This Guy's Story Has a Twist (Part 2)
Jacques kept going low at work. He tested himself through TrialNet at 45, the age cutoff, and came back positive for three antibodies. Then he got Tzield.
Jump to a moment
- It started with lows. During a treatment session he was so shaky he couldn't hold a client's head for neck traction and had to ask him for a granola bar. He has used a steroid inhaler for allergic asthma most of his life, so he self-diagnosed adrenal insufficiency. His primary care doctor ran labs: A1C 5.9, cholesterol a little high, probably metabolic syndrome — eat better, move more. At six foot three and 190 pounds, nothing about him fit a type 2 picture, and it didn't sit right.
- After their daughter's diagnosis his wife had screened through TrialNet and come back clear. With no autoimmune disease anywhere in his family, he never bothered. Last year, at 45 — TrialNet's age cutoff — he sent in the finger-stick kit. Negatives get an email and positives get a phone call. He got a call: three of five antibodies, confirmed by Kaiser. He then failed a glucose tolerance test, and half-sugar bubble tea took him to 180.
- He picked one of the two Kaiser endocrinologists listed as diabetes specialists, and within two minutes she had asked whether he knew about Tzield. She also pointed to an A1C of 5.3 in his chart from 2021 — normal range, never flagged, but for someone built and living the way he does it should have been in the fours. Normal range, wrong end of it.
- He became the first adult at Kaiser Mid-Atlantic to receive Tzield, and the nurses held an in-service the week before. It runs about $14,000 a pouch, around $200,000 in total, and pharmacy mixed each dose only after he was in the chair, because it has to be used within four hours. Fourteen consecutive days ran into the fact that no in-network infusion center was open on Sundays, so the schedule was patched across several centers. Side effects were limited to fatigue; the Zofran they gave preventively left him constipated, so he stopped it on day three.
- Before Tzield he was told he had roughly an 80% chance of needing insulin within five years. A contact who had worked on the trial told him about a third of early participants are still off insulin more than a decade later. His highest finger sticks since the infusion have been 160 and 140. He also carried real guilt: a child's risk is higher when the father has type 1 than when the mother does, so for a while he felt like the reason. His daughter barely reacted.
- TrialNet — The relatives' screening program Jacques used — at-home kit, results by email if negative and by phone if positive
- Juicebox Podcast Pro Tip Series — Management fundamentals with Jenny Smith, episodes 1000–1025
- Bold Beginnings Series — Being re-released in the feed starting around episode 2000
- MiniMed Flex — MiniMed's smallest pump yet, the size of two stacked vials, controlled from an app
- Contour Next Gen — The meter Arden carries — second-chance sampling and a downloadable coupon at the link
Every word of the conversation
Welcome and Sponsors0:03
Friends, we're all back together for another episode of the Juice Box podcast. Hey. 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. This episode of the podcast is sponsored by MiniMed and the Kontoor NextGen blood glucose meter.
MiniMed, of course, the innovators behind the MiniMed flex system, a small, sleek, and discreet insulin automated delivery system controlled from an app. Nothing comes close to freedom you can feel. To learn more, visit minimed.com/juicebox. There is one blood glucose meter in this house, the Kontoor Nextgen blood glucose meter. That meter is on my daughter's person right now and at all times.
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Sixth Grade and Preteen Hormones1:36
Yeah. So... Yeah. So so I mean, overall, it's working fine. She...
I think at the end of... Like, before the summer, so the end of last school year, her needs had gone up. You know, she's in... She's definitely a preteen, and I know hormones are are are playing a role. So it's...
Yeah. We'll just have to we'll just have to see the switch from from, like, fifth grade to sixth grade, like like, six. There's a there's a lot more changing classes. The program that she's in is a lot more intensive than fifth grade was Mhmm. From what we've heard.
So there's gonna be there's gonna be some changes. She hasn't exercised as much as we wanted to. She doesn't like the... It's the summer here in DC area, as you know. It's pretty sweaty, not not dissimilar to where you are.
So we'll we'll get back into into exercise a bit more as well, hopefully, to to both help with the resistance and with the stress. Right?
So Does she play does she play a a sport?
Ultimate Frisbee on Mondays2:43
No. She... So the thing that she does most consistently is play ultimate Frisbee, and we just have a pickup ultimate Frisbee game on on Mondays
Oh, nice.
That we both... Would we... They we both play, which is really fun. And it's a it's a mix. It's, like, adults and kids, and it's the one sport that's kinda stuck.
She's not... She... Like like I said, she's five eight, and and she can run. Mhmm. But she's not very interested in sports.
She's a big reader. She loves reading, writing. Also the program that she's in in middle school. She's in the humanities magnet I'd love for her to be... I like...
I'm really into sports. I'm not nearly as active as I should be. But as a kid, I played all the sports all the time, and it's very interesting for me to now be a parent and my kids are neither all that into it. It's kinda frustrating. I was
gonna say when you said interesting, you meant horrifying. Right?
Yeah. Not horrifying, but I I I wish it I I wish it was... So for for my oldest specifically to... Like, I... You know, exercise has so many benefits, but I...
In the in the... From the from the perspective of of being a diabetic, it's... You know, there's all kinds of value. And then the perspective of of learning learning to compete and learning to lose and learning to work at a team, like, all of that. Like, there's just so many benefits to sport, like, that I see.
