#323 Tristan's Mom Has Got It Going On

Chelsea is Tristan's Mom. A conversation about Type 1 diabetes.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello, everybody, welcome to Episode 323 of the Juicebox Podcast. Today's episode is with Chelsea, who is here to talk about her son Tristan and his type one diabetes. This is a good old fashioned conversational episode with no should we say how should I say this current events involved. This was recorded a while ago. It's just a nice talk about life with type one, you know, get your mind off other things. This episode of The Juicebox Podcast is sponsored by touched by type one, and you can reach them at touched by type one.org. It is also sponsored by the Contour Next One blood glucose meter, what you're going to want to do is go to Contour Next one.com. To learn more about the meter, the app that you can use with it, that by the way, is free. And to see if you're eligible for a free meter itself, there's a button at the top of the page, you can click on to find out, you can always find out more about the sponsors at Juicebox podcast.com. Or use the links right there in the show notes of your podcast player to click on and go right to the pages you're interested in.

I knew I like Chelsea a long time before she came on the podcast. She sent me an email to tell me that my use of the word lady time to describe a period she found to be and I quote classy. That's what I knew I loved her.

Chelsea's on the show today to talk about her son Kristen's diagnosis, the guilt she felt around it and where they've gotten to since then. It's a nice conversation to lead us into the weekend. Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan for becoming bold with insulin.

Chelsea 2:41
I'm Chelsea. I have two boys, Kristin who is four and a half. And he's the type one. And Lucas who is three.

Scott Benner 2:53
Two and a half and three, two and a half and three years is that

Chelsea 2:58
I met four and a half, maybe

Scott Benner 3:00
a half and I didn't hear it correctly. I was that lady can make babies every six months.

Chelsea 3:05
But I'm a teacher and it's the very last your workshop day. before we're off for the summer.

Unknown Speaker 3:13
A little discombobulated.

Scott Benner 3:14
Feel free in your mind. Okay, so let's go Yeah, so your son who has type one's name is

Chelsea 3:19
Tristan, Tristan,

Scott Benner 3:20
and he is four and a half so you can begin school next year. And then just Justin's brother is Lucas

Chelsea 3:30
three so three he was born with club feet and we thought that was going to be our challenge but I you just do like club feet.

Scott Benner 3:37
Haha, that's nothing.

Chelsea 3:39
Right.

Scott Benner 3:42
What do you do for the the feet like orthopedic type shoes that help bring it back and some fun? Oh,

Chelsea 3:47
yeah. A week after he was born he had to be and shaping cast every week, so we had to get those changed every week. And then after about nine casts, they had to cut his kilise tendon and then recast they would grow together again longer. And then now he's been in a night brace and he has to wear the brace until he's five.

Scott Benner 4:12
Well, that sounds scary cutting his Achilles tendon must have frightened Yeah, to no end. Wow. Yeah. Yeah, I mean, I guess it'll

Unknown Speaker 4:20
grow back. I can

Scott Benner 4:22
even see you know you thinking like, hey, look, you know, we just wanted to have some kids and get a dog maybe a fire pit. I wasn't looking for a lot here. I don't want to I don't want to deal with all this. Can the kid learn to walk in His hands? His hands look nice and straight. I'm sure there were many things with your head. He could have been a circus performer if he could have walked on his hands, but now that's ruined. Right? Isn't that something? And so when did you learn that in relationship to Kristen's diabetes? What came first the diabetes of the club feet

Chelsea 4:53
a club feet. So because we know he was gonna have club feet before he was even born. Okay. To get

Scott Benner 5:00
imaging is amazing. Okay. And so how long is Tristan had type one?

Chelsea 5:05
Then September? Hold

Scott Benner 5:07
on I'll count like November, December, January, February, March, April. That's like nine months ago. Yeah. See? Okay. Yeah. So, um, any endo issues in the family that now you look back and go, that makes sense because I have this or my aunt has that or is it right? Oh yeah.

Chelsea 5:26
Oh yeah, my

mom has celiac. And then just about everyone on my husband's side has Crohn's disease or colitis?

Scott Benner 5:38
I bet you didn't bring that up on the first day.

Chelsea 5:41
I was like, you know where this come from? I think.

Scott Benner 5:45
So tell me something about yourself. Chelsea. I have trouble holding my food in. Yeah. Yeah, that doesn't cover windows, by the way. not to get too far off the beaten path. Right. But how far into a relationship for before someone tells you. I have Crohn's disease.

Chelsea 6:01
Well, he doesn't actually have it. Oh, it's just all over the fam.

Oh, yeah. His mom does and his uncle does.

Scott Benner 6:08
He just thought he was the lucky one they got away with not having something.

Chelsea 6:11
Right. Yeah.

Scott Benner 6:13
That's okay. Life has a way of paying you back for being too hopeful. Okay, so I used to diagnose nine months ago, that's not a particularly long time ago. Where would you say you're at? In your adjustment at nine months?

Chelsea 6:31
I feel like we're doing really good. Like, we got it, we go to the appointments. And usually the doctor says I was gonna tell you to do this, that and the other thing, but I can tell you've already done it. So

Scott Benner 6:44
keep doing it, I guess. Yeah. So the doctor has maybe a plan that they don't share with you every time. Like they think the next time they come in here based on what I've seen this time, maybe I'll move them up to, I don't know, be something else and other step process and you get there and you've already put the step into play.

Chelsea 7:02
Right? Yeah, cuz she looks at the data while we're sitting there in the room because he has his Dexcom they're looking at that. He says, Well, I was gonna tell you to adjust this, but it looks like you did that like two days ago. So.

Scott Benner 7:15
Okay, so she's looking at your graph and and just doing what and you're so how did you figure out how to do it on your own? Is it just a leap you made? Did you just look at it one day and think, you know, it's going up? So I'm going to use more insulin or did you? I don't know find guidance somewhere. I'm now sound like,

Chelsea 7:32
yeah, I

Scott Benner 7:34
for you to tell me that you like the podcast, but that's not what I was gonna say.

Chelsea 7:40
But that's where I like, yeah, I figured it out. Like I started listening, not long after diagnosis. And then I was joined all the groups force and I was like, What are these people keep saying GS six index. And so I googled it. And then I found out and I had never heard of Omnipod or Dexcom. I didn't know we were on MDI till I heard you say MDI on the podcast, and like, Oh, that's what we're doing.

Scott Benner 8:07
Isn't it? What did you call it at home? Just injections or shots? Or

Chelsea 8:11
Yeah, just shot? Yeah.

Scott Benner 8:12
That's what I call it by the way, just I just I am the I because that's the the right way to say it. But yeah, when Arden was doing it, she just got shots. And even people call you I think the proper way to refer to the, you know, what you use to give a shot is a syringe, right, but I just call them needles, because I mean, yeah, I'm not fancy. So the Pen Pen. Yeah, I never got a pen didn't even get that far. Oh, geez, I have to tell you. Last night, Arden was jumping in the shower, and we were stretching her pump out to like the last second using up every drop of insulin. It was working great. There was no reason to take it off. So she's like, I have to get in the shower now. Like, I need to get the bed soon. But her pump was like dropped out of insulin. Like I'm like, Can we make it through how much is in there? And she comes back. She's like, it's done, you know, I'm done. So we went downstairs. And I gave her an injection of insulin, just to you know, carry her through the shower. And we took the pump off and you know, just the activated the pot and just injected some insulin and sent it up there. And when I was injecting it into her, I realized this, these syringes still have the half unit markings on them. These are the original syringes that we were given to us. I mean, the last time we got a prescription of syringes, Arden must have been like three and a half or four. And she's she's gonna be 15 this summer. And still when I reach for a syringe, it's from that order 10 years ago. Well, not crazy. And they work perfectly By the way, nothing wrong. But yeah, I just that's how long it's been since you know since I bought a syringe. But anyway, that's so Okay, so you go out into the world like you you go online. That's really smart. By the way, just, it's interesting what you just said, you're like I saw people saying Dexcom over and over again or this over and over again. I thought, let me find out what that is my wife grocery shops like that. Wherever. Yeah, whatever food is gone. She makes the assumption people like it. And then she tries it. Yeah. If the grocery store was smart, they just wouldn't fully stocked the shelves and whatever three things were left my wife would buy. She'd be like, people must love these. Yeah, but but that worked out pretty well for you. So you go online, just figure out what the stuff is. And then what you do go to the doctor and say, hey, what?

Chelsea 10:32
I said I want a duck. That sounds like a great idea. Do that.

Scott Benner 10:36
And we how long into the process until you got Did you get CGM first or Yeah,

Chelsea 10:41
CGM first. And then we had to get signed up for all the pump classes.

Scott Benner 10:47
Is that funny? There's pump classes, but there's not yam classes.

Chelsea 10:50
It's interest. Yeah, I was like, they just let me stick this thing on my kid. And it's gonna stay there for 10 days. But the pump like

Scott Benner 10:57
you had to go take a class learn how to counter verb. Yeah, yeah. Somebody say something incredibly boring for a number of hours and in a fluorescent lit room. And then you walk out knowing not much more than you knew before you walked in, and then they let you have it because you passed the test.

Chelsea 11:12
Right? I had already earned what I wanted to read it all online. And apparently, I felt like the only person in the class, but I was getting there.

Scott Benner 11:21
Okay, do you think a lot of other people just came in cold and didn't find out? So like? Yeah, I guess that's makes sense, right? That maybe most people wouldn't think they go out in the world and dig into this like you did? Maybe? Yeah. Okay, so how long after his diagnosis? Did you get the CGM about? About a month after very close? Okay, so do you have any honeymooning at all?

Chelsea 11:43
Not that I can. I don't think so.

Scott Benner 11:46
Okay. What's the first thing you noticed when you put the CGM on?

Unknown Speaker 11:52
Um,

Chelsea 11:55
I don't know.

Scott Benner 11:56
Like when you first by seeing the data?

Chelsea 11:59
Oh, I, I was just fascinated. I was checking constantly. And it really annoyed my husband, because he wasn't convinced that we needed any of it because he would pick finger pokes. You know, every time he fed a meal and what they'd be like, I'm doing a great job. Look at this. going on in between.

Scott Benner 12:19
Yeah, yeah, that's okay. Right. What what is happening that you can't see. Because I hear some people say like, the kind of the, like, you know, I like exactly what your husband said, like, look how great I'm doing. Every time I check when they tell me to check, my blood sugar's around where I want it to be. Then they put the Dexcom on and they see the moments in between and think, Wow, that is not what I thought was happening. Like, how do I go from 114 to 95? And then the three hours in between? Well, I was 300. For you know, right,

Chelsea 12:45
90 minutes.

Scott Benner 12:46
Very, very, it's very enlightening, I guess when you when you say it, finally, yeah, you get to CGM and a pump comes reasonably soon after that. I mean, is that how you guys have been doing it?

Chelsea 12:59
Yes. Because I have the past, pushing to get into all of the classes before the end of the year, so that my insurance would cover it, because we just had, but our out of pocket ambulance ride and hospital stays. So I wanted to get all I could for free.

Scott Benner 13:17
Right? Hey, and people really, if you're not thinking about that, always be thinking about that, you know, as soon as you're, you know, as soon as you meet your deductible, that's when it's time to be like I need stuff. It's Yeah, you know, I mean, listen, you're gonna pay the money one way or the other, but once it's paid, you know, you know like key Imagine if you know, the calendar year rolls over and you missed by two weeks and now you're putting out your your money again, right away and ticket. Oh, yeah. So that's March, you get that going? And you just think so everything's just going well, like you just, it's good.

Chelsea 13:50
Ah, no.

Well, it was like thinking back diagnostic for sent home early from his first day of preschool because he was sick. And then the very next day was when we brought him to the hospital. But then looking back, we can see signs of him having been sick for months, like the whole summer long.

Scott Benner 14:17
What were some of the signs that you did didn't cause you to go to a doctor?

Chelsea 14:21
Well, like a, he started losing weight. And everyone's like, well, he's just thinning out. You know, he's that age. I'm wetting the bed at night, which he had always done. He had never been night potty trained. So we didn't think anything of that. And drinking tons and tons of water, which it was summer.

Scott Benner 14:41
So that makes that makes sense. Yeah.

