thyroid medication, you know, levothyroxine, I believe. So she had hypothyroid. She's the only one I know of. I do have, a niece that has Crohn's, and I do have a brother that has diabetes, but his is also, I think, type two. I think that's technically what his diagnosis is.
Wait. Just to go backwards to your mom for a second, though. You don't know if your mom had type one or type two?
I don't really know what the doctor called it, but she immediately took insulin. Like, never took oral medication. She was not she may have been, like, slightly overweight before she started rapidly losing the weight. So, like, when she was diagnosed, she had lost lot a lot of weight. She's very, very thin, you know, like, because of that typical type one presentation.
Yeah. Yeah. You guys are Catholic. Right?
The Mormon listenership mystery 8:46
No. No? Members of the Church of Jesus Christ of Latter day Saint.
Gonna say, why are you not talking about how you feel? I just assumed Catholicism when I saw all the kids. Does does the, does the I oh oh, this is such a nice moment for me. Do you know in the beginning of the podcast, I was huge in the church? Did Oh, yeah?
Yeah. Yeah. Yeah. I had I had a couple of years where I thought maybe only Mormons were listening to the podcast. There were so many of them.
I was like I'm like, am I the number one diabetes Mormon podcast in the world? And how did that happen?
We tend to be online a lot, I think. You know, like social media, we tend to be on these kinds of things. I don't know why. We know. We connect a lot through the through these kind of things.
But The way I had it
for what it's worth.
Yeah. The way I had it explained to me finally, because I would ask every time because eventually, come on. They I mean, people come on and they have a ton of kids. You know, like, are are you are you in the church? And they're like, yeah.
Yeah. How'd you know? I'm like, I think you all are. They were listening. And and I would start asking why do you think the podcast is so popular there?
And they a lot of people they again, I just don't know anybody who I was talking to. A lot of people would say we're very community oriented. So if somebody's having success with something, it's very reasonable that they would be telling other people about it.
Other people. Yes. Absolutely. I was like, oh, no. Connected.
Very connected. So yeah.
But we don't talk about our diabetes?
With our with my family, you
mean? Yeah.
Yeah. No. So, like, as a kid, like, I remember my mom, you know, obviously giving insulin. It just wasn't I mean, I remember her getting low sometimes, and we we knew that she needed milk. She always treated her lows with milk.
I remember one particular severe low where she was, like, almost not able to take care of it herself. We never really had to do it for her, like, except for that one particular time, I think I did have to help her. But, you know, I we just didn't. I don't know.
Like It's okay. I'm not I'm not trying to make you feel bad. It's just That's okay.
No. I'm in the medical field now, and I would have a ton of questions for her if I could ask her those questions now.
Of course.
At the time, you know, you're 14. You're just not thinking about that necessarily.
Yeah. So you didn't know me when I was 14. I would have asked all those and I and I get I I think I get confused a lot of times. I I I don't know if everyone does this. I have a very bad habit of just assuming that my level of the way I think about something is how everybody thinks about it.
And then I get confused when that doesn't happen, which is is silly because I'm an adult and I know everybody doesn't think the same way. But I would just I'm I'm sitting here trying to imagine a thing about me or about my wife that my kids don't know, and I don't think I could come up with one. Right. Yeah. So that throws me off a
little bit.
But but nevertheless
I guess I guess the thing about it was, at the time, none of us had any medical background. Now I have a brother who's a doctor, and I'm a pharmacist. And so, like
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You know, when we kinda got more into the medical field, we obviously it became more of a conversation, that kind of thing. But, you know, when you're a teenager, your parent has this thing. They don't make it the center of their life. You know, we knew she injected insulin. She wasn't, like, hiding it or anything like that.
And, you know, I saw her insulin vials. But we just did what just wasn't like a regular topic of conversation on them. Like, this is what you need to do if if you if I need help.
I hear you. Do you think that her care was adequate? Or do you do you have any way to know?
So. I think so. She ended up being on I think it was Actos at one point to help with insulin resistance, and then that was taken off the market, I think, while she was taking it, so she had to stop that. I don't know if you remember that particular medication.
I don't know.
She she she saw an I'm trying to remember if it was an endocrinologist. I feel like it was an endocrinologist that she saw, and she went to the doctor regularly. I I remember her actually talking a little bit about how the doctor would scold her, you know, like the doctor got upset because this or that. So I don't know what her a one c's were. I don't think I knew she took her insulin regularly.
Like, she didn't skip doses and that sort of thing, but, you know, she may have had an a one c not quite optimal.
Okay. Okay. Well okay.
Which I probably would assume since she did have kind of some complications toward the end of her life. The main complication she always talked about was the neuropathy in her feet.
Okay. Yeah. Is it I don't wanna talk about other people's, but I've met a number of people recently. I think, to backtrack a half a second, I think that GOPs being so, like, prevalent in people's minds now make a lot of people look at me in my private life now and go, what do you know about all this? Because they've been, you know, hiding their health issues for a while.
And they know I make the podcast, but nobody ever asks about it in person. And then but a lot of people are asking about GLPs now. So I've had a couple of conversations with people, and I'm very surprised by the number of adults who look at me and go, I have neuropathy in my feet. I'm like, do you have type two diabetes? They go, no.
And I'm like, have prediabetes? They go, no. And I'm like, you sure?
Just got it checked.
Yeah. Yeah. Yeah. Yeah. Because it seems like you do.
And, know, like, the way you're talking and the things you're telling me about, I just had a long conversation with with, like, some I don't wanna call them friends. They're acquaintances. And as we were talking, I'm like, no. You are a perfect candidate for all of this. They're like, oh, my doctor won't give it to me.
Mhmm. But the doctor will put them on a statin. The doctor will put them on the 19 other different kinds of medications. But the one drug that I think would probably, like, most quickly and effectively help them with all their problems. Like, no.
You don't want that. You're gonna you'll have stomach trouble. And and that's all they say. Like, I'm like, well, what kind of stomach trouble are you expecting? And they actually say, I don't know.
The doctor didn't say it. I'm like, you didn't look into it? I was like, because I you know, I'll tell you, like, I had my fair of, runs to the bathroom in the beginning of JLP, and I was and they're like, oh, and you just kept doing it? Was like, well, I was also losing weight. And so, yeah, I was like, I I I stuck with it for a while.
You can't be a quitter. You but it's it's funny You go ahead.
A pharmacist in diabetes education 17:10
Sorry. I was gonna say in in my career so my first job as a pharmacist was, working for a university hospital system and, just kind of through the way that this clinic worked. I started out doing slightly different, pharmacy work, but I ended up in diabetes education like that, which this was like pre, you know, my daughter. Like, I wasn't married yet. I didn't have my daughter.
Of course, my mom had diabetes. So I learned a lot about the diabetes then. And I yeah. I talked to a ton of patients. Like, I met with patients one on one and ton of patients that it really drilled into me the the idea that, like, yeah, even before you get diagnosed with type two, for example, because most of the people were type two, you're having complications.
Like, things are happening in your body that are damaging your body before you even have that diagnosis of type two. Because even, you know, prediabetes, so metabolic syndrome and all that.
I I'm just I'm more I that's very true. I'm more fascinated with the idea that people can be having actual physical problems. And then when you tell them, I think this would help, they go, oh, yeah. But I don't want my belly to hurt. I'm like, well, your feet are trying to fall off.
Don't you like, I mean, like Yeah. Don't you think that's gonna hurt? And Oh, yeah.
People were always very, it was hard to get people to be on board with taking insulin too. Like, you know, when it was clear that, like, the oral medications were not covering the like, covering the blood sugars and it was time to go to insulin. It was like, that was a hard sell for a lot of people.
And then the first question always, will I how long will I have to do this for? It's always at well, like, if I use the GOP, when can I stop using it? I'm like, well, probably never. And and then they go, oh. And I'm like, what you you can't feel your feet.
Like like I'm like, what do okay. So, like, I guess we're gonna just try not to make sense a little longer. Anyway, I'm so sorry. That's okay. Yeah.
Yeah. Yeah. So what what do you notice first about your daughter, I guess?
Diagnosing her own daughter 19:09
Okay. So, in hindsight, a ton of things. But at the time, so she it was June, and it was getting hot where we were living. Obviously, everywhere, it's summertime. Start drinking a ton of water.
