#419 April Determines Attitude for NASA
NASA Attitude Determination and Control Officer
April Blackwell has type 1 diabetes and an amazing job piloting the International Space Station.
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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 0:08
Hello friends and welcome to Episode 419 of the Juicebox Podcast. Today's show is with an adult type one who always wanted to be an astronaut. And today works at NASA mission control. She flies the International Space Station. Her name is April. And I want to thank the people in the Juicebox Podcast Facebook group, who turned me on to April because I had such an incredible time, I really enjoyed talking about the space program with her. Please remember while you're listening and that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. Hey, you can check APR out at her blog, nerdy apr.com. And she's also on Instagram at nerdy APR. You guys ready? I'm super excited. I love talking to APR. And I hope you enjoy listening.
This episode of The Juicebox Podcast is sponsored by the Dexcom gs six continuous glucose monitor. You can learn more about dexcom@dexcom.com Ford slash juice box. And to find out about ardens insulin pump the tubeless insulin pump that Arden has been using since she is four, you're gonna want to go to my omnipod.com Ford slash juice box. There you can learn all about the Omni pod tubeless insulin pump, and even request a free no obligation demo. In that cool, they'll send one right to your house.
April Blackwell 2:00
My name is April Blackwell. I've had Type One Diabetes for 22 years. And I've always wanted to be an astronaut. And instead of being an astronaut, at least in this point of time, I get to do my dream job which is to fly the International Space Station from Mission Control.
Scott Benner 2:24
Yes. Okay. All right. We're very excited. We're starting. We're starting out very well. Let me find some things out. 23 years old, how old are you? Are 20 years for diabetes? How old are you now?
Unknown Speaker 2:35
I think I'm 3030.
Scott Benner 2:38
Interesting. You say that? I lose my age every couple of years. Is that what happens to you?
April Blackwell 2:43
Yes, I, I think ever since I hit 30. I'm just like him 30 ish.
Scott Benner 2:49
So a couple of years ago. My wife said that I I said I was gonna be 45 the whole year. And she said she'd never corrected me. But I was going to be 46. And now this year awesome. Oh, yeah. Great. And now this year, I've been running around calling myself 48. And apparently I'm 49. So
April Blackwell 3:14
I don't mean, ages, you know, it's relative. So
Scott Benner 3:17
yeah, but doesn't it feel like something I should be able to remember. I mean,
April Blackwell 3:23
he got lots of other important things to remember.
Scott Benner 3:26
So let's do this together for a second in 2021. I have a calculator. And then I'm just going to subtract the year of his born 1971. So this is going to tell me my wife says that I'm going to be 50 on my birthday. It does it. That's what it said. So apparently, I'm 49 Now we'll do you now 2020 and when you're reborn
Unknown Speaker 3:47
1987 1987
Scott Benner 3:51
your 1033 Hold on, I've done something wrong. 2027. You're 33 years old. All right, and then close, and then we subtract 23 years. And then you've had diabetes for 11 years.
Unknown Speaker 4:09
I was 11.
Scott Benner 4:12
When I got diabetes, I meant to say you were you were 11. So just from what you've heard here, just generally, can I help keep the space station in space?
April Blackwell 4:24
Math is hard in public. So we'll give you a pass.
Scott Benner 4:27
Well, that's way too kind. Okay. I'm 11 years old, this 20 years ago feels like a long time.
April Blackwell 4:36
It does actually, in terms of diabetes. So much has changed since I was diagnosed. And clearly I have changed since then. So it does kind of feel like a long time
Scott Benner 4:48
to be once you get over 20 years that that starts feeling like a lifetime. You know what I mean? Like, wow, that was so long ago that it's hard to put into perspective. For instance, I just heard recently, that this year is like the 25th anniversary of the film goodwill hunting. And when I heard that, I just thought, oh my god, I'm gonna die soon. But that's exactly exactly what I thought when I heard that because I remember seeing that movie in a theater. Like on a date, you know what I mean? And now you're telling me if it's been 25 years, I'm not in great shape. This has got to be the last decade of my life is what I thought, and and why am I measuring that by goodwill hunting? There's no way to know. But you know, so tell me a little bit about like, what diabetes was like when you first were diagnosed?
April Blackwell 5:37
Well, I, I did the mixing insulin game. So I was on regular and NPH. I remember my parents, well, really, my mom mixing up the shots for me. The blood glucose meters took, I think, around 45 seconds, they did come in some cool colors, which I appreciated. But it took a while to get a reading. And, let's see, didn't have any insulin pens, I just use shots pretty much for two years straight. And I remember being very regimented about how much I was eating. And when I was eating it to the point where in junior high, I would have to you know, bring a juice box or something and drink it in between classes as I was going from one class to another because that's 930. That's your 930 snack or whatever.
Unknown Speaker 6:37
So I remember being just very regimented on timing, and how many carbs I was eating. I'm picturing a little April marching down the hallway in a plaid skirt, going time for the juice box, and then just
Scott Benner 6:51
being like, Did you feel like a rebel just eating in the hallway? Or did did it feel like a spotlight?
April Blackwell 6:59
I didn't really like the eating part of it. I remember that being annoying to me that I had to do that. And then it was like a requirement. What I do remember feeling a little bit rebellious about was when I got my first insulin pump, which I think was in ninth grade, maybe eighth grade. And having that which at the time, you know, cell phones were the thing. And I'm dating myself a bit there. But we did that already the beginning. Everyone, everyone thought it was a pager. And we had like these security guards that were at our junior high school and they would drive around on their little golf carts. And I remember pulling it out at one point to do a Bolus or something. And you know, they like zoomed over in their little golf cart and they were like, what are you doing with this paper? Those aren't allowed at school.
Scott Benner 7:52
crocket
April Blackwell 7:54
This is my medical device. I'm a type one diabetic. And this is an insulin pump. I know this is weird because not a lot of people have these but this is my thing. So is it
Scott Benner 8:05
actually where that when you describe that whole scene in my mind that man I am the Miami Vice theme song played and those two zoomed over after you with the cart and and I saw Crockett and Tubbs get out and ask you why you were dealing drugs at the junior high school with your pager?
April Blackwell 8:21
That's absolutely cuz I was you know, I I really liked school and school was important to me. And so getting in trouble. Even having the security guards talk to me, it was like a huge mental breakdown for me, that that could even be construed as something bad. So that's great. Well, and
Scott Benner 8:41
you remember it, which is, is the most telling because I don't remember one thing that happened to me in ninth grade. course we've just learned it's like 20 years longer ago than your ninth grade was but that's not the point. I really don't have any like when you stop and think about your memories, they are the things that impact you like that. It's you never remember the kind of banal stuff you know. So, got a pump look like a page or what kind of insulin goes in that pump then
April Blackwell 9:16
I've been on human log. Since the day I started pumping, which is crazy because just this year, I switched to a different insurance. So literally 20 years I've been on human log in my insulin pump. Just this year, I switched to a different insurance, which didn't cover human log anymore. And it was just one of those moments that kind of catches you and you're like what do you mean you don't cover human log I have just switched to Nova log which I've never used in my entire life and I have no idea how this is gonna affect me. But yeah, so human log for 20 years and no blog for the past few months here.
Scott Benner 9:58
What was the impact when you sweat?
April Blackwell 10:02
Honestly, I think it was more mental than physical. Just because I had always been on human log. And so
you know, I made the switch. And I remember the first week or two being really, really vigilant about my numbers and trying to notice any trends, new trends. And I ended up not really noticing any. So I'm thankful that it was a pretty smooth transition.
Scott Benner 10:28
Yeah, I think I find that most of the modern insulins work pretty similarly, Arden use novolog for a long time. And she uses a Piedra now for a long time. And I've noticed a Peter to be more smooth acting, but that's an Arden. And, you know, that's really the extent of it, I can kind of count on what it does a little more, there isn't as many like flares, where it's like, you know, how novolog once a while, feels like it's working really fast. And then you know, then suddenly, you know, it's gone again, like, you know, gets these peaks and these tails, I don't feel that as much with a pager when I look at the data. But Arden tried fiasco recently, it did work quick more quickly. But if it burned her it, it stung so she had to she couldn't keep using it. So we tried it for a while and had to switch. But your your first reaction was the one that I see him in the public all the time when people are talking about like, Oh my God, my insurance change, I have to switch insulins it's the end of the world and I'm like, it might not be like you should try first and see. And I think most people end up having your experience, honestly.
April Blackwell 11:38
I'm glad for that, because I was really nervous. And my endocrinologist seemed like it was no big deal. So I kind of took her lead. And I was ready, of course with my backup plan, like, okay, you know, if this doesn't work, we're gonna write up this letter, we're gonna send it into the insurance and they're gonna approve this as an addition to the formulary and all this stuff. Which is just kind of what you do. As an engineer, you always have a backup plan, but thankfully didn't need it.
Scott Benner 12:08
You have the letter half written in your head. Dear Sir, or madam. I was just about to receive my retirement watch from humalog. We 20 years is a really long time. That's it's significant. I mean, honestly, I can see being concerned. Okay. All right. So how do we go from little girl who has diabetes? You said school was really important to you? At what point do you say to yourself, I want to go into space? And at what point do you find out if that's possible or not?
I'm doing the ads a little earlier in the show than normal, because I'd like to sort of just get them out of the way so I can keep talking to April. See, I know what's coming. So I know where to put the ads, you understand Dexcom, the continuous glucose monitor that allows you to see your blood sugar in real time, the speed and direction and number. For instance, Arden just had pancakes about 45 minutes ago, and I'm not gonna lie to you. We messed that up. I kind of forgot to Pre-Bolus enough. Okay, fair enough. Well, not long after, here's what I see. Arden's blood sugar is shooting up. And I can see how fast so I watch your blood sugar go from 90 to 100 210 120. And it's flying, right. So when it gets to a certain number, I say to myself move, the insulin I gave her is not going to work. And I gave her more. Now we'll use the same data to make sure she doesn't get low later. So I stopped the spike, leveled it off. And we'll keep it from getting low using the feedback that I get from ardens Dexcom je six continuous glucose monitor. Yes, you can set alarms on it right to tell you when you go above or below a certain number. Those are user definable. You can do whatever you want, which is great for sleeping or activity or just you know, trying to stay in a good range. And of course, you can share your information with other people. Like I can see Arden's Dexcom information right now, on my iPhone, you could too, you could also see it on your Android phone. That stuff's all terrific. And by the way, up to 10 people can follow you. So you could have a kid who's being followed by a mom and dad or grandma school nurse, and you'd still have room for six more people. Or don't let anybody follow you. I don't care. It's your life, do what you want. I'm just saying options. Dexcom is at the core of the decisions we get to make every day while managing insulin. And I'm telling you whether you have type one or type two, this is the way to go. dexcom.com forward slash juicebox. There are also links by the way in the show notes of your podcast player and they Juicebox podcast.com for all the sponsors, sponsors like the Omnipod tubeless insulin pump, did you see what I did there? Omni pod, the tubeless insulin pump, I know you're thinking but I saw an insulin pump one time, it was like this little metal box and had a screen on it. And there was this piece of tubing that went like three or four feet into an infusion set. And it seemed like a lot of want to wear all that. Yeah, Omnipod doesn't have any of that on the pod is self contained. And the controller that you use to tell your tell it, you know, like, give me some insulin, wireless, right wireless can put it in your purse in your pocket, you can leave it on the countertop, you don't need to have it with you all the time. The pod has everything in it, you need your insolence with you all the time. And they'll send you a free, no obligation demo of the on the pods you can try it on and where to see what it feels like. And that is invaluable. It absolutely is my omnipod.com forward slash juicebox. Get that demo sent to you right now. It's no obligation. So get it and don't like it whatever, doesn't matter. Get it and don't have to have to put it on right away. It's fine. But get it Give yourself a chance to see what you're missing. My omnipod.com forward slash juice box dexcom.com forward slash juice box I'm in a good mood nerdy april.com. Don't forget the T one D exchange at T one d exchange.org. forward slash juice box. Actually, if you're listening to this on the first week, it's out. You can watch my blood sugar live right now at Juicebox podcast.com forward slash CGM live.
April Blackwell 16:48
I started being interested in space since about kindergarten. So I guess you could say I just started school off with the idea that I was going to be an astronaut. And so that that always drove my decisions. And what I was interested in what books I checked out in the library, what summer school programs I signed up for begged my mom to sign me up for. And then diabetes happened in sixth grade. So I was already like six years, you know, into into this career choice.
Unknown Speaker 17:22
I guess
Unknown Speaker 17:24
your commitment was six years old already? Yeah. So
April Blackwell 17:27
you know, I had to, I had to really investigate whether diabetes was going to be an issue. And it turned out it was still is to this day. And it kind of led to some soul searching, they're in sixth grade, junior high, you know, was there something else I was interested in, that I can sort of pivot to instead of being heartbroken about not being an astronaut. So after that soul searching was done, I decided that there wasn't anything else I was more interested in. I thought space was just awesome. rockets were so cool. It was so cool that we could launch people into space on rockets, they could live there in low Earth orbit, they could do science experiments, and all sorts of really awesome stuff. And I just wanted to be a part of that. It's just something bigger than yourself. That's really neat that we can collaborate and come together and be able to do such awesome things in space. And so that just kind of continued on, I ended up getting an aerospace engineering degree, starting my first job out of college, which actually didn't have that much to do with space. But I learned a lot at the job. I got to fly on experimental helicopters for the army and boss test pilots around so that was kind of cool. And then eventually ended up in my dream job here at NASA.
Scott Benner 19:04
Okay, so you don't have to be a pilot to be an astronaut.
April Blackwell 19:09
Absolutely not know that. That used to be a deal. Back in the day, the the original mercury seven and you know, a lot of the Apollo astronauts were test pilots, or had a lot of jet time, but definitely not a requirement anymore. In fact, on the space station right now, we have a breath of different people from all sorts of backgrounds. We even have someone who's a biologist, we do have two pilots, but we also have a medical doctor. So it's really interesting to see all the different careers that are part of the astronaut corps now.
Scott Benner 19:50
Well, so there's only there's two pilots up there now so when they come back, if I don't, I'm gonna make up like some crazy scenario but Like space monsters eat the pilots. It can they get back? Okay, like, Can someone else do that part? Or is it mostly automated? Like I'm interested in about how, how the capsules work in Riyadh. Yeah, yeah, so
April Blackwell 20:14
mostly automated. That's kind of the great thing about how we operate. Now, if you think back in, like the Apollo era, if you've seen Apollo 13, or any of those old sort of space movies, if the astronauts are like flipping a lot of
Scott Benner 20:34
April, you, you're gone.
Unknown Speaker 20:35
But stuff,
Scott Benner 20:36
sorry, Tapsell before you disappear for a second. I'm sorry. You said they were flipping a lot of I'm assuming you're gonna say switches. Yes, yeah. Okay.
April Blackwell 20:44
So they used to flip a lot of switches, you know, they had a whole procedures for how they were going to input all of their re entry parameters and landing parameters. And the nice thing is, we have we don't have to operate that way anymore. So the reentry landing, all of that is pretty automated. And even on the space station, you know, we really try to have the astronauts focus on doing the science because that is what the International Space Station is, it is a an orbiting laboratory. So we really want them to focus on science. And we take care of most of the systems onboard the International Space Station from the ground in Mission Control.
Scott Benner 21:27
That is really cool. April, and I spoke a little before we did the recording, which I never do. April with anybody I talked to, I never talked to anybody first. I love it all happened here. And now I know why because as soon as I got on the phone with April, it was like, I started telling her all my stories. And I was like a little too excited about what she does for a living. Because I grew up right through the, like the shuttle error. And it was a big deal. You know what I mean? Like if it was like the Super Bowl when the space shuttle went up, and people stopped what they were doing. And you know, I know, this is probably strange for younger people to hear, but they would roll televisions into our classrooms on these big carts and have rabbit ears, they were trying to get the signal in or they'd move us into the auditorium. And then put like multiple televisions in front of us. And when I say this to people, you should understand I'm talking about like a 30 inch square TV that you really couldn't see if you were more than like nine feet away from it. But we would all just stare, you know. And it was it was just stunning that that thing would go up and the cargo bay doors would open and arms to come out of it. And I was like, Oh my god, this is like, felt like it was from a cartoon, you know. And and I never knew he never knew what they were doing as a young person. Like they would say they're doing experiments, you're like, Alright, and then you get older, you're like, you know, Velcro, you're like, yeah, space. I'm like, Wait, what? You know, you're like, Well, that's it. Maybe we shouldn't be doing this, just Velcro. But then you realize that what more and more and more comes out of it. And, and the idea of trying to stay there longer and longer to see if one day we can't push humanity off of this planet to somewhere else. That's all really incredibly just exciting. How does it feel to work on something that the culmination of your work may not even happen in your work lifetime? Does that feel weird? Or no? Where do you think of yourself more as day to day operational stuff.
April Blackwell 23:33
It's sometimes feels weird. I just think that, you know, being in the space industry and being interested in it now for a few decades, you realize that these things just take time. And so it's very likely that there's going to be things you work on that you won't ever get to see come to fruition. But the interim and the middle, the journey is so awesome and cool. You know, right now we're operating ISS, which if you're 20 years old or younger, there has always been a person or people in space. So we haven't all been together all the humans alive have never been together on planet earth for the last 20 years, which just kind of blows my mind because a 20 year old person could be working as an intern at NASA Now. So I think that's, you know, just a really neat facet of this kind of work and being able to sort of disconnect yourself from the day to day and step back and see things from a bigger picture. I think there's many industries in many areas of life and politics and everything where we wish people could do that. And so having that perspective is really neat. I've even compared it to you know, the diabetes industry and how, you know, there's been some pushback lately about funding sort of long term diabetes research, and that all the type ones that are alive now may never actually see that come to fruition. But if you think about all the research that's being done towards that end, and similarly, all the research on ISS that's being done, it's helping so many tertiary things in the interim, you know, on ISS, we're doing lots of science, and that's helping countries create more clean drinking water, or it's helping us develop these telemedicine visits. Because guess what, we have to do telemedicine for the astronauts that are on ISS. So all of these sort of interim things that we're learning are definitely helping our quality of life now. And same thing with these long term diabetes research programs, you know, the the benefits, we may not ever get to that end goal benefit of a cure. But in the interim, we're getting pumps and CGM and closed loop systems and better insulins. And I think there's a lot of good that can come even in the journey.
Scott Benner 26:09
Yeah, it's hard, I imagine, for a lot of people to think, you know, I'm in this room, and it needs to be painted. But it's gonna take 100 years to paint the room yet, if I don't pick this brush up and start, we'll never reach the end. You know, like, it's, it's, you have to have that kind of explorer like mentality, like, I'm gonna get in a wagon and go west, I'm gonna get in a ship and sail away, that kind of stuff is, is not pay you back right now kind of things, but they're the entire reason why you have long term success. And you know, it's funny when you said you were you compare it a lot to diabetes, you sort of talked about research, I was thinking, personally, you know, you you need to Pre-Bolus lunch today. So you don't have a spike two hours from now, you know, or an hour from now. And if you don't have that spike after this lunch, then 40 years from now, you might have a great health outcome that you wouldn't have had otherwise. And it's it's, it can be difficult to see how the work done in the moment, affects the larger picture. And I just thought, you know, when I asked you the question, I thought, like, I think that all right, April, already, when I was a little kid, I used to think if I could make a deal with somebody, I'd give away the last 10 years of my life, if I could come back for a year, every 10 years, just to see how things have changed. And more recently, as an older person, I realized I should have said, You know, I realized, in case this happens, you know that I could I should give away the last 10 years of my life to come back once for a year every 100 years. And then that's almost one of the sadder things about being alive to me is that I don't get to see where it goes. And, and that's why I asked you that because I have a feeling that one day, we are going to figure out how to put people on other floating rocks. And you know, you're going to have been a really big part of that. And you won't get to see it. But so goes it, I guess for all of us. Tell me a little bit about what you take in college that prepped you for this and what were your interest? Oh, wait, before I asked that question. I have to say this, an 11 year old being introspective about changing their job choice that they made when they were in kindergarten and having such a calm, calm. Are you like the most mature person on the planet?
April Blackwell 28:38
If you ask my mom that she probably would say yes. She's still jokes to this day that it was so funny to her that she would wake up on Saturday mornings, and I would be awake watching TV. But I wouldn't be watching cartoons I would be watching the news, because I was interested to see if there's any space stuff going on. And back in those days, actually, if you remember, there weren't websites and stuff. So if you, you know, saw a product on TV that you thought would benefit your life, you had to actually call a phone number. So I remember writing down you know, here I am age seven or eight. I'm like writing down these phone numbers. And then I would tell my mom when she woke up you know, I think this weighted blanket or whatever would be really great for you. Here's the number you can call or
Scott Benner 29:30
APR does this put you in the dork or geek category? Just quickly? Do you know?
April Blackwell 29:35
I don't know. See I am nerdy APR. So I like to think of myself as a nerd. I don't get offended if you want to call me something else.
Scott Benner 29:43
The long breakdown of this on an episode that hasn't come out yet, by the way, with a couple. So. So you were so literally you'd be like Hey, Mom, listen, you call this 800 number. I'm telling you right now we're getting rid of that planet. You've got
April Blackwell 30:01
exactly like, here's the life insurance, I think you'd probably benefit from some life insurance or Yeah, all that kind of stuff. But all that to say I, I do remember life before diabetes, I was 11. So I know not everyone has that ability, that perspective. And I remember, you know, getting diabetes at 11 just made me instantly grow up. Because for better or worse, my parents were the type that, you know, if I wanted to spend the night at a friend's house, I needed to be able to take care of myself on my own. So that meant I needed to be able to check my blood sugar, react to that blood sugar, you know, get my shot, ready, deliver my shot. And I wanted to be normal. I wanted to be with my friends. So that really encouraged me to like, get over those humps really fast.
Scott Benner 30:58
Yeah. Do you think that it's more reasonable to expect that 20 years ago than today, because I'm, obviously I'm not minimizing your care as a child, but you really weren't mixing a couple of things together, jamming a needle pushing and then just making sure to eat at a certain time, right? Like That was the expectation. Am I right? Yeah, yeah, absolutely. Right. And now you know, how to manage with more modern insulin. Do you think it's, do you think, an 11 year old you in today's world? Do you think it would have been apples to apples?
April Blackwell 31:31
Definitely not. I mean, just so much has changed. And I can't really predict, you know, what an 11 year old today would would be able to do. And I think it's very child dependent. I have two children on my own now. And I can see that just everything is very child dependent. So the neat thing is, we have a lot more tools as parents now, you know, God forbid, one of my kids got diabetes, you know, now we have all of these share apps and ability to really track trends and notice trends better and, you know, dial those in. So there's some tools that while make, they make the management tighter, they are pretty complicated. And being able to interpret all that data, you know, maybe would take a parent to actually understand that make, make decisions. When you
Scott Benner 32:27
were explaining I thought, imagine if podcasts existed 20 years ago, when I had the idea to have a diabetes podcast, it would be one episode long, I'd be like, so you take this, put it in that mix it up, inject it, and then make sure you eat it noon. Thanks for listening. Yeah. You're back in your I also wondered if your parents wanted you to be very, you know, in control and mature or if they were just swingers, and they needed you out of the house. Like I wasn't, which we you can't be here Saturday, you have to go on an overnight visit. We need you to learn how to do.