Chelsea 14:44
And you find me and moody and would say he was tired and refuse to do things but he had been that way since birth.

Scott Benner 14:52
Like this kid's always been a jerk. This is not

Chelsea 14:56
refused. Now. Looking back at

Please sing away.

Scott Benner 15:01
Yeah, no, I have a photo of Arden. I don't think I've ever shared online. I don't ever think I would. But she's in a diaper. And she looks like a you know, like, she looks like somebody I don't know, Mick Jagger would have dated in the 70s. And you know, like, she just she, she's like heroin thin. And yeah, and no one thought anything of it for some reason, just, you know, at me, she was already little. I mean, keep in mind the difference between art and looking incredibly thin. And how she looked healthily was like, you know, a pound and a half. But okay, it was a big deal on her. You know what I mean? From 19, down to 17 pounds was a huge difference. Yeah, see your ribs and, and just I don't know, I guess it happens slowly. And you don't notice it?

Chelsea 15:44
Yeah. And he was just constantly snacking. I remember getting annoyed with him. I was like, just pick one thing and eat the whole thing. But he would pick one thing and be like, that's not satisfying me. I want something else. And

Scott Benner 15:54
because nothing was gonna satisfy him, right? Because he had a primal hunger going on because of what was happening in his bodies. Right? Crazy. Oh, so so I'm trying to I'm trying to paint a picture in my head of him like opening something, taking two bites of it and being like, not good enough. And then moving on to the next thing and you're running around being like, I cannot afford to buy all this food different. I can eat it. That's great. Okay, so I guess you know, when you wrote me eat a really specific ask when you wrote and you just said that. You hear people's diagnosis stories. And they all seem one way and yours felt so different, that you are the one to talk about a little bit. So what was what was it about yours that made you feel that way?

Chelsea 16:43
I guess when I started listening, the diagnosis stories I heard were parents who noticed one off thing about their child and they would think, oh, maybe it's this, Google and bring it to the doctor. And then they were diagnosed and on their way in a matter of like a week. And I felt like I did, or month like march through September that my child was up writing it off. And we didn't bring him until he started doing that cool, small breathing, which I had no idea what it was right. I brought him to the doctor thinking he had pneumonia. And she took one look at him and said, You're going downstairs to the emergency room.

Scott Benner 17:24
She'd see the diabetes right away at that point.

Chelsea 17:28
She didn't know but she know. He was like, way sicker. She's like he's too young to be being this way. She's like, I don't know what's wrong with him. But you're going to do

Scott Benner 17:38
I don't need this kid to go downstairs right now. Because there's a lot going on here. Don't need your kid dying upstairs here with us. And so yeah, and like hoisted him down. So what were the first steps the emergency room took?

Chelsea 17:52
They got him set up on IVs. And we were there. urgency room like not even within five minutes. I just remember the emergency room doctor looking at him. Like, he's like they said pneumonia? And I'm like, Yeah, he doesn't have pneumonia. I think he's diabetic. I was just like, What?

Scott Benner 18:09
Are you sure he doesn't have pneumonia? Because we were hoping for that.

Unknown Speaker 18:12
I know. I was like,

Scott Benner 18:13
check his feet. Make sure his feet like, way the wrong way. Yeah. It could be anything else. So did that. How did that how did that strike you like diabetes? Did it just seemed like it wasn't something that fit a child or, like when you hear when you heard it initially? What would you How did you react?

Chelsea 18:31
I was just like, well, what? Like, what kind of diabetes? Like, what did we do? Like I I didn't know, I didn't know anything? I knew there were two types. And that's all I knew. And one was the type you sort of gave yourself when you were older and the other one born with

Scott Benner 18:48
Oh, and that's that's just how you saw it like you give us one you give yourself when you're old. And when you get and then but the one you get not supposed to be like, wait, what's going on? And how did they describe it to you when you asked which it was? Do you remember?

Chelsea 19:04
Um, I didn't get the difference explained to me until like the second day in the hospital when I was like, Hey, I don't know the difference

between type one and type two.

And so yeah, then they explained about

Scott Benner 19:21
well, they have lots of videos, give us an iPad and told us to watch all the videos that explain how the pancreas works and unlocks the cells and all that stuff. The hospital discharge, you're watching YouTube. That's what it sounds like to me. You paid $25,000 to watch some YouTube videos. They were like, we can explain this to her. But

Unknown Speaker 19:38
yeah, I'd be

Scott Benner 19:39
so much easier just to give her this iPad full of videos but doctors are getting lazy.

Chelsea 19:43
Okay, I actually really liked the videos. Like that's my body.

Scott Benner 19:48
No kidding. Oh, that's cool. So winning animated. Yes, little cartoon. I like a cartoon just like everybody else does. Except for the missing link movie that came out this summer. That was terrible. I'm sorry, I've digressed. But there's this great little there's this great little movie company that makes these stop motion movies. So like kubu in the two strings, or like paranorman, Coraline, like these kind of different moves are made out of this stop motion animation. Oh, yeah. So they came out with a new one this year. And even though I watched the trailer and thought that movie appears to suck, I still win because I was with the company. If the company's listening, I went on your you had a great track record. And I'll tell you, that missing link movie made you made you upset that you were the movies just like oh, this is terrible. Like, really, really bad. Anyway, but your son likes a little animated movie about the inside body. he digs it. How much of it? Do you think he understands today? Nine months later?

Chelsea 20:47
Um, I don't know. I feel like more than the average kid. He would he went home and he's kept watching videos. And we get read in the book. Yes, over and over again. He goes up to people and says, I'm interested. I have diabetes is my Dexcom. Like,

Scott Benner 21:06
does he really? Yeah, I like that. I like that. He's so open about it. And he's an bastard. What's the question here? How do people react? Does it freak people out? Or do they give them the the classic? Oh my God, you're so adorable. Like that kind of thing? Or have you ever seen it like turn take a person and put them in a position where they didn't know what to say?

Chelsea 21:28
They kind of like look surprised. And they look at me. And they're like, they know. And so I'm like, Yeah, I guess

Unknown Speaker 21:35
that's really nice.

Scott Benner 21:38
Okay, so hospital. And so I guess the jumping off point from the idea that about your diagnosis was did? Did you feel guilty? For not seeing it sooner?

Chelsea 21:52
Oh, of course. Yeah.

Scott Benner 21:54
And how did so? What's the logic that you use to feel that guilt with? Because it's one of those things that when you look at it in reality, you think, wow, there's no way I could have known any of this. But you don't. You don't give yourself that pass? Like so? I don't. Can you explain a little bit about that guilt?

Chelsea 22:12
I guess. Yeah. Like,

put all these together and figured something out. But there were other explanations for the being in the water and personality. personality, even though my husband, he's fractious. There's gotta be something wrong with him.

And like, he's always been that way.

Scott Benner 22:36
Be honest, when he was obnoxious. Were you like he's taking after you. Did you tell your husband? This is how you did? Well,

Chelsea 22:42
we had a joke that he kind of captured my sister because she was always very dramatic.

Scott Benner 22:47
That's nice. I didn't realize we were throwing your sister under the bus in the podcast, but that's delightful.

Unknown Speaker 22:51
You would agree. What she really that she's about? Yes. No kidding. Yeah.

Scott Benner 22:57
I've been called nauseous. I get that. I see. But sometimes you have to own it. So your sister Can we say your sister's name or no? Harley, Carly? Harley, Harley. Alright, Carly. Well, I'm sorry that you're obnoxious. But I like that you that you've owned it. That's just very funny. Okay, so So there you go. Like so you've got this guilt, like for just now you see these things over and over again? And they don't, you know, they don't cause you to go find out about something I would tell you that, you know, the same thing happened to us. Arden was you know, in DK when we figured it out. She was down the panting like, you know, like a dog outside.

Chelsea 23:34
Yeah, that's what he was doing.

Scott Benner 23:36
Right. So we made it all the way to the end to I don't think it's you know, is it guilt you still carrier if you've been able to sort of leave it behind? touched by type ones mission is to elevate awareness of type one diabetes, raise funds to find a cure, and to inspire those with diabetes to thrive. They have amazing programs and services for people with type one. I'd like you to find out a little more about them. How can you find out about their annual conference, their awareness campaign, dancing for diabetes, or the extensive, amazing professional dance program that they have for kids with type one. It's really easy to find out more about it. not difficult at all. You go to touched by type one.org. And right there at the top of the page says programs you can click through them and see what's going on. no better way to spend a couple of minutes touched by type one.org. Okay, we're all inside right now. I don't want to say stuck inside, right. We're lucky to have homes. But we're starting to feel a little Well, I can speak for myself. I'm bored and it's hard to Just motivate myself to do the things that I should be doing right now. There are some simple things you can be doing to help yourself in major, major ways. And one of them is something I don't think we think about too often get a little comfortable, right with the blood glucose meter we have. And we stopped believing that there's any reason to pay attention to what else is out there. Except, I know that the Contour Next One blood glucose meter is world's better, very likely than the meter you're using every day. They've got all this other great technology, your blood glucose meter should be right up there at the top of the list. Just like your CGM and your pump, all this cool stuff that you have that you're counting on. Right when you have to rely on a meter, you want it to be accurate and easy to use. And you don't want to waste test strips. And the Contour Next One blood glucose meter fills all of those orders. Check it out, right go to Contour Next one.com. At the top of the page, there's actually a little yellow thing you can click on to find out if you're eligible for a free meter you may be may not be I don't know, I don't know you. And I mean, but it's worth finding out. And even if you're not eligible for the free meter, it's not an expensive thing to switch blood glucose meters. And this is the one you want to be looking at. Check out the meter, check out the strip's take a hard look at the contour diabetes app that you can use for your phone. It's absolutely free will help you make better sense of the data coming back from that meter. This is without a doubt, no exaggeration, the most accurate, easy to use blood glucose meter Arden has ever had. And it is well worth a couple of minutes of your time to check it out. I mean, honestly, what wall are you staring at right now? You know what I mean? We're not busy. Make an improvement for yourself. This will feel like a small improvement. But we'll have amazing ripples into your health. Just having good information. Contour Next one.com. There are links in your show notes at Juicebox podcast.com. For all of the sponsors of the Juicebox Podcast. Click on those links. support the show. Hey, if you're still listening to this ad, first of all, thank you. Secondly, don't forget about the free no obligation demo you can get from Omni pod at Miami podge.com forward slash juice box. And of course, the information that you could learn about the Dexcom g six continuous glucose monitor@dexcom.com forward slash juice box is it guilt you stole carrier if you've been able to sort of leave it behind?

Chelsea 27:50
I think I've been able to find like at the hospital. They were really good. They did make me feel guilty. Oh, they're like in great sleep. Because they're unconscious. So Oh, yeah, that's the

Scott Benner 28:03
that's the line they use when you made it almost to the worst part. And then they're like, You got him here before this. So good job. We were told the same thing. We see a lot of kids come in here and they're, they're unconscious. They go into comas, some of them don't come out. Yeah, like what I realized. Now in hindsight, they were saying, well, you guys did screw up a lot, but not all the way. So just take some comfort in that if you want. And it's funny because during the diagnosis, everything is so scattered, you know that you don't really you're not processing things the way you normally do. You know, you're not really you're not really feeling the moment the way you wouldn't in a different situation. Like I felt in that missing link movie, which was terrible. Like I sat there every minute of that movie. And okay, so Alright, so now you said you found the podcast early on? again. Did you find that through? Like, like support groups?

Chelsea 28:55
Oh, yeah. And Facebook. So

Scott Benner 28:59
and people just talking about? So So what? So this is interesting to me. Because if I'm trying to decide like, In what world would I see somebody who's basically a stranger on Facebook, and saying, if you need, you know, information about your lifelong disease, I'd go to this podcast and you think, Oh, that sounds like a good idea. Because I asked, I asked listeners all the time, like please share the show, because there's no good way for it to grow if you don't tell people, etc. But I always wonder like, what do they end up telling people like what, what can you say to a to a virtual stranger that causes them to think All right, I'll check out a podcast about something like this. Like what do you remember what was said that moved you or was it just a lot of voices? or How did it How did it get you over here?