And, yeah, I don't I don't I don't know. I think she'll... She'll... She might get more into into Frisbee. She's done the Girls on the Run, which is a...
Which is a kind of a cross country running
Okay.
Program. She's done that, but I don't think they do it in middle school. So we'll see what middle school brings. It sounds like PE is actually more intensive in middle school. You like PE three out of your four quarters of the year.
Mhmm. So... And that will be, like... I think it's every... It's a it's a class every day.
Yes. Every day for the week, which
is That's good.
I would have loved to when I was in school.
Yeah. That would have been great. I mean, it's... Couple that with your 10:00 lunch and you're all set. Arden got one of Arden got one of those one year, by the way, where she was eating, like, literally eating lunch at, like, five after ten or something like that.
Yeah. Yes. It's not not not ideal.
I I...
Not ideal. So we are not super into sports.
Okay. Well, that's... Listen. Let's... I'm not trying to force kids into things they don't wanna do, and it's not a big...
If you don't do sports, it's it's okay. But if... But, you know, I would... I'm trying to imagine my son one day having, like, kids who don't wanna be active.
Yes. Your son who plays college ball.
Well, now now as an older person, like, I... Leaves my house four times a week to go to a to a local park and must play basketball for two or three hours, you know, every every night. Like, he's not like... I I... He said to me the other night, he goes, I don't understand when people aren't motivated to try to do better.
And I was like, well, what do you mean? He start... He's out in the working world a little bit. He's like, peep... A lot of people seem just comfortable where they are.
Like, they're not trying to, like, move forward or, like, everything. And he said, I'm really... He wasn't being pejorative. He's like, I'm really baffled by it. And he's like he's like he's like he's like, I don't know.
Like, I just... I'm trying to, like... And I said, yeah, man. I said, you just... You played a lot of baseball.
Like, you you were accustomed to showing up every day and being faced with the idea that, like, you're not there yet. Like, wherever there is, you haven't reached it. And and you needed to keep working and trying just to stay in the game, let alone try to move forward. You know? And I was like, yep.
Some people just don't have that feeling. And and I don't know if you got it from baseball or if it's in... Innate in you or or what, but Yeah. I did walk away feeling like, I'm glad he played because, you know, now now as an adult, he's not he's not gonna be a rest on his laurels person. That's for sure.
Yes. Yes. Yeah. No. That's, I think there's just some very important life skills to learn from from sports, and and maybe you can learn other places too.
But I... Yeah. I I... And I... You know, there's...
You have to choose your battles. Right?
So Sure.
I I hear you. I'm not gonna make her make her play a sport that she she doesn't enjoy, but I'm I'm really gonna try and find her one that she doesn't know and appreciate.
That kid's gonna
Get into it.
She's gonna have played every dumb game between here and between here and the ocean and maybe and maybe a little surfing. Right?
Yeah. Yeah. Yeah. Right.
Okay. So what what what drove you to be on the podcast? What made you think this would be a good idea and I... I'd enjoy it or it'd be valuable, etcetera?
The Plot Is Thicker7:26
Yeah. So, the plot is thicker than I've, than I've shared, because... So, you know, when when it... When the when my daughter's diagnosis and our lives with it was kind of the only part of the story, I was like, you know, I I think that people would enjoy hearing it. But but then last year, the plot thickened and and then, you know, over the over the basically the past, you know, like, ten months, I would say the the story got got more interesting, and I and I think it's...
There's some some things to consider for people out there. So what happened is last year, I had some random low blood sugars. And I... My work is relatively physical, but specifically this one time, I went to see a client and I was doing, like, manual therapy. I was doing traction on their neck.
Too Shaky to Hold a Client's Head8:34
And I was so shaky that I couldn't I couldn't hold his head to to do the traction, and I had to actually ask him for a granola bar because I was, like, literally shaking, and I and I have had periods in my life before where I would be like, I think this is what low blood sugar feels like, but I wouldn't know. Right? Because I... It's it's not it's not something I I could have measured before or whatever, even as a as a kid. And so I had this number of low blood sugars, and then, you know, because I'm in health care, because the Internet is what the Internet is, I I kinda did a deep dive, and I I self diagnosed with adrenal insufficiency.
So I and I have a whole... There's a whole thing, I went into my into my laptop and I made it... I I wrote myself in a in a email draft. I wrote what I think it would be when I go talk to the doctor. So I get, like, almost either prove myself wrong or right, that I was wrong or right from the beginning.
Yeah.
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Steroids and a Self-Diagnosis11:37
And I really like my primary care doctor. So I emailed him, and I said I've had these symptoms. I was due for a physical. He's like, yep. Let's let's do it.
And so we talked through it. I am I am also... I've had asthma, like, most of my life, allergic asthma, so I've been on a steroid inhaler for a long, long time. And so how I got the adrenal insufficiency is there's, like, a small small sample size of people who... If you take oral oral steroids, it's it's pretty common because the steroids basically do what the adrenals do, and so the adrenals don't have to do it.
Mhmm. And so if you have too much... If you take steroids chronically for too long, then you can develop this adrenal insufficiency, which one of the symptoms would be low blood sugar. And so he's like... My my primary care was like, I'm not I'm not sure.