That was the main thing that made me think, what's going on? Mhmm. Since I'm a pharmacist and I have that background, I thought one night after she had gone to bed can't remember if she she was the type of kid around that time and prior, you know, when she was younger, she would have these mega tantrums, you know, just like meltdown. Like and I just thought, you know, I have four kids. And at the time we had all four kids and they all had different personalities, you know, and My wife thought you were gonna say sensitive child.
I thought you
were gonna say, well, if we made four and only one's broken, that's not bad. Yeah. So
I just always kind of thought she was a more sensitive child. Like, things set her off that, you know, like, maybe other people didn't get set off by, you know, and not that she was having tantrums all the time.
I understand.
Yeah. Looking back, there were kind of those major tantrums. I was like, woah. Like, where did this come from? So that night, she had gone to bed.
All the kids were in bed, and I was just I had the thought, you know what? I think she needs her blood sugar checked. And I I the realization came to me that she had lost five pounds. I think we had had her stand on the scale and not necessarily because of the die like, thinking the diabetes, but, you know, the kids just like to go and stand on the scale and see how much they weigh.
Sure.
Sure. And when she had sit stood on the scale, I realized it was five pounds less than maybe her most previous doctor appointment or something. Mhmm. And so that along with the drinking, I thought, oh, boy. So I immediately caught on Facebook and I so to, like, a neighborhood group page, and I said, is there anyone in the neighborhood that has a glucometer?
Because I did not have a glucometer, you know, even through my job. You know, I just didn't have need for one of those. I wasn't working in diabetes education at this time, but so I didn't have one. I found someone, a friend like, a daughter of a friend who had a daughter with type one, and they had a glucometer. So she set it up to come over the next day and test her.
And so we had her come over, and my daughter did not I think my daughter so she was almost eight at the time. Think she knew something was wrong at this point. Like, when I said she's gonna come over and test your blood sugar, she knew, like, wait. What? And she didn't she threw a tantrum.
Like, she did not wanna get her blood blood sugar tested. She did not wanna get a finger poke.
Right.
So that took some, you know
Do you tell her why? Did you say or we're having a neighbor's friend?
No. We did not say why. I just said we really have to do this. Like, I just knew we had to do it. So we we convinced her to calm down and let this this woman was a very nice woman, and she brought over her daughter with type one, actually.
So, like and they are that similar age. So I don't know. Somehow that probably helped just having another kid there and I I don't know. So we eventually got her to agree to let us test her blood sugar and the reading was high on the glucometer. So I I immediately knew.
My husband was home at the time, and we, she and I when I realized something was wrong, I was emotional, and she was emotional. And we took some time to just cry. We cried. Yeah. And I said, we really have to go to the hospital, and she didn't want to go.
Like, we we've had to convince her. It's it's time to go. We have to go. We have to do something. This I I know I didn't say you have diabetes, but I said, this has to be taken care of.
Yeah. So my husband was able to convince her to go to the clinic, to go to the pediatrician. She was a family friend of ours, but also our pediatrician. And so they ended they started at the pediatrician and then just got, like, direct admitted from there.
So Oh, gosh. How how did she handle it in the short term? Was it did that upset continue or did she wish I I'm Uh-huh. Definitely definitely not gonna use the word regulated. But as her blood sugar came back down, was she easier to talk about these things?
Yeah. I mean, in the beginning, it's fuzzy for all of us. But Mhmm. In the beginning when she was in the hospital, like, she did fine with the shots. Once we got home, we only stayed in that.
She was not in DKA, so we caught it before that. She was only in the hospital for maybe, like, two, three days. I feel like they did IV fluids, but other than that, like, you know, it was it was a fairly easy hospitalization, and they just kept us that long so that they could get all of our prescriptions filled and ready to go by the time we got home. So that was good to be there, you know, and just kind of get the education that we needed even though I kind of knew, but I didn't for sure know what this all meant.
Right.
So she she did well. Then when we got home, you know, she I feel like overall, she did fairly well accepting accepting that she had to take shots and poke her finger, and it was not a fight every time. You know? It was definitely, like, something new that we had to get used to, and there was crying. But overall, like, not I wouldn't say it was extremely difficult.
Were the outbursts could be blocking out the memory side
of it. You're like, it's possible. I it's possible. I just can't remember any of this. Did the outburst get lesser?
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I would say yes. Yeah. I would say yeah. For sure.
Okay. Well, it's interesting. Were you I mean, you felt ready because you probably were like, I am a pharmacist. I will be fine at this. I've done this before in the past.
Did that actually help you, or did it only go so far?
No. I think it absolutely did help me. I think in the beginning, maybe the first couple of years, I was like, we've got this. Like, I know this. Like, I can learn this.
I I think for sure that helped me. My husband's really supportive. So, you know, in the beginning, especially, like, he was helping with everything also, and so he was learning. But, you know, I think because I had had experience with, you know, what insulin is and how it works and how you test your blood sugar and even, like, the insurance, you know, like, you don't really know the insurance troubles, but you kinda do as a pharmacist. So I knew how to kinda navigate medical system to get what I needed and what I wanted.
So yes. I do think it really helped in the beginning. And I had a good attitude. It gave me a good attitude maybe more than anything. Like, I can do this.
Oh, just just a little self confidence maybe where you didn't deserve it almost.
Yeah. I
guess. Nothing wrong with that. And did that hold up or did it did it was there a ceiling and you thought, okay. What I now know is not enough. I need to find more.
Teen years, hormones, and burnout 27:06
Well, so that's kind of where we kind of are right now. I mean, not that we are right now, but gosh, we're in she's 14 now. Yeah. And hormones hit and and different types of physical activity that she wasn't doing before. And so, you know, in the beginning, I think I had I had it down, and we we were getting really good a one c's.
I think we were down to 6.2 at one point.
That's awesome. Now You're like, now they're not 6.2.
I'm a little we're all burned out a little bit. You know? Honestly, I think of it's burnout, but I think some of it's just like, this isn't reacting the same way it used to. Like, you're not you're not reacting the same way that I would have expected. We we changed to a different pump also, which, you know, that took some learning.
But, and then also in the process of it all, she's kind of becoming a little more independent. So, like, we're navigating, like, different things that we weren't navigating there in the beginning. Mhmm.
Well, do
you think
the burnout leads to, like, what do you what am I asking here? Like, do you think the new challenges lead to the burnout, or do you think it's just time that got you there?
I think it's time. Okay. Maybe new challenges also. I I anticipated hormones being tricky to to deal with, but puberty and all that, I I think it's time and just the change in management, honestly. You know?
I I think for her, as she's gotten older, she's needed more insulin, and that's difficult for her because she remembers just needing this certain amount, and it always worked. And now it's higher than that. And so she has maybe a little difficulty accepting that for some reason, even though I don't really we don't really talk about, like, more being worse. You know? But
Is this is this a feeling you're having as well? Do you think it's throughout the family? Do even siblings is is everybody just like, oh, Scott, there's enough of this already? When
I don't think so. I think so. The first few years, I was very, very involved. Like, I was doing everything with her. I mean, maybe more than few years.
I think it's probably been in the last year to year and a half to two years where she's taken a more active role. So she started changing her own pump when she went off to camp. There was a camp through school that she was going to, and she had to be there for a week, and she had to be independent changing her pod. So that's when we had her I thought, you can do this, and she knew she could do it. And so we got to that point, and she started changing her pod on her own, and she does that now.
So, like, that was kind of a milestone step. You know, she's she's a really active kid. She's, like, loves academics. She loves running. She just wants to do all the things.
And so I think maybe the burnout comes because that's always in the background. You know? Like, we're all like, I'm also mom of four. I've got a part time job. I feel like I'm managing, and I volunteer here and there.
So it's kind of like it becomes in the background, like, oh, it's there, but it's not ruling our life. But, you know, it
But it is.
Managed probably as well as it was because we're doing so many other things.
Yeah. So so go through that for a second. It's not ruling our life the way it once was. Is that because you are not paying as close attention to it anymore?
At some level, yes.
Yeah.
But I guess, like, I try to balance. Like, I want I want to be involved, but, like, you know how it is with a teenage teenager. Mhmm. They want to have some independence. Right?
And I don't I I don't know that I do a great job, but I don't wanna overstep. I I wanna make sure that she feels like she's in control somewhat. And so I've had to come to this point where I think, okay. Well, we're not perfect. Like, our a one c is not not as good as it used to be.
