#422 After Dark: Amy
ADULT TOPIC WARNING
Amy has a crazy story and type 1 diabetes.
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**DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends and welcome to Episode 422 of the Juicebox Podcast. This episode is a little different in that I did something I don't normally do. I reached out to a virtual stranger and asked them to be on the show just based on something I saw in their social media posts. And I have to say that this episode did not in any way, go the way I thought it would. And that led to this being the happiest surprise of 2021 for me.
Unknown Speaker 0:36
Wait, do you meet Amy.
Scott Benner 0:47
I thought I was having Amy on the show to talk about her weight loss. And then I realized I didn't know the first thing about Amy. But by the time this was over, I knew about 40 things about Amy. And most of them led this to being another episode in the after dark series. Amy's story is so eclectic, that I didn't even know what to call this episode, which is why it ended up being called after dark. Amy please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. There are going to be a lot of sensitive topics in this episode. So if you find yourself easily triggered by things like suicidal ideology, miscarriages, anxiety, I don't actually have a full list but Amy's got a couple of things going on. But I'll tell you one thing about me that I'm 100% sure won't trigger you. She's 100 million 1000 100,000 million percent, like really delightful. And she did this episode outside. So the Snow White fans here are going to be thrilled because there's a lot of birds in the background. And it's not something I normally would have went with but Amy caught me by surprise. And I just kind of fell in love with talking to her and I stopped caring about the birds. I hope you find them delightful, at least as delightful as I found Amy g vo Kibo pen has no visible needle, and it's the first premixed auto injector of glucagon for very low blood sugar and adults and kids with diabetes ages two and above. Not only is Jeeva hypo pen simple to administer, but it's simple to learn more about. All you have to do is go to G Vogue glucagon.com forward slash juicebox g vo shouldn't be used in patients with insulinoma or pheochromocytoma. Visit je Vogue glucagon.com slash risk. Many of you may have been watching my blood sugar's live online last week at Juicebox podcast.com forward slash CGM Live, it's not live anymore. Actually somebody else's blood sugars up there now person with insulin resistance. Later there'll be other people sharing their blood sugars and bolusing methods and we're gonna start getting into some type ones in the new year. Anyway, I bring this up because I tested my blood sugar a lot over the last 10 days checking it against the Dexcom g six that I was wearing. And it was terrific. But I gained an even deeper love for the Contour Next One blood glucose meter during that time. Because thus far I've been telling you about my experiences using the meter for my daughter as a caregiver, talking about the bright light, easy to read, easy to hold easy to transport the great Second Chance test strips. Well, now I got to use it for myself. And I have to say it performed exactly the way I was hoping it would stuck in my pocket. It was easy to find in the dark. The light shone bright in the pale moonlight, and I was able to test my blood sugar with no trouble at all points if you sang deep in the heart of Texas after that. This meter is an industry leader in accuracy. And I hope that you check it out to Contour. Next one.com forward slash juicebox. There's links in the show notes where you can just type in the URL. I really hope you give it a try. Too often, people get stuck with the meter that their doctor gives them. And that meter could just be you know, the one the salesman left in the drawer or one that the doctors just gotten accustomed to prescribing to people. Maybe your doctor hasn't looked into meter accuracy in a long time either. But there's no reason that you can Contour Next one.com for slash juicebox check them out, check out all the sponsors the end of the year, get festive, go in the shownotes and click around a little bit support the show. Alright guys, I put the ads up front so that you can just sit back and relax and soak in Amy.
I'm recording now, just so you know, let me just check that I have your voice correctly. Say anything. Hi, good. Okay, we are recording, I'm gonna ask you to introduce yourself any way you want to be known. And then we're gonna start talking, but just so you know, I can hear the birds behind you. So you're just gonna really be Snow White. Just say. Sounds like you have this little blue bird flying behind. It's very nice, actually, finally relaxing.
Amy 5:56
So I'm Amy. Um, I'm just here today. So I'm a type one diabetic. So yeah.
Scott Benner 6:04
Amy, you got on the show. Unlike the way most people do. I don't usually reach out to people. But I want to, I want to tell people what happened. So I sent you a message. You follow me on Instagram? And I said, Yeah, so I just kind of assumed you listen to the podcast. And so I sent a message to him like, Hey, I don't know if you listen to podcasts. But I'd like to have you on. And you responded back with like, No, you were so like, it was funny. Do you listen to the podcast? You said no. And I was like, Oh, this is the feeder. Okay, nevermind, I'm gonna go to martial law here and see if I can see if I can get through. But the reason I reached out to you, and what I want to learn about today, among other things, is that, you know, it's weird when 1000s and 1000s of people, like, follow you on Instagram, and then you follow them back. And I used to do that and really enjoyed it. But then Instagram kept me and I can't, I can't seem to follow more people which I I hate because I like seeing what everyone's doing. But I don't know everybody when it's that many people, but you would go by in my feed and confuse me because you're in your photos. I hope you take this Well, I hope you're with me take this away intended. It appeared to me like there were two separate people in your photographs.
Unknown Speaker 7:23
I get that a lot.
Scott Benner 7:27
And it was confusing as you're kind of whipping by and trying to keep up with all these people and, and I just was like, This is strange. So one day, and I hope you take this the right way. You have a really pretty face. So I stopped longer. I was like hold on what's happening here? And I started picking through. You've lost an insane amount of weight, haven't you? Yes, I have.
Amy 7:51
I've lost like over 156 pounds.
Scott Benner 7:54
Jesus, that's a person. Okay, this is what I want to know about. Alright, let's start slow. How old were you when you were diagnosed?
Amy 8:02
I was actually 23.
Scott Benner 8:04
Okay, so And how old are you? Now? You can't be that much older than that.
Unknown Speaker 8:07
No? Okay.
Scott Benner 8:09
So five years ago diagnosed with Type One Diabetes. Can we do you mind giving context? Like, when you were 23 How much did you weigh?
Amy 8:19
30 565 pounds around there. That was like the last time I weighed myself. Okay. I just graduated college. So I was at my biggest
Scott Benner 8:28
where you did college add to it? Great. Kind of continued.
Amy 8:34
No, I just actually kind of always been a big girl around that point. And then, um, pretty much it kind of continued a little bit, but I think like, around that time. Yeah, I just was that much and I was trying to lose weight and I was down on myself.
Scott Benner 8:51
How tall are you? 511 11 Okay. All right. Big people in your family. Or no?
Amy 9:00
No, it's actually kind of weird because my dad he used to be a big guy before he married my mom and then he actually lost a week after he was like 30 and then my mom's kind of like, just over wait a little bit. But my sister on she's a she's a bigger girl. But um, she can be like a plus size model like so it was like kind of that so while everybody else my family is pretty much kind of like it and everything like my cousins and my uncles and aunts and stuff like that.
Scott Benner 9:34
So So now that you've now that you've lost weight, can you tell me like what led to it? Is it was it just the eating habits or nutrition?
Amy 9:44
So a little bit was eating habits will probably go back to like when we kind of first got diagnosed because I was at my biggest actually was misdiagnosed as a type two diabetic. And then I had all these doctors telling me Hey, you need to lose 14% your body weight You won't need insolent you'll be good. I was 14%, like to the point where I was crying because I didn't want to be a diabetic. I thought it was my fault I was I was so big. And I got to the point where I did lose that 14%, I got down to 300 pounds, and I suppose my insulin actually increased. So from there, the doctors are still yelling at me. And I was still a type two diabetic, I'm actually ended up getting an eating disorder. I'm trying to lose weight, which I didn't even know anything of. But I figured out, hey, if I just keep not taking my insulin, and my medications that I'm not supposed to, because I also was on that form, and I was losing weight, like crazy. Um, and then I actually got down to about 290. And actually, when DK and actually went out to a facility for my eating disorder treatment, because I was to the point where I was killing myself every day.
Scott Benner 11:02
Did you find that the need to lose weight over? Like it? It didn't, it made everything else not important. Were you just like solely focused on that. And if not taking this medication was doing it, then that's what you are going to do?
Amy 11:16
Yeah, pretty, pretty much like, to me it was a doctor's yelling inside my head, like, you need to lose weight. So you won't be on insulin, you need to lose weight. So you get off this. So like, I was like trying to be so persistent. I'm not being a diabetic. So I was like, okay, we're gonna get this weight loss off. And if I can do it this way, then I do this way. But when I reached out, yeah, so when I reached out to Minnesota, and then I went to their eating disorder, eating disorder treatment center. And they actually retested me and and I, I turned out to be a type one diabetic.
Scott Benner 11:48
Yes. So am I right to say that in the back of your mind, you thought, it doesn't matter if I don't take this medication? If it's gonna lead to the weight loss? I'm not gonna have diabetes when it's over anyway.