It might be related, but I'm not sure. But let's just do... Let's just run a bunch of labs. And so we ran labs, and I got my a one c back and it was 5.9. And I...
Prediabetic Numbers at 4512:50
And he was like, yeah. Well, cholesterol is a little bit high. You know, I'm 45 at the time. And he's like, yeah. Maybe some metabolic syndrome going on here.
These are like prediabetic numbers, you know. And I... So I'm six three, one ninety. I am not in the best shape of my life, But if... You know, I I do not...
In terms of how I eat, how active I am, and how I'm built, I don't fit any type two diabetes general picture.
Yeah.
And I know I know that's not a 100% how with with with people with type two, but I... There's not much about me that says type two.
Okay.
And so he was like, well, I'm gonna... You know, maybe we'll just consider something for your cholesterol. Let's let's change your diet and increase your exercise a bit and see what happens. And so I was like, okay. I mean, if that is the case, that is the case.
I'm gonna do it. So I I did I did become a bit more active, and I did change my diet a little bit. You know, there's I have a sweet tooth and I just cut back on my sweet tooth, as I would say, it was the main thing that I did. But I just... I I didn't...
It didn't sit right with me. Was like, I don't think this is right. And so to backtrack, after my daughter was diagnosed, because of the family history on my wife's side, my wife's mother's side, my wife got... Went through TrialNet, got tested, no antibodies, no nothing. Okay.
Great.
Mhmm.
I'm... There's no immune... Autoimmune disease in my family. None. None.
None. None. So I never... I didn't get tested.
Right.
Right? I just, like... I was like, it's not tested. But... So, you know, last year, I got this a one c back.
Getting In Under TrialNet's Cutoff14:38
It's like, alright. Let me just write to TrialNet. TrialNet's cutoff is forty five, and I'm 45. And, like, okay. I gotta get in quickly.
And they sent me the, you know, the package to the house, and I stabbed all my finger, and I blend into a tube. And I sent it back, and then I don't know if you know, but you, you know, you wait about four weeks, and they sent you an email if things are negative, and they give you a phone call if things are positive. And so, of course, I got a phone call Oh. In November. I think in November.
A Phone Call Means Positive15:08
Yeah. And I... Well, I got answered. I didn't know what the number... Oh, no.
Actually, I think the the person who called me had left a message, and so I had to call back. But but once I got the message, I knew. And so... Yeah. So I tested positive for three of the five antibodies.
So that was, like, the start of my LADA journey. So I went back to my private care. I was like, well, I have news for you. And so insurance Kaiser retested me and got the same results. And then I did...
In early early this year, did glucose tolerance test, which I failed not terribly, but, you know, set at about 200 for a little bit. And also when... Once I once I... I think once I got my a one c back, I started doing some finger sticks. We had an extra glucose meter lying around, did some finger sticks.
And I remember one time I had had bubble tea. You know what bubble tea is? Mhmm.
Yeah. Yeah. Oh, I'm I'm well I'm well too aware of it. I...
Yeah. Yeah. Well, I had a I had... I had half the sugar in this bubble tea because it's unnecessarily sweet. I'll just half the sugar.
And, I mean, I just... I I went to, like, one eighty, I think, halfway through this drink, I was like, oh, man. This is not good. Yeah. So I got my I failed my glucose tolerance test, and then I looked through all the all the endos on the on the Kaiser website because I'm like, I'm I'm...
Finding a Diabetes Endo16:48
I'll be damned if I get myself myself not not the the the endo with the best knowledge of diabetes because endos do, like, a lot of things. Right? Like, the
Yeah.
Endocrine system is is a whole is a whole thing. And so there was... There were two on the list that that indicated that they were diabetes specialists. And so I reached out to my... To to the one doctor t, shout out doctor t, and and, I mean, I had a video appointment with her in March, and I I spoke spoken to her maybe for, like, two minutes, and I knew I had hit the jackpot.
She she knew all the things. She asked all the right questions. She's like, you know about Tzield? I was like, oh, okay. She she knows what's going on.
So... Yeah.
Wait, You Have It Too17:37
Oh my god. Jacques, that kid gave you type one diabetes?
Correct, Scott. Yeah. Isn't that isn't that crazy?
Is that what you're here to tell me? Like, that that no. My gosh. That's bizarre, isn't it?
Yeah. It it is bizarre. But because... So, you know, so with a lot of diagnosis, those antibodies were there when I... When my daughter was diagnosed.
Sure. Sure. They... Well, so so... Yeah.
Why 5.3 Was Too High18:01
So here's the interesting thing. I had a a one c from 2021 that's in my chart. That's 5.3.
Oh, okay.
And my and my endo was like, that's a pre prediabetic a one c. It's normal range. Right? That's why it wasn't flagged. She's like, you're you're not...
You're supposed to be in the fours. If I listen to your lifestyle, how you're built, and how you eat, you should be in the fours. 5.3 is too high for you. Mhmm. And this is the same, you know...
And and when I've been listening to you talk about about thyroid thyroid numbers and how it's in the normal range, but on the on the wrong end of it, and it's like drifting in this... I don't know if it's drifting high or drifting low. That's the same. A once a once... You know, it's a range, but there's no ones within the range.