April Blackwell 32:58
I don't know, you'll have to ask them
Scott Benner 33:00
for having a tea party. Honey, you gotta go. It's a very 70s thing to say. I don't know if it would have worked as well. Nice. Okay, so you are the most mature child on the planet? we've, we've, I've never had, I'm still not sure if I've had the kind of conversation with myself that you described it as you were, like, 11 years old. But so you? Do you start paying attention in school To that end, like I'm gonna be? Because you're an engineer now. Is that right? Correct. Right, yeah.
April Blackwell 33:32
And I would say 100% it, having that end goal of, you know, being an engineer, I still haven't given up on the goal of being an astronaut. So that's still out there. It just drives all of your decisions when you're that passionate about it. You know, it makes you want to take the advanced math classes, or choose Russian for your foreign language instead of Spanish or something. I'm doing extracurriculars that, you know, you've seen in astronaut biographies, already, you know, being marching band drum major, or writing for the school newspaper, you know, having internships and seeking those out, getting scholarships, all that stuff. So it just really drives your decisions, which is maybe not a bad thing. It's just it was a little bit earlier than some of my friends maybe?
Scott Benner 34:24
Well, you know, I think that as you're talking about this, what I'm realizing, you know, it's being reaffirmed for me, is that there are some things on the planet we need people like you for, you know, it's like, it's easy to sit back and go like, oh, they're messing up this, you know, thing or, you know, they whoever they is, they mess this up. They mess that up. You got April here who's been laser focused on space since she was five. And that's how, that's how when you flip the television on, you see a rocket take off and it goes into, you know, it was up in a space and it actually works. That's how that ends up happening because I'm assuming there are 1000s of people in the organization. who all have this kind of focus? And that's not focused. Everyone has like, your job's not like a job, you don't flip the newspaper open and go like, Hi, I need some work. Oh, yeah, NASA, I'll call that one. You know, like, this is a, it's a calling. And. And it's, it's really cool to know that people like you are doing stuff like this, what are the real odds of you getting into space? Because I'm imagining a podcast live from orbit? Is that possible?
April Blackwell 35:31
Right now, it's not possible, but I'm pretty hopeful about some of the commercial companies. So, you know, NASA does just sort of the bigger missions, right? They, they spend literally months in low Earth orbit, you know, we're talking about going back to the moon, we're going to deep space, we're thinking about Mars, of course. So those are all missions that are, you know, require humans in peak physical condition, peak mental condition. And the interesting thing about how the landscape is changing, you know, there's these commercial companies coming online, and they're gonna want people's money. And the people that have money may not be perfect human specimens. So I think that opens up the door for people like me who have a chronic illness, to maybe get our moment in space. And it may not be a six month mission, but I'm hopeful that we'll at least get to see, you know, the curvature of the earth and be able to float around for a few minutes.
Scott Benner 36:41
Okay, so you're thinking that you may be able to go as a passenger? on a on a commercial flight. Right, right. Not that you get to work the camera, like, Why could you not work? The commercial flight? I can't quit? Like, why couldn't you be the cruise director of the thing that gave me like, Hi, if everyone looks out this window over here, you're gonna see whatever, like, I understand, okay, so in less somebody reaches inside of you and squishes that pancreas around and magically makes it work again, you don't you don't see that as like a job in space, but you still want to make it there? That's, that's my understanding. Am I right?
Unknown Speaker 37:19
Yeah,
April Blackwell 37:20
I think kind of breaking down barriers and, and breaking the ceilings, if you will, is an important part of sort of my life mantra, and kind of what I did already with my first job, being a flight test engineer, and, you know, getting through several different programs that the army has that aren't typically, you know, for type one diabetics, because surprise, right now, the military doesn't let in type one diabetics, unless you're diagnosed while you're already in the military. And so it was it kind of provided a unique opportunity to forge that path. And then, you know, recently the FAA has come out with some new rulings about what type of medical clearances they're going to grant to type ones. And so all these different jobs that previously restricted type ones are sort of looking at the data, again, with fresh eyes and with the fresh diabetes management techniques that we have, and reevaluating whether those rules still make sense. And I think space is just, you know, it's the next frontier for type one diabetics.
Scott Benner 38:28
No kidding. That's very cool. Okay, so yeah, I had I, I feel like I had the guy on who got the first license after the FAA changed the rules. Is it weird that I've done so many podcasts that I'm not 100% sure, if that was
April Blackwell 38:46
just a lucky guy, you get to talk to really cool people.
Scott Benner 38:48
I really, I really, his conversation with him was, was terrific. And I'm not gonna take up our time with me trying to figure out what episode number two was. But just now, I thought to myself, I had the first guy Oh, no. And then I was like, did he? Let's see the first I think he was like, I can't say it if I'm not sure. Anyway. Now, I've just kind of pseudo said it. So where do you go to college and what do you major in?
April Blackwell 39:13
I went to Arizona State University. I grew up in Arizona. And luckily, they had a scholarship program for people in the top of each graduating class. So that turned out to work out for me. Which meant that college was free. So that was really great. You know, graduating with no student debt is a pretty big accomplishment in my book. And then I moved across the country to Alabama of all places to work for the army doing flight test engineering. And while I was at that job, I got my master's degree from Embry riddle Aeronautical University in Florida. aeronautical science, masters of aeronautical science. That's cool. That's where the headquarters are. Yes, I did most of the classes online, just because I was remote in Alabama. But yes, the headquarters are in Florida.
Scott Benner 40:10
Cool. Hey, watch the wire on your headphones. Okay. Okay. Yeah. So, but yeah, I mean, plus you have to learn how to do things remotely anyway. So you please. I mean, your Isn't it funny, everyone's complaining about being remote your whole jobs remote?
April Blackwell 40:23
Exactly. Yeah, I was joking with someone about that. I mean, we have to, it's, it's literally exactly like everyone's experiencing with the pandemic, you know, trying to figure out how to fix your car or something in your house remotely by watching a YouTube video or, you know, calling your friend who's a mechanic. That's exactly what we do. Every single day on the International Space Station, you know, they have a toilet that's broken up there, someone on the ground is telling them how to fix it, you know, so it's interesting. That's really something.
Scott Benner 40:55
So, what do you write? What is your hold on? See, I have too many questions. What was your first job? At NASA? How do you get a job at NASA?
April Blackwell 41:08
Well, good question. There's lots of different avenues you can go about it. I ended up just applying through USA Jobs. They use, you know, the government jobs website, since they're a government agency. And that led to a few phone interviews, and then eventually flying out here to Houston. And part of the interview process was interesting, because a big part of my job is communication. You know, we practice communication every single day, in the flight control room, and how we communicate problems or failures, anomalies, plans to people up the chain, like flight directors as well. And so part of the interview process was actually giving a presentation about something I had worked on previously, a lot of people do college presentations. Since I had a job before I ended up doing a presentation from my previous job. But it was really fun actually, to sort of share that with them. And then of course, you know, talk to several managers, and even got a tour around Mission Control. So honestly, it was more fun for me probably then the people thinking about hiring me.
Scott Benner 42:26
What, what first, what first work did you do for them.
April Blackwell 42:32
Um, I've always worked this job. So interestingly, it, it is like a second master's degree, it does take about two years from the time you're hired to when you're actually certified to sit in Mission Control. And during that time, you are taking classes, and doing checkouts we call them so they're like oral examinations. And you also practice your skills in simulations. So they throw tons of malfunctions at you and see if you can prioritize and use your time management skills and your communication, teamwork, all that. And then you eventually have a final simulation where you know that most of the problems on ISS are going to happen in your system. And you have to pass that before you can sit solo in Mission Control,
Scott Benner 43:23
do people get hired? So because what you're describing is you're getting hired. And really, you're, you're not going to work, you're going about learning to do the job for your first two years, or just like you said, school, it's like NASA school, are there people who don't make it through and ever get to actually do the work?
April Blackwell 43:44
Unfortunately, yes, we get hired in what's called classes. So I was hired with two other guys. And most classes for our group are three or four people that you sort of go through all your your learning with. And since I've been here at NASA, which is now seven and a half years, there's only been one class where everyone has made it to be certified. So there's actually a pretty decent washout rate for various reasons.
Scott Benner 44:19
So you can work two years trying to learn this thing. And at the end, just be like, I don't get this and then that's when they're like yeah, goodbye, we noticed. Yeah, I
April Blackwell 44:28
mean, you are sitting solo in Mission Control, flying a $50 billion space station with six or seven humans on board. So you do need to know what you're doing. And you need to be able to not only know the technical, but be able to communicate it and work with your team. So there's a lot of different aspects to the job besides just technical orbital mechanics or whatever
Scott Benner 44:50
and the prioritizing you talked about. So if two if two things pop up at once as problems. You You really need to be able in an incident to say it's pertinent Do this one before that one. And and so we'll address this, then we'll address that because this is more. I don't know, vital to what's happening, I guess. And the most vital thing is, well, I'm gonna, I'm just gonna read first of all, what's your title? Do most people wait 40 minutes to ask you what your title is?
April Blackwell 45:19
They don't, that's okay. It's kind of, I don't know, maybe not very descriptive. So our console name is attitude determination and control officer.
Scott Benner 45:30
And when you email that to me, I assumed it was a typo. Did you do many people have that issue?
April Blackwell 45:38
I think it's just, if you're not involved with space, it may seem a little bit strange or foreign.
Scott Benner 45:43
Okay, cuz it's attitude. I thought she means attitude. How could she have gotten that wrong? It's your job. But anyway, then I texted back and you're like, no, no attitude doesn't go. Okay. So say one more time.
April Blackwell 45:54
Attitude determination and control officer.
Scott Benner 45:56
What does that mean?
April Blackwell 45:59
So basically, you may have heard in like old, old space movies and stuff, the GNC, so guidance, navigation and control, which is a part of what we do. But basically, if you think about it, like flying an airplane, when you're flying on an airplane, you want your pilot to sort of keep you straight and level, you don't want to be doing barrel rolls, or you know, going the wrong direction. So, with the help of Isaac Newton, who's normally driving the spacecraft pretty well. We just make sure that the ISS is going straight and level, it's pointed where it needs to point. And it's configured, how it needs to be configured. And we use sensors. So GPS, just like you have in your phone, we use GPS to know where we are, and which way we're pointed. And we use some other sensors to help us with that as well. And we make sure that we're all configured for whatever activity we're doing. So you know, you may have to move the space station out of the way have some orbital debris, I actually just got an email about that this morning, that that may happen tonight. Or if something is docking, you may need to move the space station to very specific attitudes. So like its orientation, in order for the vehicle that's coming to dock correctly. So there's lots of different little pieces to it. Okay,
Scott Benner 47:21
I find this very exciting. So you could sit in Houston, and be like, type, type, type, type type, and then watch the space station move.
Unknown Speaker 47:30
Yes.
Scott Benner 47:32
Hold on. That's so cool. All right. I don't know why. I don't know why I found that surprising. But it just made me like flush. This is I I this is how I felt when I found a playboy in the woods when I was 11. It's very exciting. Okay. That's amazing. And is it just you at a time? Or is there a group of people?
April Blackwell 47:54
There's a group of us that are certified. So there's probably 25 of us that can sit console. Normally, it's just one of us sitting there at a time, we have shifts, and we support 24 seven. So sometimes I work in the middle of the night. If we have an activity that we know about, for instance, a spacewalk or a docking, we usually have a second person in a backroom. So they kind of help us just like double check all the commands that we send and make sure we're doing everything correct.
Scott Benner 48:25
That's very, that's very, so there's redundancy in those moments. Exactly.
Unknown Speaker 48:29
And it's not
Scott Benner 48:30
just they're not just sitting back there smoking cigarettes and drinking Dr. Pepper. They're actually helping you the person who's out front.
April Blackwell 48:37
Yes, usually not smoking, but you know, the building is from the 60s, so it does kind of smell like cigarettes.
Scott Benner 48:43
Listen, every space movie, all of the white men who controlled Mission Control are smoking cigarettes. That's just what I seen. There's always, you know, there's always 9000 white guys, they all have crew cuts in these films. They're smoking cigarettes very viciously. Is it? Is it stressful? Like does does work? Make your blood sugar try to go up?
April Blackwell 49:04
That's an interesting question. I actually when I'm on console, my response to adrenaline is I go low. And so I try to keep my blood sugar a little bit higher, I run it just a little higher than I would off console. So I've console I'm kind of targeting around 100 and on console, I usually run more like 131 40 which just gives me a little runway if something were to happen to sort of catch myself before I started going low. Wow. So
Scott Benner 49:35
you get when you get an adrenaline surge your blood sugar drops pretty significantly. Yeah. Wow. always been like that.
April Blackwell 49:43
Um, I guess I've you know, I've really tuned into it while I've had this job. So it's likely that it's always been there, but I've just never noticed it quite as as you know, in real time, like I do now. Kidding.
Scott Benner 49:57
That's interesting. He has you work in shifts. I I'm jumping around, but this is how my brain works. Because you work in shifts, do you see feet on the floor like dawn phenomenon stuff, if you wake up at 11 o'clock at night to go to work.
Unknown Speaker 50:13
I'm
April Blackwell 50:14
not consistently, I definitely see interesting trends spikes. If I work the night shift, and the interesting thing is, I normally wake up, you know, I went to work, the night shift, I'll work our shift is 11:30pm to 8:30am. And then I'll come home and I usually try to like go to bed immediately because my kids are at daycare so I can sleep while they're not. And it's interesting, because I'll usually wake up around right at noon, or 1pm, and be hungry, and my blood sugar is going low. So it's like it's expecting me to eat lunch, and I'm just not hungry right then because I've been working all night. So it's way better now that I have control IQ on board. So that that helps so much with shift work and just weird schedules in general. So I'm thankful for that.
Scott Benner 51:15
If that makes sense. Arjun uses loop and it it it's amazing to watch it take away basil and try to fight off flows, you know, significantly in the future. Yeah, very, very cool. Yeah, I can imagine that would be something you would have been interested in, I assumed you had something like that. Just based on your job. Okay. Now, let's everybody slow down for a second. And by that, I mean me, cuz I'm still a little jittery, like a little like, you're like, one of the more famous people I've talked to, in my mind. So just, it's just, I guess I just I grew up in the right space, right, like my parents remembered, you know, you know, moonshot, and Kennedy and all that stuff. And they spoke about it with a lot of reverence. You know, people live growing up living in the 70s, who actually saw, you know, as a child, you know, solace, you know, put man on the moon, it was it was, it was really spoken about, just right up there, like the world doesn't work this way anymore. But you know, when you hear like the Super Bowl has, you know, the most people ever, always on television, watching television, it's usually the Super Bowl, the Super Bowl, it's because things like that were special. And now there's so much availability to everything that nothing feels as special. I don't know if that makes sense to you. But that's how it feels, to me that nothing is special, because there are so many options of things to do see, or partake in it. So my parents saw it is amazing that, you know, we put somebody on the moon. And then as a child, you know, the Space Shuttle Program was just stunning to watch. And then, of course, there was the tragedy with the one shuttle. And that felt like, I don't know how to say like that, that, that there was a morning that that covered the entire country when that happened. And I don't know if if that, if that would impact people the same way in modern day times? Because I mean, because does anybody I mean, how many people listening to this are like, Wow, there are people in a space station right now. I had no idea. You know, like, I think that that's, that's true. And I'm still one of those people. And I told you when we spoke earlier, the reason April got to be on the show is because one of you asked for her to be on the show. And I was struggling with it in my mind, because I don't have people on the program who've been on other podcasts. And you had recently been on a podcast or somebody said, Hey, please get this person on the show meaning you. So I do a little diligence. And I find out you were just on a podcast. And it's like, ah, I don't do that. And so I sort of let go of it. I was like, well, maybe I'll like reach out to her next year or something like that. And then I was awoken in the middle of the night, had to get up for something, got this little alert on my phone that said, I could go sit down right now and watch a docking at the space station, and watch people like get there for the first time. And so there I am at like 130 in the morning in my underwear, watching this. And then I was just like, this is a sign April should be on the show. And so I reached out to you and you were like so nice to want to do this. But I want you to know that like, I sat here for like 45 minutes, just watching astronauts unbuckle their seat belts, to get ready to get out of this capsule and go into the space station. And to say that by today's entertainment standards, nothing was happening would be an understatement. Like nothing was happening. You know, they were just sitting there. But there's still that person inside of me who grew up through all this. Who was just like, Oh my God, we just took four people stuck a minute Tin Can and shot them up into space. They stuck to another tin can and they're about to get into it. And that all to me is still fascinating. You know, really just, I think it's, it's overwhelming. Like, I'm stunned that the structure and how they generally mean like the big. Couldn't you just like crush one of those things in your hands, but they're up in space? Like what happens if a rock hits it? I have a lot of questions. You're not getting out of here anytime soon. So So first of all, do you feel the way I feel? Or do you feel like a million times more than that about this?
April Blackwell 55:37
Well, I'm not inside your skin. So I can't say I know exactly how you feel. But I am just, I'm pretty pumped about everything space, I was fortunate enough to see two space shuttle launches, one really close only about three miles away. And I just remember bawling my eyes out because it was the most patriotic, inspiring, just all consuming thing that I've ever witnessed. And I wish that everyone could feel that about something. You know, I think, like you're saying, there's so many things to be interested in now and so much information coming at us all the time. You know, I feel like there's not that many people that have a true passion about something. And I mean, that's just something that's so important to me, you know, and drives so many things in my life. And I wish that for everybody I wish, you know, there was a passion that everyone had.
Scott Benner 56:35
Yeah, do you think the goal is to get us off of this rock? Is that what space exploration is about, like long term
April Blackwell 56:45
that is maybe a really, really long term goal. And, you know, everyone kind of has a different goals. So the goals and missions that NASA has are different than, say Elon Musk, who's made it pretty clear that his goal is to land on Mars and, and figure out a way for us to cultivate on other planets. But what I think is so interesting is, you know, exploring with humans is still just so inspiring, you know, we have probes that are literally outside of our solar system. Now. I mean, Voyager is in deep space. And hardly anyone knows about it. You know, it's like a forgotten thing. Like, we're still getting data from Voyager that was launched 50 years ago, and is now past Pluto in deep space. But there's something really special about humans and having a human perspective on missions. And so I don't know where I was going with this. But I think it's really important to, to continue exploration with humans. And while that may not be to deep space anytime soon, I think there's really, really concrete and tangible benefits that we can feel on Earth from these missions right now.
Scott Benner 58:02
So yeah, What is today's Velcro?
April Blackwell 58:07
Oh, man, there's so many things. There's actually a lot of medical science that's been going on to help people with different conditions, different ways that we're creating medicines in space, we're researching different things. Actually, there was a SpaceX launch, just this past weekend, and the docking was yesterday. And onboard are some rats for some experiments that are going to be happening with rats. So we do those. Of course, all of the remote operations that we do on a daily basis actually help. You know, lots of people in real time now and you know, have better interactions with people remotely. Like I said, clean drinking water. We're learning so much about communications, like communication satellites, how we can deliver internet to people in really remote parts of the world. You know, different food techniques for growing food in weightlessness, and applying those to how we grow food on the earth. There's just so many different things. And NASA puts out actually a really great article every year, that's, you know, like, here's all the benefits to humanity from ISS from this year. And you can like Google that or something, but they put that out every year, which is really interesting to read about some of the really cool things. You know, there's lasers and all sorts of space age stuff, but there's really like down to earth stuff. The whole idea of ISS is off the earth for the earth. So we're really trying to use science to our benefit in space and learn and apply the lessons that we've learned to things on Earth.
Scott Benner 59:58
Sometimes I feel like it's the limitations of how the lifespan of a human being that limits us from imagining out into the future. Because if you mean if you think about it, I think Carl Benz invented the first car in like 1885 or 86 ish in there, right? So like 134. Not that long ago, you know, 130, some years ago, people rode horses to get places. That's not that long ago when you really stop and think about it. And yet, it seems like forever. If you're 20 years old, you're like, Oh, 134 years ago. That's, that's forever. And it's not it's it's just this split second in in time. And that, I think, is like when you said Voyager has been out there for 50 years. So you said like, 50 years? I think that's, I think, I don't know, like, I think then people here like, and it's only to Pluto. And you're like, No, no, you're thinking about it wrong. But it's the time, it's confusing because of our lifespan. And because of how we really see it. I mean, if you stop and I don't want to be a bummer here, but you basically spend the first 20 years of your life getting on your feet, right, and then mid 20s or so you start to pull it together a little bit. So you've basically got about 20 good years in there before your back starts to hurt all the time, you know, I'm saying, then you're on the backs, they go to the back nine, some people call it the downswing, whatever you want. And then you get as much time as you get at the end. And so you your real life, like you're making babies, expanding the planet, that part of your life is about 2025 years right in the middle there. And that just makes all this seem magical. In, in a way that's almost like, well, I don't need to pay attention to it. Because, like, I won't be around to see it. But I just don't buy into that, like I love the idea of feeling like you were in some way, a small part of like a bigger idea. And I don't know, just to consider that, you know, people rode horses less than 150 years ago was their only means of transportation, personal transportation. And now there are I mean, it seems effortless now when the Rockets go up, like they just see ignition and a bunch of fire and a couple of minutes later, you're breaking orbit. And it's just crazy. I wish people in general would just take a minute to think about that. The the, you know how far you've come in such a short amount of time. And sure I'm not going to be alive 130 some years from now. But imagine what people are going to say like, oh, back in 2020. You know, they had to do this, like, think of what a leap it is from horses to you, the car you're driving today. And from horses to the rockets. Like, it's just it feels it feels like we're really just starting to me. Does that. Is that right?
April Blackwell 1:03:00
Yeah, I think so. And it's interesting to you, you know, this year, we launched Bob and Doug, you may have heard of them. They launched this summer on the first commercial spaceflight, through SpaceX. That arrived at the International Space Station. And that was the first time that I have seen in my personal lifetime, a new vehicle, launch with humans on it and arrive at the space station. Like you said, there was the space shuttle before but you know, I wasn't around when the space shuttle took his first flight. So that was literally this generation's first new human rated space vehicle, which is kind of just blows your mind. And I think things are just going to get more streamlined and efficient from here, and there's gonna be a lot more, you know, people that aren't necessarily astronauts, but are more private paying customers or we're calling them private astronaut missions. Pam's going to the space station and we're adding a couple of commercial modules on the front of ISS to accommodate them and the work that they're going to do. So it's like a whole new era of space travel and sort of the missions are evolving. And I hope that getting I guess more normal people access to space will make it something that kind of is more interesting to the general public again.
Scott Benner 1:04:35
Yeah. Hey, listen, when things on Corona whenever that happens. There are I think there are four spots around the country where you can visit like a retired space shuttle and I've done it at the universe or Is that how you say the name is Steven? You'd var there's this Yeah, in Virginia. And until you've literally stood like 20 feet away from the space shuttle and looked up and gone. Wow. Got that into space, and then it came back and just glide it back down again. It's it's mind numbing to, to think about, hey, you just said about adding on to the, onto the station. And when you do that, does that fundamentally change everything about how you move? It does? Like, how do you make adjustments for that?
April Blackwell 1:05:20
Oh, that's awesome. Wow, you're like thinking like an engineer? That's so cool.
Scott Benner 1:05:23
Well, you're changing it. Right. So it's got to go ahead.
April Blackwell 1:05:27
Absolutely, yes. So, you know, we can basically, do you remember those like old timey little desktop models where it would be like a pin, and then something on one side and a weight on the other side. And you could like, spin it around,
Unknown Speaker 1:05:44
to kind of balance on it's like, yeah, like a balancing thing.