Chelsea 29:48
I think I was asking for recommendations. Like is there a book or something I can read and some of the other list of books and one was Oh, you should listen to this podcast. Like what I Have a car and I drive to work, I can do that.

Scott Benner 30:02
I'll tell you what, it's way better than buying a book. Book. Your books are very well, let's just be honest that they're hard to read when you're adults, because there's not a lot of time. But okay, so you just like, Alright, I'll give it a roll. Like that was your kind of your feeling like, Look, if it's no good. It's no good, but I'll try it. And it'll be easy enough. All right. So you jump into the podcast, what were you looking for when you got there? So like, I guess, like, let's go back into that moment and and answer the question. What was it you were searching for? Like, what was happening in that moment with your care that you thought this can't stay this way?

Chelsea 30:35
I just want to know, like, Oh, I could be the best at taking care of it. I guess. I wanted to know everything I could about it. And how to, like, get an A in diabetes. Like,

Scott Benner 30:50
is this part of your personality? Oh,

Unknown Speaker 30:51
yeah. Diabetes? Yes. Okay.

Scott Benner 30:55
So, so you don't want to do anything halfway. You don't want. You don't want someone to look up at you and be like, ooh, she could have done better here. So even even the guilt you felt about not getting him to the hospital as soon as you wanted to. Is that more about the idea that there was a better way to get into the hospital sooner? And because you didn't do it sooner? You didn't do it? Well?

Chelsea 31:19
Well, I just feel bad that I didn't. summer long. I was just telling them you're not tired. Just get up and walk. And you don't need any water. Come on. You just want my attention. If I thought he was just been clinging, because I was going back to work.

Scott Benner 31:35
Okay, no, it's interesting, because, because we all do that, right. Like we all take how we feel about something or what we suppose about a situation and we we put it on other people. Yeah, it's like it's, you know, as if, like, I mean, how old was he at that point?

Chelsea 31:50
was diagnosed a month for his fourth birthday, right. And we had also just moved into a new house. So

Scott Benner 31:57
okay, so so if you stop and really think about it, like the absurdity of thinking that a four year old feels the the the entire weight of the idea that his mom's going back to work enough that he would like, change his personality, like didn't mean like, it's, yeah, kids don't really care. Like, I'm going back towards the like, whatever. If it's not happening right now. I don't know it's happening. You know, he wasn't. He wasn't sitting up at night. It wasn't sitting up at night going. I can't believe this Mom's going back to work. I don't know what the day is a plan to get her really involved here with me, it's probably gonna involve me paying on something and eating a lot of cookies, but only half of the bag. I think this is gonna really get her attention. But it's it's how you felt because that's what you were probably feeling bad about. You were probably feeling bad about I'm going back to work.

Chelsea 32:41
Yeah, yes. Yeah. How many days to go back to work? This kid,

Scott Benner 32:45
let's count, keeping count of every, you know, trying to make you feel bad. Let me tell you something. I mean, this. I mean, this genuinely. When Cole was born, I quit my job. That was in 2000. around January, I have not gotten up and gone to a job since then, which as you can tell by the calendar is some 19 years. And some months later, if you told me, I had to go to a job next week. I'd probably chained myself to the refrigerator and start Yeah, yeah, I would just be like, No, you can't make me go. I don't want to please don't make me I haven't shaved every day in a very long time. And I don't want to do that anymore. I just I couldn't. I couldn't fathom the idea when my wife leaves for work. Every morning, I look at her and I think Oh my God, thank god, she's doing that. Because, I mean, it would kill me. I'm sure it's killing her too. But you know, in a race of who dies First, I want it to be me. Yeah, that's what I tell her. But in my mind, I want it to be hard, because I'd like to live. So she's out doing this for me. I'm like, I really appreciate this. Thank you. I just for all you people who work it seems horrible. And not that this podcast doesn't take up an incredible amount of my time. And, you know, it does and you know, don't get me wrong, like, you know, I fly somewhere to talk. And it's a lot of days in a row and things like that. But, but it's not every day. It's not Monday, Tuesday, Wednesday, Thursday, Friday, so I think the kid did he save you from this? Did you go back to work? Or did the diabetes caused you to change your job?

Chelsea 34:14
plans? Oh, no, I went back to work. Like I took the days off. I left early when I my mom was watching him and she was like, you should bring him to the doctor. So I think and then, you know, I took several days off work and I'm back to work. Okay.

Scott Benner 34:31
Yeah. Okay, so you're working full time. Oh, you do? Oh, that's excellent. Yeah. So your job is flexible about if you need to do something for your kids. Yeah, no, that's very nice. A lot of places aren't so that's really great. And you're working now still? Yes, yeah. Okay, so you took off enough time to make the second baby and then you were right back in the game again, like how when did you stop working when you're pregnant with your second one.

Chelsea 35:01
Uh, well, after I had my turn to tea leaves, and then back to teaching so

Scott Benner 35:06
so you worked right up until like, go time are very close to

Chelsea 35:10
Yes, actually after because my second one was a week late. So

Scott Benner 35:14
I see you made it past the due date.

Unknown Speaker 35:16
Yes.

Scott Benner 35:18
See? See, again, there's a good look into my mind. I'm like, how much time? Could I get off for being pregnant? If I was? Right, and

Chelsea 35:26
I could, I didn't have a lot of paid days, like take off, right?

Scott Benner 35:29
Yeah, I mean, that all make sense. I'm just saying, You're seeing where my brain jumps right away. I'm like, pregnant, I get off for that, right. But you don't get off for anything. And I know that because I watched my wife. I watched my wife go to go into Manhattan when she was pregnant with call. Yeah. And because at the end, she couldn't move as quickly she couldn't get back on the train as fast as everybody else. So when she'd get on, there were no seats left. Oh, and no one would give her a seat. So she said there were days where she felt so nauseous that she'd sit on the floor of the train and ride the train home on the floor,

Chelsea 36:02
oh, my God, but would look at her.

Scott Benner 36:04
I don't want everyone else to judge the Northeast by this because sometimes people let her sit down, but people would look at her see how frightened she was. And just be like, Hmm, I should have got here sooner and got one of these seats. There's something delightful about living around here that I think that people who don't live here can't really appreciate. But it's also kind of horrible. Sometimes that would be a good example of that. Like she'd get off the train. She's like, I sat on the floor for an hour on the train. And she just felt terrible. But she kept going the whole way to really you. Let's be honest. Women are amazing. And you've heard it said a million times. But if men had to carry babies, there'd be six people on the planet and we'd be close to extinction. So yeah, I would not do that. You definitely guys are definitely wired right for for that. For that little bit of keeping us all here. I don't feel like I have to thank you for it. But you know, you did bring two good kids and one of them's gonna run really fast with a super tight Achilles tendons one day. Yeah. It'd be a track star. Okay, so you go out in the world, you find out Hey, I'm gonna find out some books. I'm gonna check out this podcast, you start listening the podcast. How does the podcast strike you initially? Like, are you just like, wow, nobody said it to me like this? Or did it bring ideas together for you that you were having, but you kind of couldn't pull full circle like, like, how did it work for you?

Chelsea 37:24
Yeah, it was like, Well, why didn't they explain all of this to us at the hospital? And you were using words I'd never heard before. Like, dex Omni pod and like, what are these things? If I had to go look them up? Yeah, yeah. And then it made a lot of sense while you were explaining everything and then even before he went to the next follow up appointment, that's when they finally explained to us well, you can cover food in between, you know, the correct thing and that's fine. Like, Oh, well, that makes perfect sense.

Scott Benner 37:53
There's so many different versions of what to do spread out all over the country in the world. I just spoke to a mom yesterday. I can't use her name, but she's somewhere in the south where they put her kid on regular and NPH and put him on a feeding schedule is still the you know, you eat these many carbs at this time of day. And I just thought Oh, my god that's antiquated. Like who does that but I think it happens to more people than I think you know, and and they're also gave her humor allowed for mealtimes. So the poor kids getting low a lot. And they're basically like they're they're feeding the insulin they're you know, they've put this regular and mph and it's dragging them down, dragging them down, dragging them down and it gets to a certain time of day and he needs to eat if he doesn't need to get slow and I'm like that's just and it's it strips any kind of freedom out of your life you don't even and you're using an insulin from decades ago at this point, like how is that how you would handle somebody who was diagnosed this year? I don't know that doesn't that doesn't make a lot of sense to me. I don't know how that still happens. Right? But it seems sad You know, and they put her in the poor kids got a dex calm right? Yeah, but and so they could see but I mean, luckily they can see how the kid's blood sugar's falling but imagine even that like you put it on your watch his you know his blood sugar's like plummeting down and going back up and and all they're done, they're stuck like watching it go I guess this is what diabetes is. So So you take these people they're diagnosed, they don't know anything about it. You give them really poor direction and medications about how to take care of things and then you show them this is what's going wrong and then don't give them any answers about it. And that's just it seems cruel. You don't mean like it's almost like a horror movie where they I don't know where they let you see they you know, they kill the guy in the room next year, but you get the watch. So you know what's happened to you next, like at least have the courtesy to keep the window closed, so I don't see what's going on. It's just very, very interesting how they give them that technology. What am I trying to say? Like, I'm amazed that there's a doctor's office somewhere who's like Dexcom, g six, yo, you definitely need this. This is cutting edge. And here's insulin from 1986.

Chelsea 40:16
Yeah, very striking. I found out about funny. But other things.

Scott Benner 40:21
Yeah, how can they understand half of it and the other half, like, I get that, right. That's the part that just it threw me off when I was talking. So I, you know, I, you know, I'm sharing it without names, but I just told her, I'm like, Look, I'd go back to the doctor's office and say, I, you know, I need a, I need a slow acting insulin and a fast acting insulin and I maybe a pump, you know, and that's it. I'm switching from this, and if you don't like it off to go somewhere else, but you know, it's not 1989 and I'm not doing this this way. Right. You know, anyway, um, so Okay, so you you get on, you get on the show, you're hearing things you hadn't heard before you go find out about them, you get them started? Are you like, do you bump and nudge? And, and? And do those things? Is that how you manage your days?

Chelsea 41:06
Yeah, I was trying to do that with a pen. Get a pump yet. Meantime, I bought an in pen. Because I wanted more data and information. And to keep track of all of that, okay, then facing my poor son around the house trying to give them that's all the time. He finally got the pump. And so I tried to do the bump and nudge and all of that.

Scott Benner 41:30
It is that working for him?

Chelsea 41:32
Yeah, it is. Most of the time, I rearrange everything. And it's funny. Like, my husband didn't understand why I wanted all this technology. Or he's like we you know, if it's cheaper to do it with the finger pokes needles, why don't we just do it that way. And I had made all these parts of what it would actually cost with needles, and then with the different pumps, I was like, Look, it's just like a $500 difference. worth it to me to do the pump.

Scott Benner 42:01
Right. And it's so not about I mean, now that you're doing it that way, like it's so not about right, that right? Yeah. But is that do you have to budget things? Are you the person you're asked to like budget things out all the time? Or were you just trying to make a case for it? And you didn't know how to make the medical case for it. So you thought well, at least I'll make a financial case.

Chelsea 42:21
Well, we had just happened to also be diagnosed during my employers open enrollment periods.

Funny, so

yeah, that's what I was doing. I hear Yeah, I

Scott Benner 42:36
by the way, is it being an adult? Terrible? Yeah. Anyone? Seriously, anyone listening? Who has never had to like, it's the weekend and there's all these things I want to do. But instead, we're gonna sit down and read about the different insurance plans that my employer offers, and try to figure out which one's best And trust me,

Chelsea 42:54
it'll get me the most free thing. They're written figured out. Oh,

Scott Benner 42:58
my god, they're written Chelsea in a way where you're just like it. They both seem equal to me. I don't even understand why these two exists. They don't they don't appear to be any different. It's just like, I don't know. It's like, it's like anything else. Like, you know how every once in a while you get in your head, you're like, I'm gonna find a new cell phone carrier? Because then you can't they're not cheap anywhere. It's all price fixed. It's not gonna work. Yeah. And so you spend your whole Saturday? And then would you do you just went with the plan that you had before?

Chelsea 43:25
Um, no, actually, we switched.

Unknown Speaker 43:27
Okay, what what, what kind of little faith did you get?