Sure. And so I had somewhere, at some stage, had picked up, you know, the antibodies got activated, and then the process very slowly kept going. And... Yeah. So so I got...
Well, I'm sorry I'm sorry to hear that, but I'm glad you caught it. And Yeah. And are are you gonna take Tzield or have you?
So I finished Tzield, like, three weeks ago.
Okay.
First Adult in Kaiser Mid-Atlantic19:19
Yeah. So that was a that was a... Another thing. So my doctor was like, I think we could get you Tzield through insurance. And I ended up being in...
So Kaiser of the Mid Atlantic is a pretty big insurance group. Mhmm. And the first first adult in Kaiser of the Mid Atlantic... Mid Atlantic to get Tzield. So they had to, you know, come up with a protocol.
They had to figure out all of the the ins and outs. And, you know, the nurses that gave me the infusion did an in service the week before I got there.
Who Gets Paid to Talk About Tzield19:54
Yeah. How how was the process? I I would... First, let me say this. I see all you influencers out there being paid to talk about Tzield.
I am not being paid to talk about it. You're welcome to... You're welcome, Tzield. Go ahead, Jacques. Tell me about the process.
Scott Scott told me he was gonna give me money to talk about Tzield.
I'm Wouldn't that be crazy? Oh, no. Oh, I just I just learned the other day that some podcasts charge their guests to be on.
I I saw that I saw post.
Oh, I was baffled. I was baffled by that. Yeah. You know, I just... I I wonder, like, when you're...
The average person doesn't realize when you... For... Here's an example. In the last couple of days, you all were like, oh my god. Did you hear Libre's coming out with a CGM that also does ketones?
And you think it's just random that you know that. Libre does a massive campaign behind the scenes to everybody who has a following of any kind to try to get them to talk. They they send you the information. Have you seen our, by the way, every company does this. It's not, like, some big secret.
Right? So if you heard about the Libre with, with ketone monitoring recently, you heard about that because a PR company sent around, you know, information about it so that people would have content. That's what that's about. What I'm talking about here is Sanofi and Tzield and the whole push behind you have to test... You know, get your...
Get people tested, get your family members tested. That's a that's a marketing campaign. That's not like... It's not just the thing you hear people talk about. So when people are talking about it, generally speaking, someone is paying them to talk about it.
Now not the... I wanna I wanna be clear. Not this... Not the CGM with the ketone thing. That's just...
There... That's people sending their press release out hoping that you'll do something with it. But when
you Sure.
But when you see, like, you know, this is a paid sponsorship with, you know, TZield or something like that. That's... They're... Anyway, my point is they're not doing it with me. And yet more people are gonna hear this story from Jacques, then that's not the point.
I don't... I'm not angry. I have enough advertisers. Okay. Tell me about the process.
So your doctor says maybe we could do it. Kaiser says yes, which is awesome. What did you mean they had to... The the team had to do what a week before?
Fourteen Thousand Dollars a Pouch22:15
They do, like, an in service on the drug. Nobody knows about the drug. Right? So so, it's a infusion, and so you have to go to an infusion center. And typically what happens at infusion centers are like rheumatoid arthritis infusions or cancer infusions is my...
And there's probably some some other
Yeah.
Ones in between. But most of the people in the infusion center are cancer patients. Mhmm. Right. So so the nurses...
So there's not, like, a lot technical about except for, you know, it's $14,000 per per pouch of of Tzield. And so it's, like, 200,000 for... That's about what I... 200,000 was the total cost to Kaiser, which I certainly did not pay. But...
So they... Only once I arrived at the infusion center would they mix it. So pharmacy... The nurse would call the pharmacy, said I'm set up. You can mix.
Because once it's mixed, it's four hours, and then they have to throw it away. So they couldn't take the chance of, you know, throwing away $14,000.
So... And
then and then they had to figure out which... Like, how could they make the infusion centers work because in theory, it is a fourteen day cons... Fourteen consecutive day infusion, but there were no in network infusion centers open on Sundays and only a few on Saturdays. So I did my first five days at an infusion center, then drove somewhere else for the Saturday, then did my five the next week, and then skipped the Sunday, then did five days at another center, then drove to the same place next Saturday. So, you know, we had to kinda cut and paste to to make it work.
Yeah.
But in the end, it it went quite well. So once once my doctor told me about it, I was, you know, initially, I was kind of not sure. Weirdly because I have a daughter with type one and I was like, well, I I know I... I I think I know pretty well how to handle type one. I'll just do the same things for myself.
And I'll... Like, whenever that time comes, when my, you know, when my insulin needs are such that I... And it will start needing to take insulin. And then I reached out on the on on the Facebook group. I reached out and said, does anybody...
As an adult, they can... Gone gone through Tzield. So one woman wrote back, and so we did... We talked back and forth, which was really helpful. So she had had it three months before, and she gave me a bit of ins and outs about symptoms and kinda what to expect.
Deciding, and the Side Effects25:00
And so... And then I talked to my wife, and then and we decided, let's just go ahead. That sounds sounds like the risk is is worth the reward. And so in the end, I I had very mild side effects. I I had significant fatigue.