Sure. But, like, at the expense of me always nagging her and telling her that she needs to do this or that, like, she knows what she needs to do, and I try to gently, like, help her. But it's just not the same as how it used to be when she was seven going on eight, you know, where
she's trying
to decide. Yep.
She was little and nice? So I'm an adult. I hear that a lot.
And she's a yeah. She's the kind of kid that's kinda 13 going on 30. You know? She she feels like she could be on her own now and and make it, and she probably could honestly, to tell you the honest truth. Like, she's just does well at whatever she tries.
But
It's a it's a big part of this whole thing, and I you're outlining it so well. But for people who haven't gotten to this part yet, you know, it it's coming, and it's not a thing you fight against. It's not a thing you even want to not happen. Right? Like, you want your kids to get older and to mature and want to do things on their own.
The problem, I think, for me, always is is that during the learning period, you feel like health is waning. Yeah. And then
That's tricky. And that's been hard as a pharmacist, like, knowing, like just knowing the complications that come from even slightly elevated blood sugars. Like, that's been the hardest like, it's hard for me to swallow. And and there's been so many times, and I don't say this to her, but there's been so many times I thought, if I could just have this disease, like, I'd have it under control, you know, if I was in complete control of my body and it wasn't hers. You know?
Like, I I could get this. I really do think. But, you know Don't
you have that feeling about life in general? So you look at everybody and go, if you all just leave me alone, I could handle this. Like, I try to teach your
feelings. I really could
do it.
Maybe I couldn't, but, you know
Well Yeah. Yeah. Yeah. It it is so, I I mean, I take kind of putting this whole thing together, like, this conversation so far, even thinking back to me having conversations with acquaintances about type two diabetes. Right?
Like, people there's two things that happen here. Is your kid's diagnosed when they're young. You figure out a great way to take care of it, and then at some point, they become their own person, and that gets in the way. And then you think, well, alright. So we there's two paths here.
Either they're gonna figure it out and do a better job for themselves than they are currently doing or they're not. And how crazy is it to think when you're the mother of a 14 year old, there'll be a day when that won't even matter. Like, your opinion of that won't matter at some point. And and, like, yeah, I I say to my wife all the time, like, think back to when you were 25. Did you care what your mom was saying?
Were we over here making a bunch of decisions based on your parents' thoughts? I said, weren't. You you know, like and and Yep. And she's not going to either, by the way. So I the way I think of it is model, model, model, model as best as you can for as long as you can.
And then because then they're gonna go. And Yeah. They might turn into my neighbor who goes, my feet hurt. Are you gonna do something about it? No.
And maybe they'll turn into Jenny who's just like, I I ate quinoa today, and my blood sugar was one zero six the whole day. Like, I I don't know, like, who she's gonna be. You you know what I mean? Or who your daughter's gonna be, my daughter, etcetera. But that's a hard thing to do when you're a when you're a parent
Yeah.
Is to come to
that conclusion. It's taken a little bit of time, and I think I'm I'm getting there. I'm I'm not fully there. I still worry about it. Of course, you worry about her.
You worry about yeah. What what is your life gonna look like in twenty years or ten years even? Like, are you gonna have complications? You hear people that say they don't have any, and they've had it for so long. And then you hear people that say they do have some.
And so I you just don't know. I'm just trying to do the best I I guess we all are.
I have found that not that I didn't before, but I found that it's helped me, be more understanding about other people's problems. Mhmm. Like, you know, as an example, like a a parent or a loved one of a of an addict, for example. Like, do ever try to put yourself in the shoes of a person who loves somebody who's addicted to heroin, for example? Like, what the the the hopeless and and helpless feeling that must exist as their loved one?
And I'm not I'm not equating type one diabetes with heroin use, but I am equating it with a thing that somebody's doing that may not be optimal that you have no impact over it that could be hurting. Yeah. That could be hurting them. You know? Uh-huh.
And then and what are you supposed to do then? Exactly. Right?
So Right.
It's a I'll tell you right now. Let me say this. Kara, it's Carrie. Right? With a Carrie.
Yeah. Yep. The best part about life and the worst part about life is both people. It's always I love people right up until this happens, and then I don't like them as much anymore. I wish they just listened.
And I'm sure there's people that have been in my life that wished I would have listened. But the thing I wasn't listening about stubborn. Well, yeah, but the thing I wasn't listening about wasn't likely leading to a nine a one c. Yeah. You know?
Yeah. It's tough it's tough when you can see the when you can see the speeding up of the problem in real time. It's hard it's hard to deal with. Like, I I don't you know? Anyway, what what you said you made a list.
I I wanna make sure we what what's on your list?
What school nurses want you to know 36:24
So maybe first, like so I asked our school nurses, you know, what would you what would you want people to know? Really? I told them I'm going on this podcast and, like, I we've had two well, we've had three school nurses so far, and I reached out to two of them that we worked with a little more closely. And I said, what what would you want people to know? I've got this big audience.
And the one that was our elementary school nurse was fantastic. They've both been fantastic. She gave me a lot of things that she said, you know, you gotta remember that, like, your school nurse is not just taking care of your only, like, your child. Like, they're taking like, we we come from an elementary school that has maybe 500 to 600 kids.
Mhmm.
And so she kind of, you know, pointed out, you know, there might be some kids that get tube feeds. There might be some kids with seizures, you know, like different things that they're kind of, you know, keeping a tab on for children at the school. Right. And, you know, she's not she was not minimizing, you know, the care of my type one diabetic child.
I
understand. She did a great job. But, you know, I asked her specifically, you know, how do you feel about monitoring, you know, blood sugars through the Dexcom follow? Because we had her we gave her one of our, you know, iPads we weren't using anymore, and and she was able to follow her blood sugars. I just kinda asked her because, you know, now my daughter's out of that school.
But I said, you know, what what are your thoughts on that? Do you think it's a good thing? Do you think it's more harmful than good? Like, what do you think? And she said, well, I think it was very helpful, like, when she would test, you know, do, like, state testing that we could kinda see where her blood sugar was trending.
We could give her a little, you know, glucose, you know, beforehand if she was dropping kinda low or trending low so that she wouldn't drop low during the test. So she did feel like it was useful, but then, you know, because she pointed out that, you know, I wasn't looking at that all day, and I didn't think she was. I didn't expect her to look at that all day. I I think I probably look at it more than she did, but, you know, it was there as kind of a backup for her to to see what was going on. And it we we worked well with her.
Like, we she was very accommodating, and we went into it not thinking that she was gonna do everything for my child at school. And, like, again, my kid was she was seven going on eight when she got diagnosed. But when we had this particular school nurse, she was gaining a little more independence where she went down to the school nurse to dose, but it, or, like, to get treatment for Lowe's, but she was able to do a lot of it herself. It's so, like, the school nurse was there to assist more than anything. She wasn't giving doses, obviously.
The school nurse wasn't.
So she found the she found the iPad helpful in certain situations, but wants to remind us all that you're not the only person I'm helping today.
Right. I mean, you know, she pointed out, like, she's in charge of, like, staff members that have, like, a medical issue or, like, kids that get hurt on the playground. You know, like, they've got a lot of things that they do as a school nurse and that, like, they're not a one on one for sure, like, medical. So and and, like, I understand that. Like, we I don't think we ever expected her to be a one on one to our daughter.
But, again,
like But why do you think when you asked her to share things, why do you think that's a thing she shared? Do you think it's how she felt?
Think sometimes there's pushback from parents. Like, hey. You know, like, you need to be catching this or that with my child. I I don't know that that's really realistic unless it's a very small school and the nurse is dedicated to Yeah. I don't know.
I guess
I guess I was
some unrealistic expectations
Yeah. Yeah. I wish sometimes from parents. Yeah. Yeah.
Yeah. I I think what I was wondering was, when because if you ask me, like, what do you want people to know? And and I and my first thought was, you know, we can't be everywhere all at once. I would think that's how she felt. Like, I don't know.
It even if people didn't put that on her, maybe she's just a good person who who felt bad that she couldn't help everybody.
Possibly. You know? Yeah. I she kind of, you know, school nurses and, you know, as a pharmacist, you see all different kind of patients. And she said that we were kind of a unicorn family because I was quite involved.