Chelsea 43:32
Ah, well, the one I switched, it's a little more expensive, monthly, but in the end, that has a lower out of pocket deductible, we end up getting more supplies for free, okay. Even though it's not really free, but

Scott Benner 43:47
nothing's free.

Chelsea 43:50
I'm paying $800 a month.

Scott Benner 43:52
But isn't that funny? Isn't it funny that you pay me just $800 a month? What's that? You know, it's $8,000 a year or something like that. And you're like, Look, if we just here then $400. And it's free. After that free you paid 8000 hours? No. I try not to think about that part of it. Because then when you get your copay for something you think, but I've already spent so much money just to get the injections. Like how is it possible? You want more from me? I went to the I had to go into the hospital recently just in and out. And I'm fine, but they must have billed for like, I don't know. $15,000 and still sent me a bill for 1500. Yeah, how is that possible? Like I'm, I'm past my copay already. Like, I'm good. Like, we've paid up that I haven't kid with diabetes. And it's June. I've been good for a while. You know what I mean? Like we're paid in. And I'm gonna eventually I'll just call the hospital and be like, Look, are you out of your mind? Like I'm not giving you 1500 dollars like for what you know, for the three tests that I stood up in the room and said, Please don't give me those. I don't need those. That's not why I'm here. And they're like, No, we have to and now you want to charge me for it. And by the way, all the tests are clear, and I didn't need them, like, you know? I don't know, do you think I'll have any luck arguing my way out of that probably should be

Chelsea 45:05
like I passed the test. I don't have to pay, right. That's how it works.

Unknown Speaker 45:10
I'll give that a try.

Scott Benner 45:13
Okay, so so you should that's smart though. Like, I mean, honestly, joking around, it sucks to, you know, to have to spend time as an adult, like looking into stuff like that. But everybody really should sit down and read through those plans and see what they do. Because they're very well might be one where you could like, you know, he said, $500, maybe it's 1000, you might save a little bit of money at the end of the year. And it's a big deal, you know? Mm hmm.

Unknown Speaker 45:35
Cool. Yeah. So okay,

Scott Benner 45:38
you bump in nudge a little bit? Where are we at? We are Do you mind saying, like, you know, how's your let's, let's ask some kind of management idea questions. So like, Where's your low and high range set to on your Dexcom? Where do you try to stay?

Chelsea 45:51
At to 150?

Scott Benner 45:54
Sorry, about that. I got actually an 80 to 150. And that do you have? What am I want to call it luck with? Like, do you basically get to stay in that range? Do you leave it very frequently?

Chelsea 46:07
Yeah, basically, do, um, doesn't get low very often. That for like, today has been all day. But usually it's high.

Scott Benner 46:18
And by high, how far over 150? When you're when you have that thought, like, oh, gosh, I'm

Chelsea 46:24
under it said again? In the 200 200?

Scott Benner 46:29
Do you ride it out? Do you try to get it down? Like Have you figured out why he gets to 200? And doesn't and and you get stuck in it? How often does it happen?

Chelsea 46:38
Well, it's sort of like my husband and I have different strategies for tackling. He likes to write it out. Great of him going low. And I like to tackle it, because it's like, he's never gonna say no to m&ms or fruit snacks.

Scott Benner 46:51
So So why don't we get this down? And then we'll catch it with a snack if we Yeah. So let's say you and your husband have different strategies. If you were weren't trying to stay married, what would you say? Would you say that you're doing it right? And he's not?

Chelsea 47:05
I'm doing it better? Doing It Wrong.

Scott Benner 47:10
So if is your husband not around it as much as you are?

Chelsea 47:16
Oh, actually, he takes care of them. Morning and most of the day, and then he drops them off to me at work. So

I'm sort of in charge the rest of the day and the night.

Scott Benner 47:29
Huh? and so on. So I'm trying to, I'm trying to like figure something out. Right. Like, it's usually I think this would, I guess I'm gonna say this is what I'm getting at. I think it would surprise the people who are listening to know that in the private conversations I have with families. It is more often. The man the the male part of the mom dad relationship, who is scared. And I I can't ever put my finger on why that is because guys basically Don't think about anything like you. I don't know how long you've been married. But by now you must have noticed, like I said on a podcast the other day that will end up being six months ago. Like I'm not even like I'm basically just a rock with a pulse. Like I'm a guy you're gonna mean like I think through so few things before I do them. I'm always like, go go, go do knock it over. We'll pick it up later. You know, just I don't care kill it. Like that kind of stuff. Like just guy stuff. Yeah. But when it comes to this, it's never like that. very infrequently. The guys are, you know, most most often the guys I hear from are always the ones who are just Well, let's just be careful. And I don't know why I wish I could get a guy on to be honest and talk about it. I don't know if they I you know, there is this interesting thing when you have a baby, right? When you get married Chelsea, it's like, oh, it's me. And this guy that I love for me and this girl that I love her this girl and that whoever you are, you have this pairing of people. And you realize that you're the to each other. You're like the most important thing in the world. Then you have a baby. And you recognize, ah, I used to think she was the most important thing in the world. But now I realize that's just a girl I met at a movie theater one time. That's my son. Like, right? Like if one of us has to get thrown off a boat, because there's only two seats. I'm tossing her over, not him. You know what I never would have done that six months ago. And so you have this, like you have this different connection to your children than you do to your spouse. And I think sometimes you realize it hit me one time. But you know, when I became a stay at home dad and I'm raising coal, I was like, Oh my God, if something happens to this kid, like she's not gonna forgive me. Like whether it's you don't mean like whether it's a purpose or not like that'll be something that will happen that I don't know that somebody could ever get over. And so I wonder if guys like I wonder if that's something because men kick. Men want to keep their women, women once they're married or sort of like Alright, well You know, we've got the house and the kids all look the same. So I don't know that I really need you anymore. It's interesting how some Yeah, women's like focus changes as they've had children that the children become incredibly important, and everything else sort of takes a backseat. And I don't know if I'm making all this up or not. But I do wonder like, why it is that overwhelmingly, I see men who just would rather have their kids blood sugar high. Do they not understand that that's detrimental? Or are they so scared, they can't care?

Chelsea 50:29
I don't feel like at first, my husband didn't understand why I wanted all this stuff. And I was worried about his blood sugar being high all the time. And unfortunately, it took because I would try to long term health sciences blah, blah, blah. And he's like, Yeah, whatever. We're doing fine. But then my mom passed away suddenly. And then

Scott Benner 50:49
finally, all of a sudden got it. Like into the on top of it. Interesting. Give me one second. I have something making noise in the background. I have to stop. I'll be back in one second. Yep.

So I'm sorry. So So somebodies mortality reared its head. And then your husband thought, oh, wow, people do die. Not that he didn't know that. But it the reality of it hit him. I have to say that. That's not crazy. Because a lot of us make it through life not paying attention to those sorts of things. Like you know, ignorance is bliss kind of a situation is definitely a way to get through some things and it happens for people. So, so who pet so tell me who passed away again, my mom Of what?

Chelsea 51:38
It was really unexpected. It ended up some sort of heart problem like pericarditis like gut lining around their heart. Blame, did she? Yeah, like that? And how old is she? Everything went downhill very fast.

Scott Benner 51:56
He was 61. Very sorry. That's so young. And obviously not, uh, not not funny at all. No. And, and it's just tough because we went right into your mom dying from like, all the joking around about Yeah, it's such a weird shift. But,

Unknown Speaker 52:10
but get it? So

Scott Benner 52:12
do you think that part of your mom's death being so out of the blue? Do you think that helped, like jolt your husband a little bit like, wow, look, this didn't look like it was gonna happen. Now all of a sudden, she's not here anymore. And maybe I'm looking at these blood sugars and thinking it's gonna be fine. And maybe it won't be.

Chelsea 52:30
Yeah, I feel like that's what happened.

Scott Benner 52:33
Oh, your mom did a very nice thing with her last night. She did? Seriously? Yeah, like it? She'll never, you know, maybe she didn't do it on purpose. But if it helps your husband think about it differently, then I think it is a it's a it's a really kind of a kind thing, you know? Yeah, because high blood sugars are easy to ignore, because of the lack of physical. I don't know, feedback that tells you this is bad. I need to do something. Right. And if the kids jerky, you can just say, Oh, he's a little kid. But meanwhile, when his blood sugar is lower, is he more well behaved?

Chelsea 53:11
Oh, absolutely. It's a total jerk. wanna push sugar is high. But he's the nicest kid ever, like blood sugars are even and even has preschool teacher would recognize just like we had a difficult day, but I think that was his blood sugar.

Scott Benner 53:26
No. And that's interesting, though, because you know, it's 100% true. And people don't. People don't give it enough weight. When they're thinking about it. It's the lesson the truth? Is it controlling blood sugar with bad tools or bad information? It feels impossible and might well be. And then you get good tools and good information, you realize, Oh, this is not as difficult as I thought. And now now it's easier to hold yourself more accountable because you feel like you feel like you actually have the tools to be accountable, like but you know, but holding yourself accountable to something that you don't know how to do that just that hurts. You know, that's not a that's not a feeling that someone should have to live with. So does your husband listen to the show? Or do you just pass stuff to him that you hear?

Chelsea 54:11
No, he doesn't listen, and I

not because he doesn't want to but he just doesn't do podcasts or shows or books or things. I just

Scott Benner 54:22
like the information to him.

Unknown Speaker 54:24
Yeah, I try to do

Scott Benner 54:27
I have to apologize to all of the men in the world who I'm pretty sure at some point in the day get told the guy on the podcast said blah, blah, blah. Because I'm now meeting them. I had this most this really like a wonderful interaction when I was in Orlando recently. And a person came up to me who's gonna hear this and she was so excited to meet me, which baffles me. I hope you understand that. I'm not. Of course she's excited. Come on over it. No, I'm like really me. Are you sure and She's just jumping out of her skin excited. She wants to tell me what the podcast means to her, which was really wonderful. But right behind her is her poor husband who's like looking on, like, what is happening? And and I thought, well, this poor guy, and she's like, she talks about you a lot. But he wasn't saying it like a very upbeat way. And I, I apologized to him. I was like, Look, I'm very sorry. I said, I think there's like a couple of shows, if you listen to she might get off your back, like, there's these couple of episodes, I would try. And then you could relate a little more she think you were listening, and you wouldn't have to do it anymore. Yeah. And you wouldn't have to, you know, wouldn't have to hear about this, but I really did feel it was awkward. And then I called my wife when I got up to my hotel room. And she's like, I can't believe anyone wants to talk to you. And

Unknown Speaker 55:44
I was like, What?

Scott Benner 55:47
But, but so seriously, like, if you could get him to listen to maybe just a couple of the pro tips episodes. Do you think that would help you? Because at some point, y'all seriously, like, at some point. You can't have it so that when your son's with you his blood sugar's 120. And when he's with his dad, it's 220. Right? Right, like, cuz that's just not fair to him, you know, to your son. And so Something's got to give where he, you know, he takes on a little more, but you guys are also so arguing myself, you guys are also so you're also so new to it that you would think that some more time might help him feel at ease. What do you think would help him? Is there a way to help him feel like let me shoot for 150 instead?

Unknown Speaker 56:33
Um,

Chelsea 56:36
you know, he's getting better. It's just like, when he's with the boys, he's busy. And he just, I try to set them up good. So he's ready for the, for the day, I leave and everyone's still asleep in the house. So if his blood his person's blood sugar is, is even before I leave work, and we're pretty good. And, okay, it doesn't do that bad a job of managing he's just afraid of having dropped below below. And then him having being too busy to address it, I guess,

Scott Benner 57:02
does he work from home?

Chelsea 57:05
No, he is self employed. So he goes around and buys things from thrift stores and garage sales. And he sells them online.

Scott Benner 57:13
Okay. And so he's like, he's out of the house sometimes.

Chelsea 57:16
Yeah. And he takes the boys with him to the stores. And so

Scott Benner 57:20
but he gets, but he's afraid he could be Oh, I see. He's afraid he could get busy doing what he needs to do.

Unknown Speaker 57:25
Right and miss

Scott Benner 57:26
this thing? And yes, and cause a real issue.

Unknown Speaker 57:30
Hmm.