I would get, like, the feeling of I need to take a two hour nap, like, right now about an hour after infusion Mhmm. In that first... Mostly from, like, halfway through the first week. So they start at a very low dose, and then they double, double, double, double, double for the first five days, and then you stay at that higher dose. And...
But I never had any of the nausea. Like, I I actually... You know, they gave me prophylactic. You gave me a bunch of Zofran. And on day three, I was like, I'm really constipated, guys.
And they're like, oh, that's from the Zofran. And I was like, okay. Please let's not...
But stop doing that....
Taking that.
Yeah. I'm gonna be I'm gonna I'm gonna be nauseous for another reason soon.
Yeah. Correct. Correct. Correct. So I actually didn't take Zofran after day three, and I was completely fine.
I just... So I just had this fatigue. And then once once the infusion was done, I I felt completely, you know, back to normal. There was no no other side effects.
Okay.
Yeah. And now it's now it's kinda wait and see. It's so it's so weird. You know, people are like, how are you how are you doing now? I was like, I'm doing the same.
Like, it's... Basically, I have a I have a eighty percent chance... Before Tzield, I had a eighty percent chance of of being diabetic in the next five years based on how many antibodies I have or are positive four... Am positive four. And...
Wait Five Years and See26:43
So if I make it past five years and I'm not on insulin yet, it probably worked. But I'd have to wait five years to see that. So in theory, the shorter term, my a one c could go down or at least stabilize. So this is what the one woman that I that I talked to, she said her a one c went down, like, to... Maybe from, like, 5.8 to 5.6 or something, And now it's just, like, set.
It's just stayed there instead of slowly climbing, which you would more... Is more likely to happen.
Expect to happen. Well, so what are your... Like, forget what everybody said because, you know, they... I don't think anybody really knows yet. But expectations or your hopes, I guess, for having done it?
A Third Still Off Insulin27:32
I I will say I reached out to... Other than this... The... This woman I spoke to, I... My...
We have a a kid actually who plays ultimate Frisbee with us, who's also type one, and this kid's stepbrother is also type one and had Tzield. This... The stepbrother's mom works for Sanofi and worked on the trial. Anyway, so I got connected to someone that was pretty deep into the trial, and she... We emailed back and forth a bit.
We talked on the phone, I think, as well. People were actually very, very nice and very willing to talk to me and... Without saying I I had to pay them. I will say that. And she said that a third of the people in the clinical trials...
So the trial, I believe, started in 2015. So it's 11 later. So people that were early on in the trial that got the treatment, there are a third of them who are still off of insulin, so ten, eleven years later.
Wow.
So my hope is that I'm one of those one third, one of those thirty three percent of people. Mhmm. But, you know, if it if it doesn't work, then I will slowly be becoming more of a diabetic, and I will figure it out as I go along. And it is what it is.
Feeling Like the Reason28:58
What was your daughter's reaction to this?
Yes. She she didn't have a big reaction. I I will... I definitely initially had some feelings of guilt. Obviously, not because I, you know, I didn't I didn't want her to have diabetes or give it to her.
Right? But but once I found out and then I read, you know, the data is, if if if if the father of a child is is diabetic, their chances go up, you know, significantly compared to when the mother is a is a diabetic. And so there were definitely some feelings of guilt that that, you know, I was I would... I'm the reason why she is a diabetic. But not...
I I think I think I've dealt with it.
It's interesting. That's not what I was thinking you were gonna say. I was wondering how you felt about being able to get Tzield, but she wasn't able to get it.
Oh, yes. No. That that is not... That wasn't a... There wasn't a big reaction.
I I I think she understood that it was never an option for... She also was diagnosed before. I guess it was... They were running trials at the time. Mhmm.
But I didn't I didn't sell Tzield to her as some... As a, you know, as a risk... As a as a treatment that will guarantee that I will not become diabetic.
Didn't feel like you didn't feel like she didn't get a chance to do this. I don't deserve a chance to. You didn't have that feeling? No. Okay.
I don't It's rather think we healthy, John. It like that. Yeah. Yeah. I I I don't know that you should.
I don't think you should, and I I didn't know that you would. But I was just wondering because there's that idea of, like, well, she didn't get the chance. Now, like like, what if you never get it? You know what I mean? Like, you...
You'll be moving forward without diabetes and feeling like, oh, I got to do this. She didn't get to do this. That's the that's the part I was wondering about, actually. I wouldn't
Yeah. Yeah.
Sorry. Did I put that in your head? I apologize.
No. No. No. No. No.
You didn't know. No. I... That that... That's...
That is just not the way that we think, I think, in our I wouldn't family.
I wouldn't either. I just was wondering. So Yeah. Okay.
No. It's not... It it it wasn't a consideration. It wasn't a consideration.
Good. Good. Good. Well, I...
You know?
First of all, knock on wood for you. I hope that works. That's gonna be a third of a third of people.
Yes. Yeah. So that's not a that's not a small chat. No. Then I've been I've been doing some random finger sticks.
I I used to wear... I wore CGM initially because I wanted to get an idea of my trends and what foods really, you know, mess with me or mess with my blood sugars. And so since since the infusion, I've done done random finger sticks at times where I thought, okay, I could be a bit high now. And I've seen one I've seen a one sixty, and I've seen a one forty in the last two weeks, and the rest have been lower than that. So I'm kind of cautiously optimistic that things might have started to move in the right direction.