Amy 11:59
Yeah, so that was that was when I was like that. I was like, yeah, cuz, you know, just eat and then take your medication, you'll be fine. Like, Oh, all right, well, let's do this. But then I after I found out it was like a type one, everything just made more sense to me. And then my eating habits has changed, my physical fitness has changed and stuff like that. So after that, I started gradually losing weight. But then at the same time, I did relapse towards my eating disorder, which was not good. But I did lose a couple more. I think I lost about 30 pounds then. And then but I was sick. I actually was in the hospital 13 times that year. So I just felt horrible. And then, so I got back on track. I found a job that I love. And I don't want to mess it up. So lately, I just been keeping track of what I've been eating and exercising and my job is very demanding. So it actually really helps out.
Scott Benner 13:04
So the jobs almost like exercise for you where it is,
Unknown Speaker 13:07
all day. Yeah. Excellent.
Scott Benner 13:09
I need a job like that sit in this chair is not good for me. I can tell you that much. I feel that some days. Like today, I'm recording twice. And there is this part of me that's like thinking like you got to get up and get moving when this is over. Like you can't just because I want to edit a show now. And if I do that, I'll roll from two recordings to editing and I'll be in here for six hours before I know it. Yeah. And then the guy's gone. And it's not good for you. So I have a lot of questions. I don't know how to like, I don't know how to order them yet. So I'm gonna feel my way through this. I'm sorry.
Unknown Speaker 13:41
You are good. Okay,
Scott Benner 13:42
great. So your Are you around 200 pounds now?
Amy 13:45
I am actually 220 right now to 20.
Scott Benner 13:48
You you I guess your height helps because your photos I give you made me guess your weight. There's no way I would have I would have gone there. Like with that. Not that there's anything I'm not saying there's anything wrong with I'm just saying you don't visually. And I wonder if that's a problem? Because I've had that before where people tell you like you carry your weight well, so you just think well, if I don't look heavier than I don't care, like I've had that feeling before too. But I guess I want to know first so that so they just don't you just stop eating to lose those first like 65 pounds and get yourself to 300 there was no
Unknown Speaker 14:22
No, no,
Scott Benner 14:24
I ate more. But didn't take the medications. So you drove your blood sugar up to lose the weight?
Amy 14:29
Yes, yes, I ate more than anything and then everybody asked me how to use your weight and I didn't say I just ate more. They don't usually understand but
Scott Benner 14:41
that's not an Instagram. How did you lose five pounds I eat more food.
Amy 14:48
I do it now still but it's because I know what to eat when to eat and like I don't starve myself.
Scott Benner 14:54
So have the things that you're eating changed.
Amy 14:59
Oh, like well, you I definitely so I remember it. So my mom's a nurse. So I remember when I texted her I used to work in a restaurant. And I texted her when, when I was like almost being diagnosed, I think she remembered me drinking a pitcher of water. And she's like he was last time you checked your blood sugar. And I said, I don't know. It was during hunting season. I was, you know, when diabetics get high, they pee all the time. I couldn't hold it during hunting season. So I went to my mom's on lunch. And she's like, She's like, um, test your blood sugar. And I tested that she had this ghost face on her. So the one thing I've noticed is actually I drink a lot more diet, and I drink a lot lot more water than anything. Even if it's like, like flavored water. Yeah. So I don't I don't drink saucers. I don't know.
Scott Benner 15:47
I have to be honest with you. I drink water and like, unsweetened tea a lot. That's pretty much Germany like some like crazy kidney stone one day, it's just gonna come flying out and kill me. I don't I don't drink a whole lot else. And so Wait, you're a hunter. I seen you on your Instagram with a boat. Do you just bow hunt?
Amy 16:04
Oh, no, I bow and rifle hunt.
Scott Benner 16:06
Okay, are you within? You know, don't tell me the town you live in. But where in the country? Do you live?
Amy 16:11
I live on the border of New York and Pennsylvania.
Scott Benner 16:14
Oh, gotcha. So that's sort of the I say so you're more like North? Well, not really like,
Amy 16:23
No, I'm like Central New York. Okay, central middle of the middle. borderline interesting.
Scott Benner 16:29
Okay. Okay. So hunting is a big deal around, like, where you live? And then something, how did you get into it.
Amy 16:36
So I feel like most of my family actually hunted. And I was actually jealous because my cousin always hunted with my uncle. And then I just ended up finding a boyfriend that hunted and then I got because I've always wanted to do it. Because nobody in my family like my mom or my dad and do it. So I actually got it that way. bow hunting was actually kind of my own thing, because I thought it was more of a challenge. So I love that. But even then I had a weight problem because you know, tree stands have a weight limit. So
Scott Benner 17:08
you couldn't get into a tree stand like you weren't allowed.
Amy 17:11
Yeah, because like the weight limit was I think there are like three things. I know. Some of them are 150 and then some of them are not no 250. And then some of them are like three 300
Scott Benner 17:25
that would really add insult to injury if you were 365 pounds, do you have a tree stand? You just probably lay on the ground and go Okay, I'm just gonna die here. I guess I could give up. You know, but but it's, it's really First of all, you know, listen, we can't overlook it to a mass 365 pounds and 23 years is in and of itself some sort of an accomplishment to be perfectly honest. I guess not. I don't think that was easy to do. Were you just eating? constantly everything? Was it calories? Like how did how did that manifest for you?
Amy 17:57
I think it because when I was a kid, I actually was very active. I did. I played sports all the time, all four seasons. And then I think I actually, like when I went to treatment, I really, like suppressed so much. And I found out that one of them was that after my parents divorced, I stopped doing sports. And all I did was eat I go to my dad's on the weekend eat junk food. My mom just easiest meal for a single mom is like spaghetti. That's all I I hate red sauce to this day.
Scott Benner 18:31
You just think that the like the dissolving of your parents marriage just threw you into a depression or
Amy 18:38
I think a little bit depression because I did go to therapy. But I thought also because I actually because when you're at like 10 years old, you can't control your diet. So your parents are the ones who feed you. So I actually kind of reflect on that because I remember the first stretch mark I ever got. I was like awesome video, I was freaking out but I was like, Okay, um, because I was like, was that changing period for every human. So I, I remember I ate like, cans of frosting and stuff like that. And and, and, like, it was just what was like, a drink so much soda, and stuff like that. And I think it just accumulated slowly and slowly, slowly and slowly. So it just, it really does reflect like today I eat more protein than anything actually do not like bread that much. I really don't only if it's like garlic bread and Alfredo because that is my carb carb choice. It's amazing. We got some good pretty good Italian restaurants around here. So um, so yeah, so that I pretty much like looking back. That's how I looked at it because I still was active. I always was active I played I still play basketball. I played football cheerleading golf track in high school. So I did all that I write rode my bike around like from LA Thomson, I still couldn't lose weight, like it was just still there. But I think as much as I was pushing out for calories, that was pretty much taking a double.
Scott Benner 20:09
Right? You could be as active as you wanted to be, there would be no way to get rid of all the calories that you would take in in that sense. Yeah, I mean, honestly, weight loss is its calories, right? Like, it's not much more than that. It's calories activity hydration. I don't think there's a big secret to how how people gain and lose weight, you know, aside from people who have actual medical conditions where those factors end up not impacting them the way they should, but for most of us, it's just that do you do any, like intermittent fasting now? Or do you have any, like other ways that you try to maintain or go are you trying to get lasser Are you trying to lose weight,
Amy 20:50
actually, I'm still trying to lose weight. I actually did get down to 200 I was super comfortable then. I tell you one thing when you go from like 300 pounds down to a 200 level, buying clothes is so much more enjoyable. It's I have I have to make clothes now have like two closets full of it's so much more enjoyable because you can actually like fitness things and and actually enjoy it. So because I I did gain a little bit of weight. I am trying to lose it but I'm doing it the healthy way. During work my work schedule is crazy. So I work from like 1239 all day going in and our customers house climbing poles and stuff like that. So sometimes I don't even get a lunch sometimes. So pretty much usually I fast. I usually do for the first couple hours of the day. And then usually I come home and I eat when I come at night. Usually it's not by choice on weekends. I I really just go not full blown by usually eat regular like church and Sunday. I usually we go I get breakfast I go get lunch, I get dinner with a family and stuff like that. So it's
Scott Benner 22:01
like Sunday's your big day. And then it's Sundays.
Amy 22:03
Yeah, Sunday's my big day. Gotcha. I love my Sunday.
Scott Benner 22:09
Alfredo sauce and garlic knots and things. I don't see how we're gonna say no to that. How do you manage your type one now? Are you pumping? You have a glucose monitor? Do you have anything like that?
Amy 22:19
Yes, I am actually the G sex and I'm on the T slim. Um, so that is how I'm keeping track of everything. I yeah, I was on some other things. I was on the Omnipod. But it kept I kept with my work my job I kept pulling my pump off, which was annoying because it started screaming and stuff.
Scott Benner 22:39
So yeah, you couldn't find a place for it that that worked for you that wasn't in the way while you were working.