Scott Benner 57:31
Well, that's a fear, I understand. And at the same time, I think with the Dexcom is a little not real. Like, do you mean like he could he could set his alarms? Because I'm assuming he's falling on his own. Right? Yeah, he could set his alarms where he was, he'd be comfortable knowing.

Chelsea 57:49
Alright, I have your alarms and bring the thing and then do a turn off the bazel for a little bit, which once I told him, he could do that, he thought that was brilliant. So

Scott Benner 57:57
good. Well, listen, that's my challenge to him is to just is to just push down his expectations, like make his you know, lower his high blood sugar expectations. And yeah, you know, I mean, like, and I think that's, by the way, not just your husband and I, I'm so sorry to him for feeling like I'm picking on him. I'm not trying to make a greater point. But if you do that, anyone listening, if you haven't said this in a while, but you know, it occurred to me at one point when my daughter was younger, I used to have her high alarm set at 200. Yeah, and she was very infrequently over 200. And I just realized one day, I was like, well, I seem to be good at keeping her under 200. So I moved her to 180. And then I was good at keeping her under 180. And then so I just kept pushing it down. I was like, Oh, I get what I expect. You know what I mean? Like, but yeah, I'm working towards this. So that's what I end up getting. And I think your husband could easily do that. Even if he just even if he just went to 180 and then got that feeling like Oh, look, he doesn't get low. Let me try 170 Let me try 161 50 until you get them and really

Chelsea 58:55
it's nothing the Pre-Bolus that gets them up because we don't honestly Pre-Bolus with enough time.

Scott Benner 59:03
And is that just because does your son get like impatient?

Chelsea 59:08
Yeah. And he's unpredictable with what he wants to eat. So he'll say he wants to do one thing. And then it'll be like, No, I don't want that. You're crazy. I want this.

Unknown Speaker 59:18
Well, so

Scott Benner 59:21
are you finding because what I would say to you, if you came to me and said, This is my problem, you know, I don't know how to Pre-Bolus because my kid changes his mind all the time, what I would say is just Pre-Bolus a minimal a minimum that just pick a number like 10 carbs, you know, 10 that it's always my Pre-Bolus is always 10 carbs because he's always going to eat at least that much no matter what food he switches from, and give yourself like at least that going in because once you get the momentum of the insulin moving in your direction, then you can come through and go Okay, well now I realize it's going to be you know, meal a when I thought it was going to be meal B but now that I've got those 10 carbs in he's still moving in the right direction. Starting to eat I could put the rest of the insulin and now and not find myself behind in terms of a spike. Yeah, yeah. Do you do it? I mean, I know it's hard. Like, don't get me wrong. Yeah, yeah, for everybody listening, I know how hard Pre-Bolus thing is like, it's, it's a weird thing to think about eating before you're eating. Right. You don't mean like, I mean, of course, you know what I mean. But it's it is, it's a strange thing. Like you don't, you don't plan at nine o'clock, you know, in the morning, to eat at 10 o'clock in the morning, that doesn't, it's doesn't take you an hour to make your breakfast, you don't even start thinking about it for 20 minutes before you're going to eat. I was gonna use an analogy about watching television, but I think it's completely gone now. You know? Like, I don't think that people think anymore. Like I have to be at home at eight o'clock to watch this TV show. Like, people don't really think about that. But there was a time in the world where if you wanted to watch something on television, you had to be there. And that meant you had to think ahead about it. Like maybe the Oh my God, this alarms going off one more time. I'm coming back, hold on.

Sorry. But but maybe, maybe how easy, I want to say easy, but how kind of automated Our lives have become, has taken away people's ability to pre plan for things as well. Right? Right. Because you sort of don't need to even even if I decide I could decide tonight to watch a movie at eight o'clock. And with like two clicks have every movie ever made at my disposal to choose from pretty much. But you know, when I was a kid, if I wanted to see a movie, I had to figure out which one I was going to see. And I had to go buy tickets and you had to drive to the thing and like there was you had to plan. So I know that planning sucks now, but if it's if you can make one adjustment to your life with diabetes, it's planning to Pre-Bolus It's such a big deal. I think it's a point off your I think it's a point off your agency if you just Pre-Bolus. So our goal? Yeah, right. Yeah, please. And by the way, good point, you're coming up on the summer, you start getting into a rhythm. And then you know what, it'll carry itself over? Because it'll become your expectation. So it'll be part of your it'll be part of what you do by then.

Unknown Speaker 1:02:11
Yeah, very cool. Nice.

Scott Benner 1:02:15
It has been almost an hour. I don't know what we talked about, which is usually the indication that it was good. And did we miss anything that you want to talk about that we didn't bring up?

Chelsea 1:02:26
Ah, no. I don't think so. Yeah, I think part of the guilts like, also felt really bad because he would have nightmares after we came home from the hospital. like he'd be tossing and turning at night saying out folk. Really, oh my god, those terrible nurses. Done

Scott Benner 1:02:45
less than any good parent and by good parent. I mean, it's totally bad parenting, but you always tell someone else. You tell your kids that with someone else. You just pick up pick a faceless person in the distance, you're gonna see you're gonna be like, Oh my god, that lady did that to you. What a horrible woman. Yeah. Without making him scared of nurses. But But. So he really so he was having, like nightmares where you could hear him talking about the process of being in the hospital.

Unknown Speaker 1:03:11
Yeah. I wonder

Scott Benner 1:03:12
if that's happened to anybody else. Because that's, I've never heard that before. That's really interesting. That's I was wondering.

Chelsea 1:03:18
As another thing.

Scott Benner 1:03:19
Yeah. I wonder I I'd like to listen to if that's happened. Anybody else? Let me know. That's, that would be crazy. Um, how long did they go on for?

Chelsea 1:03:27
About a month? I feel like, okay, sort of really got in the swing of things. And I was more under control. And yeah, so now he just thinks anytime someone goes to the hospital, they come home with diabetes. Oh,

Scott Benner 1:03:43
my gosh, I hope he I can't wait for him to get old enough to realize that's not true.

Chelsea 1:03:47
I know. At first he thought the new house gave him diabetes. I thought it was the doctors But

Unknown Speaker 1:03:53
yeah, I can

Chelsea 1:03:54
get a new pod. And he thought that that made the diabetes go away. wasn't getting shot anymore.

Scott Benner 1:04:00
Yeah. No, that Arden thought when she was really little that the jdrf walks because they were a walk for a cure. She thought like, she thought she wouldn't have diabetes. At a certain point. We didn't realize she'd luckily Oh, my sister in law, so we could talk to her. But when she was like, Oh my gosh, when she was like six years old or something like that. She thought like, it was going away soon. And we had to tell her No. It was it was a I'm gonna mark it as one of the saddest moments in my life, but having to tell her that but it was interesting how she made the leap. You know what I mean? Like, she was just like, yeah, to walk for a cure. So I mean, it's common, right? Like, when's this

Chelsea 1:04:41
exam? You walk in, you're cured. That's, yeah,

Scott Benner 1:04:43
I go for a walk to make my diabetes go away. And so she thought that for a little while. And yeah, so Oh, I see that. By the way. I dropped my iPad yesterday and I jumped about it all night. Yeah. Imagine if somebody diagnosed me with a horrible I mean really, I'm so fragile that I Like dropped my iPad and I had a nightmare about it. son must have been like, he must have saw dragons and needles and all kinds of stuff going on there. Oh my gosh. Well, Chelsea, I really appreciate you coming on and doing this and being interested in being on the show and sharing your experiences and letting us pick on your husband, which I'm sorry, for.

Chelsea 1:05:21
He doesn't listen, he'll be okay. calling your sister

Scott Benner 1:05:22
names. Really? This one's fantastic. And I'm leaning heavily towards Kristen's a jerk as the title because you said that at one point, but I probably won't. But But seriously, I appreciate you taking the time and doing this. Thank you so much.

Unknown Speaker 1:05:36
Thank you. Yep. Can you hold on a second? Yeah, fun. Yeah. Oh,

Scott Benner 1:05:41
excellent. You're so Midwestern. It's hard to tell. So before I pause it like you're in Minnesota, right? Yes. Like there is just such an evenness about you that I can't like I have trouble reading you. Like, but I figured it out in the first couple of minutes. But at first I was like, I don't know if she's sad or happy. Or you just you seem like just, I don't know, you reminded me of trains, planes and automobiles for some reason. And I don't know why. Even now, when I'm saying it to your soul, kind of calm, and even like, like you when you're talking about your husband, like, he doesn't like to do that. So it's okay. I wish I could hear my way. I'm never gonna let her come on the show. because she'll, you know, but maybe one day, but nevertheless, if you said to my wife, Hey, your husband's too busy for you would even get that out of your mouth. And she'd be like, I don't care. He needs to do it. And that would be the end of it. You're just so nice. I'm moving to the Midwest. If I ever need a new wife. That's what I just Well,

Chelsea 1:06:36
my husband would say, not this way. But I try. It's like when kids are well behaved at school, and then they're terrible at home.

Scott Benner 1:06:46
So you're maybe not quite as kind and forgiving at home as you are when you're talking to other people.

Chelsea 1:06:49
Oh, that's when I'm tired. It all comes out.

Scott Benner 1:06:54
Maybe your blood sugar's just high.

Chelsea 1:06:55
Yeah, exactly.

Scott Benner 1:07:00
Huge thanks to Chelsea for coming on the show and sharing her experience with Type One Diabetes being Kristen's mother. And thank you as always to Dexcom and Omni pod for sponsoring the show. But today, especially the Contour Next One blood glucose meter, go to Contour Next one.com to find out more. And of course to my favorite type one diabetes organization touched by type one, please go check them out at touched by type one.org. Before I go, let me tell you that the meetups we're doing I know I wasn't going to mention the Coronavirus during this one. But we've been doing these meetups on Thursdays, virtually through zoom, they're going great and they're growing. The next one will be this Thursday night at 7pm. That will be April 16 at 7pm. Eastern time, you can find links through the Facebook page. And Instagram later next week. Come hang out with a bunch of people left type one, there's a great mix of adults with type one and parents of kids. conversation is free flowing. It's not structured, but it's also not crazy. People aren't talking over each other. It's not a mess. But I'm not like here's topic one. Now we're going to talk about this that bowl. I don't I would never do that. So very cool, free flowing. Nice conversation. I actually think it went like two hours the other night it was only supposed to be 90 minutes. People are just having a good time. And if you're not looking for that kind of community during this lockdown time.

Unknown Speaker 1:08:32
All good with me.

Scott Benner 1:08:34
It's just there if you need it. Okay, I'm gonna post this and then support it on social media and then I just, you know, just 48 hours later the weekend will be over. Maybe I'll watch a movie or you guys been watching By the way, man check it out Ozark enjoying that. A couple movies. I want to get to that onward movie from Pixar. I got a little teary eyed there one point I don't know what else to say. There's the days are so long. Just feel like they're never ending. house is so clean. You can eat off the door jams. I mean, there's just nothing else to do. The laundry is done. tell you I wish I knew how to cut my own hair. getting out of hand. You know what I mean? Anyway, I hope you're all safe. Wash your hands. Oh, look, it's gonna rain. My app just told me.

Unknown Speaker 1:09:32
That sounds exciting.

Scott Benner 1:09:35
Oh, you know what? You could leave an explosively thoughtful, fairly positive review of the podcast right there in your podcast app, especially that Apple App. It's super easy to leave a review. You know, make it you know, don't just be like great podcast, although that's all you can muster. I'm not gonna stop you. I'm just saying you know Something thoughtful, something that would make someone else think I should try this out. That would be lovely if you could do that. Otherwise, share the show. Please, please, please. I do not have money for advertising. Share the show help it grow. Blah, blah, blah. To tell you a joke. What a joke. My favorite joke. I've never told the same way twice. You're never gonna look at me the same if I tell this joke. Okay, all right. I'll do it. I think I can do it. I haven't done in a while. My friend Mike had an uncle. And this man could tell jokes. They were so dry and not funny traditionally. But they were so much fun to watch him tell them I think that was actually what was good about it. It was the way he told them. So I have strived throughout my life. Or strove have I strived or strobed hold on a second is Trove to word I just made up in my head

Unknown Speaker 1:11:01
No, wait.