April Blackwell 1:05:48
So that's kind of how we fly the space station, we, we use these big gyroscopes says, you know, just like a gyroscope you'd think of we use for huge ones to stabilize ISS. And so when we add a new module, or a new vehicle Docs or undocks, we definitely change our orientation ever so slightly, just to make sure that everything is still balanced throughout an orbit.
Scott Benner 1:06:17
Well see, that's cool. How long does the space station last? Like? Is it is there a retirement date for it?
April Blackwell 1:06:25
I think the last retirement date I heard for it was 2028. That keeps getting pushed back. It's kind of dependent on Congress and funding. We are an international collaboration. So we also have international partners which provide money and resources to the program. So they kind of feed into it as well. But the other interesting thing is just ISS is kind of old. If you think about 20 years ago, and think about the computer technology 20 years ago, I mean, it was crazy different than it is today. And those are the computers that are on ISS. And especially space stuff takes a while to get certified to even fly in space. So those computers are probably even a few years older than 20. So the interesting engineering challenge for us now with the space station is how can we use the technology and resources we already have in space, because it's really expensive to launch stuff in new ways to support new programs. And that's, it's a really a unique engineering challenge to use what you already have, it's kind of like that Apollo 13 moment where they throw all the stuff on the table and say, Hey, make a co2 scrubber from all this crap that we have on board. And that's all you got, because we're not wanting anything else up there. So it's kind of a fun challenge.
Scott Benner 1:07:48
No kidding. So when it Have we retired space stations prior to this one,
April Blackwell 1:07:56
the US has never had a space station prior to this one. We, the Russians have had space stations several. And they first hired those after a few years of runtime each time, the longest being Mir, which you probably remember, which proceeded ISS just a little bit and we actually had us astronauts onboard mirror, and the space station or the space shuttle could actually dock with mirror. So that was kind of the some of the first steps in our collaboration with Russia. But this is the first
Scott Benner 1:08:31
US space station when Russia was done with them. Do they crash them? Or do they point them in the other direction and just shoot them away? How do you do that?
April Blackwell 1:08:42
I you know what I have to go back because we did have Skylab. So those were short duration space stations, I guess you could qualify them as that. But um, so you're kind of talking about end of life, which we actually have plans in place, should ISS need to be deorbited. And there's this special place in the South Pacific off the coast of Australia that sort of all of this space, junk space stuff that we want to have reenter safely. We kind of shoot for that one area in the Pacific, because it's the most uninhabited place on Earth. So yeah, it takes a lot of planning to safely deorbit something as large as the ISS.
Scott Benner 1:09:26
I'm just reading here. It says right now there are nearly 6000 satellites circling circling our planet 60% of those are defunct, they're just and roughly 40% are operational. That's really crazy. So private companies like if you have Sirius Satellite Radio, that's a company just a privately owned company who launched a satellite into space to absorb assuming all kinds of communications companies have satellites. Well, they start bumping into each other eventually. Why doesn't that happen?
April Blackwell 1:09:56
It does happen occasionally. And those are Those are bad days actually. So there, there's, you know, the US has a military aspect that monitors all of the space debris or satellites, they have an entire catalog of 1000s of objects that they're tracking everything from an actual satellite down to, you know, say a wrench that an astronaut accidentally let loose during a spacewalk. So tons of different stuff they're tracking. The problem is when they when they hit each other, which happens rarely, but it has happened before. To stay in orbit, and object is actually traveling at least 17,500 miles per hour. So if the orbits are not aligned, you know, you're basically hitting two objects together at those speeds. So essentially, double the speed. And in the worst case, situation, obviously, that's much faster than a bullet. And so when they collide, it's just a huge explosion. And it creates all these other tiny little pieces that now become part of that huge catalog of space debris. And so that can actually really impact our operations on ISS. And we've had to use the thrusters on ISS to move out of the way of pieces of debris before
Scott Benner 1:11:22
so that's the part that's hard to wrap your head around, if you're me, is that there's so much space is such a strange word now. But so if you look at a blown up example of satellites orbiting, are there first of all, are there levels like in like, like the FAA fly certain planes at one height, others and other attitudes? Like, are there? Are there distances from the planet that are like rings? That stuff floating? Like if I'm 18? t, am I in one ring? Or is do you know, I'm saying does any of that make sense? Because I'm confused? Yeah,
April Blackwell 1:11:56
I'm not sure it's as defined as you think of it like, you know, altitudes for airlines and stuff. But, you know, different satellites operate at different altitudes for different reasons. ISS, you know, we're pretty low. We're like 250 miles above Earth. And so we orbit every 90 minutes, we go around the Earth. Some satellites, they want to stay over the same spot on earth in order to provide, you know, certain communications or coverage of one area. And so those satellites are in geosynchronous orbit, which is something like 22,000 miles high. So, definitely different levels for different purposes.
Scott Benner 1:12:41
Okay, that makes sense. Thank you, I really appreciate you explaining that. Because to hear that there are 6000 manmade things out there that are floating around, you would just think, oh, they'll bump into each other constantly. But if you do kind of a macro pullback, and you really think of the planet, how big the planet is, and then see how far away from the planet some of these things are 6000 things is probably not really that much. Because of
April Blackwell 1:13:06
Yeah, that sounds like a low number to me. So it must be 6000 things that have been launched into space, or maybe like rocket bodies that haven't deorbited yet, but I think there's quite a few more just pieces of debris or, or things that we're tracking that are in orbit around Earth,
Scott Benner 1:13:27
when when things do slow down? Do they mostly burn up on re entry? Or does that matter? Does the size have something to do with it?
April Blackwell 1:13:37
The size does have something to do with it. But yeah, usually they're just going to burn up. You know, even our is several of the cargo vehicles that we bring up to the ISS, they just burn up on re entry. And their reentry is planned such that they'll hit the atmosphere at an angle to make sure that they burn up, which is a way that we dispose of things,
Scott Benner 1:14:01
bring it in slower, so it spends more time in that heat and just destroys them. Yep. Okay, how about in Apollo 13? When they say if we come back at the wrong angle will skip off and shoot out in the space? Was that just for drama?
April Blackwell 1:14:17
No, that's actually a very real phenomenon. And we actually are, you know, we've been talking about that a lot and grand tree and orbital mechanics for our new missions. Because sometimes you can use that to your advantage. You know, if you are maybe targeting a land landing site that in the ocean that now has a hurricane brewing. You know, maybe you do want to skip off and reenter at a slightly different location or angle. So it's not always a bad thing. Depending on what kind of programs you have at your disposal to use.
Scott Benner 1:14:56
Do movies like Star Wars make you go this is not you anywhere close to how it would be do you have that weird feeling when you see media around space dramatisations. Um,
April Blackwell 1:15:08
there's so there's definitely sort of two categories. There's like the science fiction and the science fantasy. I am not a huge fan of science fantasy. Just because I think it's not really about space or science. It's more about the story. So you could set that in, you know, England 2000 years ago, and it would be the same story. It's just like a little bit different, you know, setting. But so I'm not a huge fan of those. I do. Like Star Trek, it's a little more of the science fiction where it seems plausible. It's just, you know, not all of that technology is is designed yet. So I'm not a huge Star Wars fan. Sorry, if that's your thing. Don't feel positive. I do. Like I do like Star Trek. And, and those sorts of things where it seems a little bit more possible, like the Martian actually, really great story. And a lot of that is super realistic. So I like stuff like that.
Scott Benner 1:16:09
Did you catch away on Netflix?
April Blackwell 1:16:11
I have not watched it yet. Like I said, I have two young kids. So they didn't watch a lot of TV. Unfortunately,
Scott Benner 1:16:17
I enjoyed it. And then they cancelled after one season, they said it was too expensive to make or something and COVID blah, blah, blah. I was like, come on. It's the first time I've liked Hilary Swank. And like five things she's done, and then they just took it from her. It's not fair. I mean, seriously, she needs to work. How old? Are those kids years? By the way?
April Blackwell 1:16:37
They are two and four.
Scott Benner 1:16:39
Oh, wow. Those are little kids. Yeah. There's so much trouble. I mean, fine at that age. Right? Does your husband do something similar to you? Or is he like, have something it's got nothing to do with engineering or anything like what you do?
April Blackwell 1:16:58
So funny story, maybe if I tell you how we met, it will give you a hint. So we actually met because I? Well, we were both counselors at Space Camp. While we were in college. That's where we met. And he is I'm an aerospace engineer. He's a mechanical engineer, recently actually switched over to NASA, and he is working on the batteries that will be used in the spacesuits when we go to the moon.
Scott Benner 1:17:32
Wow, what's the target of the moon? Sorry, what's the target date for getting back to the moon for us?
April Blackwell 1:17:40
It's a little bit in flux. The the timeline for the the current administration is boots on the moon by 2024. NASA is kind of in a wait and see mode to see what's going to happen with the presidential transition. But that's the work to date as of now. So
Scott Benner 1:17:59
is there a plan to keep them there for Speight a stretch of time or so we're
April Blackwell 1:18:06
actually planning the first missions will kind of be similar to Apollo. So just kind of go there, land, come back. But eventually, we'd want to build a space station out near the moon actually in something called a halo orbit. And that will be sort of this interim spot that the astronauts hang out there. And then they get in basically their, you know, lunar craft that's going to land on the moon, go down to the surface for some period of time, come back up to the space station, and then catch a different vehicle for the ride home.
Scott Benner 1:18:42
So you'll it's, they'll, you'll be able to put basically moon explorers on that space station and have them like they're going to work, they can just go down to the moon, do something come back up to the space station, so they can do it more frequently without having to go all the way home again. That's exciting, right?
April Blackwell 1:19:00
Yeah, it'll be pretty fun.
Scott Benner 1:19:02
So one day, we'll they'll just be like a, like a system of stations. Do you think? Or do you think those are the only two?
Unknown Speaker 1:19:13
haven't really thought about that. I
April Blackwell 1:19:15
haven't heard of any specific plans to do a system of stations, there's been lots of talk leading up to the moon missions on, you know, what makes the most sense for sort of the long term goals for NASA. So previously, we were thinking about putting a space station at a Lagrangian point, which is just this fancy word for saying sort of an equal balanced gravity point. Which is nice, because then we don't have to use a lot of propellant to try to stabilize our orbit or anything. The problem with that is we don't have a really big
Scott Benner 1:19:51
system of deep space communication yet, just because we haven't needed it. So there's just some infrastructure that's needed there. Before we can Think about kind of those longer term missions, that kind of interesting thinking should illuminate for people that the, the amount of time that it takes like you have to put a satellite in a spot just to communicate and putting that satellite there could end up taking years, right to design it. And then as technology is moving forward, everybody has that perspective from their cell phone. Like how quickly tech changes. So the moment you make the decision, this is what we're going to build this communication satellite out of the second you make the decision, it becomes obsolete, almost, as technology flies forward, it must be difficult to decide when to make something, you know, when is the technology right to to move forward like that? You just said something that made me wonder, when you when you actually move the space station, you talked about propellant? What does propel it? Like it like little tiny rockets? Is it is it air is it like what moves it? Yeah, we
April Blackwell 1:20:58
use thrusters. So essentially like little rocket engines, but they just take one propellant, so we don't need, well, we need a fuel and an oxidizer. But we, we don't need a lot of all the extras that come with, you know, the rockets that we launch off Earth, which is nice. But yeah, we try not to use those very much, because, you know, it costs something like $10,000 a pound to launch something in the space. So, you know, every little pound of propellant we use is pretty expensive. And that's why we try to use, you know, the electricity we generate from the solar arrays to drive our big gyroscopes in order to stabilize ISS. And we've come up with some really unique ways to maneuver ISS using just those gyroscopes. And very little propellant, which is really cool. We do this one maneuver, it's my favorite thing. It's called an OPM, everything in NASA is an acronym, but it stands for optimized propellant maneuver. And we actually flip the space station 180 degrees, so we flip it over backwards over the period of one orbit, so 90 minutes and we use very little propellant, we kind of just use propellant to get it started, then we use the gyroscopes and gravity actually to sort of flip us all the way over backwards to set up for an event. So it's pretty cool.
Scott Benner 1:22:27
Do you tell the astronauts that's happening?
April Blackwell 1:22:30
Yeah, we do. We give them something called an attitude timeline every day, they get sort of like this little DAILY Report. And it gives them some information about the day and any special things they need to keep in mind. So if we're going to be doing any maneuvers or anything like that, we'll add that in our attitude timeline for the astronauts,
Scott Benner 1:22:50
if you didn't tell them what they notice.
April Blackwell 1:22:54
I don't think they would notice unless they looked out the window and realize they were flying backwards. So essentially,
Scott Benner 1:23:00
there's because they're not gonna have any feeling of orientation changing.
Unknown Speaker 1:23:05
Right?
April Blackwell 1:23:06
They there's been a few astronauts, if you Google it, they've done some YouTube videos on reboost. So sometimes we have to boost the altitude of the station. And if they know it's coming, sometimes they'll set up these little like, gravity indicators, acceleration indicators, like a little stuffed animal or something. And you can see it in the video. But I think it would be hard for the astronauts to know that without knowing beforehand. Yeah.
Scott Benner 1:23:32
I my only obvious. We went on a cruise one time, and we were up on the deck. And you know, the launch time was coming up, but I wasn't really paying attention. And my wife's like, we're moving. And I was I don't think we are, we're still right here. And she says, No, it's moving. I'm telling you it's moving. And no lie. She was right. Like she could feel it immediately. Whereas I had no inclination of it at all. I don't know what that you know, it's probably something in your inner ear or something like that. But I just wondered like, you could actually flip them around. And if they couldn't see out the window, they'd have no idea that was happening is very clever. Meet an astronaut as part of your job.
April Blackwell 1:24:13
Oh, yeah. So we have astronauts that are kept calm. So one of the flight control disciplines is kept calm. And they are the ones that talk to the astronauts on board. So a lot of times they are astronauts themselves. And then also our group is responsible for teaching the astronauts about our system. So each astronaut candidate goes through like two years of training on just how to operate ISS and what all of the terms mean and you know, what to do if they don't have communication with the ground and so our group teaches them how to control the station's attitude if they don't have calm with the ground. Okay,
Scott Benner 1:24:57
so you have friends that are astronauts basically Like you send Christmas cards to astronauts, stuff like that just just, I wouldn't
April Blackwell 1:25:03
say super close with any of them. But they're
they're definitely in, you know, all of our meetings, we have astronaut representation. And they're a big part of what we do, because we want to make sure we're keeping their perspective in mind while we're designing procedures or planning events.
Scott Benner 1:25:24
Gotcha. But if I said to you at work, stand up and go talk to an astronaut, you could do that. Yeah, excellent. This is what I need to know. Okay, that's fine. That seemed like the most important thing to me. I don't know why I'm imagining when you said that astronauts are communicating with others that are in space that almost felt like, yeah, you'll usually hire like an X player to coach the team kind of feeling like, you know, like people who speak that language and kind of have been in the shoes of the person they're talking to. Does that make sense? Honestly, I don't know if that's part of the consideration. But it does make sense to me. All right. Here's
April Blackwell 1:26:01
the whole idea, you know, how to package a call, so that someone on board would understand it?
Scott Benner 1:26:07
Yeah. So here's the thing, April, I'm going to just keep talking to you. So we have to stop. Because I'm not going to stop, you're gonna say something that's gonna make me wonder something else. And then this is going to be the longest podcast in the history of time. So I don't want to do that to you. Because I promised you an hour. And it's been longer than that. Now. Tell me, what's next time you go to war? Well, no, no, let's go back to the email. So you get the email that says that you might have to do a maneuver because of junk. And then you can't like what happens next? Like it's such an odd thing, that it's an email, just in case you're wondering.
April Blackwell 1:26:47
Yeah, so we have, we have procedures for everything. And part of this procedure, you know, is that we need at least three and a half hours. Notice before something we call a TCPA, which is time of closest approach, that's the object that stratcom is tracking or whatever. And then we have to basically talk on the loops to our Russian colleagues, set up timing for when the thrusters are going to fire, which thrusters we're going to use, how long we're going to burn, and what time we're going to perform that burn in order to make sure we're clear of the space debris in time.
Scott Benner 1:27:28
That's amazing. All that made me think is that I'm very glad that there are spark dedicated people in the world to do what I'm assuming there. You know, there are jobs that are not as cool as yours, that still take this kind of dedication and understanding. It's very, you know, very fun to bring your story to the people listening to the podcast, because I know that one of the things that happens very frequently to people, especially when their children are diagnosed, is they just think that possibilities are gone now. And you do something really cool. So obviously, obviously, I
Unknown Speaker 1:28:02
think so.
Scott Benner 1:28:04
Well, you know, April, Tell, tell everybody, as we say goodbye here a little bit. When I said I was really excited to get you on the podcast, you couldn't imagine why really, you were like, Why me? Like this isn't excited, like, Do you not see this as amazing? I mean, I know you do you just assume other people don't care? Like, what was that disconnect there? Yeah. Do you remember saying
April Blackwell 1:28:24
that question? I do. I guess I just, you know, this is my job. Everybody has a job. And you know, just because I am, I guess I'm fortunate enough to be able to work, a job that I truly love and think is absolutely incredible, and never imagined that I would get to do this. You know, I it's still a job. And I don't know, I'm not sure that it should be celebrated more than someone else's job.
Scott Benner 1:28:59
That is a very 2020 answer. I appreciate your kindness towards other people, you do something really cool and most of us are idiots. That's really what I'm here to say. You understand that? If, if I hopped off the Mayflower, right, like, and people were like, go make a new world. I'd walk like 15 feet away and go like is here. Okay, you know, like, and they're like, no go in farther. The middle I got to a creek or a river. I just feel like I can't go any farther. That would be it. Like, I don't have that in me. Whatever that is that like push over this thing. build a bridge over this to get to the next thing. My brain just doesn't work that way. I would just set up shop somewhere like here's good. They live on the beach property. It'd be like the far enough so that there are other people who look at a river and think I can build a structure over top of that river. Or, you know, it would just be easier if there were roads. Or, you know, wouldn't it be great if we put up poles with wires on them, so we could talk to people farther away like that those are special people who who do those things, and propel us forward. And I know I'm not one of those people. And I imagine a lot of people are more like me, like, I just wanted to, like, be somewhere and, you know, have a family and I don't have thoughts like that what you do is like fanciful. It's, it's almost, it's magical.
April Blackwell 1:30:22
Will you say that? But I mean, anyone that lives with diabetes, or takes care of someone with diabetes, you know, faces challenges like this, literally every single day, we have to figure out, how are we going to get this high down? How are we going to find something to eat when we're in the middle of I don't know, Yosemite or something? And, you know, how can we streamline our diabetes management to make it easier for everybody and tighter control? And so, I mean, you say that, but I think all of us, as people that interact at diabetes, do this on some some smaller scale, maybe almost every day?
Scott Benner 1:31:01
Isn't it interesting that, first of all, you said Yosemite, my favorite vacation I've ever taken in my life. It's possible, you and I are supposed to be married April. And secondly. So I hear what you're saying. And you're 100%, right, my disconnect, for feeling good about myself as I'm building all kinds of bridges. But my bridges are made out of thoughts, and not something physical. So I could sit here and make the argument that I have propelled people with diabetes forward with words and ideas and everything. And I guess that is building a bridge over a river. But like I'm talking about, like physically doing it. Like saying, we have this and it needs to get there and actually making it get there. I don't know, that's maybe that's part of your engineering brain that you think is normal that other people who aren't engineers? Don't, you know, just don't possess. So I think you're right. I think people living with diabetes make big decisions all the time. And the ones who are continuing to move forward are doing the exact same thing. So they're, they're launching theoretical space stations in this into diabetes space, let's say. Absolutely. Yeah, that I believe I really do. But nuts and bolts. You're way smarter than me and just take it. Okay. Just say thank you and stop arguing. Because this is really cool. Yes, sir. Thank you. There now we're getting to it. Take the compliment April.
Unknown Speaker 1:32:27
I'll try.
Scott Benner 1:32:28
Is there anything that we didn't talk about that I should have asked you about? You probably feel dizzy because I just I jump around a lot when I'm doing this stuff.
April Blackwell 1:32:41
You're like my husband. He is like really bad add. So we'll just be doing something and then it'll make him think of something totally different.
Scott Benner 1:32:50
I would argue that's what makes this podcast interesting. But okay, it's fine.
April Blackwell 1:32:53
No, no, yeah, yeah. No, I think it's good for a podcast. It's just sometimes annoying being married to that person. That's okay.
Unknown Speaker 1:33:02
Do you want to restart and complain about your husband a little bit? We could do a half hour on that if you want
Unknown Speaker 1:33:08
to be married to someone with a DD when you have diabetes.
Scott Benner 1:33:12
Then right now, I listen. I take your point. You say something, I can feel myself fighting. Like I have a I ask you a question. And I have in my mind a question. My my next question that's going to propel along like, I don't know what you're gonna say, but I can imagine extending it with a second question. But then while you're saying it, you say something that I find so much more interesting than what I was gonna ask that I just deviate and go to that. And that's how we ended up 40 minutes into it before I was like, you should probably tell people what you do at NASA.
April Blackwell 1:33:44
Oh, it's awesome. It's, it's good to talk to someone who's really interested in it. So
Scott Benner 1:33:49
I don't know how everybody's not completely interested in it. It's just it's, it's one of the most fascinating things that we do is people like send people up into space and they live there, and they don't die. And a thing doesn't hit them. And it's just, it's, it's so incredible. It tend to not see that as as incredible is you know, I had a cellist on recently. And I'm, I'm just a massive cello fan. I like I like an unaccompanied cello played with feeling and heart by one person. And as I was talking to her, I probably talked to her the way I talk to you about this. And I've gotten a lot of notes since then from people are like I didn't understand I never heard the cello. I've been listening, that kind of thing. And I thought good, like that's a complicated thing that a brilliant person does and and it's just people don't pay attention to it. And I don't know like you know, I shared with April I'm gonna let you go in a second like you're not having like a low blood sugar. Your kids aren't locked in a closet or something like that. Right. Okay, so I shared with April that I was not when we spoke before this, that I was not a good student in school. And I had a book report to, which I didn't do. And I came to my mom the night before it was due, literally. And I said, Hey, had a big book report due tomorrow. You know, it's a lot of points, I haven't started it. Not gonna lie. If you let me pretend to be sick tomorrow, and stay home, I'll get it all done in a day, which probably was also a lie, it was probably just me procrastinating more. And so I was home, in my living room, I can picture it, sitting on the sofa with a coffee table in front of me, with encyclopedias, trying to find out information about this thing I was writing a report on, because God knows I wasn't gonna, you know, read the book. And so I am sitting there trying to do it, I have the television on. And it happens to be and I did not do this, you know, purposefully, it happens to be the day of the shuttle disaster. And so I flipped the television on and I watched the shuttle go up, I watched it explode. And I watched everything that happened afterwards. And it just sticks with me to this day that there were these people who were strapping they're asked to a rocket to try to move people forward, and it killed them. And that somebody just came along afterwards and did it again, like that the next person just stepped up and said, this is so important. I'm going to strap my ass to the next rocket, we're going to try this again. Like I find that completely inspirational. And I don't know if it has much to do with having witnessed it as much as I could, you know, live. But I just think it's amazing that the next person steps up in in all walks of life. But this one specifically like this isn't driving to the mall, April, you know what I mean? Like this is your feet are on the ground? And then I mean, what is it? Three, four or five minutes later? You're in orbit, right? Just there. If people haven't watched a launch, they, they should they should watch it straight through? Because I find it astonishing. And yeah, I
April Blackwell 1:37:00
agree. I wasn't alive for challenger, I was alive for Columbia, which broke up on reentry. But it's interesting, because at NASA, we really take the failures we've had seriously because we have had failures. And that's part of this game. It's it's a risk. And you know, astronauts know that going in, and we try to mitigate the risks as best we can. But there's just some element of risk that remains when you get on top of basically a huge explosive. So NASA is really great about, you know, reflecting and reviewing the lessons that we learned. And every year as flight controllers, we have proficiency. And we have to read the Columbia accident investigation report. And see, you know, where the links in the error chain happened and apply those to the situations we're in now. So it is really interesting, and I can't say, you know, I can't speak from the astronaut perspective of actually getting back on but just us as flight controllers sitting there, you know, even when you're in a simulation, and you know, it's all made up. But something happens to an astronaut. It's, it just amps up the whole room. And, you know, we're also invested in this, like you said at the beginning, it's not, you know, it's not just like a job, everyone who works there loves space and loves doing this. And so that investment means that we have to be able to control our emotions and compartmentalize a little bit, but realize that this is a huge deal.