Amy 22:44
Yeah, because sometimes I'd crawl up in attics, and then they crawl under houses and in crawl spaces and stuff like that. So I'm like every single angle possible. And then even when it was like around my belly and around, like anywhere, especially on my belly, I had like my tool belt and my climbing belt. So sometimes they would yank and pull off. So So I ended up going to Tucson because I can, I don't know, I feel a little bit more freedom. I know a lot of people say they feel freedom with the Omnipod, which I kind of did when I was at my previous job. But at this job I feel more freedom with a pump.
Scott Benner 23:19
You're able to like hide it differently because the set and
Amy 23:23
yeah, it really depends how how long my tubing is. So like sometimes it's just in my pockets. And then I get customers that asked me like what it is. And then I had like a lady yesterday say, Oh, is that the G six? You're like, Oh, I thought you only put that in your stomach. And I said, Well, I said you're only supposed to but there's pages out there that like some people do other places and had good readings and they said this is one of my best readings because it's on my forum. And so I love it and they even have like a tattoo. Um, that is actually a molecule for influence. So that on your
Scott Benner 24:00
waist. This is gonna get creepy. I know too much about you
Unknown Speaker 24:05
know my left arm.
Scott Benner 24:06
Oh, yeah, the thing gets flipped in the we're all backwards on Instagram. I hope everyone everybody, everybody's been bid mirrored. I was watching. I don't know if you know the comedian, Deon Cole. But he's been during the the Coronavirus thing. He's been DJing on his Instagram Live and it pops up in front of me sometimes, but it always freaks me out because he's got something on the back. Behind him. It's a science. It's like the ankle calm or something like that. But it's backwards and it always catches my eye and I'm like, Oh, that's right. We're all flipped around backwards and but but yeah, I saw you so it's a it's a big tattoo the molecule like you have the whole molecule out like on the top of your forearm, right?
Amy 24:48
Yeah, well, it's not the whole night here. If you look up the whole night here, that's pretty long, but it's pretty much the basic one. Okay, yeah,
Scott Benner 24:54
that's very cool. I saw you mentioned. So there's a couple of things that I've been paying closer attention to you now because I knew I was going to talk to you than I normally would. So just don't feel too creeped out.
Unknown Speaker 25:04
But you already do. It's fine.
Scott Benner 25:08
It's your fault. You've lost all the weight. No, it's not me, I didn't do it. Sometimes you talk about anxiety. But moreover, I see you talking about being uncomfortable with the loose skin that you have now. And first of all, in my opinion, is meaningless to you, you're really a beautiful person. So I know you shouldn't. Like, it doesn't matter what other people think, etc. But, you know, I'm trying to find out what that's like, like, you've lost so much weight? How much skin? Do you have that you need to do something with? and What? What's the play? They're like, what do you do?
Amy 25:44
Okay, so actually talk to my doctor about the surgery I'm getting, it's protecting me or something like that, which is the bottom half, which is like, like past your pelvic bone, depth below your belly button. And he said, we're gonna have to wait on a little bit, because I do have a lot of anxiety and stuff. So he wants to get that all controlled first, before we do that. But other than that, he really doesn't want to do anything about it.
Scott Benner 26:11
Does he think it's gonna shrink up on its own?
Amy 26:17
I should not worry about it, and just try to deal with it. Okay, um, he said that I would have to go see a plastic surgeon myself. So, so I'm trying to look into that and see how much that's gonna cost because I kind of really want it done. It's not It's not because it's like a, it's a little bit it is an image issue. Um, because I, like I know people like I, I used to wear a bikini, I was like, body positivity around like 290. And I wore a bikini at a theme park. And I was like, you know, I don't care. It's like, the 2000s we can do anything we want these days. But I still get those looks those concerning looks like if I go to a hotel room or something like that has like a pool or a private setting. And people just look at me. And I think people and then I had some comments like, you shouldn't be worrying socially around, like, certain kind of people. And I'm like, Okay. Like, some people like they're all around, like your co workers or your stuff like that. And I'm like, oh, okay, like, I'm like one, like, I don't think they really care. I don't think I know, some people probably think or why she nap, stuff like that. And it kind of a little bit of it. I don't like it, it just hangs and it just it does bother me. But at the same time, there's a little bit of body positivity in me. But at the same time, it's like, I really just want this gone. And then plus, I think some, like a lot of it. I mean, my doctor told me that is probably like, about 15 pounds of loose skin 15 to 20 pounds on the skin. So then I'd be like, so we're just Yes.
Scott Benner 28:02
Is it shrinking at all or no.
Amy 28:05
On some places it has like, like, I think because I was big for so long. It's not going anywhere. It's not like I got big and then went back down. It's like because I like was big for very, for most apartment. Well, not in most part of my life. But like my teenage years and stuff like that when your body is pretty much in their growth rate. Yeah, so. So pretty much like my legs. My arms aren't too bad. It's actually around like my back and then like pretty much like a domino in my lower abdominal and like, my upper back is everything I want to get done.
Scott Benner 28:40
What's up? It's a astonishing I guess people are you cool if people check you out on Instagram, or do you want to mention your handle? Or? No, it's okay. If you don't?
Unknown Speaker 28:49
Yeah, definitely.
Scott Benner 28:51
So what is it? How do they find you? It's
Amy 28:54
so my Instagram. I know you're
Scott Benner 28:58
breaking up. Don't say, john, you broke up. Don't say that. There you go. You're back.
Amy 29:07
Alright, so my Instagram. I know what I'm looking at. Yeah, Rob. I look. Good. Dragon Warrior. rugged, warrior,
Scott Benner 29:16
rugged period warrior. And yeah, it's mean, what you did is I know it didn't start out the right way. But the I guess the focus on not wanting to do you think that was the case? Do you think if you would have found out you had Type One Diabetes immediately. Do you think you'd still be bigger?
Amy 29:35
No, I don't actually I really don't because like, I'm actually a couple months ago. I went to a doctor and they're like, we're gonna retest you. Because I had severe lows. I was in the hospital for a week because I couldn't stay above 40 I ate I literally two days I was eating everything I could to the point that I was like, Alright, I need I just need food, food, food food. And I got to the point where I was like, I can't Do this no more, we have to live in emergency room. And I remember I was getting the sugar shots, glucose fixed shot, so you know what they called? I got seven of those within four hours. So one my veins, her and then they're like we're gonna retest you because we don't think you're a Type, Type a type one. And then I guess they did the one test again. And then they did like an insulin in your body test and I guess it came back in, like I don't even know I think low or something like that. So, um, so then they were like, okay, so we don't know what's going on here. But we think they're a type two, and I literally cried. Because I was like, This is my fault. I am big because of like, all this weight in my head. I'm like, I lost all this weight and I'm still on insulin. This is just a weird week. I said, I'm still on insulin. I still have like today. I mean, I still have to count my carbs. I still have a G six. Like, my, my endocrinologist knows I was at a different hospital. So they tested me and then it was just weird. And I literally broke down in tears because I thought it was my fault again, because everybody,
Scott Benner 31:05
maybe you were just gambling. Maybe you just had maybe you using maybe your pancreas just kicked back in for a little bit. During that happens.
Amy 31:13
I have no idea. I have no idea what happened. It was last year and I have no idea what happened. Like I was like
Unknown Speaker 31:21
I was like,
Scott Benner 31:24
dammit, leave me alone. You mentioned anxiety a second ago? Is that been a lifelong thing? Or is that since your parents divorce?
Amy 31:33
Uh, no, actually, it's kind of been recent. Um, I had it actually kind of got worse since I've been diagnosed, um, to the point where I'm actually on medication for it. Um, yeah, so actually, since I got diagnosed, I have been taking, um, anxiety and doing like DBT skills and stuff like that I've learned in the past couple of years. So and I and I am a true believer that managing your blood sugar does affect your hormones in every single way. Like even if you're angry, sad or anything like that. I truly do believe because when my sugar was high all the time, I was having panic attacks left and right. And I was crying all the time. And I was like, angry and I was sick and everything like that. So does the
Scott Benner 32:25
anxiety stick with you? No matter what your blood sugar is?
Amy 32:29
Um, so if a tie I am freaking out every two seconds like it's not because I just my boyfriend can tell you that that's the case. I'm He's my emotions are all out of whack. But when I'm usually stable between where I should be I'm usually having my life is awesome. It's kind of like having rose colored glasses like if your sugars out of whack everything's just like seems all colors go. And then when it's like right in perfect range. Everything's just perfect. And you think your life is great.
Scott Benner 33:03
You're really interesting. I do know that like your your there's a very thick you keep saying things that make me feel like they would come from a different person, but they're all within you, which I think is great. Like I didn't meet the gloss over earlier. But you're climbing through basements and attics and up polls. Are you installing some sort of utility?
Amy 33:21
Yeah, so I'm Kate. Yeah, I'm a cable technician.
Scott Benner 33:25
Okay. All right. So that at least makes sense. I'm like, Why is she in people's basements? People. Hi, it's me. You may be from Instagram. I've lost a lot of weight and I'm in your basement now. Just I figured that was what was going on. Is it scary to climb a pole with without a CGM? Like is it like it's an interesting paradox that you're an anxious person but at the top of a telephone pole. Does that make you anxious?