Scott Benner 1:11:04
Did I mean strived? Alright Google apparently I meant strive strove just not a word. Although strove is Alright ready to exert yourself vigorously. Try hard he strove to make himself understood. But strobed ed is not a word. It's strived. So, and then by you can go deeper into this isn't striven or shirt or strived. I didn't even think I strive and I thought strobed have striven is plural effect tense, whereas stroeve is past tense.

Unknown Speaker 1:11:40
blooper. perfect tense.

Scott Benner 1:11:43
Oh, we've gotten past my eighth grade English education. The actual forms are to strive strive, striving strove Ooh. And striven when strived is used instead of an authentic form of the word, it's sometimes replaces the simple past drove and other times it replaces the past participle striven. Anyway, I've tried really hard to mimic this man's ability to tell a story. I used to watch him in large groups of people. And he could hold their attention telling the seemingly dumbest jokes. And I realized now it was it was watching him tell it that was interesting, was animated, had all this life in his face. And I was always very impressed by his ability to do that. So let me see if I can remember one joke that he used to tell. His name was Frank, by the way, and I knew him as Uncle Frank. He was my friend Mike's uncle. Okay, so there's a farmer on. There's a farmer at his farm, and he's outside working. And the fuller brush salesman pulls up in his car to try to sell brushes to the farmer. And the man gets out of his car and he straightens his jacket and tightens his tie and fixes his hat and grabs a suitcase and walks very steadfastly to the farmer, who's often a field working, feeding the pigs. Man makes his way over to me says Good afternoon, sir. How are you? I'm here to speak to the lady of the house. I have these quality toilet brushes for sale. And I'd like to show them to you and your family. Please let me inside I will clean your toilets to show you how well they work. And perhaps you will buy them. And the farmers like yeah, you know, we could use new brushes. So I guess we could do that. And you know, I mean, I'd love to have you clean the toilet? So seems like a win for me. Even if I don't want the brush right guys? Like absolutely, sir. There's no obligation to buy the brushes. I'll just come in and demonstrate them for you. So the farmer is like, Alright, cool. Let's do it. And the brush salesman then catches a look at the pigs in the, in the pen, and notices that one of the pigs has only three legs. And he says to the farmer. I see here, sir, that one of your pigs only has three legs. And the farmer says Oh, that pig is amazing. Can I tell you a story about this most amazing pig. And the brush salesman's like short, no problem. So they lean on the fence. And the farmer says one time years ago, my house caught fire in the middle of the night. And none of us woke up we didn't notice and the smoke was overwhelming. And we were certain to die. Well this pig sees the house on fire. He leaps over this fence runs across the property makes his way to the house is locked out. picks the lock picks the lock with the sticky finds on the ground comes inside wakes my children, gets them out of the house. wakes my wife can't wake me, picks me up and carries me to safety. As if that's not enough, the pig then went and fashioned a hose to the trough and put the fire out himself. All the brush salesman's like, Oh my God, that's amazing. And the farmers sir that is, but the beginning of the story of this three legged pick. So the the brush salesman said, Well, we know what else is there guy says I'm out one day I'm plowing the fields. My tractor breaks down. I get underneath of it to see if I can fix it. And the tractor collapses on top of me the weight of it pinning my leg to the ground, I was certain to die. calling for help. No one could hear me except this pig, who again, leaps over the fence, makes his way a mile out to our fields. gets there assesses the situation, fashions a fulcrum and a lever,

Unknown Speaker 1:16:01
lifts,

Scott Benner 1:16:02
lifts the tractor from my leg pulls me to safety. And then and I can't believe this happen. But I saw it with my own eyes. The pig set my fracture. Well, the brush salesman is just beside himself. He can't believe it. And he begins to gesture towards the farmer. And before he can even say anything. The farmer says I know what you're gonna say. But it's absolutely true. As a matter of fact, that pig delivered my second daughter Petunia. It does the dishes at night. And it keeps track of our planting schedule. has quite the mind for numbers. Well, the brush salesman's like I, I believe you it's it's astonishing. But that doesn't explain why the pig only has three legs. Well, the farmer goes Sir, I don't know where you're from, but around these parts. You don't need a pig like that all at once.

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#322 Justin is Recovering from Coronavirus

COVID-19 with Type 1 Diabetes

Coronavirus disease (COVID-19): Juicebox Podcast conversation with Justin Wilhite. Justin had Covid-19, has Type 1 Diabetes and he's on the show to share his experiences.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio -  Radio Public or their favorite podcast app.

+ Click for EPISODE TRANSCRIPT

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

COMING SOON

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The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!

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#321 Ask Scott and Jenny: Chapter Twelve

Answers to Your Diabetes Questions…

Ask Scott and Jenny, Answers to Your Diabetes Questions

• How long can you safely turn off basal?

• Let’s talk about ‘extreme’ management tactics and controversial lower A1c results.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Pandora - Spotify - Amazon Alexa - Google Play/Android - iHeart Radio -  Radio Public or their favorite podcast app.

+ Click for EPISODE TRANSCRIPT

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello, everyone. Welcome to Episode 321 of the Juicebox Podcast. Today's show is an ask Scott and Jenny. And in just a moment, I'm going to tell you what the topics are and who the sponsors are. But first, I'd like to spend a brief second, discussing how I'm programming the show with consideration to the Coronavirus and what's going on in the world. So my family and I'm sure many of you have been held up in your homes. My family's been here at home for almost a month now. And in that time, I've been paying attention to the Coronavirus maybe more acutely than some parts of the country because I live in the New York Philadelphia metropolitan area. And it struck here pretty quickly. Now, some of you may live in places where it might not reach anywhere near that it has in New York. And I hope that for all of you. And some of you may just be a little behind where New York is right now. One way or the other. I felt like it was important for people to understand what Corona or COVID-19 is. So you know, back in mid March I had Adam Edelman Come on. He's a doctor we discussed Coronavirus, kind of in a broad way. Jenny Smith and I talked about Corona The following episode. So these are episodes 314 315 There were a couple other episodes came up. And before I knew it, Sarah who's listening to the show, reached out and said she's a nurse in New York City. And she's got Corona very mild case of Corona, she came on and told us about what a mild case of Corona was like. Adam came back on Dr. Needleman came back on again, just recently did a little bit of an update. And in that time, I was able to interview a gentleman named Justin, who's become kind of famous online for being one of the first people to put a picture of themselves up with a mask on saying that they had Coronavirus and asking everyone to be careful and, and follow the rules. Because it was serious. Justin happens to have type one diabetes, so I couldn't pass him up. Even though I thought I don't want too much Corona stuff on the podcast. Now Justin had a more significant more severe case of Corona, and I interviewed him just the other day, his episodes going to be out after this one. So what I'm gonna do this week is put an extra episode out, I'm gonna try to strike a balance, I don't want people who aren't interested or maybe are having anxiety around Corona to feel like they're not getting content. And for those of you who are interested, I don't want to stop providing the content. Now I can see the downloads and the corona episodes are very popular. And so I'm going to kind of override my inner voice that's telling me too much Corona. And I'm just going to try to continue to provide good solid information that's not click Beatty, and not meant to make you upset, you know, so that you'll come back and get more, which I think is what a lot of media does just want to offer you good information. You can do with it what you want. But there'll be three episodes this week, so that everybody gets what they're looking for. This episode of The Juicebox Podcast is sponsored by Omni pod makers of the tubeless insulin pump that my daughter has been wearing now for a very long time. Now, since she let's think, already got an insulin pump around the time she was four and she's gone. And she's 15. She's going to be 16 this summer. That seems like 12 or 13 years, it's hard to know because my math skills are limited. Anyway, Arden has been working on the pod every day for that time. She's also been wearing a Dexcom CGM. Currently Arden wears the Dexcom G six continuous glucose monitor. And we absolutely love it, you can tell that if you listen to the podcast, that's sort of a no brainer, I don't really need to tell you her meter the Contour Next One blood glucose meter super small, super convenient, lovely and accurate, like they talk about and of course you know near and dear to my heart touched by type one. And I asked you to check them out at touched by type one.org. There are links in the show notes of your podcast player to all of the sponsors. Or you can type their links in yourself. My omnipod.com forward slash juicebox dexcom.com forward slash juicebox. Contour next one.com And of course, touched by type one.org. Let's play the music and then talk about some stuff with Jennifer Smith.

In today's Ask Scott and Jenny, we answer 123 questions. Wait. Yeah, three questions couple more bigger. I asked me a question. We chat a little bit about the Zoom meetups I've been doing on Thursdays come on out and check them if you want. There's one In the Facebook page, this Thursday is going to be at 7pm. Eastern time, I guess I should tell you that Thursday's date will be April 9 2020. In this episode, Jenny and I are going to answer a question about shutting off Basal, and how long you can do it safely. I'm going to tell a quick story about meeting some fans in public. I Muse a little bit with Jenny about the social meetups and whether or not they're valuable ways to help people make improvements. And I'll talk a little bit about that at the end of the podcast as well. And then we talked about extreme management. I put extreme in quotes here. Because is being healthy extreme. And why do people think of it that way? Sometimes. I'm going to want you to remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And to please Always consult a physician before making any changes to your health care plan are becoming bold with insulin. Helen says, I hear Scott say he turns Basal off. If Arden is running low, we started to do this for my daughter, Ella. And it works amazingly well. However, we only dare do it for about 30 minutes. We were told ketones develop quickly if she doesn't have background insulin. How long is safe to do? I have my answer. Let me go first this time. Let's see how wrong I might be sure. Well, you're not wrong. Yeah, I could be wrong, you hold tight.

Jennifer Smith, CDE 6:32
Hold tight,

Scott Benner 6:33
I'll wait. Here's my thought. If your background insulin, if your Basal insulin is dragging you that low, then taking it away for a little while. It's not really gone, because you probably have too much to begin with. Now, if you take it away for a long while, and create an absolute black hole where no background insulin exists, then I think DK can come on very quickly, depending on a lot of other physiological implications. How was that?

Jennifer Smith, CDE 7:07
I was actually pretty, pretty good. Not bad. Not bad. Not bad at all.

Scott Benner 7:11
I gotta get you know how some people are like online ministers. I just need one like company to start online CDE. And I think I could get one wouldn't be like real, like, you know that while you're being married by a minister of the like, bah, bah, bah, live charge that got something by filling out a form online. It's not really a minister but it's legal. It's legal. I think if somebody would start that around diabetes, I'd be okay. Go ahead.

Jennifer Smith, CDE 7:38
Yeah, no, but you're I think that's a really good like baseline, and even a little bit more. It's a little more in depth than baseline even because you did go into the fact that if you're on Basal alone, there's little, literally nothing else left such as like an overnight, you go into bed, your last meal in Bolus was around six o'clock, it's three o'clock in the morning. And you can see that, like you said, before Arden's friend, she had a bad pump, or a bad pod site, or whatever it was, and she was middle of the night, you could see blood sugar was rising. There was no other reason for it to be rising. None at all. It was a bad site. So that kind of a deficit of insulin was likely started a couple of hours prior to the rise starting Yeah, right. Because anytime you're at a deficit of Basal, you can shut a Basal off right now, you still have circulating Basal insulin going for at least another hour, perhaps hour to two hours, right. So you're really not at that complete, utter zero level of Basal yet. So a 30 minute shut off, is really it's nothing, it's, I'm glad it's helping for the reason that you're using it for, but that 30 minutes is really like a drop in the bucket of nothing, as far as impact for causing decay a right. And the other, you know, piece that kind of goes into that as well. In this scenario. For example, let's say this low is happening during the daytime, and you shut the Basal off for just 30 minutes. And it helps for whatever reason that 30 minutes is really stabilizing things, evening things out into the next hour or two. So you don't stay low or go lower. Great. But you also have to look back and say if this was during the day, the low was probably as long as you've got Basal figured out. It was probably not from Basal. It was probably from insulin on board from a Bolus that drove things too low. Yeah, with whatever other variables in the mix that caused it to happen, right. So just that 30 minute deficit again, of only Basal it's not deleting any insulin on board from a Bolus that might still be in the picture. So again, the risk of decay a while it is higher on a pump than it is with multiple daily injections. Because once you take your injection of Basal it's there, you know it's there, you're never at a base at a deficit of it. With a pump though, you do have to be careful. And our baseline is when it usually comes in and discussions in summer when kids are going to the beach and using their pool a lot or you know, whatever it might be, they disconnect from a lot of pumps that are tubed. We usually say do not disconnect for more than a two hour time period, come back check blood sugar, take a Bolus of at least 50% of the missed Basal amount in that disconnected time period so that you don't have problems with a deficit leading to potential decay in the next several hours. So So yeah, so there's my long explanation.