Scott Benner 1:38:41
Yeah. And it's not just someone's life in your hands. It's it's public perception of NASA, which I remember, you know, you talked about the re entry. And we follow that you follow that news back then, like you said earlier, like you couldn't just open your phone up and find out what was going on the workday and turn the news on at night to find out what was going on. And to finally learn that this just basically the square of you know, foam, popped off of the front of the shuttle and allowed heat to penetrate the hole is it took them forever to like, actually come out and tell us that and and you learned about it. I never forget like thinking like, wait, it's foam. Like there's like, like foam on the outside of the space shuttle. That's what was keeping it from like, really, you know, like, what, okay, like any That's crazy. who figured that out? What genius figured out if you put me in charge of that, I'd be like, Well, obviously we need nine feet of steel thick. You know, like, you know, like I wouldn't know like I would have no idea how to imagine things like that. So when you say you know, people's, you know, you kind of have people's lives in your hands you definitely do. But it's also like it's the life of the project and, and all that that touches because when it's slowed down for a while when you No kind of politically, there was no taste for pushing forward. That was scary to me. Like, we can't stop doing this, like, because what did we do all this for? If you're going to stop now, like you have to keep going and find out what's next.
April Blackwell 1:40:14
Yeah, you know, that still drives a lot of our decisions, you know, keeping that in mind. And, you know, ensuring that we have the most safety we possibly can with the budget that we're given in the schedule that we have to, to meet in order to fulfill those requirements. And keep everything safe so that we can keep going and keep exploring.
Scott Benner 1:40:37
Yeah, I'm up for that. as much money as possible should go towards any kind of exploration, scientific exploration. In my mind. That's the only way you're going to get somewhere, you have to come to the conclusion that your life isn't the point. And that sounds crazy. But it's, it's humanity's life. That's the point. Like it's not about where you are what you want, personally, it's about where do we send it? And if it's constantly like that, then then the possibilities are endless. But when you focus inward, then everything stops and stands still.
April Blackwell 1:41:13
Yep. And it's like that, even outside of space. You know, I think just the recent political cycle has shown us that, that sometimes it's really important to step back and have that sort of out of body experience that it's not about me, it's about what's best for for everybody. Yeah, so
Scott Benner 1:41:30
yeah, it's basically the wear a mask of space travel just like hey, maybe it's right, maybe it's not just do it. Let's see, if we can't move forward a little bit here. It just in general, it's, it's, it takes a long time, I didn't always think like that either. It takes a long time to be mature enough to say, that is not the most important thing here. And to make the most important thing, something that you'll never see feel touch or know about. But that's how I feel. I to me, like, human exploration feels. Just, it's the whole thing. Like it's everything, like we used to, like I said, we used to ride horses, we used to, used to not live here, people, you know, we're on different continents, and he imagined how scary it was to get on a ship in you know, 16 something and be like, Hey, I wonder what's over on the other side of that ocean? I wouldn't have the nerve to do that. I feel like I'm standing right here, buddy. Where I know I'm getting dysentery and dying. All right. Anyway, you were really delightful. I really appreciate you coming on and doing this.
April Blackwell 1:42:35
Yes. Thank you so much for reaching out it. It's sort of a dream come true to be on the Juicebox Podcast.
Scott Benner 1:42:41
Oh, wait a minute. Let's not cut away too soon. were you gonna say something nice about the podcast?
April Blackwell 1:42:48
Well, I just think, you know, it's definitely one of the staples, I think in the diabetes community. And you know, I've been in the diabetes online community sphere for, I don't know, probably 10 years, I've been writing my blog sporadically, and sort of recently got on Instagram and stuff, but it's just one of those staples that has been around forever. We can probably think of, on one hand kind of the things that have really shaped the community and, you know, propelled us forward as a community. April,
Scott Benner 1:43:24
if you're trying to make me cry at the end. You almost got there, but you fell short by not calling me the john glenn of diabetes.
April Blackwell 1:43:30
Oh, well, Chuck Yeager just died yesterday. So we got to you know, we got a hold off. I really, you know, comparing so
Scott Benner 1:43:38
Oh, I didn't realize that's terrible. Yeah. Huh. The gallon died to famous Philly yesterday, I felt bad for him, he was gonna get into the Hall of Fame. But because of COVID-19 they didn't do it this year. And he didn't he was definitely getting in this year. And then he passed away without knowing the ever made it so and he will make it they'll put him in the very next time. But I didn't know about Chuck Yeager. That sucks. Yeah, there's so many pioneering people that, um, that we forget about along the way. It's, it's tough, you know, but, but to your I want to answer what you said seriously, or respond to what you said, seriously, I in my heart, it's very nice to hear you say that because I'm, I am very much trying to shift the way people think about their diabetes in a in a big way. Like, I don't just want to fix it for a dozen people. And it's a high minded idea, and maybe I'm crazy, but I think I'm moving. I think this podcast is moving forward the way people think about their care. And I just, I just keep imagining that there's a there'll be a tipping point where it'll just, it'll explode out of my hands, and it won't be up to me anymore. And I'll have reached enough people who speak about using their insulin in a meaningful way that that'll reach more and more and more people and and hopefully nobody will ever sit around staring at To 300 blood sugar, four hours and thinking like it's gonna come down, it's gonna come down, which is what, you know, a lot of current direction would lead you to do. So. That's it. I just, that's, that's this is my moon landing right here. This is not quite,
April Blackwell 1:45:19
you know, there's a lot of people out there who, you know, probably haven't talked to you personally and, and I was in the same boat until just a couple of weeks ago. So from all of us, maybe silent ish voices, we appreciate what you're doing and all the hard work I know this takes to put together
Scott Benner 1:45:37
Thank you. I hope you understand that this is exactly for me. Like when you were like you want me to be on the place. I'm like, I think you're talking about the wrong person. Now I don't have a hard to I guess we made a lot of points that came full circle here, but it's hard for me to see this is more than my job some days, because it's um, it takes a lot of like, in the moment effort. It just feels like a thing I have, I'm supposed to do I have to do. It's on my schedule. Like I just booked Jenny. Do you like Jenny on the show? Yeah, I just booked Jenny out like through through 2021. Like, I have Jen on the schedule. And I already told her what I'm going to make her do in 2022. She's like, are you alright with all this because, you know, she's not an employee. She's not she's just a person who we enjoy talking about diabetes together. And, and, and she gives a lot of her time to the podcast. So. But yeah, I have plans for the show out like two or three years from now. Sometimes it's hard for me not to just want to dump it all out there at once. But I know that people won't find it. And it has to kind of be disseminated more slowly. But anyway, that's awesome.
April Blackwell 1:46:44
So you're you're already working long term just like we are over here in the space industry.
Scott Benner 1:46:49
Maybe my ADHD is more conversational. A huge thank you to APR for coming on the show and talking to me about the International Space Station and her job at NASA mission control. You can learn more about APR at nerdy APR comm or on Instagram at nerdy APR. And NASA is@nasa.gov I don't think they need the pimping for me, but you should check it out. There's some pretty cool pictures there. Let's thank the pod for sponsoring this episode of the podcast get your free no obligation demo the Omnipod tubeless insulin pump right now do it now. My Omni pod comm forward slash juice box after you've done that, jump over to dexcom.com forward slash juice box and look into that Dexcom g six continuous glucose monitor. If you're using insulin, you could use a Dexcom. And if you're a veteran of the United States military and get your health care through the VA, go check it out because I think they're covering it pretty much for everybody. But it's worth looking into is mappoint dexcom.com Ford slash juicebox. I do not have type one diabetes, but I am eating a lot of things that normally make people's blood sugar spikes so that you guys can see how a pancreas handles those things. You can check that out right now at Juicebox podcast.com forward slash CGM live. And we're going to be having other people after me. put their blood sugar's up there so people can watch if you're interested. Like say there's a meal you're really good at. If you're interested in sharing a blood sugar during a Bolus for a specific meal. Get in touch with me at Scott at Juicebox Podcast calm because we're looking for people to share their knowledge at the link and I want to thank sugar mate for helping me set up that webpage so that you can see blood sugars live Juicebox podcast.com forward slash CGM Live at that link. You can find a link to sugar mate. So you know once you get there feel like whoo this sugar made thing. Amazing. Just click on the sugar mate link and then you'll see it they're not a sponsor. Josh, the owner of sugar made just did me a huge solid and helped me set it up so you can see my blood sugar online. So thank you very much to Josh. Josh, this is your shout out thank you guys blow Josh up on social media. Let him know how cool he is. All right, next episode of the podcast will be coming up soon. Episode 420 it's gonna be another one about looping. algorithm pumping. Very interesting. Sorry to all your weed smokers out there that for 20 doesn't have anything to do with weed. I can't be that well planned out.
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#418 Dexcom G7 Update
With Dexcom CEO Kevin Sayer
Kevin Sayer returns to talk about Dexcom. Learn more about the Dexcom G7 and find out how you can see video and pictures of the new G7 right now.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or their favorite podcast app.
+ Click for EPISODE TRANSCRIPT
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 0:07
Hello, everyone and welcome to Episode 418 of the Juicebox Podcast Today is a special episode for a number of reasons. I have Kevin Sayer back, and Kevin is the CEO of Dexcom. He's here to tell us about what's happening with Dexcom. It's giving me as much information about the g7 as he possibly can, and some of it is very exciting. We talked a little bit about how Dexcom is doing and where they're headed. I asked him as many of your questions as we had time for I only had Kevin for a half an hour Today's been really busy. But I got in as many of your questions as I could. And I'm already making plans to have somebody from Dexcom come back on and answer the rest. At the end of this podcast episode, I'm gonna give you two links. The first one is going to allow you to watch my blood sugar live online, so you can see how it working pancreas functions, and I'll talk about that with Kevin inside of the episode. At the end of the episode, I'm going to give you a link where you can go see pictures and video of the new Dexcom g7. Right now though, please remember 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, or becoming bold with insulin. If this is your first time listening, hit subscribe in your podcast player don't have a podcast player, get one. This episode of The Juicebox Podcast is sponsored by the Omnipod tubeless insulin pump, you can get a free no obligation demo of the Omni pod sent directly to your door right now by going to my Omni pod.com Ford slash juice box. When you get there, you put in a tiny bit of information. And guess what? They'll send you an omni pod right to your house. It's nonfunctioning so you don't need to be scared of it. But you can wear it and see exactly what the process looks and feels like for you personally. And if you'd like to find out more about the Dexcom g six continuous glucose monitor, go to dexcom.com forward slash juicebox. dexcom is a longtime sponsor of the show. This ad is not just here because Kevin is on today. dexcom.com forward slash juice box my omnipod.com forward slash juice box and let's just throw this in for good measure. Checkout touched by type one at touched by type one.org absolutely fantastic Type One Diabetes organization. Okay, before we get started with Kevin, I recorded myself putting on a Dexcom g six just a couple of hours ago. And there's a special guest with me helping me out.
Okay, everybody. Hi, Scott. I'm gonna put on a Dexcom g sixth.
Unknown Speaker 2:52
Right now, actually.
Scott Benner 2:55
Where did I put the box? I see it. It's a Dexcom je six but on the box. It says hello Dexcom which is a new opportunity from Dexcom for people to test drive the Dexcom heaven say who is going to be on the show and just a little bit to tell you more about it. But I have one right here. And also if you're listening to this now, and it's December 10 2020. Let's see if it's between December 10 and December 20. My blood sugar will be live at Juicebox podcast.com forward slash CGM live. And I'm going to double check that to make sure I'm right about that. Yes, Juicebox podcast.com forward slash CGM live. When you go there, you will see my blood sugar in real time. And I'm going to be putting in the food that I'm eating. My goal here is to give you a reasonable look at what a functioning pancreas does. So that you can have an idea of what it is you're shooting for. As you're managing type one diabetes. Alright, so nice little box. It's like there's like a startup guide in there. You have to go to dexcom.com forward slash hello to activate it looks like and here's a sensor. One banging into the microphone and a transmitter. Okay. Let's see. I know how to do this to somebody else. But I don't have a lot of experience doing it for myself.
Wash and dry hands. I just got the shower, peel off adhesive backing, do not touch adhesive place applicator on skin, fold and break off safety guard. press button to insert sensor remove applicator from skin leaving patch and hold her on. I know how to do all that throw away applicator. Clean transmitter with alcohol wipe, insert transmitter tab first, snap into place. Rubber out the patch three times so far I know what I'm doing. And the rest is for after the sensor session ends, it's about how to get rid of it when you were done. Okay. Look into my startup guide.
guides nice it explains everything your smart devices, shows you what the applicator is shows you how what's interesting, it shows you how the transmitter excuse me, it shows you how the sensor bed is inside the applicator shows you what the transmitter is how it works to your phone, choose app receiver, both
of the other Dexcom receiver you can use the Hello Dexcom with it.
Unknown Speaker 6:11
Set up the app
Scott Benner 6:14
tells you how to set the app up. Alright, I'm gonna put this on. I kind of want to put this on my arm. I'm gonna try to get some help. Hold on one second. I'll be right back.
Okay, so I'm going to put this G six on, but I'm going to put it on the back of my arm so I enlisted a little help. And somebody here who you've never met before. Just say hello, hello. Get a little closer to the microphone.
Unknown Speaker 6:49
Hello. Okay, this
Scott Benner 6:50
is Arden. Arden is going to help me with the application. You know what you're doing? Open that up for me. I'll get the transmitter. So I'm going to put it What do you think? Should I put on my dominant arm or my arm? I don't use as much. You have no opinion about this whatsoever. All right, I'm gonna put it on my left arm. So want to put it let me take these headphones off. I want to put it
Unknown Speaker 7:28
like what do you think? Do you want to go this way? Or this way? What do you think? It's up to you.
Unknown Speaker 7:38
And I think it should be back here more. So like this. Do you want to go in this way? and have it go the other way? This way? Yeah. Like, where will that be when I'm standing? Here? Okay, let's do that. Okay, good to see ya. Take off the sticky.
Scott Benner 7:58
Wait, we should follow the directions. We do this all the time. Yeah, no, but this is like a different might be a little different. says when prompted enter your sensor code. All right. I guess we can stick it on now. Right. All right. You're on the microphone. Sorry. God. You put it you figure it out.
Unknown Speaker 8:25
Let's just figure
Unknown Speaker 8:26
it out. There,
Unknown Speaker 8:30
okay. Push it down real good. Okay, now you're gonna do the Take this. You're going to do this like pull away method with the pinch. No idea what that means. So pinch it, like give it a little tension.
Scott Benner 8:51
And then kind of pull slightly away from the direction it's gonna go in.
Unknown Speaker 8:56
Okay, can you turn this way? Yeah.
Unknown Speaker 9:00
What am I doing?
Scott Benner 9:04
As I push it, yeah, before you push it, hold it there. I'm ready. This feels wrong. Okay, just do it. Oh, I didn't even feel it. It's done. Yeah. Nice. Okay, push down on the stuff for me. Okay, clicking the transmitter. So put the shower cover on.
How's it look? Alright, do better than you do. What you did it better than me. Say hi to everybody. Just say hello. or didn't hear she's helping me put on the G sex transmitter. So we just put it on. And I'm going to set it up as an app on my phone as you do. And then I'm going to make it available for you to see online. So it's on it next. So as to take a picture of The transmitter box that says
Unknown Speaker 10:07
done.
Scott Benner 10:09
Enter the code from the sensor. It wants to pair already with it. Take a picture of the sensor code
Unknown Speaker 10:19
done.
Scott Benner 10:22
Next sensor has been in and start center. So I'm in the warm up. Thank you. Arden. Come here, come a little closer to the microphone. tell everybody what you're gonna do next year. Say it. Say it. Arden's gonna be on the podcast, aren't you say? Say, say, say? You are though, right? Yep. Yeah. Look how excited she is about it. tell people exactly how excited you ready to be on the podcast. bare minimum bare minimum excited. That's not bad. Right. Okay. Well, thank you very much. And here comes Kevin Sayer with some news about Dexcom. And then I'll give you details at the end about how to follow my blood sugar. And how to see video and images of the brand new Dexcom g7 coming in 2021.
I can't unmute you. That's because I'm not used to someone else starting a zoom call. I'm used to being the one in charge. Okay, well, this is perfect. I just, I have mine set up to come up. unmuted. Let me just check you on the recording.
Kevin Sayer, Dexcom CEO 11:35
I usually start on mute as well.
Scott Benner 11:37
Yeah. Let's see. All right, you're good. Well, how are you?
Unknown Speaker 11:44
Good.
Scott Benner 11:45
Yeah. I I see
Kevin Sayer, Dexcom CEO 11:47
Christmas boxes in the back. You're at least attempting to celebrate?
Scott Benner 11:51
Yes. Old St. Amazon comes every day here. It seems like it's just Yeah,
Kevin Sayer, Dexcom CEO 11:56
I know how
Scott Benner 11:58
that goes. That's awesome. Not exactly the most fun way to a holiday shop for people. But no,
Kevin Sayer, Dexcom CEO 12:04
especially when they see it dropped off and go. What did you get me?
Scott Benner 12:07
Someone checks there? The box like, Oh, this isn't for me. And I think the unspoken end of that sentence is and I know what I'm getting for Christmas. So it's we're doing our best. Not the worst thing.
Kevin Sayer, Dexcom CEO 12:18
Hi. We all we're all just doing our best.
Scott Benner 12:21
Yeah, I mean, maybe right. Maybe the vaccines will start to to get in use. And this time next year, this may be it'll be a little bit of a mess this
Kevin Sayer, Dexcom CEO 12:30
time next year. I think we could I think we could expect to be in a good place this time next year.
Scott Benner 12:35
Yeah. I know. My wife is downstairs killing herself working on one of the vaccines. So if she Yeah, she worked with. She works for Janssen. Okay, so she's working on Yeah,
Kevin Sayer, Dexcom CEO 12:48
here. And I've read very good things about about that
Scott Benner 12:52
vaccine. Everybody's got their fingers crossed, that's for sure. I if everyone's working half as hard as she is we should be okay. So awesome. Down there all day and night. So I have to say the last time we talked, I teased that I asked if anybody had any questions, and I sorted and get any. And I did it two hours ago, and I am up to 305 questions. So I might have jinxed myself. I
Kevin Sayer, Dexcom CEO 13:13
think we got I don't think we are talking 305. So
Scott Benner 13:16
a lot of them seem more Jake related. So I might have to maybe I'll hassle Jake to come on in the in the new year.
Kevin Sayer, Dexcom CEO 13:23
Well try me. And then if I can't do it, I'll do it in general terms, and you still ought to have Jake on anyway.
Scott Benner 13:29
Cool. That sounds great. All right. Yeah, he's been great. And these are a lot of technical, more technical stuff, like people ask him for things about apps and stuff like that. But anyway. So you had a, you had your revenue call yesterday, and I feels like you let some new information out into the world. And I thought I would get a piece of it here on the podcast.
Kevin Sayer, Dexcom CEO 13:49
Sure. We had our investor day yesterday we do. We've done two now we did one in 2018, where we told the world that we would be at $2 billion between two and two and a half billion dollars in revenue by 2023. And we gave him some profitability metrics as far as operating margins and such. And as we look at the end of the 2020, we're not quite to $2 billion, but 1.9. And we've exceeded the operating margins we gave them back then. So we felt it was important to reset the bar and give everybody a clearer vision because obviously the growth has been faster than we had projected at that time. We didn't project growing another 40% each of the last two years combined. Yeah, you know, and continuing that growth rate. And so we want to make sure everybody knew where we were coming from and and we said another five year target to four to four and a half billion out in 2025. We talked about our three pillars of growth. And then this is our base business in US type one intensive insulin management because that's the backbone of our company. That's where we come from. Those are our roots. We always want to be big in that market, then going moving to type two patients who aren't on insulin in the US to start but you know, elsewhere in the world on top of that, and then finally, geographical expansion more into our, our core type one business we we don't have near the revenue Oh us as we do in the US and we need to, you know, become more of a global company, we have plans to do that. And we laid some of that out. We talked a bit about our future product offerings. And, you know, just some of the things we see it was a good day, very well received by and large. Excellent.
Scott Benner 15:32
Now, you guys very recently, you're in is the g7 in Australia yet? It is right or no,
Kevin Sayer, Dexcom CEO 15:39
not quite. I think it's fair. There's just been one other administrative snag there close. There'll be there very soon.
Scott Benner 15:46
Yeah, I hear from Australia, a lot. People in New Zealand, Saudi Arabia as a country, I hear from listeners a lot, looking for Dexcom. It's interesting, where
Kevin Sayer, Dexcom CEO 15:55
I hear the same thing. And we were working on distribution arrangements in Saudi Arabia that I haven't yet been finalized. But I think they're very close to getting the right distribution partner. One of the things about a company like Dexcom, that's somewhat lost on people. When we decided to go to Saudi Arabia, we don't have anybody there. Whereas you take the larger conglomerates, the j&j, the Abbott, the midroc, whoever, well, they have other businesses in Saudi Arabia, they do business there, they have somebody to call, they have somewhere to go, we don't. And so we figured out from scratch was as led to some great experiences and some great learnings. But it's, it's just something that is kind of ignored, is a very complicated factor
Scott Benner 16:42
in growing a business, you literally have to start from the ground up, you have to build Dexcom in a new country. Well,
Kevin Sayer, Dexcom CEO 16:47
and I think, five, six years, six years ago, we had three or us employees. And now we have several 100 direct offices in the UK, Canada, Germany, our corporate headquarters, Ramya. In Scotland, we have our call center, Manila, started a manufacturing plant in Malaysia, and we're setting up another call center for our, our EMEA business, or you're a business owner in Lithuania. So literally, we are fulfilling that. But we have to build it all from the ground up. We don't have anything
Scott Benner 17:22
else to rely on. Do you share how many current users you have?
Kevin Sayer, Dexcom CEO 17:27
We did we shared 900,000 was the number we put out yesterday. And that's active users. It's not you know, a this one bought a receiver this one, but it's based very much on on actual data, who we sell centers to it cetera. So that's a good number. That number was in the 600,000. Last year. So obviously, we've grown a lot. And that's absolute growth in active users, not just users, we've really done a good job expanding technology. And we'll push it much harder. Even next year.