Unknown Speaker 33:55
so much? Well, yeah.
Amy 34:00
I love heights. I know top a telephone pole. And usually like, even when I didn't have my CGM I was totally fine. Um, I cuz I didn't really give a crap at that time.
Scott Benner 34:14
Probably really high. Not. Wasn't low ever, I would imagine.
Amy 34:17
Yeah, it wasn't low. Yeah, it wasn't lonely time was when I had that week and I was out of work for a little bit because they didn't want me climbing poles or driving. But other than that, no, I love heights. I really do. I actually love skydiving, actually that as soon as I got to the weight, I went down and I jumped in. Everybody's on you scared? I said no, I've been waiting for this since I was 18. And I was the happiest person I did not hesitate one bit. I can't I'm so glad that this Corona thing starting to lift because they have opened up and I'm going to go again. And I actually I was mad because they actually canceled the halo jump which is like where you it's like 23,000 feet and you drunk with an oxygen tank up in
Unknown Speaker 35:01
Yeah,
Amy 35:06
they got cancelled because of the whole Corona thing. So, but I am so excited to go jump again. I love heights. Yeah, it's one of my favorite things.
Scott Benner 35:17
That's, that's astonishing. But I want to dig into it a little bit for a second. So your anxiety is more? Is it more personal? is it and how did you manage it before the medication?
Amy 35:31
So I didn't manage it. I was actually self mutilating. It wasn't because I wanted to die. It was more of a it stopped everything rushing in my head. You were cutting? I was cutting. Okay. All right.
Scott Benner 35:47
I have more context on that. I don't know if you heard I know you don't listen to the podcast, maybe that's fine. Don't worry about it. But there was a we had a self harm episode recently with a person who also cut like so now that you're talking like, it makes more sense to me than it would have the first time like eat your story. If I heard it the first time I would have been like, No, wait, what but now I I know how it goes. For some people. So I'm, I'm a little more, a little more educated, educated around it now. So. So anxiety starts in your teens, right?
Amy 36:20
I yeah, I didn't really have much like, I mean, life was okay. I would say okay, high school wasn't bad, I lived it. I lived in a small town, small school school. So everybody knows everybody, you're friends with the popular kids all the way down to the non popular kids. And that was kind of popular because I played football. And everybody kind of looked up to me. And so that was kind of cool. But other than that, just my living situation wasn't the best. So that was a little bit part of my anxiety. But I'm like one of those people say, that's a very independent person. Um, I try to do things by myself. And I kind of don't reach out for help if I don't need it. I'm learning a different way. But yeah, so like I said, my anxiety didn't start until I became like, type one. And those doctors were just telling me, you have to lose weight, you have to lose weight. I'm not till this day. I still have like, if I start gaining weight, I still have those doctors in my head and I have to tell myself, this isn't my fault. It is an autoimmune disease. I know you can gain like 1020 pounds here and there. You know, maybe it was like a big barbecue weekend. So I like tons of cake and ice cream and meat and regular soda. And then so I literally have to like don't tell myself all this stuff and like, just be like, you know, just give it another week you'll be okay.
Scott Benner 37:50
Well, that's just because it's gonna stick in my head if I don't ask organized football like for high school, or when you play school football? Yes,
Unknown Speaker 38:00
I did.
Scott Benner 38:01
With position.
Amy 38:03
Tackle garden tighten.
Scott Benner 38:05
No kidding. Nice all fans can catch a ball. And guys, you guys were okay. Like, hitting you. They did you ever like did people ever not?
Amy 38:16
There was like, No, I actually, I don't know, I once you put that helmet on. I don't think they knew who they were up against. But I know a couple guys on my team didn't want me there. And they laid me out during practice. Sometimes I remember the coach yelling at them. But no other than that, like, I I had a blast. I know they say like, being on high school, something that they usually tell boys is something that you're gonna it's like the best time in your life.
And it is. I mean, it was it was amazing. So I'm glad I got it was one of the lifetime things that I do not regret cool.
Scott Benner 39:02
No, I wouldn't think you would regret it. It's just that I keep wondering how much longer I would have to talk to you before you'd say something else that I didn't expect. So because for clarity so far, think about it. You're 28 years old in those 28 years. It sounds like you survived a divorce that wasn't particularly fun for the child. You gained. Your your weight was 365 pounds. You've lost like 160 pounds of it. You found that you had type two diabetes, you didn't have type two diabetes, type one diabetes, you climb polls for a living you like to jump out of airplanes, and you played football in high school. Like, what else don't we know about you?
Amy 39:41
know, everybody says I should be writing a book.
Scott Benner 39:48
What did she just say? And you know, it's I'm trying to figure out you know, oh my god, and you live by the way your your internet connection, flies in and out every once in a while with Don't worry about like, I'm living through it because I'm just like, I'm not telling her that I can't hear you because your voice slows down like, but you live in the like you're in the woods, right? Are you not?
Unknown Speaker 40:10
Yeah. Yeah,
Scott Benner 40:12
yeah, you should get a cable company to bring in a better signal for you.
Amy 40:15
Was it I came in get I get free internet and I can't even get cable to my house. I have to have satellite.
Scott Benner 40:26
If only you knew somebody, alright. boyfriend, you mentioned a boyfriend. How long have you been with this guy that you're with them?
Amy 40:33
This is this is a complicated part of the whole thing. So I actually live with my boyfriend and I live with it. So hold on,
Scott Benner 40:42
hold on. Your voice broke up and we're not losing this. Hold on. Let's get a hold on a second. We're not we're not listening this. Okay. Let's take a breath. You have. Okay. All right. You're still breaking up. I'm trying now. So fast.
Amy 41:00
Wait, hold on. Let me let me walk. Now, am I good?
Scott Benner 41:07
Yeah, stay on the microphone. All right. Okay. You're with your with your boyfriend who you've sounds like you've had for a while.
Amy 41:14
Actually, our one year anniversary is gonna be 20.
Scott Benner 41:18
Okay, so you've been with this guy for a year, but you live with an ex fiance?
Unknown Speaker 41:22
Yep. Okay,
Unknown Speaker 41:24
hold on.
Scott Benner 41:26
Just wait. Does the boyfriend live with you too? Yep. Okay, so you, your boyfriend, your ex fiance live together? Let's keep talking. This might turn into an after dark episode. It's fine. If it does. Are we? Are we like a throttle? No, okay. No. So there's no fun stuff between all three.
Amy 41:46
No. So my pretty much my expense. I just kind of grew out of our sexual interest with each other.
Scott Benner 41:57
By the way, every married person is laughing going. Yeah, me too. But go ahead.
Amy 42:04
So Well, no, he's like my best friend. He has been. We've been pretty much I would say we were dating for about 766 years. And we did get engaged, but we never got married. And it was just it just never happened. I mean, we never were in a financial state to get married. We were always too busy. and stuff like that. And then but he's my best friend to this day. If anything, if I'm having anxiety. That sounds so bad because I have a boyfriend. I'm having anxiety. or something's going wrong. Or, like, we still have our dog something wrong with our dogs. I forgot something, I'll call him. He is literally my best friend. He actually is training my boyfriend how to take care of me. And it's the greatest thing because my boyfriend will call him and be like, what does he like on your pizza? or walk with me like this? Like, like everything or like Amy's like panicking. I don't know what to do. Um, can you come over like, Oh, it's like, this is like before we live together and he's like, can you come over? and stuff like that? So but they get along great. They hang out. So there's nothing they never fought or anything. And it's been a year. So yeah, plenty.
Scott Benner 43:20
Were you with him at all. Wait, the fiance like were you 365 with him? And 200?
Amy 43:26
Yes. So so he's been like with me, like since I got diagnosed, and then he has, he knows my eating disorder. He knows when I'm like, like, my ketones are higher. I'm not feeling good. And he knows when I'm low and like you I don't even have to tell him and he's like, Are you feeling okay? And then he'll just go grab my, oh, he won't look at the CGM. Well, sometimes you will, but he'll go grab my poker also, because you know, sometimes that can be off a little bit, and hold testing and stuff like that. My boyfriend doesn't do that. He's getting there. But don't worry.
Scott Benner 44:00
Your fiance will get your boyfriend trained and then you'll be fine. There's a sentence I never thought I would speak out loud. It's fine. That's that was very first of all, that's incredibly progressive and and I like that you're still friendly with a person who means something to you. And I hear that so you know, that's cool. Did he prefer? I this is such a weird question. But sexually did he prefer you bigger? Or
Amy 44:26
he said he said he loved me in any single way. That's like me anytime. Yeah.
Scott Benner 44:31
Nice. I don't see why you wouldn't. I'm just wondering if like, like now I was like literally thinking like, was there? Like, did he have a fetish? And then he was like you lost weight? And he was like, Oh, no, forget it. Now if you're gonna be 200 pounds, like I'm out on this, but no, you guys were together together like in your minds and your hearts. Gotcha.