Like, you know, I I checked in with her once in a while. I made sure there were snacks at the school. I made sure we had supplies. You know? I I had good communication with her.
So, like, I she became one of, like, almost like one of the teachers at the school. We had that much, you know, contact with the school nurse. She said, like, it's not always like that. You know? Sometimes there's people who like, their child doesn't have any snacks at the school or, like, they can't get them to the parents to bring supplies or
You just chase them all the time. Yeah.
So she's you see all different kind of situations, and then, you know, there's kids that may not be getting that extra kind of thing. The the extra things that they'd really need that the nurse can't really do on her own. So
Mhmm. No. Anything else? What else was on her list?
What else did she say? The main thing was, like, she did say, you know, families should know that if you can't bring supplies or you can't bring snacks, like, say, financially, this is too much or, you know, for whatever reason. Like, say, you don't have extra supplies that you can give to the school. She said there's resources out there. I didn't specifically ask her what resources, but she said there's resources.
So, like, we can remedy that situation. You just have to let us know. And I think from a nursing perspective, you know, she felt like, know, in those situations, she can't really do her job if she doesn't have what she needs to take care of her child. So she she said, you know, families need to let the nurse know if that if that's an issue so that we can remedy the situation rather than just either not communicating or, you know, not bringing the supplies.
Yeah. I wonder how hard people would find that to do to admit to a stranger they you can't afford, you know, a couple bricks of juice boxes or something like that.
Or even if it's just, like, you can't get extra from the insurance. Like, everything you have is at home for, you know Yeah. You know, because you just when you run out, you run out and you can't get extra or whatever. So
Yeah. Where am I how am I supposed to give you an extra CGM? I don't have an extra CGM.
Right.
Yeah.
Right. Right. Yeah.
I got that. So Awesome. What go. Keep going. I'm got a list here.
I wanna hear about your list.
The case for insulin double-checks 42:35
Let me look at what else I had on there. So okay. So kind of going along with school nursing, I had listened to your episode, which I think most a lot of people have listened to that episode where that nurse gave too much insulin to that child school.
Yeah.
Yeah. As a pharmacist, you know, working in a hospital so, like, nurses are always required to have a double check on certain medications in the hospital. Mhmm. And I believe insulin is one of those medications. Like, if they're running an insulin drip, they have to get a double check on if they change the rate or is this the right rate to be running it at.
Right.
So I don't think this exists, but I feel like it should. Like, I feel like nurses in schools should definitely have a double check on things. You know, if they're gonna be dosing a child's insulin, there should be a double check whether it's the parent or another trained individual in the school to double check based on, you know, their training and know like, someone that knows this child and knows what they need and understands, you know so I I feel like there should be double checks always. And so if that doesn't exist in your school, like, you should you should make that happen whether it's double checking.
I gotta point out that you just, in two different situations, pointed out that people don't have enough time to do the job they're already supposed to do. But here's some examples of where I think they should have to do more. It's not I mean, I I I hear what you're saying, but, like, real world, that's not gonna happen. Yeah. Yeah.
Well, I mean, like so insulin with it being a medication that, you know, it could have a serious adverse effect if dosed incorrectly, You know, that needs a double check. So why shouldn't a school nurse have a double check with that at at school if they have to do it in a hospital setting? I feel like that should happen at a school also.
Yeah. So Keep it keep in mind, though, that in that that scenario, that person didn't think they were doing didn't they think they were changing anything. They just made a they made a measurement mistake.
Right.
You know? Right. But yeah. I hear listen. You you you that to me falls under the category of, you know how things should be?
Yeah. I know I I know how they should I know how they should be. But
that's that's the main thing I wanna say is, like, parents should advocate for that at their school. Like, if the if your nurse is going to be dosing your child, make sure they have a double check, especially if they were drawing up insulin. Now that's where it gets, like, more a lot more high risk is if they're drawing up the insulin because it's not as high risk if you've got the the child wearing a pump and you put in the number. Right? But, like, if you're having to draw out insulin and get it to the right, you know, level on the syringe and make sure they're reading the syringe correctly, you know, that's well, that's higher risk than, like, giving a dose on a pump, for example.
I hear you. I don't functionally know how to make that happen. Like, what am I gonna do? Am I gonna FaceTime you and show you the needle?
Right. No. I mean but I think you could take a picture and send it to some the parent or you could have a double check by another staff member. I don't know. I just feel like it should happen.
You are definitely not the attorney. I'll tell you that much because if hey. We brought an attorney to this conversation. They'd They'd shoot shoot this this down six ways from Sunday. They'd be like, we're not doing that.
Give your own kid insulin. Screw off. Just do I listen. I'm not you know I'm not arguing with you. I think I No.
That's a very, like, lovely idea, and and and it would be awesome if it could happen, but it ain't gonna happen. So I can't get my township to pick up my recycling. You think that's gonna happen?
No. And I think it's more a situation where parents just have to advocate. You know? Like, there's not gonna be a rule that this happens, but if you advocate for that to happen, then and make sure that that's a hard, like you know, this has to happen if you're gonna give my child insulin. Like, I think that's I think that's appropriate.
Yeah. But I would also like to point out that it's one story in you know, with a million kids getting five doses a day in you know, all over the country in the world. It was it was a one time story of a thing.
It kinda makes you wonder too though, like, how many kids are actually getting dosed with insulin syringes at schools anymore? I I don't know. I don't have statistics on that.
Oh, I would think it's a lot. More people are MDI than are on pumps. Yeah. Yeah. Pretty by pretty significant
on a pen, but like a syringe.
Sure. Yeah. Or or a pen, you know, which now you're twisting and turning and trust me, no. Everybody's confused by everything. So, you know, like, you can try to make these pens as easy as you want.
There's always gonna be a person who's gonna be confused by it.
I There's a chance for error.
I'm stunned every day by how people are thwarted by their phone. You know, it's a thing a thing they a thing they carry with them constantly. What's the example from this weekend? Somebody tried to jump onto the Facebook page and say, hey. I don't know if any of you are using that that bolus estimator on Scott's website, but you can, like, create a shortcut on the on your, on your phone you know, to so you don't have to go to the website every time.
You can just click on it. Like, it almost acts like an app because it's a button. Uh-huh. And Yeah. Then watching people go, I wanna do that.
I can't figure that out. I can't like, I'm watching that. I mean, you're saving a shortcut on your on your phone. It ain't hard. Okay?
And and I'm watching these people try to do it. I'm like, oh my gosh. Guys,
you
have things in your pocket constantly. You really have never looked at it. Look at it to figure out how
it works.
But but I I'm with you. Okay. Like so I you know what? You know when I hear somebody say, every time a kid comes into a a doctor's office and they have flu like symptoms, you should check their blood sugar. And I go, that would be nice.
That's not gonna happen. Mhmm. You know? Yeah. And and then somebody's like, well, I'm gonna start a a nationwide campaign to make this happen.
I'll be like, well, you will be the fiftieth person to do that since I've been paying attention to diabetes, in the last twenty years. And I once watched, who was it? Was it Beyond type one? Beyond type one tried hard, and they had money and an infrastructure behind them. And do you notice that that didn't become a role?
Yeah.
Yeah.
Yeah. You can't that's that's gonna be a really difficult for you to change.
Good luck. Listen. I take a lot of comfort in this in this alone card. I don't know how the world's spinning. I don't understand why it's not on fire, why it hasn't exploded, why we're not all dead.
But for some reason, it is and we're not. So just go with it. You know what I mean?
Sounds good.
It's working. Mostly. Mostly. Not mostly. It's working enough.
Okay. Yeah. So
anyway, what what else you got there? I like your list. Keep going.
Advocating in the hospital 49:18
So since I work at a hospital, I wanted to talk a little bit about, like, diabetes management in the hospital. And, again, like, you have to be an advocate for your child or for yourself if you have type one in and you're having a hospital stay. Like, you know this probably already. But, you know, I asked my coworker, like, I asked I asked my coworker, what would she works in critical care? And she's I I said, you know, what would you want people to know?
And she said, like, I walk into nurses' rooms and I'll say, hey. Is this patient using an insulin pump? And the nurse will be like, I don't know. And the nurse doesn't even know if if this diabetic patient has an insulin pump. And so, again, she said and I believe, like, you have to advocate for yourself in the medical system, and you have to communicate.