Scott Benner 18:00
I wonder how many people realize that companies will report like a million people downloaded our app, but only 10,000 of them ever opened it. But when they talk about they're like we have a million users. And
Kevin Sayer, Dexcom CEO 18:10
well, it's like, in the old days. We used to talk about going way back to 2008, nine months board member we based on how many receivers we sold. That's how many patients everybody thought we have. And that was it. I mean, that's how sophisticated it was. And if those receiver sales didn't meet the quota of the analysts, when everybody thought the world was ending, it's not that way anymore. It's but you know, you try and develop analytics and all this stuff you do the best you can. We have certain groups that are hard to track. I mean, for example, a tandem pumper who doesn't ever download their day to clarity and they buy their centers from from the pharmacy, we may never have visibility to that person. And their use cases. Patients use the receiver all the time we get visibility them if they downloaded clarity into their office, doctor's office, but otherwise we don't have as much bill visibility that so we have to come up with other metrics through groups like acute VA and pharmacies to to track and
Scott Benner 19:18
make sense. I happen to be wearing a Hello Dexcom I
Kevin Sayer, Dexcom CEO 19:23
just Oh, you got the highest so you're doing the Hello Dexcom experience
Scott Benner 19:27
I am I just put it on. It's not It's not even through the warm up yet. It's gonna be on for about another hour. And it got me excited right away because I don't talk about it usually, but my brother has type two diabetes. And he he should have a Dexcom he just should. And I don't know if I've ever been able to explain it to him in a way that you know, some people just don't hear it. So now I'm excited that he can just he can is that am I ready? You just go to his doctor and ask for it.
Kevin Sayer, Dexcom CEO 19:54
He can try it. He can get a prescription now then the tough part for your brother. If he's hot. on multiple daily injections or a pump, and he should qualify with most payers certainly with with, with Medicare and Medicaid programs. But yeah, he can get a prescription he can try it and he can learn. And we just, you know, patients have asked for that forever, we had to restructure our business. To do that we were there were certain federal laws that prohibited us from a sampling program. We've gotten out of the business activities that prevent us from doing that. So we we can, we just think the sampling program is very important to give people an idea of what they're going to experience. And and Scott, you know, this, if you go back in time, particularly two, three years ago, where we had very little pharmacy coverage and didn't have the commercial reach, we have now going through the paperwork to get a Dexcom. And then paying that copay, upfront, just to try it was something a lot of people really struggled with doing. Yeah, well, now we can give you an experience, okay? Where this right, we're confident you'll like it, we're confident you'll learn about your body, learn about what you eat, you'll learn about your workouts, you'll learn good things, and and we think it's going to be a great tool for clinicians and for patients, well, I'm
Scott Benner 21:11
going to use it. So the reason I asked for it was, I've actually, I've got it set up on my website. So when this goes live, anybody's gonna be able to watch my blood sugar while I'm wearing this sensor, okay, and, and oh, so I wanted
Kevin Sayer, Dexcom CEO 21:26
I tell you what not to eat.
Scott Benner 21:28
Well, I'm gonna go the opposite way, I'm gonna I want to show people who are using insulin, how a pancreas works, so that they don't freak out when they see a little bit of a rise sometimes and comes back down. You know, I think too many people are shooting for an absolutely stable line at 85 that never moves, and it makes them crazy sometimes. So I thought, let them see what it really looks like, if you don't have diabetes, maybe that'll make them feel a little more comfortable.
Kevin Sayer, Dexcom CEO 21:53
So it's interesting, you say that, because I showed my line to a leading endocrinologist and you know, I wear these a lot. And his response to me was your lines too flat, either you're not eating anything, or you produce too much insulin, and that's not healthy either. Wow. And, and, and physique wise, carrying too much weight in the middle, which I do, anybody who knows me can see that. That's a sign of over insulin production. So I, I watch that pretty closely. It's okay to have a spike, you're right, it is okay to have a spike. Now, the spikes that you create that are bad. I mean, I can give you a list of my top 10 worst foods pretty easily. The worst by far is chocolate covered raisins. Because you combine the rapid acting sugar in the chocolate, the rapid acting sugar in the raisins, and then you get another shot from the fat from the chocolate later, I can send myself into a glucose coma with that. And I learned that I said an investor conference back in the g4 days wearing a sensor and my glucose hadn't moved at all. I was in the airport and I got myself a cup of chocolate covered raisins and ate it and it's probably one of the two or three times I've broached the 200 mark, ever. And it wasn't a good thing. But that's that's probably my nine raisins are held that raising all those foods are fine for you. It's just moderation in them and understanding what to do so yeah. Well, people are going to have fun watching,
Scott Benner 23:23
I'm going to let everybody actually after they watch now that I figured out how to act, allow the data to be accessed. I'm actually going to let listeners who feel like they're really great at bolusing for certain foods, let them go live eat a meal and show people how they do it so that people can learn from each other about how they Bolus so I'm kind of great What a great service and community I think that's gonna be something Hey, are there any foods that you have learned that you just don't eat anymore? Or do you
Kevin Sayer, Dexcom CEO 23:51
worry about my laundry cars use anymore? And it wasn't great some requests for me but I loved it but that gives me a huge spike. Me personally, I think I've learned some things that aren't as bad pasta and white sauce is bad and I will occasionally have it because I I like it so much but boy I think twice about it. Yeah, some foods not as bad as I thought like for me a piece of chocolate cake is much worse than a bowl of ice cream. As far as a glucose spike for me and I would prefer the chocolate cake. But so you start looking at things and I obviously am not so physically fit that I've eliminated everything bad from from my diet but and you think twice about quite honestly about about bread you know, do I really need that rice. Rice is a and those sweet sauces with Chinese food are a killer. So if I you know there's a when I'm in the office, there's a barbecue place downstairs, a fresh grill place I get the veggies in the steak without the rice and My glucose doesn't move at the rice up. So I bet you'll learn things like that and sauces. Because I love a teriyaki sauce or something like that it, it makes everything significantly worse. My other biggest learning is just exercise. If I get a good workout in the morning, I have a glucose spike with a workout. But the entire rest of the day is 10 to 20%. better for me, well, no matter what I eat, because just getting your body to get things moving, I think does mean a tremendous amount
Scott Benner 25:34
of good helps your insulin be more effective. I got a bunch of questions. And I think this is something you guys must have spoken about yesterday. But a lot of questions about app updates are follow and are those apps being updated?
Kevin Sayer, Dexcom CEO 25:49
Well, I can walk through it. g seven will obviously have a brand new, we said to show. So we'll have a brand new app, completely different experience than what we have with G six. And our goal here is again, to create something more engaging, we certainly are going to get rid of our the the arrow and the you know the up and down thing or we think our glass has kind of a trademark for us and graphs. But adding some of the retrospective data from clarity into the app to give you a direct time in range computation, for example, and things like that at right in the app rather than going to another one we think will be very helpful to patients. So we've got a new app coming for g7, we announced that we are going to launch a couple of other products with different user experiences we didn't get into the details. But those are coming we are working on on a follow upgrade. And that's when you'd have to talk to Jake more about because you know follows not a product that we charge for. It comes with the system, but we you know, ever since the outage that we were talking about a year ago at this time, and I still wake up in a cold sweat with nightmares about for the patients not for me. Yeah, you know, I, I, we've done nothing but work on that platform to make it more robust. And we continue to invest in it because I think ultimately this data is going to be critical to our future success. So we are making big investments or you'll see a new follow up. Okay, but I can't really give you a time frame of that. I know they've been working on it for quite some time here.
Scott Benner 27:19
androids in that working to
Kevin Sayer, Dexcom CEO 27:22
Android is working out for follow, I'm sure they'll do both we we do have a an upgrade to the Android app coming. And we couldn't override the mute button with Android. And we've had discussions with FDA about trying to get to the same place we got to with iOS on the mute button, we are working towards that. We did announce there is a new there's improvement to the algorithm that just got approved, it will not be out immediately. They'll be out soon. We have to since we embed our firmware on the transmitter, we have to go through the transmitters we have an inventory now that what that algorithm does really those sensor failures where data shuts off, we eliminate a lot of those with this upgrade. And so with the with the new algorithm, the team has worked very hard to make the product better and and you know, we want to deliver the experience we promise. And and that's why we've been a bit you know, people asked a bunch of questions. Last earnings call, why are you doing g seven, you know, for 10 days to start? And the answer is very simple. We want to deliver 10 days like we promised it's taken us a while to get g six to the 10 day delivery point that it is now but instead a very good place. These can be better with that algorithm, we can do the same thing with G seven. The accuracy of the product 15 days is not the problem. It performs very well we show to display a chart in the presentation show how well it worked. It's just as he said, we got to make sure we have the right adhesive that they don't fall off and number two to meet I CGM standards. And as we as we do this, we do turn the sensors off. And if appears there, they're not going away. It should be in anticipation of that rather than give a patient that data. We don't want to be turning a bunch of sensors off at 12 or 13 days. And our reliability data. You know right now it's a 15 day we showed in chart was around 71%. That's not good enough for us. We need that number to be higher. We don't want to say hey, you get a 15 day sensor but you can call us 12 days every time and get a new AI now think of the business model what what are we accomplishing with that so we'll get there. Right? But it's just a it's a question of time but those are the things we talked about on the technology side we showed more pictures of g7 how easy it is to use, how easy it is to put on. We showed some real about the automated factory everything is automated all the steps to it so we think we can scale very quickly as we Get Real Estate, replicate one manufacturing line from the next and get going, we've got the first few in and we'll have several of them up and running before the end of the year. So I'm good on that future technology side.
Scott Benner 30:12
So you think not holding you down anything but this time next year you and I'll be talking about g sevens on the leash
Kevin Sayer, Dexcom CEO 30:20
I what we've said, and I go back into our statements, we said we'd launched it in 2021. Okay, it's now going to be a function of how quickly we can execute our clinical studies, prepare submission and get it filed. all at the same time while scaling up, we will launch it in 2021. And we've said geographies, which means certainly there's some international element to this, we've finished this study that we just filed on clinical trials.gov for up to 150 patients, we finished that. And in November, we're analyzing that data, we have more studies that start that'll be included in submissions in January. And we'll update people more as we go. A lot of it's gonna depend on how we how well we execute or confident in a product's performance. These ice jam standards, the FDA is set Well, there's part of me that will sit in bitch about how hard they are to me, I'm gonna tell you something, if a product can meet those standards, what the FDA did is they said you got to be good. If you're going to do this, you have to be really good. And and and that's what makes it tough. We have to make sure we're really good. And you've got to get low glucose into steady high glucose points across the board. I mean, they really addressed all the problems that happened with CGM, when they hit those standards and to fit in those buckets, you got to be pretty well. And we want to fit in those buckets to whereby we did announce our warm up will be an hour or less. That a lot out of town what we seen the clinical study faster, warm up is good for us. But when we're done with warm up, we want to be done. That you can rely on the data immediately not wait for 12 hours before you can make an insulin decision like others have done or have to calibrate it four or five times or we're not going there. We know what our patients want. And we need to deliver it then those are the decisions that
Scott Benner 32:08
we're making. And that one hour warm up that'll be for g7. It's not
Kevin Sayer, Dexcom CEO 32:12
Yeah, I said I said one hour or less. I haven't given you the we have place that we have it we have a we have I have my aspirations, the team has their aspiration. And then we have the our on the upper bound. So we'll see where we land, Kevin's aspiration is always turn it on and go and they aren't to my aspiration yet. So we'll see. Ironically, I don't know. It's really interesting to study sensor data and learn about that. It does take a while to warm up. But that's very much a function of into into individual physiology as well. There's some people you can put these in and they go immediately there's some people you put them in and it takes a while. I'm starting
Scott Benner 32:49
to learn that with Arden it it's um, depends on some of our hormones. Actually, I get a different reaction certain times of the month. Wow. Wow, I
Kevin Sayer, Dexcom CEO 32:57
did not know that he or she I haven't I've had I've been I've had other parents tell me that.
Scott Benner 33:02
Yeah, it's interesting. I got a question about COVID assistance you guys offered it is there any chance it's going to be extended?
Kevin Sayer, Dexcom CEO 33:09
We'll continue to offer COVID assistance to Dexcom patients who lose their insurance. And that program is relatively robust as far as, as patients, it's, you know, for our patients, and there's a process they go through. We do have an outside party, administer, administer it. But yeah, we will continue with that program. And we'll analyze it and look at it and see if there's other things we should do as well. I can't commit to anything, but I have asked the team to look at some other things we could do. But if you're on Dexcom last year insurance and come to us, we absolutely can get you in that program.
Scott Benner 33:46
Okay. A couple other quick ones. A lot of people just wanted me to convey that they love Dexcom that happens all the time and how great it is. But almost equal number of people asked me to ask you if you could make some green considerations about packaging, who was that they just they liked to see less cardboard and stuff like that. So I thought I would tell g7
Kevin Sayer, Dexcom CEO 34:06
is maybe half the size of G six. As far as the insertion device. The box is much much smaller. With respect to the cardboard and the packaging. It's interesting. We've had long writing discussions with the FDA about how much we have to publish and put in a box on the green factor. Couldn't we do this all electronically but it's a medical device. FDA relies on labeling and they believe patients read all the labeling and may not go to online to read them all. I think you'll see a lot of that stuff change. We are looking at Green options for the future of other changes, we can make less class less plastic, obviously 15 days versus 10 is less plastic. But at the same time, 15 days if it doesn't work 15 days in and being more plastic. So we're we consider all that III agree with everybody on that one I think we need and we are better, we will be better. Ironically, as big as the G six applicator looks, it really was no more plastic than the G five
Scott Benner 35:10
What was I realized? While I was looking at people's questions today that I'm steeped in this 24 hours a day for years. So when they ask questions, I'm like, we've answered that question before, but I realized they're new to it, and they don't, they don't see it, you know,
Kevin Sayer, Dexcom CEO 35:23
everybody's a different place. And I'm happy to address those.
Scott Benner 35:27
I appreciate it. Somebody asked me to ask, you know how you you guys are free with your data for like, third party apps? Is there any changes coming to that? Or is that gonna stay the way it is?
Kevin Sayer, Dexcom CEO 35:37
They'll stay the way it is. Okay.
Scott Benner 35:39
So apparently, there was a rumor floating around that that was gonna change. And it got to a person who third
Kevin Sayer, Dexcom CEO 35:44
party apps. Now the question becomes, or where this becomes difficult over time is those who who use the data in their own ad systems and things like, you know, patient choose our data and our things for a number of varieties of activities, does this become a an activity that Dexcom cuts off for everybody else, and we monitor it closely we watch. We've had discussions with the FDA, we've we've, you know, we've been tried to be helpful with the patient community, there may, there may come a day when we can't, I would love the opportunity or the ability to be able to figure out a way to do this in a structured manner. But so far, it's been tough, but now we're not we're not shutting out third party apps at all, if anything I want, I want more of them. And and maybe someday, you know, again, you asked me like to the future, maybe there's a day where we say, you know, but your app doesn't do anything for us. It's okay not to go there. I don't, I haven't seen that yet. But but we'll see. There might be some. But right now, we've been pretty open with that.
Scott Benner 36:53
When you when you do upgrade to another sensor, when g seven comes out, is all the other. The pumps that now are incorporating g seven in their algorithms like on the pot horizon or control like you, that's all taken care of.
Kevin Sayer, Dexcom CEO 37:09
So here's how this, this will work. g they're all up there, all with G six, right now, with G seven having an ICBM level, they will integrate with G seven, but we have changed the electronics in the interface of G seven from g7. For example, we've added heightened cybersecurity to the g7 chip, because it's available now. And that's a very big concern of everybody out there. And so they will have to do some more work to integrate, they won't have to run a study. But we'll work with our partners. In fact, we're working with them now giving them access to g7. Saying, here, let's start building this today. So there will be some lag, I hope it's not more than six months, but put a look at a six month window because they will have to file and just say, Hey, we're working with this and get approval, no additional clinical studies if we're an IC jam. And I think that's where the FDA has been very helpful. And we've tried to be cognizant, I mean, and I go back in time, the way our transmitter works with the phone and sends you the number, it doesn't send you just a bunch of electronic goopy goop that you figure out some glucose value. This is very easy to integrate. And we we built it for that integration was one of the primary considerations we had when we went from the g4 to the G five platform. So it we're trying to ensure this, we know how to do it, we've worked with several partners. Now we don't have all the offerings that we'd like to have, but we're gonna do and I think and there's other ways to do it as well. app to app can work, which is one way that people are doing it. I like it best when the data is embedded together. But over time, you'll see a number of different options here.
Scott Benner 38:53
Yeah, I think the fear gets in people. And I don't even know why because I Arden has you know, we have an integrated system that Arden's using, and it's terrific with G six, I hope it will be even better with G seven. But if you if you drop g seven today and said here it is, and I had to wait six months for it, it wouldn't okay. Yeah, I don't think much would change for us to be perfectly honest. That's the fear
Kevin Sayer, Dexcom CEO 39:16
and and you know, it really doesn't. And it's in the past, it was a big deal. Because, again, that hardware those receivers in those transmitters people spend so much money on them when you dropped a new sensor and they didn't want to give it up. And I'll be honest with you, we still have some we shut g five down earlier this year, we still have some g five patients who send us letters saying how could you possibly
Unknown Speaker 39:41
take this from G five?
Kevin Sayer, Dexcom CEO 39:43
So yes, but g six is going to be around for a while to support the integrations and and geographically we while we want to have a lot of capacity on the go, we can flip the entire switch and we have capacity to build 10s of millions of G sixes. There's no need to we'll make unavailable for some period of time. But what the beauty of G seven is you don't have to buy another transmitter, you'll be able to switch over the day is compatible because the transmitters built in and go pick up a couple sensors and go
Scott Benner 40:12
that opens you up to the question that you answer all the time. But I just for people who are listening new, direct to watch Apple Watch connectivity, that's going to wait till g7, right? That's
Kevin Sayer, Dexcom CEO 40:24
it is in the electronics configuration and g7 is just much better suited for this. It's better suited to communicate with multiple devices. You know, if you think about, about the devices that you have that have Bluetooth, how many of them talk to four or five things at the same time? Well, that's what people want us to do. And we've engineered it to talk to multiple, multiple devices at the same time. But that's hard, you know, your earphones, talk to one, your phone talks in your car, but you might lose something else. I mean, Bluetooth is evolving and becoming more sophisticated. But it's just it's something that we're very cognizant of, I think more cognizant than anybody else in the marketplace? Well,
Scott Benner 41:04
I have to say that people's misunderstanding about how the technology works, was never more evident than today. When somebody and I won't use their name, obviously, I don't want to embarrass them asked if you could add a Bluetooth extender to it. And I was like, how would that even work? Would you bolt it to like what I wear it on my shoulder? Would it be a little antenna off my ear and it's just somebody who just desperately wants the Bluetooth range to be longer, you know?
Kevin Sayer, Dexcom CEO 41:25
Well, and hopefully we'll have great range with the g7 and I I do have my next call Scott. It's always a pleasure to talk to Jake about all the technical things have him back on the show.
Scott Benner 41:35
He'll be great. All right, Kevin, thanks so much for being here. Hey,
Kevin Sayer, Dexcom CEO 41:38
it's great to have a great holiday
Scott Benner 41:39
YouTube. Merry Christmas.
Kevin Sayer, Dexcom CEO 41:40
Merry Christmas.
Unknown Speaker 41:42
Oh by
Scott Benner 41:44
a huge thanks to Kevin and Dexcom for coming back on the show. Thanks also to Omni pod for being a sponsor. You can find out more about the Omni pod tubeless insulin pump and even get yourself a free no obligation demo pod sent right to you by going to my Omni pod comm forward slash juice box. Learn more about the Dexcom je six and get started@dexcom.com forward slash juicebox. And of course touched by type one can be found at Facebook, Instagram, and it touched by type one.org. If you're interested in watching my blood sugar, and it's between December 10 and December 20 2020, head over to Juicebox podcast.com forward slash CGM live. And if it's not in between those dates, check it out anyway, you might catch someone else sharing their blood sugars. At the very least there'll be an announcement of when the next blood sugar is going to be
Unknown Speaker 42:44
live
Scott Benner 42:46
Juicebox podcast.com forward slash CGM live. And if you'd like to see video and pictures of the Dexcom g7 the videos really cool. Go to Juicebox podcast.com. forward slash Dexcom g seven d x c o m g and then number seven Juicebox podcast.com. forward slash Dexcom g7 to see those pictures and video, grab them up, take them for yourself, make them into a wallpaper that you can stare at until the Dexcom g7 comes out. Thanks so much for listening to the Juicebox Podcast. If you're enjoying the show, please tell a friend show them how to subscribe. And if you're not subscribed, what are you doing? Hit the subscribe button. If you're listening online, you know there are podcast apps everywhere. They're very free. It's easy to get this show. There are links all over Juicebox Podcast comm to get yourself a podcast player that is free and compatible with your phone. And if you're here just for Kevin, there's a lot going on in this show. As a matter of fact, if you have type one diabetes, I implore you to check out my diabetes pro tip series that begin at Episode 210 diabetes pro tip newly diagnosed, we're starting over I think it would add a ton of clarity to your life. And if this is your first time listening to a podcast, you can also find those episodes at diabetes pro tip.com. Thank you very much for listening, for subscribing, for sharing. I'll be back very soon with the next episode of the Juicebox Podcast. Actually, somebody from NASA is gonna be here next time. What do you think of that?
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#417 Fossil Friends
From OK to AU
Skylar is an adult living with type 1 diabetes who enjoys searching for fossils.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or their favorite podcast app.
+ Click for EPISODE TRANSCRIPT
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
There's a way for you to support Type One Diabetes Research and the Juicebox Podcast. And you can do that through the T one D exchange. The T one D exchange is looking for type one adults and type one caregivers who are us residents to participate in a quick survey. As a parent of a child with Type One Diabetes, I've taken the survey, and it only takes a few minutes to complete. And the questions are not deeply probing, or overly personal. They're pretty basic questions about living with type one. The process is 100% anonymous, completely HIPAA compliant, and does not require you to ever see a doctor or go to a remote site with the data that the E one D exchange collects. They've helped to bring increased coverage for test strips, Medicare coverage for CGM, and they've helped to implement changes in the ADA guidelines for pediatric a one segals. I find it really exciting to imagine what my participation may lead to, but they need help. They need people data, they're looking for up to 6000 respondents. So just my data alone is not going to be enough. Every time someone completes the process. If you use my link, T one d exchange.org. forward slash Juicebox. Podcast will benefit. So if you're looking for a way to help type on research, and the podcast, this is a simple way to do both. And it's really valuable. So get involved, go to T one d exchange.org. forward slash juicebox. There's links right there in the show notes of your podcast player. We're at Juicebox podcast.com. When you get there, click on join our registry now. And after that simply complete the survey. I want to thank you for your help and get the show going.
Hello friends and welcome to Episode 417 of the Juicebox Podcast. On today's show. We have Skyler scholars and adult living with Type One Diabetes who's living in Australia, but he's from Oklahoma. And that makes for a very interesting accent and Skyler makes for a really great episode of the Juicebox Podcast. 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 changes to your healthcare plan or becoming bold with insulin. I have a little time here. So I'd like to remind you that if you have a great doctor, or need one, check out juicebox docs.com send me your favorite diabetes practitioner, and we'll add it to the evergrowing list from all around the world. That way when people need a great doctor, they know where to look juicebox Doc's calm. And if you're looking for those diabetes pro tip episodes, they begin at Episode 210 right there in your podcast player, where you can find a list of them and even listen online at diabetes pro tip.com. Alright, here we go. This is it. You're coming Skyler.