Amy 44:51
Yeah, so today like he's my family. Like I really don't really have any family out here. Even though my family's from here, but some have passed. My mom there. Arizona sister doesn't really talk to me because she's up there Bluefin but so I'm pretty much like so he like so we've been through everything like financial struggles on to like me getting diagnosed and other illnesses and stuff like that so like it's so we're tight.
Scott Benner 45:21
Listen, I'm not judging I just didn't expect again did not expect you to say that. Right? So let's, let's find something else to ask you about that you're gonna say something I can't imagine what is your a one c right now?
Amy 45:38
Oh no, I just got back it was a bad day. Actually Was it the front? Yeah, I go the first every month, the first Monday of every month. It was a 15.20 my
Scott Benner 45:53
gosh, okay, so alright, so you have now let's figure this out. Let's figure this.
Unknown Speaker 45:59
Wait, wait, can I tell you what my last agency was? Is it gonna be like four and
Unknown Speaker 46:04
I'm gonna be flipped out there. What was it? Good?
Unknown Speaker 46:06
6.2. You went
Scott Benner 46:08
from 6.2 to 15? Yeah, is that eating cake and soda at a barbecue like that?
Amy 46:15
There's a lot of birthdays.
Scott Benner 46:17
People You know, I've got it's not me.
Unknown Speaker 46:22
But that's
Unknown Speaker 46:23
birthday. So
Scott Benner 46:24
that's super interesting, because that's it. I mean, a fairly massive swing, like from like one quarter to the next. You know how to keep an agency in the sixes like when you had it in the sixes? Was it because of a lot of lows? Or was it you were doing things that were leading to like a stable six?
Amy 46:41
All right, you ready? For another surprise thing?
Scott Benner 46:43
I don't think it's gonna be a surprise at all. But go ahead, whatever you're saying.
Amy 46:46
So when I was pregnant, my sugar stayed at a constant level would mean barely taking an insulin.
Unknown Speaker 46:54
Do you have a kid? How come? I don't know?
Amy 46:56
I do not. That's why. So I actually went, I was 2323 24 weeks, and then I had her. So then after that, things didn't work out, which is okay. I'm kind of a little glad because during my pregnancy, I couldn't take any my pretty much my mental medications, which I was going insane. And I was doing self mutilation again, and I was like, I can't do this. I can't be a mom. And then I was back and forth about having a kid and I was actually really suicidal too. And then I was having pseudo seizures. Which I don't know if you know what those are. Those are the ones Yep, they're not epileptic. I can't say the word. Yeah,
Scott Benner 47:47
I can say epileptic.
Amy 47:51
Yeah. So they're not those seizures. See, the seizures is actually when your mind gets like, a bunch of chemical imbalances in that and it shuts down. So then you have a seizure. So I was having tons of those I wasn't having regular seizures. At the point in my pregnancy, so my life so I couldn't work. I couldn't do anything, even though I'm the kind of person that was kind of cool was pregnant. Some people might not like that, but I like to have a stable income.
Scott Benner 48:20
Climbing. I guess you're pregnant, by the way. So you're, so wait a minute, I and I feel like we're being we're bouncing around from serious to lighthearted, so much. I don't know what to say ever. But you, you the pregnancy ended with a live birth or no,
Amy 48:36
no, no. Okay. All right. I was I was at 24 weeks, and she had a heart condition.
Scott Benner 48:41
Gotcha. I'm sorry, first of all it but I but I hear what you're saying about the the other stuff. So when you're pregnant, you can't take all those medications that are keeping you where you need to be with your anxiety and and all that.
Amy 48:57
Yeah, even if I don't take my anxiety meds, I'm usually I'm pretty good for the day. But you know, every person says, a pregnant lady is not who they really are. Because they're sometimes a monster. I don't
Scott Benner 49:08
know who says that. Amy. I don't say that. Anybody would never hear me say that. My wife was completely normal the entire time. She had children just so you know. That's
Unknown Speaker 49:18
okay. Okay. So
Amy 49:23
so I had like, the extra extra hormones running through me. So everything was just super bad. But my sugar did stay in like the range the whole time with very low insulin. So that's why my last a Wednesday was in the sixth.
Scott Benner 49:40
So this was very recently so this pregnancy is with your boyfriend. Yes. Gotcha. Okay. I'm okay. I'm getting it. So you're making me feel old just in case you're wondering what's going on over here. Like, I just I went to high school and I got out and I was like, that girl seems nice. And then I just, you know, I made a final Yeah, let's go. But you you're having more fun than I did. But, so Okay. So pregnancy wasn't on purpose I'm imagining.
Unknown Speaker 50:11
No, it was.
Scott Benner 50:12
Are we doing stuff now to make sure it doesn't happen again?
Amy 50:16
Yes, I did. I got the ID you IUD Marina IUD.
Scott Benner 50:21
Now I hear that's helpful with blood sugar's actually, because it keeps you know it's finding that because I bought what's been told to me is that that keeps you from me keeps you from having a period is that right?
Unknown Speaker 50:35
Yes. Okay.
Scott Benner 50:36
I know. It's so because there's hormones on it. Maybe it doesn't keep you from having it here. But there's hormones in there. Those
Amy 50:41
keep like after like six months, you shouldn't have it no more, but it does like the hormone thing. I haven't know. I don't know. I learned another thing. While we're on this topic, I, when I was a big girl, I used to never get them. I probably got one a year. Okay, one a year. So I was like, I ain't getting pregnant. Well, wha wha. And so and I lost weight. And then I started getting them regularly, which that means you're more healthy. So I was like, when I started to hate him. I didn't like him. I was like, This is the dumbest crap in the world. I was like, why am I a girl? This is so dumb. I was like, I liked it. When that was like the one positive thing of being a bigger girl. Like I was like, No, no, yeah.
Scott Benner 51:33
It's the worst idea. Like the plant. It's the worst plan. Like it's somebody. Like, I mean, whoever designed it is just, they weren't thinking yeah, there's a better way.
Amy 51:42
Yeah. So I so I was having unprotected sex. So I didn't think anything of it. I really didn't. I was like, it's not gonna happen because I was so used to not getting one and then, and then like, a month went by, and I was like, Oh, that's okay. And then. I really was so yeah, it was July, when it was conceived. I went to the hospital for the August 2, Pregnancy came back. Negative. So I was like, Okay, I'm good. September came around. I went to the hospital again. No, no, it's weird. I didn't even go to hospital. I had an interview somewhere else. And I was like, I kept seeing babies everywhere. And I was like, I should go get a pregnancy test. And I did it. And I was like, oh, and then the first person I called was my ex fiance. I didn't call my boyfriend.