But I'll get a a one c c in the next about two months, which will... So my last a one c... So I one done right after Tzield, which was 5.9. And so we'll see see what it is in the in the winter.
Do you find yourself eating differently, trying to just not tax your system?
Sinus Surgery and a 27032:50
I... Well, so I also had sinus surgery earlier this year. Scott, 45 to 46 has been has been Shock. Been a handful.
Shock you already?
Yes. No. I'm alright. I'm alright. But it's it's been, like, really, it's it's been a thing.
Yeah. So I had, like, sinus. I had really bad polyps for a long time, and and so someone finally convinced me. And it's actually been a very successful surgery, but I was on a lot of steroids after the surgery. And my blood sugar one day went to two seventy, which I'd never in my life seen.
And I emailed my endo. I was like, what am I supposed to do? And I'm supposed to be on these steroids for, like, two weeks. And she's like, well, emailed, yeah, I emailed her, and she emailed the the ENT, and he said, okay. Let's just half...
Just cut the the the prednisone in half, and that really helped. But my endo was honest, and she was like... And this was prior to the infusion. She was like, this might push you over the edge. It might push your pancreas over the edge.
The stress might be too much, and the and the t might... You might not end up qualifying for the Tzield. Like, my my a one c in this period could have gone up Oh, yeah. Significantly Yeah. Enough.
And so over that period, I definitely ate kinda low carb, and I tried to to not stress. I couldn't really act... I wasn't supposed to exercise, so the only thing I could change was my diet. Yeah. And I did...
You know, I could... I I could walk, and I did a bit of walking, but I... But but I... Very shortly after I went off the steroids, things started looking better and then got got back to baseline. And so I was very thankful because it it apparently didn't have to go that way.
I have to tell you, modern medicine is really... It's just a absolute marvel. As you're talking about, like, that... I had that nose surgery, the same thing you did. So I I make a podcast.
I talk... I almost said I talk a lot, but then I I hear the people listening go, yeah. We know. Don't worry, buddy. But, I was getting to the point where I was holding my breath while I was making the podcast because I couldn't move air through my nose at all.
And and I finally went... And the guy's like, your septum's deviated in two different directions. He's like, at the top, it's going one way, and further down, it's going another way. And then you have all those polyps. He's like, I...
You're not moving any air through your nose really at
all. Wow.
Yeah. To the point where after the... Right before he did the surgery, I said, how am I supposed to breathe when it's over? Because I realized I was only breathing through my mouth. Right?
And Yes. And I actually... I said to him the most naive thing. I said, hey. Is the right way in through your nose out through your mouth or in through your mouth out through your nose?
And he laughed he laughed, and he goes, well, peep... People do it all kinds of ways. And I and I I was like, oh, I was like, oh, I thought there was, like, a way, and I wasn't doing it. And he's like, no.
Well, I think there's a way. I think if you teach people, with, like, asthma or something to breathe that's in through your nose out through
Well, I thought so too. But, like, I think he was just stunned by the question. He's like, oh, jeez. I... Maybe I should check him for a head injury while he's in here too.
You know? But he cleaned that out, and my god, that made a big difference for me. But as... But also, the big toe on my right foot was, like, frozen in pain. I had to have that cut open.
They had to do this needling thing so that, like, the ligaments or whatever would grow back to the bone. I had to have my my right knee cleaned out. I mean, if you've listened to this, the the podcast enough, I had to have, like, internal hemorrhoids, like, because, have you heard that episode?
Yeah. I think I did. Think I
heard that a while back. Yeah. They had to go had to go in through my groin with, like, like, the wire and, like... And they had... I think it was five different arteries inside of my body had to be, like, shut down because
I remember that.
Yeah. Yeah. Yeah. And and and the GLP, you know, like, fix so many different things, like, listing them all here would feel silly. Without all that stuff, I'd be limping hard on the right side, bleeding from my ass, unable to breathe, and, like, a nine other things.
And so when I hear people talk about, like, well, I don't know if I trust it. I'm like, you're out of your mind. I was... Yeah. A hundred and fifty years ago, you'd be, like, leaned up against the saloon half dead, and someone would shoot you because they felt bad for you.
Just go take the... Just go do it. Like, what are you doing?
Yeah. You you know? Yeah.
I don't know. Whatever. Good good luck to all of you. I'm in a much better situation because I did all those things. But to your point Yeah.
You hit a certain age and your body's like, yeah. That's gonna break now.
Yeah. So... Yeah. No. That's how that's how I that's how I feel.
Your shit's breaking all over the place, Jacques.
No. I'm I'm... I have I have said I've made a deal with myself. There will be no big medical issues in the next at least twelve months. That's my that's my deal myself.
You see how that'll work out.
Yeah. Well, also, they're hard... They get harder and harder to rebound from. That's Yes. That really is true.
My my wife had a surgery this this summer, and she's still dragging her ass about it. You know? So Yeah. It ain't easy.
Yeah.
Yeah. So, nevertheless... Well, I'm glad you're finding answers. And, you know, it's funny. I should...
I I can't believe I asked you about South Africa because I heard you say Kaiser early in the conversation. And and in my mind, I thought Kaiser is in South Africa? That doesn't
sound right.