Unknown Speaker 3:11
Hello.
Unknown Speaker 3:14
Can you hear me? Yep.
Scott Benner 3:16
Hi. Good morning.
Unknown Speaker 3:20
I just turn you up a little bit.
Scott Benner 3:21
Is this better?
Unknown Speaker 3:23
Yeah, that's better.
Scott Benner 3:24
There you go. I have this just one setting. And no matter how many times I put it to where I want it. It puts itself back. So I I stopped arguing with it a while ago and I just go do it myself.
Skylar Cox 3:40
Yeah, technology is great when it works. Yeah.
Scott Benner 3:43
Yeah. I felt that way about my uncle. A little weird. Anyway. Uh, hi. Good morning. What time is it? Where are you at?
Skylar Cox 3:54
Um, I'm in Queensland, Australia. So it's 11pm here. Wow.
Scott Benner 4:00
Well, good evening to you then.
Unknown Speaker 4:03
Yes.
Scott Benner 4:04
I'll tell you what we're going to do. I'm sorry. Good.
Skylar Cox 4:08
I was just gonna say good morning to you.
Scott Benner 4:10
Thank you. I have to tell you, this is my second Australian interview in like the last five days. Really? The podcast is oddly popular in Australia.
Unknown Speaker 4:23
Yeah, yeah.
Skylar Cox 4:26
I was actually recommended to me by an Australian Facebook groups.
Scott Benner 4:31
No kidding. That's lovely. There was a person who once tried to bring me to Australia but we couldn't quite raise the funds to ship my carcass on an airplane. And it was one of those weird things where I was like, Am I gonna fly 20 hours to talk to people for three hours then fly back. I was like, that doesn't seem to make sense. No, yeah. You know, so we were not
Skylar Cox 4:52
that those flights are terrible.
Scott Benner 4:54
See, that's what I thought
Skylar Cox 4:58
they are you do not think You know that your bomb can hurt sitting, but it can.
Scott Benner 5:07
I just seemed like a bad idea. Like, logistically, it seemed like a bad idea. The idea itself was lovely. And I was excited to try to do it. But that's just crazy. I would have to, I would have to build some sort of a vacation around the idea. And then
Skylar Cox 5:23
yes, yes, definitely. And
Scott Benner 5:25
then do that while I was there. And if I did that I told the person to I was like, let's just do like days of it. Like, let's not just do a couple of hours, let's bring people together and, like, do giant Q and A's and workshop and stuff like that. And I can't just come down there and be like, here's what I think and then leave us like I could, I could do that over zoom for you, you know, that? That'd be easy. I've done it before for Japan, and a couple of other places where you just jump online for a couple of hours. And, you know, yeah, that seems nuts. Oh,
Skylar Cox 5:56
I think it'd be, you know, I think there'd be a lot of interest in it. If you were to come over here and do workshops, and the like, I believe that too. I
Scott Benner 6:05
just don't know. Like I said, one day, I'll, I have to be first of all, when I record all this, so you know, if you go crazy, like understand that, I'll take it out. But in a minute, we'll you'll just introduce yourself Anyway, you want to be known. And we'll start talking. So I was gonna say why don't we do that now so that we don't, we don't waste any good conversation.
Unknown Speaker 6:30
Oh, good.
Skylar Cox 6:34
Okay, just let me know when
Scott Benner 6:36
it's okay. Sorry. It's funny. Some people want to try to do it. And some people are like, wait for the go and it amuses me to figure out. Like you can go whatever you want.
Skylar Cox 6:47
Okay, so my name is Skylar Cox. And I live in Australia. And I use MDI, manual daily injections to manage my diabetes.
Scott Benner 7:02
That's interesting. You call it manual? Daily injections?
Unknown Speaker 7:06
I yeah. Yeah.
Skylar Cox 7:08
I know, some people call it many daily injections. But
Scott Benner 7:11
this is what I've heard.
Skylar Cox 7:14
Yeah, yeah, I've heard multiple as well. I think they're interchangeable.
Scott Benner 7:19
When you said when you said it the way you did, I thought, oh, that works too.
Skylar Cox 7:24
Yep, yep. I think I've heard both interchangeably here.
Scott Benner 7:29
I think many is. seems more ominous. multiple, multiple, just makes it feel like there's gonna be more than too many is just like, you want to keep your blood sugar down, you're gonna inject, man,
Skylar Cox 7:43
I guess it depends on the mood you're in for the day.
Scott Benner 7:46
That's great. I didn't realize you're gonna get off to such an auspicious start. Thank you. So you said as we were kind of warming up, you said that you found out about the podcast in a Facebook group.
Skylar Cox 7:59
Right? Yeah. So I think it was Australians living with Type One Diabetes, or type one diabetes support group Australia. Those are the two main two main ones that I know about.
Scott Benner 8:10
Right. That's a That's very nice. I had, I once had this long conversation with a person from from Australia while I was watering, newly planted trees in my heart. I remember having had headphones on my phone. And we couldn't seem to figure out how to speak because I guess it's not as easy to call internationally for some people as it is for others to I was under the impression that at this point, we were all just allowed to call wherever we wanted, but it ended up being really difficult. And I don't know, we may have actually used Facebook audio to talk to each other. Which is, is that something pretty common for you guys?
Unknown Speaker 8:54
I
Skylar Cox 8:55
yeah, I have personally found that it is a lot better to use Facebook messenger to call people overseas than it is to actually use the phone. For whatever odd reason.
Scott Benner 9:08
Yeah, well, that's what we did. And I got on the phone with this person. And they had been a fairly, I believe, lifelong diabetic. And we're having really like terrible outcomes. And it's always interesting when someone reaches out to you and they're sort of persistent. Like I really wish we could talk and I was like, Alright, well you know, if you don't mind the sound of spraying water. I'm happy to you know, have this conversation. And you get on the phone and or even sometimes on the podcast. I mean, you guys maybe can tell sometimes in the episodes like sometimes someone starts speaking and I think, ooh, this is more than I bargained for. And and at that point, you know, you're you're in And anyway, that person ended up doing really well. And it was exciting because, like I said, there had been a long distance of time with a lot of trouble. And it was it was, it was nice to be able to help. So maybe that one good deed got all the way around Australia? I don't know.
Skylar Cox 10:11
Yeah, well, it's it's likely it is likely.
Scott Benner 10:16
You guys have like a real thing a telephone going on there where you just one person says something and tells another person. And I mean, in my mind Australia's like as big as what?
Skylar Cox 10:26
I don't know. Well, it's actually approximately the size of America. Actually, a lot of people don't realize that
Scott Benner 10:34
is that the map thing with a map is drawn in a weird way for navigation. Have you ever heard that the world map is? This is like the second time I'm bringing this up now. And don't know anything about it. But I was joking, I'll show you is huge. And it's a it's interest. But on the world map, it doesn't, in any way seem so.
Unknown Speaker 10:57
Yeah, yeah.
Skylar Cox 10:58
I think I actually learned in human geography a few years ago that depending on what kind of dimensional map you use, or whatever, some countries are a bit more squished look smaller. And generally, Australia does tend to get the brunt end that makes it a lot smaller than what it actually is. I
Scott Benner 11:17
feel like there's another country near you, that sometimes gets left off of maps to remember hearing about it. Anyway, this is not a typography podcast, if it wasn't. People would be like, wow. And they don't see anything about maps. Anyway, I'll show you really big place. I'm gonna reference back for a second to a recording that I just did that no one's heard yet, with another person from Australia, who sort of outlined a fairly bleak view for me of how a lot of people their diabetes is managed. Are there are the haves and have nots? health care wise? Pretty obvious there?
Skylar Cox 12:04
Yes, and no, I'd say Australia is really, really blessed in with the public health care system when it comes to being a diabetic. But at the same time, we don't have access to up to date technology. So, for example, insulin for a script of insulin 25 300 mil pins cost you $41 flat out to anybody. But in saying that, we may not have access to all the insulins available, such as tresiba. You know, and test strips are subsidized. So they're $15 flat rate for 100 strips, for a personal on a health care card. But, you know, your CGM devices actually aren't subsidized for people who are basically working enough to not be on a healthcare card. And they're over the age of 21. And it's not covered by private health insurance here either. So you're having to cover the brunt of that out of pocket.
Scott Benner 13:16
Is health care card a way of saying government assisted?
Skylar Cox 13:20
Yes. It's kind of the equivalent to the Medicare card in America. Yeah. Yep. So I think the Danny foundation is a big advocate group over here. Trying to raise awareness to the government as to why CGM devices need to be subsidized for every type one diabetic. And that's actually how I currently have my CGM. It's a scholarship through them.
Scott Benner 13:50
Interesting. Wow. And you're younger. Am I right? How old are you?
Skylar Cox 13:56
I am 22 years old. See, that
Scott Benner 13:58
sounds younger. And to me like with numbers, but you have a more mature voice. So if you told me you were 35, I would have just been like, Alright, okay.
Unknown Speaker 14:07
I'm 35.
Scott Benner 14:09
Would you Really? I would too, just in case you're wondering. Yeah. No, I just you mentioned a course a moment ago, and I would think that anyone who heard you say I learned in a course. But heard your voice would think, Oh, this lady's gone back to school. That's lovely. She's probably trying to better herself, but you're definitely younger. So what were you studying in school?
Skylar Cox 14:31
Yes, I am. I'm currently enrolled in uni. Actually, my last test is tomorrow. It opens up online at 2:30pm has to be online because of all the Coronavirus.
Unknown Speaker 14:44
Are you going to cheat? No.
Skylar Cox 14:46
No, it is open book. It is open book now.
Scott Benner 14:50
I'm just gonna say everything is okay. Let me ask you a serious question for a minute, Scott. If you're going to cheat, would you tell me
Unknown Speaker 14:57
Yeah,
Scott Benner 14:57
no kidding. Good for you. I think that one, I've watched two kids, one go completely through high school and one now halfway through high school and a, you know, a Corona a couple of months. And I think that we're teaching our children how to collectively come up with answers. unintentionally. So I'm seeing a lot of a lot of kids, they just they talk to each other they have, they have text chains going, they have all kinds of messaging, they're talking about their homework in the class, they're not talking about the learning. Interestingly, and it's not a good thing. But they are talking about the problem solving aspect of it. And so while I don't believe that a lot of American children are going to know who William Barr was, I do think they're going to know how to pull together six of their brightest friends and conquer anything. So it's a, I think it's a very unintended thing. I used to think of it as we were teaching our children to cheat. But now I don't see it that way any longer. Now, I, you know, it looks like it looks like really good adult tools to have but you know, the way people can communicate so quickly. You know, like, if you had to, if you were taking your, I don't know, you're doing something in school, remembering back when you were even younger, and you couldn't get the answer, and you had to get on your bike and ride to a friend's home to, you know, find out the answer, you wouldn't do that. You'd be like, I'll figure it out. But when you can text somebody and be like, hey, real quick, you know, answer seven, what is that? People do that all the time. So anyway, I would cheat if my test was online, just to you know, want to be very clear about that. I was about the worst student ever. And I would have, I would have taken the easiest way out possible, which, ironically, looking back now at this podcast, this whole podcast exists, because I wanted the easy way out of diabetes. So, you know,
Skylar Cox 16:58
yeah, I never really had that issue. Growing up, because my family was a bit slow to get up to date with your technology. So I, you know, my household didn't actually have a computer until I was just entering high school. I didn't have a phone available to me until my junior year, consistently anyways, so, and I was socially awkward on top of that, so I wasn't really connected enough to be able to get away with that. I
Scott Benner 17:36
want to know how you were socially awkward. But before you tell me, I want to point out that you paused right. After you said slow, you said my family was a little slow. And there was this pause. And I thought, is she going to tell me that her parents are stupid, or that they didn't get the technology quickly? Like I couldn't tell where you were going to go? And you said you'd be honest about cheating. So I was like, Oh, my God, this is gonna take a dark turn. But it didn't. How were you socially awkward? How does that manifest in your life? Um,
Skylar Cox 18:05
I'd say that I was just never really concerned with talking about superfluous things. You know, I didn't really care about who was dating whom, or you know, the latest trend or whatever. I was more interested in talking about more pertinent subjects. And nobody really wanted to engage in that kind of depth of conversation.
Scott Benner 18:32
Can I ask, do you find yourself at gatherings? I don't know, if you remember, gatherings. It used to be, people would go and get together in the same place and talk with each other and eat food and things like that. But back when that happened, did you? Do you feel like Do you ever have that feeling like, Oh, I don't want to be here, because the conversations aren't where you want them to be? And when you try to take them to where you want them to be, it turns everyone else off. Has that ever happened to you? Um,
Skylar Cox 19:02
not really. Because nobody ever really talked to me. Just to be honest, I was just always kind of on the outskirts of those gatherings, you know, prom nights or whatever. I only went because my mother wanted to do my makeup and put me out there and yeah, so I just kind of wander around the tables and sort of eat some of the kinky
Scott Benner 19:27
your mom was pimping you out so she could practice makeup.
Unknown Speaker 19:30
She's like, Oh, yeah, I
Scott Benner 19:32
don't want to do that mommy can figure out this eyeshadow.
Skylar Cox 19:36
Oh, yes. Oh, yeah. It even got to the point where, you know, she was bound determined that I was not going to wear my glasses to my high school prom. And so because I can't wear eye contacts, I went without my glasses, so I could not see anything. So neither Let's just say I ended it about 30 minutes in.
Scott Benner 20:02
Was that so that you'd find a boy? Is that what she was thinking?
Skylar Cox 20:08
Well, yeah, my my mother. Really? Yeah. She She tried to hook me up a few times.
Scott Benner 20:16
Would your mother say bloke if she was talking about a tea or is that not Australian?
Skylar Cox 20:21
Well, I'm actually American. Living in Australia. You
Scott Benner 20:25
ruined the whole pot, and I'm just kidding. That's fine. Where were you born?
Unknown Speaker 20:29
Oklahoma,
Scott Benner 20:31
where the wind comes whistling down the lane. sweeping down, sweeping dammit. God dammit. Can we do that again? where the wind comes sweeping down the lane? Is that the place? You're talking about Schuyler?
Skylar Cox 20:40
No, no, no, no, no sweeping down the plane.
Scott Benner 20:43
Hold on. Third try. Is that the place where the wind comes sweeping down the plains?
Unknown Speaker 20:49
Yes. Oh, I
Unknown Speaker 20:49
thought so.
Scott Benner 20:51
Well, I do know that the waving weed smells sweet. So I've got you there. But so how old were you when you moved to Australia?
Unknown Speaker 20:58
I'm
Unknown Speaker 21:00
- Oh, well, that
Scott Benner 21:02
wasn't that long ago.
Skylar Cox 21:04
Well, not terribly much my entire independent adult life.
Scott Benner 21:10
So you're not there with your family? Your family's in Oklahoma? Yep. Oh, this is interesting. Okay, let's get into this. What makes you leave Oklahoma and go to Australia? Is it that your mom would dress you up like a hooker and send you outside to find a boy?
Skylar Cox 21:31
No, I found my own boy. And he happened to be in Australia.
Unknown Speaker 21:35
Ah, gotcha.
Skylar Cox 21:37
But there were a few other things because it The decision was he either moved to America or I moved to Australia. So there were a couple other deciding factors in that.
Scott Benner 21:50
And he talks to you even though you wear glasses. Yes. What a progressive guy.
Skylar Cox 21:56
Oh, he actually prefers me with my glasses. He finds it weird without the mom
Scott Benner 22:00
who is joking. I think calling him progressive seemed ridiculous to me. So you meet Okay, hold on. How do you meet a boy from Australia? In Oklahoma?
Unknown Speaker 22:11
Oh, well,
Skylar Cox 22:12
we had a shared interest in pre history. So fossils.
Scott Benner 22:16
Ah, that's right. You like the bones of things that have been dead for quite some time they get stuck in rocks.
Unknown Speaker 22:24
And that is one way to put it.
Scott Benner 22:26
Thank you. I like to, as you know, from listening the podcast, I'm very good at boiling things down to almost simple. And by simple I think we know I mean, you know, really, really, really simple terms. I don't know enough big words to say anything another way. But you so you had this interest together. But he wasn't in Australia, you meet online?
Skylar Cox 22:50
I yes. Yeah. But not through a dating website. It was actually through the fossil forum. So it's actually a pretty well meaning forum. The people are very respectful. You have a lot of scientists on there a lot of avocational paleontologists that have contributed a lot to science and such. And yeah, it just kind of fell in place from there.
Scott Benner 23:21
It'd be great if they change the fossil forum slash dating app. Because where else are you gonna meet other people who enjoy fossils? That's not something you can bring up on your own?
Skylar Cox 23:33
No, we actually have another mate. He's looking for a girl. And you know, we always joke Well, you need to go to the fossil forum because he's also interested in fossils.
Scott Benner 23:44
I think it's a reasonable decision to be perfectly honest with you. Okay, so you guys meet on the fossil forum, which we're getting very close to calling this episode fossil forum. I don't know if you've noticed or not. But that's only because your parents didn't end up being stupid when the simple thing came up earlier. And so he's in Australia, you're in Oklahoma, Oklahoma is not a bad place to what would you call it when you're looking for fossils? There's a word for it right.
Skylar Cox 24:11
Not really is just called fossil hunting or fossil collecting. Okay. And that is
Scott Benner 24:15
that something you did as a child like in high school?
Skylar Cox 24:19
Yep. Yep. I used to go to Black Cat mountain in Oklahoma to look for trilobites.
Scott Benner 24:26
You say that again? Cuz I don't know what the hell you're talking about that look for what?
Skylar Cox 24:30
So trilobites? They're kind of like these pill bug looking things that used to live before the dinosaurs in the oceans.
Scott Benner 24:40
And the fossils look swirly. Is that what I think?
Skylar Cox 24:45
Oh, sorry. pillbugs rolling police. Oh, okay.
Scott Benner 24:50
I found it. Don't worry. I can't believe that. I can't believe that based on what I just typed Google knew I was trying to say trial. Fascinating. Now that algorithm works amazing because I was pretty far off. Okay, so these things are weird. And so you'd go out looking for these. Did you actually find these?
Skylar Cox 25:13
Yeah, quite a few. Wow.
Scott Benner 25:15
That's pretty cool. How old are they? And how to get
Skylar Cox 25:20
cheese? I think the black cat mountain site has been dated to like around 405 million years
Unknown Speaker 25:27
old. Wow. That's really kind of cool.
Skylar Cox 25:31
I think around that anyways, before the dinosaurs came into play,
Scott Benner 25:36
that's amazing. I'm just Anyway, I'm a little lost than in what you're showing me here. That's really cool. How old were you when you were diagnosed with type one?
Unknown Speaker 25:44
Um,
Skylar Cox 25:45
well see that but bits a bit confounding to my doctors. I have been showing symptoms for probably about two or so years before I was actually diagnosed. And they reckoned that those two years may have been the honeymoon ending before I actually got diagnosed. And when that ended, that's when I finally went in and got properly diagnosed. So I was officially diagnosed August 13 of last year. But blood tests back in January show that I was clearly diabetic, but that was missed. And yeah, it's and I've had symptoms since before that. So the idea is, is I was in my honeymoon before I was actually diagnosed. And at the end of that is when it actually got bad enough that I had to go in. And yeah, get properly diagnosed. Gotcha.
Scott Benner 26:47
I have a lot of questions about that. But first, I thought this will stick in my head if I don't ask this. You said I reckon is that that's from okhla. homo, right. Not from Australia, using the word reckon. Do you know
Skylar Cox 27:03
you know, I'm not I'm not sure.
Scott Benner 27:05
That's not a colloquialism from Australia. And from
Skylar Cox 27:08
I mean, I have colloquial is, colloquialisms that aren't really from either place. It's just from reading a lot to gotcha. I thought
Scott Benner 27:19
you're gonna say from being in the desert by yourself. But we're in the mountains myself, but you make up words, Scott, after you're out there for a while. So I so I have a ton of questions. So first of all, you were diagnosed about a year ago, so around the time you were 21. And you had been in Australia for, obviously, about three years, and you still shacked up with this guy, or have you gotten rid of him? Is he still in the picture?
Skylar Cox 27:42
No, he's still in the picture.
Scott Benner 27:44
Yeah, very nice. So you guys are together doing your thing? He about your age?
Skylar Cox 27:48
He's a bit milder.
Scott Benner 27:52
Do you want to tell me about that? Or are we gonna leave that out?
Skylar Cox 27:56
Oh, he's six years my older. I know some people like to preliminarily judge against that. Yeah. A few people
Scott Benner 28:08
don't know how so cuz I was thinking Good for you. Cuz he's probably already got it.
Skylar Cox 28:14
But yeah, well, yeah, that that did help me moving over? Well, a lot of people think, you know, that is too big of an age gap. And to be fair, it is with the mentality of some people. Especially, you know, across different generations. But we were born in the same generation. And, you know, being from different countries. Anyways, we had some differences we had to work through. We dated long distance exclusively for three years, yet three years. So we kind of got through a lot of those differences. And also, my father, for example, knew that I was always going to go for somebody older than myself, due to just my mentality, I guess,
Scott Benner 29:09
what I would think if you're looking for a conversation, you're, you might be hard to find it. 22 years old with another 22 year old I was, I kind of half brought up earlier. I'm not good at some get togethers. If I don't like having I'm not good at just basic conversation. Like I can't just sit around and talk about cars. Were boobs with guys. I can't do that. Yeah. And and so when I try to speak about the stuff that I'm interested in, I see most people's faces glaze over and I'm like, okay, no one cares about this, but me, that's fine. You know, and then you can get into another space where you are with like minded people. And it's it's obviously a much different conversation. But in a lot of those situations, I just find myself like sitting there thinking like, Oh, I wonder what I can get out of here. Because nobody cares, and I can't I just can't do it. Like,
Skylar Cox 30:05
I guess I share that sentiment.
Scott Benner 30:06
Yeah, I try, but I can't and it comes off, I will come off as judgmental. If I get into those conversations. If I don't stop myself, or if I'm not aware of it and stop myself. Just like I'm like, how long can we possibly talk about this? You know, the Sixers are doing great. Let's move on. I don't see why we need to break this down. Like I don't work. I don't work at ESPN. I don't no one cares what I think about this guy's work ethic? How is this what we're talking about? So the world's falling apart around us? Maybe? No? Okay. All right, let's talk about Joellen bead for 10 more minutes. Anyway, point is, don't love it. And, and I get it like I get wanting to be with, I can see how it would shake out to age. With me, Kelly is just, she's so much smarter than I am that like she she grades out as an older person. So even though she's a little younger than I am, you know, I could talk to her. I'll tell you right now, when people ask like, what are you looking for in a person? Even when I was in my early 20s. And I don't even know where I got off believing someone would like make a baby with me at that point. But I thought I really do want somebody who I think will be a solid parent. That seemed very important to me. And I wanted someone I could talk to. Okay, really, I know that sounds like I don't know, like I'm making that up. But it wasn't to me like I want to be able to say something deep to someone and have them pause, consider and respond, not stare through me. So I guess
Skylar Cox 31:43
exactly that that's the key thing, I think to a relationship is finding somebody that you can communicate to, you know, on your deepest passions, you know, interests and everything and have them communicate effectively back with you. And that's really where my husband, Troy and I come in, you know, fossils bind us together. But we also have a love for nature and history and
Scott Benner 32:12
the like. That's beautiful. Exactly. Yeah, I didn't, his age didn't interest me as much like in a salacious way as it did in the idea that I, that made sense to me, because how could you relocate from Oklahoma to Australia, if you didn't have some sort of stability when you reached Australia? And I don't know how 20 you know, three years or four years, I don't know how like a 17, or 18, or 19 year old person could offer you stability to move across the world. So I wasn't and you didn't seem like a person who was just gonna be like, Whoa, let's do it and just see what happened.