So if you're gonna use your insulin pump, you tell the nurse, you tell the doctor, you tell everyone who's in your like, taking care of you that you use an insulin pump and make sure that everyone knows that.
Mhmm.
And then, of course, like, I'm not saying, like, that nurse doesn't have responsibility to find that information out. But, you know, the reality is sometimes they just don't. You know?
Like Yeah.
They might not ask or that might not get put onto your medic medication list on the chart, but it should be there. So, yeah, so that that kind of thing can happen.
Can I share my perspective there? I I here's what I would tell you. I assume everybody's an idiot. Okay? Moreover, I would assume that nobody cares about me the way I care about me or or that cares about my kid.
And by cares is the is the wrong word, but it makes the right point. Right? Like, I I just don't ex I don't expect anyone to do a great job. Mhmm. And I don't think it's their fault, and I'm not here to blame them.
I just think that, you know, people are people are limited by their intelligence, by their interest, by their amount of sleep, by their own health, by the relationships they have in their life. You don't know what they're going through. They still have to go to a job every day. You look at them and you think that's a nurse. Well, it might be yeah.
Okay. There's a nurse. But that nurse might be fighting with her husband. Her mom might have breast cancer. She might be three months behind on her car payment, and she's dragging her ass to that hospital and probably thinks, what am I doing this for?
And you want that person to remember that you have an insulin pump or that, you know, you it it just my assumption is is that I'm responsible for me and mine always. And that and that if someone else steps up and does a great job, that's a lovely bonus, but I don't think of that as an expectation.
Uh-huh.
Yeah. And so no matter in what situation I'm in, from the lady ringing up my groceries yesterday, okay, to the guy who changed his attire on my car, to the person that shows up at my house to to fix a crack in my wall that I he says he's a a professional about, but turns out he's not. And and everyone in between, my assumption is is that nobody is doing their best. Their best wouldn't be great even if they were doing it, and I'm the only one between me and oblivion. So I don't know if that sounds terrible, but that's the baseline I run my life on.
Yeah. Well, no. Like, I I it it's probably true to many on many levels, and that's why patient advocacy, like advocating for yourself or advocating for your loved one is really important. You know, like, you can't expect that the doctor, the nurse, whoever is going to be a super superwoman, superpower, superman. You know?
Yeah. No. I yeah. A 100%. I I almost don't I I understand advocate for yourself.
You have to. Media I mean, if you ask me, I'd say the same exact thing. I'm telling you that in the back of your mind, the way you should think of it is everything and everybody is trying to kill you and it doesn't care about you. And if and if you if you want to succeed, flourish, etcetera, then you need to pay attention. And then and and if that and if you're counting on somebody and things aren't going right, your next thought should be, I wonder if they even know what the hell they're talking about.
I should check. Or is this a thing I don't have to check on because good enough is good enough? Like, to me, that's and I don't even think of that as cynical. I don't even think of that as sad. I just think that's I think that's reasonable.
And when you do bump into somebody who's above and who's doing a great job, I I think of that as above and beyond, and I think I'm very lucky to have met that person. Like, I'm not mad at the bad one. I'm pleased that I met the good one. Does that make sense?
That's good. Yeah.
That's good.
It's an optimistic way of looking at it.
It's an optimistic way of looking at the sheer horror of the effort people put into their lives. I
think, like, often in the hospital too, like, as a clinical pharmacist, you know, blood sugar management. Doctors have you in the hospital for more urgent manners matters most of the time than your blood sugar, unless you're in DKA. You know, unless you came in for DKA, your blood sugar management is not the number one priority of why you're in the hospital. And so it does kind of fall to the background sometimes. And, because I have the background, I do.
I when I work in critical care and patients in the ICU or whatever, I'm always looking at blood sugar. Like, I just that's part of what I always think about.
Yeah.
But not everyone is always thinking about blood sugar. And so, again, like, if you have a loved one in the hospital and you don't know what their blood sugars have been, like, you can ask and you can find out. And if they're not to your acceptable level, then you can advocate again. Like, hey. Like, can it is something that kind of unfortunately, it falls to the background and especially with type one.
But even type two, like, providers are not in the hospital setting. They're trained to, like, treat your more emergent problems.
Mhmm.
And blood sugars in the two hundreds are not making you well, I I don't wanna say they're not making you sick, but they're not making you hospitalized.
It's just yeah. They're they're focused on the thing trying to kill you most aggressively.
Right. And to get you get you better so you can get out of the hospital.
But here's the opposite side of that. You're not gonna get out the hospital as fast with a 200 blood sugar.
Exactly. Yeah. So it's very important thing to have your blood sugars well controlled when you're hospitalized because you're going to heal faster. You know, everything's gonna be better, but, unfortunately, it does fall a little bit on the back burner from what I've seen. And so I try to really make sure that it does not in my care.
You know, when I'm caring for someone, I make sure, you know, do we have this patient on a long acting insulin and mealtime insulin if they're insulin dependent? And you'll see sometimes where even type ones, like they don't get on the right regimen. So you just have to again, if you know how to take care of your diabetes, you need to make sure the doctors know and they are taking care of your diabetes.
Mhmm. Because people can't keep that many thoughts straight in their head. I I don't know if there's a a a, like, a a scientifically understood number of those things. But I mean, if you stop if you stop and think about what you just said and you step back and you examine it, it's ridiculous to think that a hospital and a doctor and a and a, you know, a battery of nurses can't single can't, I don't know, fix your broken arm and keep your blood sugar in range. Doesn't seem like that big of a lift.
You you know what I mean? But but it is. So get past that part because that shit's not happening. Okay? Like, no.
That that's not going I just explained to you how the world works. Just keep that in mind, and then and then keep that's not happening. Okay? So, you can cry about it if you want or say there should be a rule or they should do better. Blah blah blah blah blah blah blah.
Ain't happening. It's on it's on you. And the problem is is you're also probably not able to keep that many things in your head at the same time. What am I saying is you want the machines to come and take care of us. Okay?
They they the only thing the only thing that's gonna be able to keep all those balls up in the air is a is a is a nonhuman mind. Like, it just doesn't people just don't have that much access to bandwidth to handle those things. You're also not their only patient. So Right. You know, you've got a nurse who's helping a floor full of people.
And they all have problems like you. How there's not enough time or or compute power in that person's brain to handle all that.
So Right. And I don't wanna, like, minimize No. You know, health care provider's responsibility because I do feel like it's responsibility of the health care provider to take care of the whole patient while they're in the hospital. But the reality is is that some things become more urgent than others, and they the blood sugars often get put on the back burner. And so and some people maybe are okay with that.
Like, if my blood sugars are in the 200 when I'm in the hospital, whatever. But I wouldn't be okay with that. Like, I would want them in control. 100. That's just
I agree with you.
On that.
I 100% agree with you. I really now you're making me think I wanna do a whole, series of trying to find out how many active things, that a person can keep in their head. I actually just asked our overlords, and it said a useful answer is about three to five active chunks, but usually one only one thing is in sharp center of consciousness at a time. Wow. So active thought in a spotlight.
So your active thought is in a spotlight around three to five things you can keep in working memory. Ideas, concerns, you can keep accessible without writing them down. And these are just basic concepts around life like, I have to call the doctor. I have to finish editing something. I gotta pay a bill, like, something like that.
Right? So imagine that. Imagine that that's the the capability of the nurse, and the nurse is helping 20 people. And then say
The screen-time revelation 59:26
Well, that makes me sorry. That makes me think a lot about so this morning, was looking at my kids', like, screen usage time, you know, when you look in their controls, like, parental controls. And my type one diabetic daughter had I think it was, like, three to four times of the number of times she had picked up her phone compared to my other children with devices. And the things she was on was her Dexcom app, her Omnipod app, you know, like
Yeah. Right.
And so, like, you know, she's she's having to think about that, which my other kids don't, you know, that's on her mind constantly.
Sure.
So, like, it it it opened up my eyes to just how often she's having to think about this. You know, I think about it all the time and I don't, like, think twice, but, you know, she's only 14.
Well, that's by the way, way to pivot to a a bit more positive part of this conversation. Good job, by the way. But but, seriously, what a great point. You you know, like like, your kid, you, somebody so so if you're the parent of a kid with type one, you you're you're worried about low blood sugars, high blood sugars, and long term health. You're probably thinking about it all the time.