No. But I didn't make the I didn't make I didn't make the leap there. Yeah. Well, that's really been... Look at you.
You should go. So... Alright. So the hope is you're a one in three coin flip for this just to, like, push it out for a decade, which would put you into your
Yep.
Mid to late fifties. That'd be awesome.
Yeah. I'll take it.
Yeah. No kidding. Isn't it interesting how, how quickly your desires can get adjusted? Like... Because if I find you a year ago and I say, hey.
You don't want type one diabetes. You say, no. I do not want that. And then when it becomes a possibility, you think, well, I'd love to be able to push it off ten years.
Yeah.
Yeah. Your line will change
pretty quick. You have to just... You just have to roll with the punches. It's a... I mean, I'm very much a a realist, and I I I I think, you know, health care...
Perspective From Rehab39:27
Working in health care really gives you perspective. Mhmm. And I've I've seen I've seen so many people in such really terrible situations, scenarios with... I I feel like cancer is the one that always comes up. I...
I've had I've had so many cancer patients in in rehab of of all ages. I mean, I had a patient with cancer. He was, like, 14 who passed away a few years ago. Like, just, like, horrible. I just...
You know, so so I I I don't wanna... I'm not gonna minimize the effect because there are days... I'm not gonna minimize the effect of diabetes because there are days where, you know, it just frustrates the heck out of us, you know, as a as a family or just my daughter or just me or just my wife. But I would certainly... This is honestly my perspective.
I would certainly choose it over some other options.
I... Yeah. I was just made aware of acquaintances of ours who... One of their children played sports with one of our children, and they're not older people. Like, you know, they're maybe late forties.
And Yeah. The father has a has a brain cancer just out of nowhere. Yeah. You know? And just fine, fine, fine, and then one day not.
And, you know, I don't I don't know a ton about it, but the looking into what I did, I... I mean, it's, you know, it's it's a thing that's gonna end his life at some point. And Yes. Yep. Yeah.
I... You know, any opportunity to stay above the dirt, they say, is is worth taking. So...
Yeah. Yeah. I know. And and, you know, kid having diabetes doesn't mean that something else doesn't come around. We listen to all these episodes of people with multiple autoimmune disorders and how that affects their life.
Like, if you, you know, you can't you can't eat gluten and you can't eat dairy and then you're also diabetic and... Right. That's... It... Things can get very complicated.
Just because something's gone wrong doesn't mean something else couldn't too.
No. No. Which which is a very bleak... It's a... It sounds like a very bleak thing, but it it is also true.
Like, I'm... It's really just... I am... I try to be thankful every day that I have and that that we have and and keep that perspective every day.
Yeah. No. You have a great attitude. You... I mean, through the through the story.
I I... There's this... I don't know if it's a folklore or not, but I think there's a rule that once you get a speeding ticket, can't you get another one the same day or something like that. It'll... And if that's true, I don't know if it's true or not, don't go out speeding to try to find out.
But I... What I always took from that, whether it's true or not, is the idea of, like, you know, you got... We got you once. Like, fair is fair. Like, let's let you go sleep and wake back up again and not have this happen to you again.
And I do think our my... Our minds work that way. Like, well, my kid has diabetes. Nothing else bad is gonna happen. Yes.
Yeah. Like, that... Like, that's the thing that's gonna happen to us, but you Yes. You could... First of all, I think there are things, you know, happening to more people than you know.
People are very Yeah. Very private about stuff. I I have a a a friend right now who's trying to find out stuff from her parents about, like, health stuff, and the parents won't share it with them. They said that's private. Like Wow.
Like, what... It's like... It's just, like, extended family stuff. That's private. I can't tell you that.
Like Yeah. Oh, okay. So, like... So when when the world works that way and people think like that, you know, you think, well, the bad thing happened to me now. It's not the case.
You could you could have a car accident today and rent a car and drive out in the right of the car and get hit again. That that could happen. Yeah. You know?
Yep. So Yep. No. It's... No.
No. There's not... Nothing's guaranteed. I tell my patients often when they get kinda down down about their situation, I'll say, you know you know when you are somewhere and you you look at people, and I I do this, and I watch people walk or run or do something and they look they look... They have a spring in their step and they look very healthy.
I... And then I just I just say to my patients, do not do not think that you know what is going on in that person's life or in that person's body. Like, you cannot look at a person and say, oh, they, like, they don't have pain. They don't have something going on. It's...
That's a completely false narrative. You have no idea.
Yeah.
We have no idea. So so don't don't don't woe is me. There's there's no value in being woe is me because woe is often to other other people too. You just don't know about it.
Yeah. I say go till you can't go. And Yeah. Yeah. I don't know.
It just doesn't seem... I had a a person on the other day, and she shared that when she was diagnosed, she promised herself that she wouldn't complain in her head. Like, she wouldn't she wouldn't complain to herself.
And Yes.
I thought, well, that's a simple but very thoughtful idea. Yeah. So Yeah. Well, anyway, I really appreciate you coming on and sharing all this with me. I love...
It's funny because you you have sparse, you have sparse notes, and they're up off to the side. I didn't really look at them, but I did glance by them once and it said Tzield. Then Mhmm. But then you told the story of your daughter's diagnosis, and I thought, well, there's no Tzield in that story. I wonder if he's just gonna bring it up because it's been in the zeitgeist lately.