Unknown Speaker 52:44
I was like I
Scott Benner 52:46
said, Listen, I hope you know something about babies, because you're gonna have to teach my boyfriend about it so. Well, I mean, that's Listen, obviously, that's none of those things were intended or went away. I guess anybody would hope for them. But no, but I mean, as long as you I mean, if you take steps moving forward to stop that from happening, you know, and get yourself you know, if you want to have a kid one day, you're you're gonna have to think it through like you're gonna have to have a plan because obviously just you know, hey, here we go isn't gonna work out for you. So yeah, you have to know what you're doing when you want do you think you want kids one day? Or is that
Amy 53:24
still up in the air there's this world is crazy. If I want to raise a kid and at the same time, like even before that, like I was like, open air about it, but like, I think now since I hold her, I was like, I could do this. I can be a mom. I think the next time if I do get pregnant, and I'm like off medications and stuff like that, I will remember that moment. Like, I can do this. And it's actually quite interesting. I'm kind of glad that I kind of went through it because there's so many extra steps a type one diabetic has to do to even before you get pregnant like you're a one sees me to be Ranger sugar not even just your even sees like your sugars need to be like soup, because you can have a 401 day and then like, like, and still have a good day one See, your sugars have to be like in line all the time, even before you get pregnant, like about six months to Have a Healthy Pregnancy throughout. So I'm glad that I know that now because like I have my blood sugar's were a little bit high before that, because my agency was like 10.6. And that was they said that, that could cause heart problems. So so I kinda feel bad. That was my fault that I couldn't bring a beautiful person in this world. But at the same time now I know for next time
Scott Benner 54:40
you really did Oh, right. Like the all that stuff is a little lost. I mean, everybody doesn't get great, you know, information when they're diagnosed, then some people do and some people don't. I don't know that that's anyone's fault. Sometimes it's where you live or the kind of insurance you have. There's all kinds of reasons why, why it varies around I'm going to say something to you don't usually pitch my own show to people. But because you haven't listened, I'm going to give you a link to something. And I'm going to, I'm going to see how interested you are. But there's a grouping of episodes within this podcast. They're called, like, diabetes pro tip. And I think if you listen through them, I don't think your agency will ever be 15. Again. So and it's not about restricting food or anything like that. It's just about understanding how insulin works. And you have the right tools to do it with with a pump and, and that glucose monitor that CGM is is a quality device. So you'll be able to I love it. Yeah, it's been it's really fantastic. So I will, I will give it to you when we're done. I'll send it to you. But it's just diabetes, pro tip calm that way. You don't have to listen to the whole podcast, you can just kind of hit some of that. I think that might be helpful. The, the anxiety part though, it it's involved in everything. And I don't know that people understand that because everybody gets anxious sometimes. But the difference between anxiety that needs to be medicated and not like I now understand better from talking to someone else, that it can hit you out of nowhere and cripple you. Right? And then the pain is just it's massive. And then, you know, prior to I guess the anxiety, medication, everything you were, I didn't understand cutting until someone really explained it to me, but it's that it's a relief in a weird way. Right? And have you done that recently? Or do you not do that any longer? What's the
Amy 56:31
last time I did it was when I was pregnant? Because I was freaking out. So I mean, but before that, I think was about a year and a half ago. Um, yeah. So what I wasn't actually I was getting medicated for my ADHD and a DD. So my doctors like, you know, let's throw these out. And let's try anxiety meds. So that's what we did. And I'm so much better now. Um, the thing is, I think the big part of it is like, even though like you totally understand it, I and then you get to the point where you want to quieten everything. It sucks when you're having an anxiety attack, and then you're getting upset that you're having an anxiety attack, because you're like, this is not the place in time to be doing this right now. So then it just gets even worse. And you're like trying to calm down and you can't really do anything. Like actually, the last panic attack I had was actually a couple weeks ago in Walmart. And I don't know why I think I had a little bit that I was noticing all the shelves, were getting super low again. And it wasn't being explained. Like I don't know how everybody else's world is out here. Like there was no TVs on a shelf. There were some game systems, there was no like food, baby stuff as though everything. And this is only a couple weeks ago, we're kind of coming out of the cold stuff. So I was like, What is going on? And then I actually was walking down an aisle and I said, Oh, what should they eat? And I said she get something healthy. And then it was down like a snack aisle that had all these snacks, it said and that was in my mind saying no, no, no, no to all this food. And I was getting anxious about that. And I literally got into the frozen food aisle squat down and like starts bawling my eyes out. And and I call called my ex fiance and he's like, I don't know what's going on. I am like freaking out right now. And then the Walmart employees helped me and it was a it was it was a whole deal. Like I it was I haven't had one since I was pregnant, even though it was like recently, but it was like earlier in my pregnancy. And it just sucked because i was i was i was good. I was good. And as early as
Scott Benner 58:42
I think that it's it's visual, right? And there are things that you just expect to be there. And then when all of a sudden they're not there and then more and more things disappear. like okay, like in the beginning you think oh, people are hoarding food that makes sense. Toilet paper, like I understand that people are doing that. But when a television disappears, you're like, wait a minute, where are the PlayStations at Little League? Like Wait, wait, why is everything gone? And it feels it could I can see how it would make you feel it because I've had that thought too. I've walked this store and thought Hmm, supply is really low on a lot of things. One of the strangest things is you can't buy a flower pot anywhere. I know that's a weird thing. But you can't find a flower pot. I'm just like, I'm like the duck did COVID-19 hit the flower pot industry extra hard, you know, like, like, you know, very interesting thing, but then I don't have anxiety. So then I just noticed that I move on. But
Amy 59:32
no, so I didn't give me exactly yeah, the one thing I think that did give me anxiety so I'm in a great financial position. I'm really good. I love my job. It's really good. I have a place out in the country. And then so I was like, last four years. I was like mega pool. I'm going to get a pool to pool All right. Finally I have enough money. I just go out by pool whenever I want. I cannot and i and i don't know if any other diabetics are like this. I hate summer. It hurts. I don't know why I since I've been diagnosed, I cannot stand here. Even though I'm outside all day, I'm glad I can go into my air conditioned van when I need to. But like, it bothers my skin like I don't like it I get angry. I know some people just like get angry when they're hot. But it really is a very discomfort feeling past like 78 degrees. So I need like I need like, I was like, I'm going to the pool. So I can just come home and just go in the pool or break before work. And I can't find pool anywhere. And then if you do look for pool, they are price gouged so much like a normal pool that will cost like 350 bucks is like, like almost $1,000 I was like, Nah, not gonna do that. Never do that.
Scott Benner 1:00:43
Well, I have to ask, have you ever had your thyroid checked your thyroid levels.
Amy 1:00:50
So I saw because I seem like that dirt the first Monday of the month. So it was like a week or two ago. Actually, my thyroid wasn't large. My thyroid wasn't large throughout my pregnancy, other doctors that said, Oh, it's because of the pregnancy, after the pregnancy hasn't went down. I actually had an ultrasound on a Monday, Monday. And I have to go get a biopsy now.
Scott Benner 1:01:15
Okay, and have them just keep on top of that, because an inability to regulate your hot and cold could be from thyroid, thyroid autoimmune, like type one. Diabetes is not uncommon for a person that have type one diabetes and a thyroid issue. So check into that. Because maybe that that might help you with some of the other with some of the other stuff, especially with the heat. And I know that both my wife and my daughter have hypothyroidism. So there are nights when I get in bed, like I bought my wife one year as a Christmas present a ceiling fan that runs so fast that it's like a jet engine and my children as I'm wrapping it, my kids were like, you're getting mommy ceiling fan for Christmas. And she's not going to like that as a gift. And I was like, No, you don't understand mom's gonna love this. And so it, it this thing, just it makes a turbine of air that it cools the air in the room to the point where sometimes it's hitting me in the face, and I'm like, I can't breathe. And I look over and I look over at her and she's so happy. She's like, it's nice, just nice and temperate in here. And I'm like is it because I'm freezing my nipples feel like they're gonna fall off.
Amy 1:02:24
I love the cold everybody hate later on the gold bar drops so hard when it's cold is a little harder. But I will I will take the cold any day of the week, then
Scott Benner 1:02:34
levels check while they're doing this other work on you and keep taking good care of yourself like that. That's I mean, in the end, that really is going to be your pathway to to everything. I don't know. I don't know if that the anxiety. Listen to my opinion, the anxiety should be treated as much with medication as it should be with therapy. I don't know how available therapy is to you. But like there's So here
Amy 1:02:56
it's it's horrible.
Scott Benner 1:02:59
That bird behind you or something like that
Amy 1:03:01
I that's it out in the woods is pretty much as good as talking to anybody in this town. Yeah, honestly, do they I even had a therapist out here say that the health, the mental health care system out here sucks. That's how bad it
Scott Benner 1:03:14
so here's an idea. Maybe you could do telemedicine with a therapist that's not in your area.
Amy 1:03:21
I have to write because not a bad idea. Because if you
Scott Benner 1:03:26
could find ways to lessen your anxiety aside of medication, that might be a big deal for you, you know, because I'm going back to the Walmart story. And I'm hearing that like, and you said something prior to that, that I didn't want to skip over which is you have an anxiety attack. And then not only are you anxious about the thing that made you anxious, you're now anxious about being anxious. Yeah, that's screwed up. Like that's not a big deal to me. Like that's difficult in a way that people won't understand if they don't go through it. And I didn't previously understand either, but now you're now it's just coming at you from both sides. And what are you doing? You're telling yourself Don't be anxious. That's not a plan.
Amy 1:04:08
There's a I've learned DBT skills.
Scott Benner 1:04:11
Tell me about that. What does that stand for? You want me to look it up because I just lost your audio anyways. Let your audio come back and I'll figure it out.
Unknown Speaker 1:04:23
Is it back?
Scott Benner 1:04:24
Yeah, you're back mindfulness. distress tolerance. mindfulness can go a long way but isn't always enough. Die.
Amy 1:04:32
Yeah, diet to diet.
Scott Benner 1:04:36
therapy. Why? Why do things have to have? Why can't they just say DBT and let it be. DBT refers to dialectical behavioral therapy. It's an approach to therapy that can help you learn to cope with difficult emotions. Today it's used for eating disorders self harm, depression, substance use disorders at its core DBT helps people build For major skills, mindfulness, distress, tolerance, interpersonal effectiveness, emotional regulation, it's helping
Amy 1:05:09
sometimes. So there's like different things like grounding. Like if you put your hands on your legs while you're doing stuff take deep breathing talent. There's another one that I don't know what it is. But it's like you see two things smell one thing, see a color and something else and just focus on those people. Put your mind somewhere else. Um, I can't Brown, I tend to kind of dig into myself a lot on so I can't do that. Breathing is my biggest thing I try to breathe on that day at Walmart. Even prior to that day I was having. I was very anxious the whole day. So I was trying to breathe through the day. And it just moment just made it worse. So just so I learned that and I even like go to see these other doctors because it's, it literally has learned he took me about five years to see a psychologist. Pretty sure that someone that's prescribing medication. And this is actually
Unknown Speaker 1:06:05
prescribed. Yeah.