That's eaten up most of your focus. And and now you you need other things to get in there, like, you know, sleeping or doing a sit up or eating better for yourself or cleaning the kitchen or they need a number of a billion other things you have to do.
Right. Learning at school.
Yeah. Yeah. Exactly. Like and then try to, like I mean, for yourself, you know, I I would say keep that in mind to offer yourself grace on the things that you're not getting to. But don't forget that for the people in your life.
Either, you know, you're type one, if it's a child, you know, a spouse that has type one, you gotta really realize that this isn't easy. You you know what I mean? Like, we have, like like like, t shirt slogan ways to talk about, like, life's hard, like, that kind of stuff. But this is what you're really talking about is you're asking somebody to do more than they have the physical capacity to do. Uh-huh.
And then you're mad at them when they don't do a thing you wanted them to do or that you think should be important or whatever. Now I'm just directly talking to my wife in case people are wondering.
Well, that kinda leads me, so, like, I another thing I have on my list was, you know, because I'm in the health care field, I'm definitely like pro health care professional in, you know, managing type one diabetes. And I know, like, people don't have good experiences with their provider or their doctor, unfortunately. But I like to see our doctor as more than just the person that prescribes the insulin. Our doctors helped us with a list of therapists in the area who are familiar with treating type one patients or counseling type one patients. They've, you know, obviously had have a nurse educator there or a diabetes educator.
We've talked to the Omnipod rep through our doctor's office, which was helpful. What else? Oh, like the MA that checked in my daughter last time has diabetes herself, and she was a runner. And my daughter's a runner. So we started talking about, well, how do you manage at this, you know, this certain situation with running?
You know, how do you prevent your, you know, blood sugar from going low? And she was helpful. You know, she gave us some real world experience of someone living with diabetes. So I I like to see our doctor as someone that can help you with all of those little tricky things that, like, that you deal with with diabetes more than just, getting your insulin prescribed, getting your a one c checked, you know, ordering the labs or whatever. So
A part of your community. Really?
What's that?
The doctor's a part of your community.
Yes. Yeah. And, hopefully, like, everyone has that. You know? Like, I guess if you don't have a provider that you feel like can provide those kind of extra helps to you, then maybe it's time to find a different doctor.
But I it's out there, you know, like, the diabetes educators, they're out there. The people living with diabetes, they're working in the health care field are out there.
Oh, the good ones
are workers, counselors, the they're out there. I guess you just have to find those that are gonna help you with
So good luck finding one of those people. I'm sure with all the free brain space that we just talked about that you have, you'll be out there looking for a new doctor and finding the right one in no time. Or or being being super serious, you're on your own. Surround yourself with people that can be like, I think that's why community is so important. Yes.
If it happens
social media can be so helpful too because so many people can give you tips on, hey. You know, try out this or I I tried this or this person was helpful. You know, like
Cuts through the noise
connected in a way that we have never been connected before. So you don't have to live in a community with, like, a great endocrinologist that's connected to all the things. You really can be, served well by the Internet and social media and support groups and that sort of thing.
So I try to think of it as a faster path to an actionable thing. Like right? Like, instead of me imagine imagine you you sat up today and you're listening. You go, this is I this is right. I need I need that kind of support in my life, but my doctor doesn't offer that.
Well, now I have to find the time to find a doctor. And then I'm gonna have to make an appointment, go meet them. And what if they're not the right one? I might have to do this over and over and over again. And then, oh, eventually, I'll find the right doctor.
Then I'll build a relationship with them. And then, you know, in just two or three short years, I'll be able to ask my question and then, oh, oh, oh, they didn't know the answer. That's okay. Like, or they did. Like and instead, you go to a you go to listen.
I'm just gonna tell you my Facebook group's awesome. Like, you go to my Facebook group and say out loud to 85,000 people, I have a question. And you're gonna have an answer twenty four seven at some point that will at least be actionable for you or a reasonable place to begin the rest of your journey instead of Absolutely. Yeah. It just it listen.
I it is pretty obvious what the Internet does, but instead of it being one person, and this is a coin flip as to whether or not it's even gonna be the right direction for me to go, You just open yourself up to tens of thousands of people and then get back ten, twenty responses and go, okay. In here must be the answer. Mhmm. You know? I think that's just it's invaluable.
And if you don't know that and you're listening to this, please try to, you know, open yourself up to that idea. Yeah. Yeah. I think it's really really important.
In my practice, I also realized there are so many people, living with type one diabetes that are not connected to all of this stuff.
Most of them.
They really aren't. Yeah. There's so many people that are living out there with a one c's and 11. They've had diabetes for a long time and Yeah. Just not it's not being managed.
And that's, like, how do we reach how do we reach those people? I don't know. I guess that's like
Good luck. I haven't figured it out yet.
Like I yeah.
I've learned how to reach people room. Yeah. Yeah. I've learned how to reach people who have an iPhone and free time and and are motivated to learn more. And, otherwise, if you're trying to figure out how to go grab another person, it happens randomly.
And, you know, every time you help somebody, it feels great, but it's not an en masse idea. Like, you can't en masse grab those people and say, hey. I've got the answer for you. It's right here. Like, you know, it just it those people are busy with their own problems too.
Yeah. And and very likely, don't have the kinds of jobs or lives that lend themselves to having free time, extra energy once they have free time, even maybe the knowledge or or desire to ask the right questions to get them moving in the right direction. Like, it's it's a not it's not I don't think it's fixable. Like, I think you can put the information out there and do your best to get it in front of people and then hope that they see it. Mhmm.
But, I mean, honestly, if you really look at the people, like, I'm helping people of a certain age, of a certain economic stature that, you know, thought to go out and help themselves already. Mhmm. I don't know how to find those other people. It's incredibly necessary. I just don't know how to do it.
Yeah. Well, I guess that kinda gives me motivation as a health care professional because we do, you know, interact with, you know, all of the all of the different types of people. Mhmm. And so I always try to just make a connection with people, you know, like, even if it's just like a, you know, a connection that has nothing to do with the diabetes. But, like, hey.
I hear you. I see you. I I am trying to show empathy toward you and your situation. You know, maybe that will help those people. I don't know.
Well, all you can do is your best. And
Yeah.
And then you just you know, that's what you do. I mean, I don't I I speak in public a lot, and I think, well, there's an example of me finding people who wouldn't find me otherwise. But to see the the grand effort that has to go on through an organization to pull 1,200 people into a room on a single day is it's a massive lift. It takes them all year to accomplish that. Uh-huh.
And it's amazing for the 1,200 people that show up, and that just leaves the other 2,000,000. So, you you know, like, it it really it really is just I I don't know. Like, I really don't know because you're you you say, wanna count on the doctor, but here's where the doctor's limited. What what I hear every time any of these things are brought up is I hear there's a limitation at some point, and it comes from being human. And so, you know, is the answer eventually, that, you know, like, you're diagnosed and someone says to you, look, here it is.
Like, I it's it's on your phone. Go push a button. It'll tell you. And and still they're not gonna push the button. Yeah.
You know, some people. Like, some people will, and that'll help more, but you're never gonna get to everybody. And that's the thing No. Like, when you do what I do, like, that used to that used to be burdensome to me. Like, I would have, like, real real problem with that, like, feeling because I I've developed the thing that I know helps people.
And then the pressure to reach more people hits you very quickly.
Uh-huh.
You know? And then once you can't once you realize that there's a limitation to that, it feels like you're letting them down. And if you can't get past that, then you can't even do the good job you're doing for the people who are finding it. Right. So it's been, it's I've gone through this.
That's why I probably sound cavalier about it, but now I'm trying to be funny. But, like, I people are like, yeah. Keep trying. Asshole, ain't working. But, but, like, I I really it's it's not a fixable it's not a fixable problem that there's an answer to and you just don't know, you you know, and nobody's doing it.
Like, there's there's no answer, really.
Right. So But I just have to accept that you're not gonna be able to help everybody, but just do your best with it.
Yeah. Exactly.
Or You interact with. So
or skip over all that and say, we should be focused more on automated insulin pumping that doesn't need your interaction.
Yeah. You
know? And then the for the and for the people who do wanna put more have more time or effort to be able to put into it, then give them other controls and dials to work with. But for the but for the mass of people who you either can't reach or once you reach don't understand or whatever the problem ends up being in the middle, imagine if you slap this thing on them and it gives them an a one c in the sevens.