Scott Benner 10:45
Oh, that's a great explanation. And and it brings up you know, what it reminded me of, you reminded me of how proud I am of the podcast, and how we can have long conversations about stuff like this, because 15 years ago, in the diabetes space, this was the message, you're more likely to go into decay with a pump. Because what if something happens and you stopped getting your insulin, and then that became the rule pumps are dangerous. And then people thought that for years, until people got other people bought pumps, and wore them and proved everybody hey, look, I'm still alive. I have a pump. So saying something, and it's not a wasn't a, an incorrect statement, right? You could be sleeping and Rick, rip out your site. And now you're not getting insulin. And that is a

Jennifer Smith, CDE 11:29
danger that could chew the to but you don't know it. I wish I could name this

Scott Benner 11:33
episode, the cat that chewed the tube, but no one would listen to it. But but but the point is, is that we used to say these very basic things, because that's what communication allowed. And then people were allowed in their minds to take the scariest part of that and run wild with it in their own imagination. Yeah, so I like that we can talk more about this. I like that. Helen can now think if I give a Bolus at noon, and I need to make it more aggressive upfront because of the nature of the food, but I know that at three o'clock, my kid's going to get low. I can still make that Bolus at noon. Turn Basal off at two o'clock, create a deficit of Basal at three when the Bolus from noon peaks and balance those things out. That is so cool that we can talk about that like that.

Jennifer Smith, CDE 12:24
That's great. Yeah. So I appreciate your tools, more tools for the toolbox.

Scott Benner 12:27
It's just more stuff to understand. I saw Jeremy in the Facebook group. He's being helpful and making fun of me at the same time, which I appreciate. Oh, because when people sometimes people are like, I don't know, like, how am I supposed to get to this place where a lot of you are what Scott's talking about? And my answer always is, you got to listen to the podcast. Like just listen through it because these things will build it's not it's not a checklist of five things you just do. And it all of a sudden works. There's you know, variability and, and nuance and everything. And Jeremy's like Scott's gonna say to listen to the podcast and, and he's like, but try this year. And he's both right in making fun of me. And he's right about what he said, too. Because this is not a quick fix. And it's not information that your brain just learns. Hearing it one time, you know. And

Jennifer Smith, CDE 13:23
when you since we've got some time now

Scott Benner 13:27
turn it up here.

Jennifer Smith, CDE 13:29
On those headphones, go for a walk with your dog, push your stroller, listen to it while your kids are running around in the backyard and whatnot. Actually, somebody yesterday that I talked to she and their family, they had come down to Atlanta for the JDRF conference to hear you, which was great. But all the way there and all the way back. They actually listened to the podcast to the podcast, because they had like I think she told me it was like an eight hour drive there an eight hour drive home. So they drove there and back listening to the pod.

Scott Benner 14:02
That's really nice. I thought was really cool on my way to Atlanta. I was I had to park my car to an airport, and I got a little shuttle bus to get to the airport. And there was this woman and her like 17 year old ish son sitting next to me, and we start driving out of the lot. And she just stands up and like goes way, way, way, way way. And like everybody's like, Oh, you know, what's this? She was I still have my key. So she was valet parking. So her car still running somewhere. But she left with her key, right? So she the driver stops, she runs out takes the key to the valet. And I turn to the boy and I say is that your mom? And he goes yeah, I said, my wife and I embarrassed our kids all the time. And he looks at me really strange, to the point where I thought Ooh, did I just offend this kid? Right and I felt bad. So I kind of withdrew back into myself and stopped talking to him. She gets back on the bus and begins to very kindly apologize to everybody on the bus. Oh, I hope I'm not making you late. Meanwhile, it was 30 seconds. You know, she just I hope I'm not making you late, Bob, I'm sorry, but and I looked up at her and I said, I just did something really stupid with my key two weeks ago. If you sit down, I'll tell you about it. It'll make you feel much better about this. She looks at me and goes, Are you Scott from the Juicebox Podcast? And I went, what? Because you know, we're on a bus at an airport with only eight other people. And I said, I am. And she goes, Oh, I saw you speak at this thing. And we listened to the show. And just as that happens, the kids CGM beeps, and I turned to him and I go, Oh, hey, and he looks at me. And he goes, I thought your voice sounded familiar, but I couldn't place it. My mom and I listened to the show together. And I was like, just think he wasn't mad at me. He was like, oh, man, why is this guy's voice seem familiar to me, you know, and it was just absolutely crazy. And then days later in Atlanta, I literally walked into them in a hotel lobby. I was like, they're there again. Funny, it was very, very strange. But, but nice. It was it was lovely, actually. So it might be different. You're being kind, but I appreciate that those it was very strange. It happened two weeks after I was recognized in an airport in Dallas. And that threw me for a loop. That was a woman approached me. He told me about Yeah, you're just sitting. Like, I was getting ready to get on a plane trying to decide when I was going to change my shirt, my sneakers, you know, like, and a person I have music on. And this lovely woman comes up to me, she kind of puts her hand out. And you know, you're just like, what's about to happen? You don't I mean? So I'm like, Hi, how are you? And she goes, good. I'm like, Can I help you? And she goes, Sure. Are you Scott? And I'm like, Uh huh.

Jennifer Smith, CDE 16:56
And who are you?

Scott Benner 16:57
And I was like, Were you just at my talk? And she goes, No, I'm in town. My daughter's running a marathon. And we're here to support her. And I was just like, wait, what? Like you weren't just at the thing I spoke at? And she's like, No, she says, My husband and I were sitting over there. 10 minutes looking at pictures of you online trying to decide that he's finally I think that's him. Go say hello. That kind of stuff. I gotta be honest with you. From diabetes podcast, I never thought and now it sticks in my head when I'm in public now. Now I'm like, Hmm, is there?

Jennifer Smith, CDE 17:27
Anybody knows what I look like?

Scott Benner 17:31
You just got to keep a lower profile. Because Because now I find myself thinking like, do I have to be nicer in public? Not that I'm not but like, am I gonna be judged by? Like, is there gonna be a story online one day, we're like, I saw this guy from this podcast, and he was being so he was being rude to a lady, you know, which I'm not. But now I'm worried about it. Right. So silly. Absolutely. So So I said, Jenny, let me ask you a question. I haven't asked Jenny question. I have. I'm doing that thing tomorrow on tomorrow, the first, you know, kind of group meet up for people. And I was thinking during this Coronavirus thing of starting like some sort of a challenge to lower your a one, see your deviation, your variability, like all that stuff, like we're all just sort of sitting around. Like, I wonder if we shouldn't, like try to help people like, right, like, I'm wondering if when everybody comes on this, this zoom later, if I'm not just gonna go through one by one and be like, Alright, everybody hold up your 24 hour graphs. Let's look at your Basal insulin. And then, and then talk about getting Basal adjusted for people, and then maybe see if we can't get back together once a week and see what we could do about like, I do a cool thing to do I do it with single, like people by themselves. Like, I think I could do it with a group.

Jennifer Smith, CDE 18:52
I not do it together and teach a big group. Right? Yeah,

Scott Benner 18:55
that might be fun. I think that would work.

Jennifer Smith, CDE 18:59
I do. And I think from the standpoint of looking, you know, I, in terms of looking at data, when you look at so much data, as I do, every day, lots and lots of data, lots of people's different kinds of data, you actually start to notice more things, right. And from a teaching tool, sometimes when it's only your own data that you're looking at, you can kind of get lost in it. Right, right. But when you bring together a big group, kind of like, like a kids for diabetes camp, or kids with diabetes kind of camp, you know, they they do a lot of things that are interactive like that, and they bring the information together and that sort of camaraderie. in a setting like this, yeah. where everybody's showing a graph. Somebody might be like, Hey, that looks like this is happening, right? Or, Hey, that looks like this is happening. And not only is it like a learning experience, you're also helping other people. You don't necessarily know.

Scott Benner 20:01
I just, I see it in the private Facebook group. So if you go on Facebook and search juicebox discussion group, I think that's what it's called. I named it, I should probably know what it's called. But it's a private group where people talk, and there's times people put graphs up. And I'll like jump in to say what I want to say, and somebody will have settled already, like, oh, great, you know, and I'll like, like, somebody comment and put a finger under it, like pointing to it. Like, this is what I would have said, Yeah. And then there are other times where somebody makes an explanation. I think that's better than what I was gonna say. And, you know, terrific. So I'm thinking like, maybe we can do it. Like, again, a mass like, you can get 100 people together and bring everyone's blood sugar down, Louis, Zoom call. I'm like, I'm like people. Yeah, I think I can. It's so and then like, yeah, I hope so. I really hope it works out. So I'm gonna even have

Jennifer Smith, CDE 20:51
like, focuses, like you said, kind of like Basal or like, even like a challenge of, okay, your challenge today is to go home and just Pre-Bolus for all of your meals. Right? And let's look at what that did from today. Compared to tomorrow. What did that do?

Scott Benner 21:06
That's what I was thinking. Alright, I like that you are doing. Jenny makes me feel better about myself. Sometimes. Like you said, one, though. Seriously, you said one time, I forget how you put it. But you said something about, like, you could do this for a living. I know you don't have the credentials, but you could. And that made me feel really nice. I just I never told you that. So thank you. Okay, let's see. How are we an hour and a half today?

Jennifer Smith, CDE 21:38
I set up for about an hour, hour and 15 hours.

Scott Benner 21:41
Okay, so let's do we'll do one more. Um, ah, Kelsey, I'd be curious to hear Jenny's thoughts from a clinical perspective on the post from earlier regarding extreme she without in quotes, management tactics versus being bold. And what her take is on lower a one sees and the pushback in the medical and sometimes social community based on available studies showing no benefit. Also thoughts on lag time of published studies and the advances made in the last decade? Have we talked about this? I brought this up in passing with you once. I just mentioned it as an article. I don't know if you've seen it or not. Right. But so I guess what Kelsey wants to know if I'm, by the way, that's a very well written question, Kelsey. It is no, so many smart people are listening to this podcast.

Jennifer Smith, CDE 22:34
They're all smart. Everybody's smart in different ways.

Scott Benner 22:36
Yeah, no kidding. But I'm saying this is a really well written question. Usually people's writing doesn't read. Well, Kelsey can write is what I'm saying. So, but but to boil down what she's asking. I think what she's saying is that there's a way that you know, the medical community generally talks about this, right? Like, oh, a seven a one C is fine. And then you see somebody say, Well, you know, me or somebody else. My kids got a five five and I just handle that by stopping spikes you know, making sure her blood sugar's Well, I don't think anything I'm saying is crazy, right? Like it's and, but to the, the masses, it seems like over management to them, because they've been given such a baseline of like, just do this, and whatever happens is fine, and go live your life. Right? So is her question really? Well, her, you know, let's ask answer a question first, like, what's your take on doing what you want, you do what I do with art, and with a lot of people listening to this do and what happens when those poor people then go into their doctor's office and then get sometimes really chastised for it? Like, like, I know, that's a hard thing to wrap your head around you and I talk about this privately, sometimes, but a lot of people that listen to this podcast, their next leap to make is to then talk their doctor out of being upset about it. Correct?