This Guy's Story Has a Twist45:13
I did not think you were gonna say what you just said. Wait. Because Arden texted me. She goes, hey. Where are you at?
You're late. And I said, this guy... I texted her back. This guy's story has a twist. And so I, actually, you should see our texts of, can you come rub my leg?
I said I'm I'm recording, then I can come. Okay. Are you done? Then randomly, she says, Friday smells like a Subway cookie. That's her dog.
And then she sends then she sends me the sad face because I haven't come quickly enough. I don't know if other people's children tried to guilt them with that sad face. Then a little later, I got, are you alive? And then I said, this guy's story has a twist. So, I don't know what to call your episode, but it could be in that text somewhere.
I'm not sure.
That... Yeah. That that sounds good.
Seriously, Jacques, I really do appreciate you coming on and taking the time. This was awesome. More people more people
should reach out. Given the... Given... Getting the chance. No.
It's... It was actually quite good. I... This is random, but my wife and I met at a summer camp, and the director of the summer camp... I'm not...
He's not from... You're from New Jersey. Right?
I... I'm from Pennsylvania outside of Philly, but I
live I live in I live it.
I live in New Jersey now though. Sorry.
Okay. Okay. No. But but you and and him, I think if I if I recorded the two of you, two separate recordings, you sound like a really similar, not just your voice, but like the the how of how you speak. Mhmm.
So it's... That... That's been kind of enjoyable. I... And and time I listened to the podcast, I'm like, oh, this guy sounds like...
Scott sounds like Greg.
I prefer to think that Greg sounds like Scott, but I I appreciate what you're saying.
Yeah. That that... No. That's what I meant. I'm sorry.
I said that the wrong way. Just like just like you said it the wrong way to your wife this morning Yeah. Yeah. Or last night.
Vince Vaughn47:10
Question. Do you ever think that Greg sounds like Vince do you ever think Greg sounds like Vince Vaughn, the actor?
Oh, yeah. Maybe... Well, so now that you said that, you sound like Vince Vaughn too. I think you're probably like a clone between Greg and Vince Vaughn.
I... So I get I get Vince Vaughn a lot from people.
But I I Yes. No. That's that's accurate.
I think it's the the... It's interesting how you put that. The how of how I talk, I think it's the how. I don't think I I don't think I audibly sound like Vince Vaughn. I think he and I, like, speak in a similar pentameter maybe.
And and Yes. That that really might be the case, because I've had... I've told these stories before, but there was a stretch of time in my life where the the people would turn just absolutely exhilarated in my direction thinking they were about to meet the guy from some movie that they enjoyed and then to see me and be just wholly disappointed. But but I've had... I've literally...
Oddly enough that... I I I... This is such a strange thing because Arden said the dog smells like a Subway cookie. Mhmm. She means the sandwich shop.
And I was in a Subway once. The... Not a thing I do often, which is really interesting. And I was, seated talking to somebody, and a child in another booth said to his mom, that man sounds like Santa Claus' brother. And it took me a while to realize...
Yeah. He meant the movie Fred Claus.
Which is is Which is Vince Vaughn. It's Vince Vaughn.
Yeah. Oh. And and, and that's... I've... I had one time, like, like, a a group of girls, like, in their, like, late teens, early twenties, were sitting next to me at a diner.
And Uh-huh. The one girl just, like, stops, turns in the booth, puts her head over into our into our booth, and, like, just to find me. And I looked at her. I said, sorry. It's not...
And she goes, I thought you were Vince Vaughn. I said, no.
I know you... I know. I I know
I know what you thought. And she just looks... She looks so disappointed. I can't be... I can't tell you.
She's like...
That's... Yeah. That's really funny. I don't think I sound like anybody.
Well, I don't know about that. I just... Maybe I... You just... Maybe you just sound like somebody I I...
I'm not acquainted with yet.
Yeah. Maybe.
Yeah. It's... But it is interesting, isn't it, that that, you know, I I... When people ask... Because there's plenty of people who come to me and say, like, you should go on one of those business podcasts and tell people about how you make the podcast popular.
I'm like, yeah. Don't know. Maybe one day. But there's a a lot of people who like that kind of content. And I I will tell them privately.
I was like, you know, I do have a deep voice. It's a Yeah. It's an important component to all of this. And and it it does make me wonder, you know, Vince Vaughn's famous. And may...
Maybe there is just something about the speech pattern or the depth of the voice or something that grabs people's attention. Like, it it might have much much more less to do with me than you think. So...
Yeah. No. That's a chance. There's a chance. I mean, there are other, successful podcasters with deep voices for sure.
Gotta be. I... Listen. I there's... I've listened to podcasts where I've liked the content and can't take the person's voice.
And so... And often those
Oh, yeah. Yeah. Yeah. Same. Same.
Yeah. Like, pitched or... And I don't just... I don't mean female specifically, but, like, higher pitched or their register's weird. You know, like, I can't deal with this.
So...
Yes. No. No. That's... I I fully agree.
Alright. Well, Jacques, I'm gonna go rub Arden's leg apparently.
Okay.
And Sounds good. You'll go live your life. Hold on one second for me. Okay?
Okay. Thanks.
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