Yeah.
Amazing. For sure. Right. Yeah. That kind of thing.
Anyway, keep going on your on your list of things that
I think I've got to almost
everything. I'm not saying anything other but more hopeful stuff, Scott.
Coining “teen factor” 1:11:13
Well, there's one thing that just kind of, like, a funny thing that kinda came to my mind that I put on the list. I think it was one particular day just dealing with kind of, like, the teen type one diabetic child in my in my family. I thought, you know what? We should coin a new term called teen factor. Like, there's correction factor.
Why can't we coin the term teen factor? Like, what's what's my teen factor today?
I was gonna say what's that what's that setting in control of? The amount of, like, SaaS or Sinai? Is it can it turn Sinai up and down? Is that what it's for?
Yes. Exactly. Because, you know, I I might know my correction factor or your correction factor, and I might know your basal rate. But, you know, like, your teen factor might be what's affecting everything today, and it's not anything else.
Mom, I know what I'm doing. Then why aren't you doing it? So
that's just a little bit of humor that I've had to remember. Like, we're in a phase that, you know, we can't we're we're probably not gonna be perfect with our blood sugar management. We're we're darn trying, but we we're not there.
I I and and, really, the patience part is what I can be I can pivot quickly back to being serious if you need me to. I that's where, like, the patience and time comes in, I think. You just, again, keep modeling the right thing. Try not to get upset. Understand they're going through a lot too.
They only have, you know, a a certain amount of of conscious space they can hold thinking thoughts in. They also wanna go bowling or have a girlfriend or a boyfriend or are are struggling in class or they have a lot of other stuff going on too. Right? Yeah. Every day, every second can't be about this blood sugar thing.
Right.
And yet, I know what happens when it's not. Right? And and why you're trying so hard. So listen. My best advice, get a CGM, get on automated system, and at least when those moments come, when life gets in the way such that you're not actually going to put the effort in that's necessary, let the let the system jump in and and do that part.
Yeah.
You know? Yeah. Until you can be your better self or have more time or or whatever it is we're waiting or or grow up or, you know, till till your teen factor goes down.
I guess I hear that adulthood is very different. So, yeah, I don't I don't know. We'll see.
I don't know. I also know adults are adults.
We're just dealing with this.
Yeah. Yeah. No. I again, it's all just gonna be human. It's all just different variations of of people's ability, inability, desire, nondesire to do, think, say, feel something.
And Yeah. And all the while while this concrete thing of your blood sugar is not varying along with you. It doesn't it doesn't you know, people like to say it doesn't give you a break, doesn't care if it's Christmas morning. It doesn't care if you're fighting with your spouse. It doesn't care if you're sick, or it's going to keep doing the thing it's going to do.
And, you know, so maybe getting through a life with diabetes without making yourself crazy is more about allocating time and resources, both mental and physical.
Uh-huh.
I don't know. You know, by mistake, I might have said some pretty thoughtful things in this episode.
Pump choices and the runner’s rule 1:14:37
Well, I think we're in a phase right where, yeah, we're kinda, like, just okay to keep what we're doing. We've hesitated to move to a different pumping system because we just don't know if we have the bandwidth to learn something new right at this moment. But we're hoping for I I don't know. We're we're sticking with what we have right now because I feel like we haven't quite optimized it. I don't know.
I guess maybe I don't know if
that's What are using right now? What are you using now?
Omnipod and Dexcom seven.
Okay.
Omnipod five and Dexcom seven. We've thought about doing looping with Omnipod dash. That is a little overwhelming to me. I think we could do it if we just dedicated the time to the learning curve, you know, learning learning it. We're hoping my daughter had been on the tandem t slim x two, which is when we had the better a one c's.
I don't know if it was necessarily because of that pump. We had more lows with that pump, but
Well, I can tell you this. Omnipod five
wanna go back.
Yeah. Omnipod five is, in, like, late stages of an upgrade to the algorithm that's coming. So Right.
That's what we're kinda waiting for.
Yeah. Summer, right, there'll be a lower target, some other adjustments to the algorithm. I think they're already working on Omnipod six, you know. Any of these companies should actively aggressively be trying to make their algorithms work better.
Right. Absolutely. And that's kind of what we're we're we're kinda sticking with it because of that. I think, you know, otherwise, I think we would have maybe gone back to tandem. But my daughter, being a runner, I think it's a lot easier for her to not have tubing just being since she became an athlete, she the tubing is the thing that kinda keeps her from going back.
But, you know, we haven't never tried the Mobi, but I don't know that we would
I'm gonna say something that I'm sure every company who buys an ad from me will not be happy I'm saying. But, like, if the thing you're using has an a thing about it that's valuable for you, then that's what's best for you. Right.
You know what kinda been for my daughter. I've let her choose because that is valuable. The fact that it's just on you and it's there's no disconnecting involved and yeah.
That's million percent. Like, I I mean, listen. I think Tandem makes a great pump. I think Medtronic does. I think that Twist pump is very interesting and doing a very good job.
I love Omnipod. I like them all. I think there's the DIYs, we've used Loop. We've used Trio. I know people doing great on Android APS.
Like, they're what's working for you is what's best.
Yeah.
And that's Yeah. And that's a bigger thing than just what is my a one c. Like, it it's gotta be it's a it's a I think it's a holistic thing. What what works best for us? Right?
Like, I've talked to people who are like, I don't care about tubing, but it means nothing to me. I honestly think that if I put a tube pump on Arden, she might throw it across the room in five minutes. I think it would I I think she would hate it. And but she's used to an Omnipod. Right?
Like like so, like and and I think if I would have put her in a tube pump when she was four years old, I don't think she'd think twice about it. So, like, just whatever's working for you. And keep in mind that working means more than one thing is the right thing for you. And if it's not working for you, then switch. But no matter what you switch to, always use one of my links.
That's really what's important. Corey, that's that's the important part. If you're going to switch to Medtronic to Tandem,
to
Twist, to Omnipod, you should be using my link to do it. Okay?
Your advertising's working. I think I learned more about Omnipod through listening to the podcast than anywhere else. Yeah, been good for
us. Yeah. Yeah. I I I'm I'm joking. I'm not joking.
But I'll tell you this. If you are looking for a a person who's gonna be willing and able to have an hour and a fifteen minute long conversation like the one you and I had today, then, Scottie gotta sell ads. Okay? Because, like, that's that's how this works. There's no one else
out I know. I mean, it's education too. Like, it's not just advertising. It's education. I I didn't really know much about Omnipod until we started listening to podcasts regularly.
So
Yeah. You hear that insulate? Alright. By the way, when I say that, I'm actually talking to a certain person who I know is listening, and I'm laughing because she's so lovely. And I'm just and now I now I'm I'm thinking about her making it like that she's so embarrassed right now for no reason.
But, like no. Yet, I mean, listen. Being, like, super serious and I and talking to, like, people like this is what I'm gonna shut it off. But, I'm talking about myself for half a second. I'm doing a thing no one else is doing.
Like like, it's and it's it's supported by ads. Like, it just it is. So Yeah. You know, we I'm glad you like it. I see people all the time talking about how great it is.
You don't subscribe to this, follow me on social media. Click on those ads once in a while and and and listen to some a podcast. This this doesn't exist anymore. Like, that's what keeps us all alive. The social media, these these different platforms are so so different than they were when I started doing this.
When I started doing this, it was enough to just do a good thing and put a good thing out in the world and it spread. And now whether it's Facebook or Apple Podcasts or any of the other podcast companies or YouTube or whatever it is, is they they don't care about you. They don't care about me. They don't care about our diabetes chatting. They care about users in their ecosystem.
And and what I am to them is a person who drags somebody into their ecosystem. Once I get you there, they don't care if you're helped or not. They care if you're served ads. And I know this sounds crazy because I just said you have to click on the ads. I mean, my ads, not their ads.
Clickbait, influencers, and staying real 1:20:27
And, like and so it's a really this is how it works now. And and if you're gonna exist and succeed inside of this, you have to find a way to bring people good conversations, quality information, and do it within the rules of the game. And and where I fall short is that I refuse to do it through clickbait. And Yeah. And no one else seems adverse to that.
So Uh-huh. I am not gonna go out there and hit you constantly with, like, oh, there's something new better. It's coming. Better is coming. Better is we're gonna cure it.