Skylar Cox 32:46
No, there was a lot of paperwork, and the like that I had to go through.
Scott Benner 32:53
Yeah. Okay, so do you do fossil collection, which I guess is called anthropology. Am I right? Did I get that alien
Unknown Speaker 33:02
knowledge?
Scott Benner 33:04
When the wind comes sweeping down the plane? I hear it. So paleontology, is that a is that a hobby? Or is it a profession? Or is it a future profession? Like how do you see all that?
Unknown Speaker 33:15
We
Skylar Cox 33:16
like to call it avocational? So we're a bit more invested than your hobbyists, but not to the point where we're professionals. So we're friends with the Queensland museum curator, and we kind of work in tangent with him to identify our funds and to eventually work on allocating our collection to the Queensland museum when we're ready to pass it on.
Scott Benner 33:42
Okay. Is your studies at University are they focused on paleontology? Or what are you studying?
Skylar Cox 33:49
Nope, I'm actually studying nursing.
Scott Benner 33:52
Perfect. That makes total sense. Okay, so there, I was being sarcastic. How did you so you found your way into a nursing track before you had type one?
Skylar Cox 34:08
Um, no, I actually decided to change after my diagnosis.
Scott Benner 34:14
Gotcha. What were you doing prior to that?
Skylar Cox 34:17
biochemistry.
Scott Benner 34:19
Wow, that sounds incredibly difficult. So I Oh, I'm sorry. I just got the chills thinking about taking a biochemistry class. So your your C are you close to being a nurse? You getting there? This? Is that what this last test is for? Are you gonna be a nurse after today?
Skylar Cox 34:38
No, no, unfortunately, I still have two and a half years.
Scott Benner 34:42
Okay. So so you get in like a basic like an undergrad, and then you're gonna go to nursing school? Is that how that works?
Skylar Cox 34:49
I know, two and a half years and I'll be a nurse.
Scott Benner 34:51
Ah, okay. All right. I'm trying to dig out the Why does it take six years to be a nurse or is it because you spent the first couple of years on a different track and then Switch. Yeah,
Skylar Cox 35:01
yeah, pretty much. So I started University in America right after high school. I had a year under my belt, studying biochemistry. And then I decided to move here to Australia. Partly because uni is a lot cheaper here. It's 8000 a year versus 40,000 a year. Um,
Scott Benner 35:23
while you were getting college for 40 it's a good deal.
Skylar Cox 35:26
Yeah, yeah. I'm always Yeah, forking over 40 grand a year. Wow. And anyway, so I moved over here. And then I went to go through and finished biochemistry, I had about two years left on then got diagnosed and realized that I didn't have any particular direction. With that degree, and I felt nursing afforded me a more direct pathway.
Scott Benner 35:56
Good for you. That's wonderful. So when you're, I guess there's two ideas, I want understand. So you're on your, you're doing MDI, we ended did we meet? Because in the in the Facebook group, I was asking for people who are doing really well on MDI. Yep, that's how that happened. Right? So tell, talk to me a little bit about that, like, how do you? What do you What's your management style? And what does that mean that it's working out really well. This is super simple and super quick. I'm just stopping back to remind you about the T one D exchange, please go to T one d exchange.org. forward slash juicebox. Fill out their survey. And when you do, you're supporting Type One Diabetes Research, and the podcast. Super simple way to do good things for people living with type one and help out yours truly keep this podcast going. T one d exchange.org. forward slash juicebox. took me about seven minutes to fill out the survey. It's 100% HIPAA compliant. It's 1,000,000%. Anonymous. And it's definitely going to do good things for people living with type one.
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Skylar Cox 37:19
I am typically between 92 and 98%. Time and range. I don't really have any highs above 8.5. I try and keep it under 7.2 millimoles. So what is that
Scott Benner 37:37
that got you here? 8.5 would be around 150 ish, little more. 7.2 is about 130. So your your highs are about between 130 and 160. ish.
Unknown Speaker 37:50
Yeah,
Skylar Cox 37:51
I consider 130 a high. Okay, I will actually act at 6.5, which I think is 117. So I'll actually act at that point. And then my lows I consider 70. That's my action point anyways.
Unknown Speaker 38:10
Okay. Okay.
Skylar Cox 38:11
I like that. 70. Yeah. 70 to 130. But I act on 117. And whatever. 4.4 millimole is 4.4 80. Yep. So I'll start kind of eyeing it off around the 80. Mark. You know if it's dropping or not, but if it's just leveling out, then I'll just kind of let it sit there. If it's not like a pressing concern,
Scott Benner 38:38
are you using a glucose monitor of any kind?
Skylar Cox 38:42
Yep, I'm using the CGM provided to me by the Danny foundation. It's the Medtronic one.
Scott Benner 38:51
Very common. That's the common commonly available CGM. And in Australia, isn't it?
Skylar Cox 38:59
No, I'd say Dexcom is actually more prevalent. Um, but in saying that I have tried the Dexcom. And the Dexcom wasn't as accurate for me. Now given that's on the older versions, we still don't have the G six out here yet.
Scott Benner 39:19
Yeah. Where we're using like the g4.
Skylar Cox 39:22
Yep, yep. Gotcha. Yeah. So
Scott Benner 39:26
Well, yeah, we're almost a seven, honestly. So.
Skylar Cox 39:29
Yeah. Which is just crazy. It really is.
Scott Benner 39:33
I'm wearing something right now. Actually, this is my last few hours with it. I'm wearing the Dexcom Pro right now.
Skylar Cox 39:40
Which Yeah, I heard about that. It sounds like it'd be a good diagnostic tool.
Scott Benner 39:44
It is and it's been it's been an interesting an interesting 10 days seeing my blood sugar excuse me and and how, how my body reacts to different scenarios and it's it's fast enough. get really as the things that move my blood sugar around that I would have never imagined away from food. So even though
Skylar Cox 40:08
you have no idea how tempted I am to put one on my husband to see his because each time I pricked his finger, he's at a perfect 100
Scott Benner 40:16
just constantly 100
Skylar Cox 40:18
Oh, yeah, just just constantly, you know, either 4.8 or what's 4.8? Like, 85?
Scott Benner 40:26
I didn't know we were gonna do that again. It's about 87 ish, like, right in there.
Skylar Cox 40:31
Yeah, yeah. So he's just constantly always in there, it's like, Okay, well, I kind of want to see what's going on behind the scenes, you want to be my guinea pig.
Scott Benner 40:40
I, I'll tell you the one thing that that fascinated me more than anything is it when I go outside in the heat and work, my blood sugar tends to go up with or without food doesn't matter and not go up a ton, you know, not, not the way people would type one think of going up if you would go up like 1015 points. But when I was really active or working outside, especially in the heat, my blood sugar would go up a little bit.
Skylar Cox 41:04
That makes sense. Because your body would be utilizing more glucose, I'd be Yeah,
Scott Benner 41:10
elevating. I'm assuming there's like a little control guy inside of me that's like, Oh, this fat ass is gonna try to do something strenuous, he needs help. And they just, you know, hand over a little bit of glucose to make it happen. But I tried eating well beyond my desire to be full, to see what happens. And it still my blood sugar won't go over like 140 something. And I mean,
Skylar Cox 41:36
yeah, I am do see with doing I'm gay, I have tried pushing myself and basically subjecting myself to my own experiments. You know, so I will sit there and you know, I'll have my relatively healthy food days, and then I'll have my days where it's like, I will just gorge out on carbs to see how much I can push myself with this. You know, so it's, while I empty your perfect sugar levels, at the same time, I find it engaging to be able to experiment with my own because they actually do fluctuate a little,
Scott Benner 42:18
I do actually have to do the process of elimination to figure out what's actually causing what I think it's, I think it's amazing to do that. I think it's how you come to bigger answers and how you can then eventually take care of food in a way that you want. That could be problematic, because if you know what the problem is going to be, then you know how to, you know, act on it before it becomes an issue. And
Skylar Cox 42:44
exactly, I just call me crazy, but I actually find it. You know, diabetes is the one chronic illness that you can actually sort of play around with and see your results in lifetime. So I actually in some morbid way find it fun.
Scott Benner 43:03
Well, you like digging around in rocks looking for things that have been dead for a long time, so I'm not judging. Yeah,
Unknown Speaker 43:08
yeah, well, I
Skylar Cox 43:10
don't make sense anyway. So well, to one
Scott Benner 43:12
guy he did. That's good enough. I keep flashing back and thinking like what did your dad expect painting up his daughter and sending her out to the world was going to happen?
Unknown Speaker 43:24
Yeah,
Scott Benner 43:26
that's so funny.
Skylar Cox 43:28
He was a bit uneasy, but he trusted my instincts, my instincts, he knew that I was very cautious reasonable. I was going to say from the outset, with any relationships, my motto has always been go for character, not beauty, because beauty fades character remains. So yeah, that's always been sort of my prerogative when looking at a relationship. And, um, yeah, so I didn't really,
Scott Benner 44:04
yeah, in fairness, I only know one thing about Oklahoma. Those people are incredibly scared to drive in any kind of inclement weather. And it was a huge letdown. When I found out I was in Oklahoma, and given a talk. And I thought, this is like, I'm gonna meet a bunch of cowboys. Like that's how I felt about it. I was like, everyone's gonna ride up on a horse, they're going to probably have like a steer like like lassoed and like slung over their shoulder, they're gonna cook it for dinner. These are the people I'm going to meet giant pickup trucks that and the weather got in climate for an hour and people were like, We can't come I was like, wait, why? Just like it's it's and I was like, wait, it looked outside and like, You're kidding. Like, this is gonna stop you thought you were cowboys. But turns out rough and tumble people in less any kind of precipitation falls out of the sky. And they're like, why you Is that exactly if you have any idea?
Skylar Cox 45:03
Well, it depends. Where did you hold that workshop?
Scott Benner 45:06
You're asking me to remember where I was. Exactly.
Skylar Cox 45:09
I said Oklahoma City, Tulsa
Scott Benner 45:12
felt more north. I don't know what that means. Anyway, I don't remember. I feel bad for the people who were there. Like words,
Skylar Cox 45:22
names, your big city, people are a bit more trepidatious about that sort of thing. When it comes to ice and the sort, I'd say we're a bit more cautious, but that's more so because a lot of Oklahomans do drive big pickup trucks. I
Unknown Speaker 45:41
thought that I was like, this is your time. Like,
Skylar Cox 45:43
yeah, but see, the issue with that is trucks like to fishtail. And unfortunately, Oklahoma doesn't get so much snow is what it does ice. And ice can be pretty scary to pick up driver. Because you're fishtailing all over the place. No way back secure. Yeah, exactly. Understand. And because Oklahoma has crazy weather. We also you know, we actually call her bipolar. Nobody expects to constantly have a weight in the back of their pickup truck to prepare for a sudden you know, bout of ice. You know,
Scott Benner 46:17
just thinking if anyone ever says to anyone that, hey, it looks like you've gained some weight in your your back part. You can just say I'm trying to get ready for the ice. I don't want my essence sliding out from under me. Oh my gosh. Anyway, so when I'm interested in about, you know, what are you using is your slow acting insulin.
Unknown Speaker 46:39
So I use Lantus.
Scott Benner 46:41
Okay, and your fast acting is probably novo rapid, I'm guessing.
Unknown Speaker 46:44
No, it's humalog.
Scott Benner 46:45
jemalloc. Okay, humalog and Lantus. You're injecting? How frequently? Do you find yourself in inhospitable places? digging around for fossils? And how long? Are you out there? When you're doing that? How do you manage through that situation?
Skylar Cox 47:04
Okay, so usually about anywhere towards the end of June into late August, October is what we call the fossil season, it kind of depends on the wet season prior. So see, Australia doesn't really have intermittent rain in our area, it just kind of dumps everything in the beginning of the year in one week, and then you're left to deal with what you got for the rest of the year. So during that wet season, we can't really go look. But during the dry season, we can. And so what is there's like anywhere between six and eight months timeframe. And during those six to eight months, Troy and I will go out every weekend. And, you know, anywhere between four and eight hours, we'll just be trekking along, looking for fossils.
Scott Benner 48:05
And so you're pretty removed, I would imagine from amenities during that time. Yes. Okay. Yep.
Skylar Cox 48:11
Yeah, um, we're kind of, we're in areas of very patchy reception. We're well away from where emergency services can get to us quite readily.
Scott Benner 48:29
What do you bring with you then to be ready for that? Do you ever spend the night?
Skylar Cox 48:34
No, no. Because our fossil areas are pretty close to us. So you know, we can just drive, you know, about an hour or so away and come back the same day.
Scott Benner 48:50
Gotcha. Gotcha. I'm gonna ask a question. You don't have to answer. Have you ever found something that it was so exciting that you had sexy time out in the middle of nowhere? No. May I suggest that because it seems like that would be nice. Not that you need to take my suggestion.
Skylar Cox 49:07
Yeah. Yeah. Well, it's it's been brought up before but just the habit ties in Isn't that nice? It's pretty.
Scott Benner 49:17
Everything I gotcha. And by it's been brought up before you mean, Troy brought up and by Troy brought up, you mean every time you're out there, he brings it up? Is that what you're saying?
Unknown Speaker 49:27
No, no, not.
Scott Benner 49:32
He probably has a calendar. And at least like I said it last time, I'll skip this time. For clarity, I would say it every time to I just be like, Hey, you know, we haven't done yet while we were out looking for fun. There's so many simple jokes here that people are filling it in their own head.
Unknown Speaker 49:53
Yeah, but
Scott Benner 49:54
I tried to keep it friendly. But anyway, I can
Skylar Cox 49:59
only imagine What the listeners are thinking of right now?
Scott Benner 50:02
I can't even say what I'm thinking. That's that's where we're at right now.
Unknown Speaker 50:06
Yeah, yeah.
Scott Benner 50:08
But, but no, I just, it just seems very secluded, I guess was my my overall point. Yeah. And so you're right. So you're by yourself. What do you bring with you as far as like, food to sustain yourself? And do you ever do you pack for the idea of like, what if we became stranded, have a car broke down or something like that? Um,
Unknown Speaker 50:31
let's see, well,
Skylar Cox 50:32
I usually have a pack. My pack usually includes like, you know, jelly beans, it's got, you know, your glucagon cha it has insulin. What else is there, we usually pack like a fiber one brownie, because they're like 15 grams, some nut bars, which are like 12 grams, that's protein. You know, and just, every couple hours or so we'll just find a spot a shade, we'll pull over, you know, drink some water? I'll check my sugar levels on them, we'll proceed accordingly.
Scott Benner 51:13
Does the process of looking bring your blood sugar down? Is it is it, I'm assuming it's like a lot of manual labor, right?
Skylar Cox 51:22
Um, it's mostly walking. Because you're looking in areas of erosion. So you're kind of wanting to let nature do the work for you. Because I mean, the chances of you just picking a spot and digging in, the chances of you actually finding something are quite low. But if you kind of let nature do it for you, and you just cover a lot of ground, you're more likely to pick something up. So there is that. And usually, when we go collecting, it's interesting that no matter what my blood sugar levels are, they will drop down to about 4.6. And they will just stay steady around that point the entire time.
Scott Benner 52:13
Do you feel like you just have your basal insulin really well?
Unknown Speaker 52:16
Yep, like, yep, figured out. Yeah, I
Skylar Cox 52:19
do frequent Basal tests. Not, not necessarily test, but I will do continual checkups, like I'll do a lot of examinations of my blood sugar levels to make sure that it is in tune. Because if my base was not said, Nothing is said, I will get, you know, correction doses off, I'll get insulin rebounds and everything. So as soon as my blood sugar levels start going wonky, the first thing I look at is my Basal.
Scott Benner 52:55
I just I'm sure you've heard me say but I think that the Basal is the base and B if it's not right, nothing else works. And just makes sense. I mean that you're out wandering around like this for hours at a time. And holding a blood sugar around 85 is it's amazing. It's well done work. And so how often do you have to adjust your basal insulin like a little more, a little less? Do you find yourself doing that?
Skylar Cox 53:25
I usually only have to do a major change about maybe once every three, four months. But you know, there will be some weeks where it's like, Okay, I'm a little stressed from this, I might need an extra unit or two on and I'll see how that goes. Or Ah, you know, like this last week, I suddenly, you know, I went through one of my major changes. And so I actually went from 24 units down to 15.
Scott Benner 53:55
Well, what was what precipitated that?
Unknown Speaker 53:59
I'm not honest.
Skylar Cox 54:01
I mean, is there really any ever clear cut answer with diabetes?
Scott Benner 54:04
No, no, I was just wondering if maybe, like, you know, you, I don't know threw away like your head. And then you were like either body or something like that. Like that's a it's a big jumps.
Skylar Cox 54:14
It's interesting, because it actually came at a time where I am more stressed. Because, you know, at the end of the semester, you have exams, I recently changed jobs. You know, so there's a lot of crazy things going on right now. And yet, you know, my basal insulin, just just, you know, my body just decided to be more sensitive to it.
Scott Benner 54:37
That's interesting. It's cool. And how long did it take you to figure it out? What do you have some lows and you're like, what is happening?
Unknown Speaker 54:43
Um,
Skylar Cox 54:44
actually, no, I was having a lot of weird highs. So usually, I actually have my insulin to carb ratio and insulin sensitivity factor pinned down in so much that I can do a quick calculation. And I can tell you exactly where one unit of insulin will bring me approximately within point two millimole. Or you know, how many grams carbs will raise me millimole wise, you know, I actually have a graph for conversion factors. That works really well. Basically, based on a variety of scenarios, just simple math, simple algebra, conversion factors. But once you nail down your insulin to carb ratio and your insulin sensitivity factor, it makes it really easy. It's basically kind of like doing the Bolus calculator, you know, your Bolus calculator on your insulin pumps, I'm just doing it manually, you know, adding in a few others, a lot of reading. So, I read a lot of scientific reports, I read about the equation of dividing 460 by your total daily dose to get your insulin to carb ratio. And then 130 divided by your total daily dose to get your insulin sensitivity factor. And then, you know, I never necessarily liked algebra or chemistry, but I was proficient in them. enough that I put two and two together, and I was like, Hey, you know, this is actually really simple algebra and conversion factors. In fact, in chemistry, there's a graph showing how to easily figure out your conversions from like millimoles, to particles, to units of measurements or whatever. And basically, I just took that concept, and I plugged it in with diabetes. So my graph shows millimole units, insulin units, and grams of carbs. And in between those conversion factors, you have your insulin to carb ratio and insulin sensitivity factor, and you use one of the two or a combination of the two to get from one to the other, depending on your situation.
Scott Benner 57:15
Wow. So Geez, that's fascinating. And you figured this all out in the last year?
Skylar Cox 57:22
Yeah, yeah.
Scott Benner 57:26
I told you, you were more like 35. That's why you were so like, I would take that. In the beginning. You're like 35? sounds right. For me, I think that's really uncommon for people to figure out on their own to begin with, and I think at your age, it's really, it makes it a little more uncommon. Do your, does your period change things for you? I'm
Skylar Cox 57:49
not really, because I actually have the implant. Um, so that actually keeps my hormone levels pretty darn stable, thankfully,
Scott Benner 58:00
is that the ring? The my thinking of the right thing?
Skylar Cox 58:03
No, I have the implant on.
Scott Benner 58:06
Oh, the one thing that that literally goes in your arm?
Skylar Cox 58:09
Yep, yep. Yep. And it works really well. For me, the only thing I noticed is before my diagnosis, I had the next one on, which is like the same thing, just different brand. And I found that at the end of like, after a certain amount of time, it starts scaling back on how much of whatever units it gives you. Um, and so interestingly, when I had to go in for my implant on renewal, I noticed I did the calculations because I noticed that my insulin needs increased by a fair bit, and funnily enough, they doubled which accounts for like, the difference between the two because it was a fresh implant, so it was putting out more units or whatever chemical or hormone it puts out in you. So yeah, once I figured that out, I was like, Okay, well, maybe I need to double my insulin does because this is doubled the dose of
Scott Benner 59:15
hormones, whatever I was on, but it becomes consistent and stable.
Skylar Cox 59:20
Yeah, exactly. Exactly. Um, you know, it only took like the first week of fluctuations. And then after that, you know, like, Okay, this is a new implant, it's putting out you know, twice the amount or whatever, of the former implant because when I was diagnosed, I was at the end of the life of the last implant. So once I did that calculation, I was like, Okay, well, my insulin needs probably doubled, and I increased it And sure enough, it matched. Wow, that's
Scott Benner 59:51
really cool. I actually just I looked it up here, because I knew what you're talking about. It's um, do you use there's only two of them right. Then next blomidon or there's next put on next next point on is that is that the one you use?
Skylar Cox 1:00:06
It's the first one I had I currently have the infant on, I think they're the same thing. They're just different brand names.
Scott Benner 1:00:13
Gotcha. And this just this little, how long does it like, I can't tell.
Skylar Cox 1:00:20
Don't know, it's like an inch and a half long. Okay.
Scott Benner 1:00:23
And it's just inserted, is it injected? Or is it inserted surgically? Or how do they do it?
Skylar Cox 1:00:29
Yeah, it's sort of insert, like, they make a small incision, and then it like, injects itself in.
Scott Benner 1:00:35
Hmm. That's crazy. And and it lasts for years, right? Yeah, it
Skylar Cox 1:00:40
lasts for three years. Wow.
Scott Benner 1:00:41
So it's funny, you brought that up? Because I've been looking for a birth control for it not because I, because somebody brought it up to me the other day. I just don't want to get pregnant. I think at my age, it would be it would be difficult. But somebody brought it up the other day and said, Hey, when your daughter gets older, I got a lot of stability in my blood sugar by using an IUD. It was a note i got i get the strangest notes, by the way. And that was one of them. Which I was really grateful to hear about. And it just made sense. instantly. It's like, yeah, this just, you know, give us it. You know, I don't have I forget how this this implant, or this thing? It's probably not an IUD. I'm probably using the wrong words. But it's another it's like a ring or something like that. That has, I guess, hormones on it. Right arena? Yeah. Listen, if something like that, like it again, a lot of emails and I'm standing and I'm like, this one's super interesting. Like a person has taken the time to write me just say, this might help your daughter when she gets older. And I was like, oh, I'll keep that in my head. But then you just brought it up to and it's just, it makes total sense that you take that information away it gets easier to manage your blood sugar's that's very, very interesting. cisely
Skylar Cox 1:01:53
Yes, I see. The only caveat with that is each birth control, you know, each person reacts differently. So the implant on works perfectly for me. But it may not for other people. I know other people have had issues.
Scott Benner 1:02:11
Like they grew like a third arm or something like that, or
Skylar Cox 1:02:15
no, I think the most common issue is inconsistent bleeding. where, you know, some people control Yep, weight gain. But you know, side effects are to be expected when you're changing the chemistry of your body.