Jennifer Smith, CDE 24:03
Correct. And he we even get, sometimes not often, but again, a lot of the people that end up coming to us to work with us is because with all the information that is out there now and is so available online, we can not only see what other people are doing, but we're also reading such as she refers to, you know, these studies about lower isn't necessarily proving to be better in the long run, etc, etc, whatnot. But people want to do better, and they want to do better from the standpoint of understanding and I know that we addressed this somewhat in another podcast, there was a brief talk about this because I had referenced the fact that a one C for the population of people without diabetes is under 5.7%. Yeah, Why are we not aiming for that in a safe in in safety, right? With safe constraints? I'm not saying run at a blood sugar of 55. So you can get an A one C of 4.7. By no means, however, why are we not aiming for the goals that people without diabetes already have? Because their body does it for them? Right. And I bring it in to and I think I commented before as well about like pregnancy targets. If pregnancy targets are what, what we're aiming for, which is the normal blood sugar that the population of people without diabetes already has naturally, if we're aiming for that in pregnancy, why should somebody go back to aiming for higher or loosening that up? Once they're not pregnant anymore, but the baby's healthy? I guess I can, like, you know, lighten up on everything,

Scott Benner 25:57
go back to racing to my death,

Jennifer Smith, CDE 26:00
aiming for a target, you know, under 250. Target under 140. I, I don't I mean, from my personal and my clinical perspective, I don't know why that is the recommendation other than as we've also sort of alluded to, or really commented about previously, a safety factor from the conventional system of management that we have kind of that we've had to use, because that's all there is. There is a safety component that I think many, many, many practitioners, they, they don't see the every day. And so when they see data that's showing them and they're only looking at an AE one C, somebody comes in with an A one C that's 5.7. They're thinking, Well, gosh, this person's got to have a whole bunch of lows, or there are this a one C would not be 5.7. But if they looked at the actual data, and now that a good portion of people are using CGM, we should be looking at that to go along with the actual glucose management indicator, or the a one C or the average glucose, because if they're achieving an A one c that is phenomenal, 5.56, you know, 5.1, whatever it is, and their time in range is phenomenal. And their percent low is not more I mean, we as a practice, aim for less than 5% low. So if they're achieving that, why are you? Why are you upset that they're managing something? So well, a lot of preventing problems, a lot

Scott Benner 27:43
of people that reach out to me with a story indicate that the doctors even presented with the data, it doesn't stop them from being upset. They're so pre programmed to believe if you've got a great day one, see you did it wrong. And that no one can get that. And

Jennifer Smith, CDE 28:01
I'll tell you that I've had I had one really, really, really phenomenal Endo. In, I've had a couple of really good ones. But one really phenomenal one. When I lived in DC, he was fantastic. He he could side by side power with me on the level of information that I needed to talk at. And he was like, he was like a go for it. You know, it's here, let's attack this, I see this could be a problem area, he was happy when my a one C was like 5.4%. He's like, That's phenomenal. And your lows are not in the picture causing this. I mean, he could really talk on that level. And he was comfortable about that. Because I was also and I think maybe this is also a piece too. If you have the ability to talk back to your doctor about what you're doing to get there and to manage that. I mean, if you go in being like, I don't know why I'm here, I don't know how I achieve this, or whatever they're gonna be like, well, that's this isn't this isn't safe, I don't see data that's proving that this is safe. You don't really know what you're doing, obviously, but from the standpoint of many of the listeners, and many of the people that I work with. I don't love the data that I read the report that you mentioned the research report. I don't don't love that it's kind of telling people that they should aim higher when we know and diagnose pre diabetes and diabetes at certain emergency levels. If you're pre diabetic above this level, if you're diabetic at this level, why? Why is that then healthy for somebody to maintain once they do have diabetes?

Scott Benner 29:58
I think to that anecdotal evidence is more valuable in a time where we can all talk like this. Because, you know, calcium makes the point. You know, when was the study even done? You know, and just because data collaborate, right didn't look right, that study could be years old, just to get it out the way that's, that's and I'm not saying that the scientific community shouldn't do their studies the way they do. But the problem is you do a study with, you know, the proficiency of starting a fire with matches. And five years later, when you put your your data out, there's a flame thrower Now, that doesn't match up anymore. You know, you mean, I've got a flame thrower. I'm not using matches. Your dad is 100%, right about the thing that you thought I started thinking about four years ago, except we are in a different world now. So you're using CGM, and pumps, and you know, algorithms and everything else. And they're giving you you know, they're giving you advice from five years ago? Correct? I think too, it's important to remember. Not everybody's a bad student. Sometimes there's bad teachers. And so if you're failing, with bad information, are you failing? Or are they failing you? Right. And so if you start with a person who Jenny mentions having a great endo in Washington, right, so she met a person through happenstance, who really wanted to be a hands on endocrinologist, and sunk in and found out things and learn things, and was good at sharing them with other people. For every person like that, there's going to be a handful of people who, you know, we're coming out of high school and going, what should I do for a living, I'm good at math and science, I'd like to have some money, I'll be a doctor, my doctor goes on vacation twice a year, this is perfect. You don't just like there are some people who really want to teach children. And there are some people who just want to have off in the summer, they both end up being teachers. You don't I mean, and so not everybody's the great doctor from Washington. So if I'm just giving you look, I read the articles, this is what it says to tell people with type one diabetes. So this is what I say to them. And if they're failing, that's their fault, because I gave them the directions. You didn't tell them how to use the directions you didn't you left out all these other things. And so again, I used to talk about this a lot more in the podcast years ago, you have to just believe in yourself a little bit and what you're seeing, you know what I mean? Like you can't keep having outcomes that you know, are bad. And then turning back to the guy in the white coat. And he says, No, you're doing great. And then you swallow on that big fat pill and just going okay, I guess it's alright, the guy said, It's okay.

Jennifer Smith, CDE 32:37
And I think sometimes it's also hard. I mean, I've heard from many people, not many, but some people who've actually said, Well, if I, you know, if I choose, I choose to work with you or your practice, my endo doesn't want to see me anymore. Or if I do all of these things, and make my own adjustments, I get hand slapped every time and that doesn't change. Well, you know, in our healthcare system here in the United States. Thankfully, many of us with our providers, we've got the ability to change providers, we can look at our network, we can see who else could I go to, with social, you know, connections and whatnot. Now we can even ask, Hey, in your community, who has a really good Endo, who's a really good pediatric Endo, who do you love? What do you love about them? I mean, we can like network that way and actually make some different connections. I mean, I got an email from a woman in Canada, actually, probably at least a month ago, who she was asking how they could work with us, because she said, our endo makes all the pump adjustments. We literally get hand slapped. When we come to the office, if we made any adjustments. She's like, I even like, I save the adjustments My My doctor gave, I go home, and I make my own adjustments. And we go back to the office, I make them to back to what the doctor recommended. She's like, I know, he's also not really looking at the data, because otherwise the doctor would see that clearly. We weren't running on the profile that they told me to run on. I made my own adjustments or no, but they're also being told that a glucose value, you know, that's in United States milligrams per deciliter term was like a blood sugar of 105. They were being told overnight, was too low, to run their child at overnight. And so from that standpoint, you have to say, you do you have to say enough is enough, but I can't work with this practitioner. They're not willing to expand and allow me to manage something that's 24/7. It's not every three months of management that I come in, and I get your feedback. I look at this every single day. Every hour of the day. There is no shut off.

Scott Benner 34:55
Yeah. And at some point, you just have to The, you just have to say I can't change this person's mind. And the reasons why are unimportant. Like what it be, maybe the doctor doesn't understand, maybe the doctor is lazy, maybe, maybe, maybe, maybe who cares why it's happening to you just, you know, you have to remove yourself from a bad situation. And it's tough because some people will say, Look, I don't live near that many doctors, I need these prescriptions. And, listen, I don't know what to say about that. If you've got to suffer a fool to get your prescriptions, then you're gonna have to find a way around it. But stop trying to stop trying to make it. What do I want to say here? I have my example popped into my head, but it's too personal to share, because it's not about me. Not everybody does the right thing. And a lot of people want people to do the right thing. You can't make the fight, teaching someone else what's right, sometimes you just have to get through it on your own. And so if you've got some chucklehead, but they've got a prescription pad, then you've got to put yourself in that mindset, I'm going to go play a part for 15 minutes, and then I'm going to get out of here, and I'm not going to worry that he's wrong. I'm not going to worry, I'm just going to do what I need to do for myself. And I'm sorry, if you find yourself in that situation, but if you do still got to protect yourself. Yeah.

Jennifer Smith, CDE 36:16
And I think from the standpoint of even, you know, her question going further into like the research part of it, I think, if this is the kind of information that doctors are looking at and saying, Well, gosh, you know, running with an A one C of 5.5, doesn't seem to be any better than running with an A one C of 7.2. So why why would my patient want to get down here? I'm going to just tell them that that seven 7.2 is just as good? Well, again, we don't know necessarily where and when was the data collected? From what kind of information? What was the lifestyle of these people, etc, etc. I mean, we do know that glucose values that are well controlled, decrease, and for the most part, do limit potential complications down the road. We know that right? Now, is that to say, you're never going to get a complication, even if you did this sweet management your entire life. No, of course not. Now, sometimes things they they happen, right? We don't know necessarily everything because we we don't know 100% of how the body functions, right?

Scott Benner 37:24
We don't, don't you find that most questions around management are probably at the very core of their question. Hey, Scott, Hey, Jenny, how do I stop from anything bad ever happened to me or my kid because I have diabetes. And it's such a sad thing. But you have to, you just have to say to yourself, I can, this is my situation. And I'm going to do the best I can with it. And put myself in the best position to hopefully thrive for as long as possible. And that's sort of it you know, the rest is sort of out of your hands. Right. But the part you can control. That's the part you should focus on, I think. All right, Jenny, I'm gonna let you go live your life. Okay. This was excellent. You do? Yeah. Thank you. Oh, I'm gonna record again in 45 minutes with somebody.

Jennifer Smith, CDE 38:09
Oh, good. That's fun. Yeah,

Scott Benner 38:10
I'm doing today. Jenny Smith works for Integrated diabetes calm. She's also lived with type one diabetes for over 30 years. Jenny holds a bachelor's degree in Human Nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator and certified trainer on most makes and models of insulin pumps, and continuous glucose monitors. She's also pretty damn lovely. Check her out at Integrated diabetes that com if you'd like to hire her to help you with your type one, diabetes management. I have more to say you want to chill out for a minute. Okay. So we did a meet up? Two weeks ago, there's been two already. There'll be a third one this week. As I told you on April knife that I say the knife. Yes, April knife. It's a Thursday going to be 7pm Eastern time, not the point. Point is did the first 175 People rolled in very cool. And I thought people would just hold up their graphs or ask their questions and we'd roll through their answers and their answers may help may help other people and other people may have helped for them. And it did mostly go like that. But there was something that happened. I didn't expect. And I don't know why I didn't expect it. Because now in hindsight, of course, it seems obvious. But some people were very quiet. And they were not wanting to hold up their graphs. As a matter of fact, the amount of notes that I got out that I got afterwards. That said I was embarrassed or ashamed or nervous or a lot of different words to describe how people felt to talk during the thing but could you help me now? That piece makes me feel like that what you heard me say to Jenny about like we should all just come together and do a challenge. Like it would be, you know, I maybe that doesn't make that reasonable. Perhaps most people aren't interested in sharing that much. And I get that. So in the second meetup, I just realized, let's make it informative. Some people will speak up, some people will be willing to share their data, and some will learn from watching. So while I like the idea of a challenge, I don't think it's reasonable. But what I found afterwards was that getting together is hugely beneficial for everyone there, no matter how they choose to participate. So I hope you come out. Like I said, there'll be links in the Facebook page for bold with insulin. I'll try to put something up on Instagram to remind you there, but here's a reminder right here. I think it holds 100 people. So it's kind of first come. The two we've done so far have been in the afternoon. So I'm going to shift it to the early evening to help accommodate other people. So 7pm April 9, it's on Zoom. Anybody can come and hang out. Just look for companionship, meet new people. There's a chat people can go off and chat on their own. Listen to the conversation. It's just a nice way to distract yourself during this time of crisis. Today's Juicebox Podcast was sponsored by Omni pod makers of the tubeless insulin pump that my daughter has been using for most of her life. You can get an absolutely free, no obligation demo of the Omni pod sent to your home by going to my Omni pod.com forward slash juice box and filling out a little bit of information. You can learn about the Dexcom G six continuous glucose monitor@dexcom.com forward slash juice box and to see if you're eligible for a free Contour Next One blood glucose meter go to contour next one.com Learn more about touched by type one at touched by type one.org 10 second dance party

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About Jenny Smith

Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a Registered (and Licensed) Dietitian, Certified Diabetes Educator, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. You can reach Jenny at jennifer@integrateddiabetes.com

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