Amy 1:06:06
Yeah. So it took me about five years in this area to find one, even after I got out of the eating disorder treatment center. And she was like, I can't help you. You need to get control. You're eating the server's Well, a little bit. I, you know, I, I know. She was like, I can't help you. Control your eating disorder papers. If your primary peers like I'm doing your medication, just have him do it. And he doesn't feel comfortable with it. Especially he does also this substance abuse. So anything that is a narcotic, he doesn't want to give me so that's kind of hard. And it like I said, it took me five years to find somebody to talk to them for the first time for an hour to tell me that they could not help me. And I've had a couple doctors tell me that and that I cried that day. And I was I was I was kind of a little bit suicidal that day, I was like, I can't do this. I'm never going to be fixed. I said, Nobody can help me, bla bla, bla. And even like, there's a point where my medication I get to the point where I can tolerate them. And then my anxiety gets a little worse. And then I notice it and then I'm like, I get anxious because I don't my doctor is like, well, maybe you should just deal with your anxiety a little bit. And I don't like that because once my anxiety starts a little bit, I don't want to go to that dark rabbit hole, which scares me, which causes me anxiety. So I don't want to go there. I was very suicidal. I actually tried to do suicide with my insolence several times. And luckily, my ex fiance knows how to use Google gone and forced me sugar things while I'm like almost passed out, so
Scott Benner 1:07:52
and what and that feeling of being suicidal, it's just that idea like, this is never all gonna be okay. Like I can't Yeah,
Amy 1:07:58
like I'm never gonna be fixed. Like, I'm like, there's a there's like, now I'm good. I like, Alright, we're medications are doing pretty good, we're good. My doctors following up with me more, I see him about at least every four weeks now to make sure that everything's good. Um, so it was good. But between, like, I don't know, like, I thought every, like, nothing was going good. Like, I was having a hard time. Even if I like, was struggling at work. Or just like most of it was because I my head wasn't straight. And I have been trying for years like I've been on medication since I was a kid. And I've been trying for years to get my head straight to the point where everything is okay. And I it's it sucks because this area sucks in mental health. I had a good time getting to where I wanted to be when I was out in Minnesota. My doctor wants me to go back out there and so that was my boyfriend and the next day but I did say I've been doing good and in the last year so I'm pretty good but I just want
Scott Benner 1:09:02
you had Karen Minnesota that was better for you you think Yeah.
Amy 1:09:05
Oh dude. So there was actually eating disorder treatment out here to the point you gotta walk to the facility they have like housing for you. You had to walk to the facility that was like a block away. No, sorry, not block away, like eight blocks away. And even if it was in the middle of winter, which it gets like negative degrees out here. So you had to walk there, then you're there and then they had this eating thing and I noticed a lot of eating disorder clinics don't treat all eating disorders they usually just focus on anorexia and that's that sucks because I they give you a piece of paper where you had to eat Yeah, they eat this many fats this many this and this many that. The thing is, is I didn't have a problem eating and I think a lot of type ones like that have died, believe me and stuff like that. A lot of us love it that we can eat anything we want and lose weight at the same time. So literally When it came to eat, I was fine. I eat whatever I want. But the thing is, is then it got to the point I remember I was on the couch, it was like a break time I was on the couch, and I did not feel well. And I did have my pump on me. And I like, literally rolled to the floor, and I thought I was gonna die. And I took some insulin. And then I remember the next morning was, I had a walkover and and I my ketones are super high. And neighbors sent me to the emergency room. And I said, No, I'm fine. And then they told me if you don't take your insulin that we're going to have to kick you out. And I'm like, this is why I'm here. I'm struggling to take my insulin because of fear of weight gain and stuff. And you're telling me that if I don't take it, you're gonna kick me out. So actually reached out to the diet, believe me on page, and I called them and they actually found a place with my insurance and stuff, and they got me to Minnesota, the only thing to do is find a way to get there and I got there. And that place was amazing. They have a special group for diabetic patients with eating disorders. And they have a mental health care, and they do so much like it's it was the greatest waste, like I couldn't ask for better treatment than any anywhere else. And with that said, like they had nurses that give you your insulin, and if even if you didn't want to take it all, they would talk to you about it to get you to take it. So it was it was like it was it was a really good treatment to the point where I was taking my insulin again. Um, so that was that was in the eating thing. It still went towards the people who had anorexia, who are anorexic, and I ate. So I don't know if anybody else but I heard a lot of people who restrict your insulin and then go back on insulin, they turn into a garbage can like they will eat anything and everything in their sight that that they can eat. Because for some reasons, like your body, start your body for so much. And now it can take all that although carbs that it can take that you've been like not giving it. And
Scott Benner 1:12:16
so you don't gain a lot of weight right away by re No. And using your hands.
Amy 1:12:21
No, I did I know. But you turn into a garbage fan like I wanted. Rise, I wanted this, I wanted pizza and it got to the point. So I got to the point where we were all eating around a table we all eat together. And then I got to a point where when I got done with my plate, I still wanted more. So that wasn't normal, so that I was considered an overeater at that point. So it got to the point where they're like, okay, so one through 10 How do you feel sevens where you want to feel 10? Is that your point that you feel like you're at a bus. So it actually got to the point where I was there and I had to tell myself to stop eating. Because for some reason, I don't know if you ever, like you know how you get like a chocolate bar, you're like, Oh, we just got a little piece. And now you want the whole thing. So if I went past that part of eating over that seven, like I already ate, I had like a balanced meal. I would eat, eat that one little bite. And I was like, Alright, let's just finish it. So though I had did come into a conflict, what we're all eating. And my therapist said, we'll talk to everybody there. And when you get to seven, you can stop eating. And remember, this girl said no, you can't stop eating. And I was like I was told to you that I can. And she's like, No, you have to eat our food. And just run you already ate my portion size. Like I already ate more than enough. And, but they only look at the people who didn't want to eat, who didn't want to touch your food, who was a fearful of her food to the point where I just wanted to do this. And I remember I shut down for like three days. Like I shot right down. Everybody's like me, you're not acting normal, like what's going on? Like, I was quiet. I was like, Okay, I'm not gonna eat no more. I was like telling myself just become anorexic. But I did work through it. And then they recognize that and it was it was good thing. But I think you have to be careful when you go to some places because they're not gonna focus on what your true eating disorder is, especially one that has to do with diabetes. But they did really well out there. So
Scott Benner 1:14:23
Well, I think that it sounds to me at least like you should find, even if it has to be through telemedicine, like find somebody who's better equipped to help you in your local your local area, that person doesn't exist. I still think it's good for you to have somebody to talk to because it sounds like it went much better and you are in a good place there. And this is obviously a maintenance thing. It's not going to right it's not going to go away on its own out of nowhere, like you're gonna have to maintain and maintain and is that the goal to like someday? Like I wonder what that did they ever excuse me Did they ever share with you what your goal should be like what it is you're trying to get to?
Unknown Speaker 1:15:05
Like a weight goal?
Scott Benner 1:15:06
No, like a, like a psychological goal, like,
Amy 1:15:10
yeah, you should be happy with yourself. And that's pretty much it. But there's days and I and I know everybody strolls. And my boyfriend didn't really understand it a lot, because he didn't understand suicidal. And I don't think a lot of people do. And I still I still, that's why I'm really open to it. So when people ask me about my cut marks, I tell them about it. And some people are like, Oh, why don't you cover them up? And I'm like, because I want to tell them my story. I want them to be educated about the same thing with my CGM on my phone, like you asked me about it, I'm gonna tell you about it. And my boyfriend's like, oh, people get down all the time. And I used to not believe in depression at all. I really didn't. I just thought somebody had a million dollars, maybe fine. That'd be okay. You know, if they had their family around them the whole time, if they had what they truly wanted the whole time, they'd be fine. No, it really I remember, I was crying one day, and I didn't know why. And Dylan, like ex fiance, was like, This is depression. And I said, I don't know why he's like, this is it. And then I realized, okay, I'm depressed, I need to get this treated. Like I didn't want to take medication for I didn't, because I felt like if I did take medication for it, that meant that I was sick, I was sick. And I wasn't like everybody else. And I and I, I'm glad that a lot of people are speaking out from this from like, celebrities all the way down to just me to say that it's just a chemical imbalance in your brain, it has nothing of being like a sick person, you're just, it's just like, somebody being diabetic, something doesn't work, you have to take medication for it, it's not making you any different than what you are. Hey, so I actually
Scott Benner 1:16:52
think that's a perfect way to end this too. Because I, I've been struggling for how to bring this to a close and, and I think that's exactly right. Just, you know, do what you need to do to live your life. And don't you're not, you know, if your pancreas doesn't work, your pancreas doesn't work if you know, and whatever else comes along, but I completely agree with you. Depression, anxiety, those things from the outside can be looked at, like they're, you know, like, oh, they're just crazy. But that's just the case. You know, it's, it's, it's very simple. Like you said, there's an imbalance of chemicals that lead you to feel more strongly about empty shelves, and I felt about them. And yeah, and I think a lot of us, you know, in regular everyday life prior to COVID-19, specifically, our lives were pretty comfortable. Like we had a, you know, it happened in a certain way I get up, I do this thing, like I have coping mechanisms. And now all of a sudden, those coping mechanisms are shot. And visually, everything seems different. And you're seeing people reacting to these things differently. And you're right, somebody has to share what's happening to them. So someone else knows. Otherwise, they're gonna think they're crazy and not just know that there's help to be had. So yeah, I appreciate you doing this very much, especially because you don't listen to Why are you following me on Instagram, by the way,
Amy 1:18:16
because I follow other type one diabetics on Instagram. And then you came up a lot. So I was like, Okay, I'll follow this. And I was gonna listen to podcasts. I'm a very busy person.