This is I'm not gonna clickbait you into this. I'm gonna have a conversation with Carrie. We're gonna this is what we talked about. I'm gonna say in the in the description, it's gonna say, Carrie has a 14 year old daughter, has type one diabetes, and we talked about this, this, and this. I can't explain to you all the what's good in there, and you might look at that and think that's boring.
But trust me, this conversation will be valuable if you have type one diabetes. What I won't do is every day post some new bullshit thing about, like, oh my god. There's a new CGM coming. No. There's not.
There's not a new CGM coming. It's not. It's a company who started a thing. It's four guys in a room. They raised a $500,000.
They're never gonna bring it to market. Like, stop acting like that's actually gonna happen. Okay? Like, you know, stop. So what do they call it?
It's clickbait. It's all just clickbait. I I love what that doctor's doing in Chicago. But if you're out there pushing the cures here, the cures here is over. No.
It's not. Like like and and I think that's disingenuous, and I think it's a sign of what social media has pushed people to try to do. And there are you know?
I think, you know, listening to your podcast, you know, it provides a little bit of support. It's like you're kind of eavesdropping on someone's type one diabetes conversation Yeah.
For sure.
But, you know, like, you're you feel supported. And but then also, like, I loved hearing, like, that doctor that you had on that's doing the, oh, the name is escaping me. The trial where they're doing the islet cells.
The Eladon trial. Like Yeah. Yeah. Eladon trial. Wakowski.
Yeah. That was so interesting. He was fantastic.
And very, like I think it was good for people to hear, like, hey. Like, this isn't gonna be tomorrow. You know? Like
Yeah.
This is this takes a lot of time and a lot of money, and it takes a lot of effort, and it's not tomorrow. Mhmm.
Well, I'm and my
I love listening to your conversations with all the different types of people you have on because I I just feel like you're yeah. It's a good it it's educational. It's supportive. It's it helps us stay positive about all this. Right?
At least for me.
No. I appreciate that very much. And I'm I'm sensitive because I already had a conversation earlier today with somebody else in the space where they said, Jesus, this space is overrun with influencers all of a sudden. And and and I said, really? You think there's that many people with influence?
And he goes, I no. They don't actually have influence because they wanna be influencers. He's like, they're everywhere right now. And I I was like, yeah. And I answered very simply.
I said, I was here before them. I'll be here when they're gone. Like, we're just gonna keep doing this very sensible way of talking about things with some reality, and and and it's not gonna be flashy, and it's not click baity, but it's consistent, and it's valuable. And I'm gonna keep doing that. Like, I am not going to turn into a person who's just like, they cured it.
Like, no. They didn't. Like, there's twelve people who aren't taking insulin right now. There's two million of you that have type one diabetes. It's not cured.
Okay? And and by the way, I had the doctor on, and he said the same damn thing. So, you know, stop stop stop trying to bait me into clicking on your stupid Instagram reel. You're so sad. All you.
Just I'm sorry. That's as close as I've come to being shitty to people, but just stop already. Okay? Go get a job for Christ's sake. You're not a creator.
I am. And I would never call myself one. It because it's douchey. Okay? There.
Jesus. Have some fucking self respect. Get a job. I'm sorry. I know this is what I do for a living already, but I'm already doing it.
Like like, how many somebody how many how many openings do you think there are for this? Like, Jesus. Seriously, what happened to people, Kari? Why won't they just get a job? Why do they think you're you're just being polite now.
You know what I'm talking about. Right?
I guess.
You guess. You're so nice. Stop it. Stop stop being so although, let me give you a lot of credit before we hang up. I thought you did a really good job of making your points about the health care system, letting me push back on the other side of it, and not getting offended or I I I was really impressed by that because I've try No.
No. I'm not easily offended. So yeah.
Well yeah. I yeah. You have four kids. I don't know. You you gotta be tough.
You know what I mean? And what are you one of six kids?
What I've what I've wanted is
But, no. Are you one of six kids? You are. Right? You said your mom
had six? Yeah. Yes. Yep. I'm the youngest of six.
Yep. Hell. You're feral, probably.
I'm a pretty strong willed independent kind of person.
I was gonna say they were probably done being parents by the time they got to you. They were like, that one will be okay. Don't worry about it. Well, I really do good parents. Oh, no.
I'm sure. I I I really do appreciate your time. And, if you hold on for one second, I'll tell you a couple things after we go. But Perfect. Okay.
Thank you. So much. Hold on one second for me. To learn more and see if you might be able to get Twist from the pharmacy and try it for free, head to visit.twist.com/juicebox. That's visit.twist.com/juicebox.
Or give them a call at 18774. That's +1 (877) 489-4478, and tell them Scott sent you. Twist requires a prescription and is indicated for people with type one diabetes six and older. Arden has been getting her diabetes supplies from US Med for years. You can as well.
Usmedcom/juicebox or call (888) 721-1514. Many thanks to US Med for sponsoring this episode and for being and for being longtime sponsors of the juice box podcast. There are links in the show notes and links at juiceboxpodcast.com to US Med, Twist, and today's other awesome sponsor, the Eversense CGM. They make, of course, the Eversense three sixty five, and that thing lasts an entire year. One insertion every year.
Come on. You probably feel like I'm messing with you, but I'm not. Ever since cgm.com/juicebox. Check it out. T1dexchange.org/juicebox.
Why aren't you typing t1dexchange.org/juicebox? Take survey. Be done. Wanna take another survey? Juiceboxpodcast.com/survey.
Hey. Take surveys. What are you? You busy or something? I I can see in your house.
I know you're not doing anything. I can't really see in your Sometimes people think that's true. It's not true. But please take the surveys one way or the other. Thank you.
Let's face it. Diabetes is tough, but it's easier when you have a community around you. So if you're looking for a great community around type one diabetes, check out the juice box podcast private Facebook group. Juice box podcast type one diabetes, but everyone's 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 the Juice Box Podcast private Facebook group. Juice Box Podcast, type one diabetes on Facebook. I promise you it is the most unfacebook like experience that you'll ever, ever find. What a great group of people. I don't like saying this usually because it dates the ad, but right now, there are 86,000 active members.
86,000 people in there who might have your experience, know what to say, or just be a great shoulder to lean on. Don't be too proud to find a community. It really does help. And it's completely free. Juicebox podcast, type one diabetes on Facebook.
I just wanna say thank you so much for listening. I'll be back very soon with another episode of the juice box podcast. If you're not subscribed, please subscribe in a podcast app. It really helps Apple Podcasts, Spotify, or whatever your favorite audio app is. Like and subscribe.
You know what the kids say on the YouTube, like and subscribe. It really does help. And if you're already subscribed, please tell a friend or your endo or somebody you think might enjoy the podcast as well. Word-of-mouth is the only way that it grows. Once again, I've been Scott.
You've been fantastic, and we'll be right back with another episode of the juice box podcast.
- She diagnosed her own kid. Constant water, five pounds gone, tantrums that didn’t fit — Kari borrowed a glucometer from a neighbor on Facebook, saw the number, cried with her daughter, and got her admitted before DKA ever set in.
- A pharmacist’s head start goes far — then hormones arrive. Knowing insulin, insurance, and the medical system carried them to a 6.2 A1c. At 14, with running, puberty, and growing independence, the old math stopped working and honest burnout crept in.
- School nurses aren’t one-on-one care. One nurse may be covering 500–600 kids, tube feeds, and seizures alongside your child — and if supplies or snacks are a financial strain, tell the nurse: resources exist, but only if they know.
- In the hospital, blood sugar falls to the back burner. Her critical-care colleague finds nurses who don’t know a patient wears a pump. Tell everyone on the care team, ask what the numbers have been, and advocate — patients in range heal faster and go home sooner.
- “Teen factor” is the setting no pump has. Kari’s screen-time check showed her daughter picks up her phone three to four times more than her siblings — mostly the Dexcom and Omnipod apps. The diabetes is always in her head, so some days the teen factor rules everything.
- T1D Exchange Registry — US residents 18+ with type 1 can complete the survey and help move T1D research forward.
- Bolus Estimator — The free interactive bolus strategy tool on the Juicebox website that listeners are saving to their home screens.
- Juicebox Podcast survey — Another quick way to support the show — take the listener survey.