Scott Benner 1:02:32
Yeah, you would think I yeah, I guess it's it becomes a trade off at some point. If you decide, yeah,
Skylar Cox 1:02:38
it really does. When you're taking any sort of medication, you have to outweigh you know, you have to weigh the benefits versus the side effects.
Scott Benner 1:02:45
Okay. Hmm. All right. So, how much of your stability is based around your diet? Do you think?
Skylar Cox 1:02:58
None at all. You know, there'll be some weeks where, you know, I'm a star pupil, while not even some weeks, even some days where I'm a star pupil, and I'll just sit there and only eat my meat and my veggies or whatever. And then there's other days, like the other day, I had. Don't judge me. I had doughnuts for breakfast. Um, what did I have for lunch? I had a beasting for lunch, which is like some sort of pastry with cream. And then I had carbonara for dinner. All terrible, terrible, carby thing,
Scott Benner 1:03:35
all the same day. Just went? Yeah.
Skylar Cox 1:03:38
But I never once went above 6.8.
Scott Benner 1:03:42
Wow. That's and that's just with your management of insulin.
Skylar Cox 1:03:47
Yeah, so, um, I do have like some markers. So I try to aim for non diabetic levels, because I know a lot of diabetes educators, endocrinologist, doctors, caution against it, because, you know, they think that's too low for you. But my thinking is, okay, well, if non-diabetics can achieve that, and as long as there, you know, as long as I'm stable and not really dropping below those numbers, then why wouldn't I want to try and aim for non diabetic levels?
Scott Benner 1:04:27
I listen, that's what I do here. So you know, so
Skylar Cox 1:04:31
yeah, so my range is between 70 and 130. And from here, I don't know the conversions. But I think what is it a normal non diabetic is between five and 7.21 hour after eating. And then 3.8 to 6.12 hours after eating. So I try and match those patterns, myself recently.
Scott Benner 1:04:59
So you're saying between 90 and 135, five and 7.2, I have to admit, and I'm gonna do a, I'm gonna do an episode with Johnny about this, at some point, when, when I first began doing the things that I do the things that I talked about on the podcast, and etc, I was able to have even tighter tolerances, like the idea of like any kind of spiking, I mean, not that you could really call 130, a spike, but a blip, right? I just was like, I can keep them all out. But once Arden became a full fledged card carrying lady, that that was not as easy to accomplish. And I've really come to believe that there are people doing amazing things for young kids. But you know, as with timing of insulin, but I don't know that that's a lifelong possibility, all the time of that super steady, you know, 85, blood sugar all day long. It's a, it's a, it's a ton of work that goes into it. And I don't know, like, what I'm not sure of is the love of a parent who can think of a way to do that. And to actually keep up with it. People don't generally feel the same way about themselves when they get older as parents feel about you. Like you don't realize it when you're young, but nobody cares about you more than your mom, and maybe your dad. And and you know, and so once you become an adult, like to keep your blood sugar at 85, constantly, I think you would have to have a fairly strict restriction of carbohydrates to accomplish that. But I agree with you, I don't know that there's anything wrong with a blood sugar going to 130 for a little while and coming back and having a couple of gentle rolling hills throughout the day. That seems very reasonable to me. And it's very doable. I have a question is, did your concepts lead you to liking the podcast? Or did the podcast lead to the concepts?
Skylar Cox 1:06:57
admittedly, my concepts led to the podcast, but I would think yeah, it was my I love learning as much as I can to incorporate my own sort of, say, My way of handling diabetes is knowing it is being able to battle
Unknown Speaker 1:07:17
it.
Skylar Cox 1:07:19
So I decided, you know, as soon as I was diagnosed, I realized, Hey, I don't have to feel achy anymore, I actually have tools within my grasp and knowledge that can be obtained to reverse this around and leave lead a completely normal life. So I just dove ahead in to anything and everything, I could research papers and everything, to formulate my own concepts. And then, you know, as I said, Before, I subjected myself to my own experiments. So now I sort of have like guidelines by which to direct myself as to when to act when to you know, ease up, you know, for a more holistic view of my health. And then, you know, just in all of that, you know, it was just inevitable finding through Facebook, you know, tips from fellow diabetics, and then, you know, of course, the podcast was mentioned. And that's really how I came across it.
Scott Benner 1:08:29
That's what I mean, from talking to you for the last hour. I didn't think you were gonna say, Oh, I was lost until I found you. I thought you were gonna say, I found you because it was a like minded idea to what I was already doing. Yep. Yeah. That's excellent. That's very exciting. And you found all that on your own just like reading research and figuring things out. That's your to be that's really, like I would applaud for you. But that seems weird because it's a podcast if I started clapping right now people like there's a weird noise at the end of the show. I don't know what it was. But seriously, if somebody should stand up and clap, because that's really well done. Good. Now, you handle everything like this. Are you a bit of a mess in other ways, but um,
Skylar Cox 1:09:11
yeah, it's pretty much how I tackle life if I can't stand. Well, I I admit that there are always going to be some things that can't be known. But those things that can be known I want them to be known so I can figure out how to deal with them. That's
Scott Benner 1:09:29
really cool. And by the way, for anyone listening, jump back a couple times to hear Oklahoma come right out of scholars mouth. She said I can't. It just literally went like that for a second. I thought I thought you were gonna get the vapors and start fanning yourself. I was like, Oh my god, we're going right into. We jumped right back into the dialect from Oklahoma. You have a really interesting accent. It's a It's a neat blend. really is. Do you think you'll stay in Australia or do you think you'll finish up uni and drag Troy to go Go home again. You know,
Skylar Cox 1:10:02
yeah, um, to be honest, I'd be happy visiting America, but I think I'm really happy with the way Australia deals with diabetes over here. And you know, because diabetes is obviously a big part of my life. Um, I wouldn't say it dictates it, but it definitely you know, I think Australia better supports it.
Scott Benner 1:10:28
That's really cool. That's amazing, actually, that you found that he only had to fly. You know, like a whole day to get there. Do you come home ever? Like how do you see your parents? Is it like video stuff?
Skylar Cox 1:10:39
I, yeah, I pretty much voice message them. They came over and visited last year. But otherwise, I haven't been back to the States since July 29. of 2017.
Scott Benner 1:10:53
Wow. Did your dad try to shoot a wallaby while he was there something because you know, America?
Unknown Speaker 1:10:59
No, no.
Skylar Cox 1:11:01
He was more keen to try and pet one.
Scott Benner 1:11:04
Gotcha. I have to be honest. Right now. If you showed me pictures of three different animals. I am not 100% sure I could pick a wallaby out. So know why the lobby
Skylar Cox 1:11:14
kind of looks like a smaller kangaroo. Oh,
Scott Benner 1:11:17
hold on a second. This is this is how we're gonna end this episode with me trying to figure out what a wallaby looks like. Alright, so I figured out the spelling. So we're halfway there. Somebody wants to know if you can have them as a pet. That seems like a poor idea. Sir, it's very cool. Oh, wow. If you just told me it was a kangaroo short. I'd be like, Oh, if you told me this is a baby kangaroo. I wouldn't know the difference. Are you sure it's not? Maybe you guys are just used?
Unknown Speaker 1:11:47
Yeah, yeah.
Scott Benner 1:11:48
Do you think I figured out that Wallabies are actually just baby kangaroos? And no one else knows. I think that's
Unknown Speaker 1:11:54
not i i'd
Skylar Cox 1:11:56
say you know, it is pretty it is a pretty reasonable assumption.
Scott Benner 1:12:01
Skyler I like you. You have not let me get away with any bullshit whatsoever. While we're talking for the entire hour.
Skylar Cox 1:12:07
I'm sorry, I am. I am terrible. When it comes to sarcasm like I can even understand. You know, when I can pick up that somebody being sarcastic to me, I will still give them an honest direct response in relation to the thing they're trying not to.
Scott Benner 1:12:25
You were you were terrific. I I wasn't saying it in a bad way. I was just like, you'd never like, I was like, oh god, I'm married to this girl. That's how it felt to me. Exactly. Because you were just like, you were not letting anything go. And I was like, here we go. I already I already have women in my life who treat me this way. Skylar, I don't know. Oh, my goodness,
Unknown Speaker 1:12:44
it is it is
Skylar Cox 1:12:47
it has been such a struggle. That's been one of my biggest struggles here in Australia is everybody is sarcastic here. And their tone of voice doesn't give it away, like we do in America. So in America, where, you know, we kind of, um, you know, exaggerate our head movements, or, you know, exaggerate our tone of voice to indicate that we're being sarcastic. And over here, they just, they don't give any indication whatsoever. And, you know,
Scott Benner 1:13:17
I have to tell you that away from this podcast, I am proud of how dry my sarcasm is. I I'm only happy when no one understands what I'm joking about. That is my happiest place ever. It's not great in personal relationships, in case you're wondering. But, but you should I am never happier than when I say something I completely don't mean and everyone believes it. I really appreciate you doing this. Is there anything we didn't talk about that you were hoping to get to?
Skylar Cox 1:13:45
No, not really. I was a little surprised. You didn't ask about corrections. But I mean, that's sort of a touchy subject in and of itself.
Scott Benner 1:13:52
Well, hold on a second. Let's get to that. I don't I'm not Can you go a couple more minutes?
Unknown Speaker 1:13:59
Yeah,
Skylar Cox 1:14:00
I am usually up to like two or three in the morning anyway, so it is no big deal for me, to me. And you go.
Unknown Speaker 1:14:08
Um, well, um,
Skylar Cox 1:14:11
I just noticed a lot of people have issues with corrections. And I probably do a bit I'm a bit more daring in my approach. So again, I'd say I probably do what you do with the insulin pump with iron, but I do it the best way I can with manual daily injections or multiple daily injections. So when multiple daily injections we don't have the option of stopping insulin, or you know, delaying it or extending it or any of that are two options are. Give yourself a correction or give yourself more food. Right. That's the only two weapons in your arsenal. So with corrections, to be able to stay within my target range, I kind of go off of how quickly I'm rising.
Unknown Speaker 1:15:11
So
Skylar Cox 1:15:14
I'll just walk you through one of my concepts that I arrived to. So, um, this is the way I think insulin takes about 10 to 15 minutes to work. Food absorbs in about 40 minutes, depending on what type of food you have, this is just an average, obviously, you would see, you know, whether or not you have fat and protein or not. But generally food peaks in about an hour. So that's why you Pre-Bolus about 15 minutes or so 10 minutes for me, I have found if i Pre-Bolus, 15 minutes, I started dipping, and then rising a lot because that insulin, you know, didn't actually cover the carbs, it dipped me a bit. So basically, if I am still trending up between 45 and 50 minutes after eating, so I'll have like, says sly arrow up. And I'm around the 6.5 millimoles per liter mark, you know, just before I hit my 7.2 Mark, one hour after eating, because I want to try and stay under that mark, I will go ahead and give an additional small bolus. Depending on how heavy the meal was or not, you know, if it was just, you know, quick in and out carbs, I might scale it back some if it's just your standard carbs, I'll give the standard amount. And that additional Bolus actually usually kicks in immediately for whatever reason, and starts fighting those additional carbs to bring me back down. To say I'm like going slightly up 4550 minutes after eating. So 6.5 millimoles. Around that time, I usually give like 20%, or whatever my initial dose was, or if I'm like rising rapidly double arrows up or whatever, 30 to 40%. And then, yeah, I will be prepared, generally, to kind of lay down a small blanket of carbs to slow down that drop, if I start seeing myself drop, so I kind of like do the reverse. You know, I can take that 20% of the initial dose, you know, if I have like straight arrows down and go like,
Unknown Speaker 1:17:41
okay,
Skylar Cox 1:17:42
I might, you know, take some carbs to kind of cushion my landing or whatever. But I know most endocrinol address doctors, what not, they don't want you to do a correction until like two hours after a meal. But at that time, you're already suffering from a higher low. Yeah. So, you know, you're generally speaking, if the arrows going up or straight up, that means that my initial bolus or timing was wrong. And more often than not, I can rule out the timing. Um, and, you know, I go, yeah, I configure, yep, I can figure out that it's the amount. So I will go ahead and give that additional amount that I should have probably taken.
Scott Benner 1:18:34
And then it's not stalking if you need it. And that's
Unknown Speaker 1:18:37
exactly,
Skylar Cox 1:18:38
exactly. And you know, it, I hardly ever have any issues with it. Like, you know, because it takes about four to five hours completely to leave the system. If it does drop me, it's usually not that very, very tail end, where it's just starting to really slow down, and I can really see that and it's like, okay, throw in, like, three or so carbs, and that'll raise me half a unit and then you know, I'm sitting easy the rest of the day,
Scott Benner 1:19:09
how often do you find yourself in that situation where you have to bump a little bit after a meal?
Unknown Speaker 1:19:15
Um,
Skylar Cox 1:19:15
hardly ever, actually.
Scott Benner 1:19:18
I bet you that doesn't happen to you much. Because you probably once you see it happen a couple of times you adjust your ratio for the meal then.
Skylar Cox 1:19:25
Yeah, yeah, exactly. And I think I would say it's very similar to what you do on a pump. I just do it manually, and I keep a close eye on it as you would, regardless of MDI or not. Yeah, and yeah, so And I'll just cushion my landing with carbs if needed, but more often than not, it's it's not needed, because that's insulin I needed anyways. You were
Scott Benner 1:19:48
the right person to be listening to this show, that's for sure. That's excellent. I couldn't agree with what you said anymore. I just don't. I don't watch you know, I've boiled it down to ideas like Don't watch a high, you know, do something about it, catch it with food later if you have to make an adjustment if it keeps happening. That stuff all to me just makes sense. It's, you know, if you ever considered, I'm not pushing you. I'm wondering, because of how you talked about it seems odd that you don't have a pump
Skylar Cox 1:20:21
that don't have a pump. Yeah. Yeah. Um, well, at some point, I may try a pump. Just because I want to be able to subject myself to everything and say, you know, I've tried everything. But at the moment, I am happy.
Scott Benner 1:20:44
There's nothing wrong with it. I was just yeah, it just seems like you would have fun manipulating bazelon I just see you at home going, Oh, my God, the greatest thing happened today. I did a Temp Basal decrease.
Skylar Cox 1:20:57
See, with my chances, I'd probably hit the pump with a hammer.
Scott Benner 1:21:02
While you were while you're out there looking for, you know, bones in the ground? Yep. Gotcha.
Skylar Cox 1:21:09
I can't even begin to tell you like you damaged things that you don't even think would be damaged. Like I had to go and work out like $800 for a new set of glasses. Because in digging for bones, I didn't realize that the dust, you know, the dirt was kicking back in my glasses and scratching them. So you know, we're prepping your fossils particularly. So yeah, that that would just be my, my luck. Again, this
Scott Benner 1:21:39
dust is causing problems. More than what I've pointed out earlier. I hear what's happening. I gotcha.
Skylar Cox 1:21:44
But I mean, the reason I brought the corrections up is because it just it amazes me with a lot of people with manual daily injections, you know, that have issues with that. And it's like, Okay, well, if the pump, you know, a lot of people say the pump mimics the pancreas best. Well, if that's the case, then why don't you do the manual version of what the pump does?
Scott Benner 1:22:13
Do you know you think they're just trying to avoid injections, though?
Skylar Cox 1:22:18
Yeah, but initially, I would say yes. But after a bit of time, you hear a lot of people say that injections no longer bother them.
Scott Benner 1:22:29
So why not just
Skylar Cox 1:22:30
Oh, I can't Yeah, so why not just do it?
Scott Benner 1:22:33
I think it doesn't occur to them. I think that I think that they get stuck. It's it, they get stuck in that idea of like, Listen, I count my carbs. I put in the insulin, I wait three hours I test and then I look and I correct if I have to? That's what I've been told do. I'm still alive? Exactly. You know what I mean? So likely, I hear
Skylar Cox 1:22:51
because they were told to do it. And that's the biggest issue I have with that is because diabetes is I think I forget which doctor was maybe Val Wilson or something like that. basically said that diabetes is the only chronic illness where the patient has to do the majority of their health care decisions on a day to day basis. You know, it is impossible to think that an endocrinologist or diabetes educator can make half the decisions that we make during that day. So why, you know, would you it just amazes me that you know, why you would listen,
Scott Benner 1:23:42
watch a bad outcome and then do it. Yeah, yeah, exactly,
Skylar Cox 1:23:44
you know, precisely and it's like madness heating it and not change it. Right.
Scott Benner 1:23:50
Um, well, everybody isn't in the same boat. With their curiosity. Yeah, intellect. me like ability to figure it out. Thank you. You described reading some things and some simple math. And I guarantee you that there were plenty of people listen that it was I did not think that was simple what she said. And it's just because people's some people's minds just don't work that way. mind doesn't. Like this whole podcast exists, because I understand that.
Skylar Cox 1:24:17
Yeah. Yeah, yeah. I think just trying to think of what I'm wanting to say it's, it's not saying anything against, you know, their willingness or not to engage in that I think.
Unknown Speaker 1:24:40
No, you do.
Skylar Cox 1:24:42
Yeah. yet. You do. And I think there's a lot of stigmatism that oh, you know, you can't disagree with the doctor or anything. You can't take diabetes management into your own Hands. That's not what you're supposed to do. You're only supposed to listen to the textbook or whatever, right? You know, but I think I think what I'm trying to say is that diabetes, because of the very nature of what it is, it demands a more dynamic management system, you need to
Unknown Speaker 1:25:23
be active,
Skylar Cox 1:25:24
if, if you want to do well with it, then you have to be willing to
Unknown Speaker 1:25:29
be involved, you know,
Skylar Cox 1:25:31
be involved. Exactly. And that doesn't mean, you know, completely fine in the face of what your doctor saying, or did you know any of that, but by no means I'm saying find a doctor that has a concept, you know, has the concept that you know, diabetes is unique, it's very dynamic, it's going to require dynamic managing methods. And you know, to be there to support you to basically to enable you to manage it on your own, not make the decisions that you need to make. To manage yourself. Well.
Scott Benner 1:26:08
Well, I agree with you, 100%. And I very much appreciate you coming on and doing this and taking this extra time at the end to go over what you said, I think it's important, you know, people you got to do you got to be involved. You have to you can't just watch numbers and and hope it's, you know, you have to do something. And if you don't know what to do, you have to step back and figure out what it is that's happening. And if that's not clear to you, then find somebody that can help you. But don't just stare at it and spend the rest of your life thinking, you know, my blood sugar just goes to 250. That's what it does. You know, I get 400 once in a while it happens. I yeah, I cannot even begin to tell you that I sorry. 422.20. Yeah, probably I don't
Skylar Cox 1:26:57
think I've ever had that recorded. yet.
Scott Benner 1:27:01
It'll happen at some point. But you're all well, so it's not like you have a site that can go bad on your pump or something like that. So there's some stuff like that. But I'm just going to tell you that the last time Arden's blood sugar was that high. I don't know when that was, that is not something that just randomly happens to us. And it's not luck. And it's not magic. It's on purpose. I stopped that from happening. And so could everyone else. So exactly, just need to have a couple of tools and then know when to use them. That's pretty much it.
Unknown Speaker 1:27:30
Exactly. I
Skylar Cox 1:27:30
think diabetes management needs to lean away from you know, stagnant. Hey, okay, do this and do this. adjust this. See in six months, I think it needs to be okay. You need to look out for this. And do this when you start seeing this. Maybe try out this? You know, they might be? Yes, exactly. I think for me, my three main concepts, and I think this has mentioned on your podcast is diabetes problems, blood sugar level wise, are usually either due to miscalculation of an insulin dose, miscalculation at the timing, or miscalculation on the carb count. And, you know, obviously, if you didn't get the results you want, then you need to eliminate go through the process of elimination to figure out which one did you end? Yep, it's timing, or amount or combination of both. That's just how I think of it like it CDs, the right amount, the wrong time,
Scott Benner 1:28:36
the wrong amount, the right time, that's not gonna work. It's got to be the right amount at the right time. That's it. And it sounds super simple, and it's not, but it is, and once you figure it out, it's one of those things that you'll think I can never believe I struggled with this. I just have it now. But in the run up to just getting it is can be painful. So
Skylar Cox 1:28:55
yep, I could not think to succinctly sum it up more aptly. You should
Scott Benner 1:28:59
have a podcast and then you would figure out how to say a whole bunch of words in three words, because if you don't do that, nobody can remember it. And I know that because I couldn't remember it. Trust me. I I I dumped this stuff down for me first not not for you guys. And and then after I could follow it, I was like, well, I bet you somebody else could understand it this way. So Skyler, thank you very much. I'm going to go I have another recording and a little bit so I need to get ready for that. Fair enough. But thank you so much. Huge thanks to Skyler for coming on the show and sharing her story. Also, I'd like to remind you that if you find yourself listening to stuff like this going, Oh, I wish I knew how many five millimoles where you're going to Juicebox podcast.com. Right up there at the top, you can click on a one C and blood glucose calculator. There's a quick conversion calculator there. That will also help you see what your average blood sugar means. In a one. See, it's very cool. Like I'm here now. So if I type in the my average button was 123, it tells me that instant Scott, that's an average agency of 5.9. And that cool. Let's say your agency was 6.6. That would mean that your average blood sugar is 145, or 8.1. It does all those calculations in an instant, thanks to a very lovely listener who built this beautiful calculator for me. Again, it's at Juicebox podcast.com. And at the top, you just click on a one cm blood glucose calculator. If you're considering going to the T one D exchange to fill out the survey, I want to personally thank you. It's very valuable for people living with Type One Diabetes. And it's incredibly helpful for the show when you do so T one d exchange.org, forward slash Juicebox Podcast diabetes pro tips or diabetes pro tip.com, or right there in your podcast player beginning of Episode 210. Lastly, I'd love to thank you for listening and of course, for sharing the show with other people. And let you know that in Episode 418, I'll be leaving a link that you can go to to watch my blood sugar in real time. So I'm going to wear a Dexcom g six for as long as I can. So that you can see what a working pancreas looks like, while it's working. So thanks to sugar made, I want to thank Josh, the owner of sugar made for helping me do this, you'll be able to see my blood sugar live at Juicebox podcast.com. But there's a specific link you're going to need. So you'll get that in Episode 418. My idea here is that if you can see how a pancreas handles things, it might help you to understand what you're shooting for. That makes sense, as a person using insulin. I know there can be this pressure to just you know, keep the line completely flat all the time. But I thought maybe if you could see that sometimes someone's blood sugar goes to 131 40 and then comes back down again. I thought that would be really helpful and kind of comforting. So I've set this up. I'm going to thank Dexcom for giving me the gear that I needed. And of course Josh from sugar mate for helping me put it online. And I'm excited to share with you so that information will be in Episode 418. Then after that, I'm going to show you the blood sugar of someone who is pre diabetic, has some insulin resistance. And then I'm going to be looking for people who are really great at bolusing for certain meals to put their blood sugars live online during the Bolus, so we can watch them Bolus for these meals, you'll be able to see pictures of the food. And when the insulin goes in and how everything reacts. I think that'll be really cool. And I'm going to be doing the same thing. By the way, when I put my food in, you'll see a photograph of what I ate. It'll correspond with when I ate. Anyway, I think it's a really great idea. I'm super excited for it. That information will be in Episode 418 which is coming in just a day or so. Thanks so much for listening to the Juicebox Podcast. We'll be back soon. Talk to you later.
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