Scott Benner 1:18:29
You got to play football. You got to talk to Paul.
Amy 1:18:37
Meaning to like, there's like other podcasts that I've been meaning to listen to. And I just don't get around to it. Yeah, this
Scott Benner 1:18:43
is the one Don't worry about the other ones. Well, I really appreciate you doing this. I want to thank you. And I'm going to stop for a second stop recording you because I want to share with you, you know, what I think might help you a little bit. So and I've mentioned it here already, but I want to make sure you have the information. So thank you very much for doing this. I really appreciate it. It
Unknown Speaker 1:19:06
was a pleasure. Oh, thank
Scott Benner 1:19:07
you. For me as well. You really are delightful. I hope nothing but the best for you because I think you deserve it. And not that everybody doesn't. But you've come a long way and I you know, I'd hate to see it. I hate to see it not finished for you. Like I think there's whatever it is you think finishing is. I hope you get to it. I really do.
Unknown Speaker 1:19:30
So looking for that.
Scott Benner 1:19:31
I hope you find it. A huge thank you to one of today's sponsors, g Vogue, glucagon, find out more about chivo chi Bo pen at G Vogue glucagon.com forward slash juice box. you spell that GVOKEGL Uc ag o n.com forward slash Juicebox Podcast To learn more about the Contour Next One blood glucose meter, check them out at Contour Next one.com forward slash juicebox. super accurate meter, incredibly easy to use and carry, really, really, really take a minute to look at it. The website has a ton of stuff, including links to their test trip program, and you may even be eligible for a free meter. I want to thank Amy for coming on the show and for being so incredibly honest. And for just going with it and continuing to tell our story after it became obvious that I didn't even understand a tiny bit about her when I asked her on the show. I really sincerely thought I was just asking somebody who had an incredible weight loss to come on and talk about it. I did not know where any of this was going to go. Thank you so much for listening. If you're enjoying the show, please give it a great rating and review on Apple podcast. Tell a friend, subscribe in your podcast player, support the sponsors. Whatever you can do. I hope you have a very Merry Christmas. But there are more shows coming in 2020 this show does not stop still coming. A great chat I had with Jenny that kind of rounded out the year we just sort of sat down and talked. I have a defining diabetes coming. And I just recorded a show that I think I'm going to launch 2021 with that was really spectacular. I'm super excited to keep bringing you the show. I appreciate everyone's support. I'll talk to you soon.
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#421 Rachel Likes Pockets
Rachel is a T1 and CDE from Australia
Pinto beans…..
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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 0:01
Hello friends and welcome to Episode 421 of the Juicebox Podcast. On today's show, Rachel is here she's a type one who's a CDE. And she's a Australian. Yeah, I mean, right. Okay, well, that was awkward. Let's get to the rest of it.
I don't think I've left this much in a long time while interviewing someone for the podcast, Rachel Baker is fantastic. She brings a perspective, that's a little different, but not as different as you would think. And she has a lot of great insights about a number of the things that we talked about here on the podcast. This episode was both fun and insightful. Thanks to Rachel. Please remember, while you're listening 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. Before the end of the year gets here, I'd like to remind you that by visiting T one D exchange forward slash juicebox, you'd be supporting the podcast and Type One Diabetes Research. So if you have a cell phone or a computer, and you have a few minutes, and you live in the United States of America, and you have type one diabetes, or love someone who does swing on by and see what you can do, join the registry support the podcast support research.
This episode of The Juicebox Podcast is sponsored by the tubeless insulin pump that my daughter has been wearing. Since she was four years old, Omni pod on the pod, we'd love to send you a free, no obligation demo, all you have to do to get it is go to my Omni pod.com forward slash Juicebox Podcast show up in your mailbox after you go to the website and fill out the stuff. And to learn more about the Dexcom g six continuous glucose monitor dexcom.com forward slash juice box. That's it. Links to all of the advertisers are right there in the show notes of your podcast player. And it Juicebox Podcast calm. Let's get going.
Rachel Baker 2:27
My name is Rachel Baker. I'm a credential diabetes educator that works in Brisbane, in Australia. I myself have type one diabetes and have done so for 13 years. So relatively a baby, I would say I'm just about to study my nurse practitioners in diabetes education and I just love the flexible approach to managing type one.
Scott Benner 2:51
So you got a very, very quick response for me, because you said that in your work, you talk to people in similar ways that we talked on the podcast and I'm very interested in that idea. So I got back to you very quickly. And so I want to pick through that a little bit. But first, let me think 13 years 2005 2000
Rachel Baker 3:13
Oh, hang on. Maybe I've done wrong now. Maybe I'm wrong. He doesn't seven, seven.
Scott Benner 3:23
So we have our new babies. Oh, no. You know what I just did. That was interesting. Sorry. Arden was born in 2004. You said 13 years, which seemed like one year less than Arden has had diabetes. So I said 2005 even though Arden wasn't diagnosed until 2006, which would have made me say 2007. So I sometimes confuse the year she was born with the year she was diagnosed. And I've just done it there.
Unknown Speaker 3:48
Okay, good.
Scott Benner 3:48
So let me just start over again. I was gonna say So Rachel, were you diagnosed in 2007?
Rachel Baker 3:54
Yes, that's great. That's amazing. Yeah.
Scott Benner 3:59
It's interesting. It's in that middle ground. It's a shorter compared to some people but very long time to have type one diabetes.
Rachel Baker 4:08
Yeah, I do feel in that middle ground. I feel like I'm in that middle ground.
Scott Benner 4:12
Yeah, right. Like you're like you're you're ready for your second contract. But you're not gonna make the big money. Not yet. You don't even like it. Yeah. Yeah. Yeah. Like you've proven yourself and you get to stay a little longer. But you're not an all star yet.
Rachel Baker 4:29
Exactly that exactly. That you guys even
Scott Benner 4:31
have sports or you guys just get on this kangaroos and ride them around with a stick.
Unknown Speaker 4:37
Now we've got we've got Australian football.
Scott Benner 4:40
Did those things really fight? Do you ever see them like you're outside? You're like there's a kangaroo beaten up a mailbox or anything like that. Nothing like that ever. Really?
Rachel Baker 4:48
Yeah. I mean, I mean, not a mailbox but yeah, kangaroos to other kangaroos. Yeah, sure. Yeah. If you're out if you're out out rural. Yep.
Scott Benner 4:56
How can that happen? That Instagram is not just filled with that. If I lived in Australia, my Instagram would just be videos of kangaroos get out of each other. We have the UFC down here for marsupial's. Everyone luck, and I have the most popular Instagram ever. I don't know, somebody's got to get on it. Anyway. So 13 years, but Australia and Australia is really interesting. And as I told you right before we started recording, you're the third person from Australia. I've recorded with this in like seven days, your health care system, and what's available there for you has been very kind of stringent. And but it's getting better, but it's getting better for cash patients. Right. Is that the extent so far?
Rachel Baker 5:42
Huh? Yeah, I mean, pretty much. I mean, I mean, I find it very interesting comparing out health care, I guess, accessibility with diabetes compared to overseas. Because I feel like we're always a couple of steps behind. My passion is in technology and all the different types of therapies. So my number one thing that I do is constantly stay up to date with what's being released. But you're right in saying it feels like particularly with CGM. And I think you've mentioned this a lot on your podcast, and I truly believe CGM is the game changer. Whether you've got a pump or not, I think a pump is excellent. But CGM, for me. And in my clinical experience is the game changer. But if you're in Australia, you can only get subsidized CGM. If you're under 21. If you're planning pregnancy when you're pregnant, or you're over 21, and you have a concession card, so you're reaching a sort of a low income, or you're achieving a low income that enables you to access it. But otherwise, I mean, if you want to run the Dexcom system, it is it is about five grand per year.
Scott Benner 6:45
Hmm, that's $5,000 a year. That is just a lot of money for most, most everybody, you know, of course, yeah, yeah, it's, it's, and at the same time, if you really knew, if you really knew, and you had $5,000 that you could shave out of your budget somewhere. You do it, you know, you and I see, I see people do those things all the time. Make make this you know, it's funny, I was gonna say concessions, because you said concession card, and I'm still not sure why it's called a concessions card. But we'll get back to that. What is the concession that you can't afford it?
Rachel Baker 7:20
Yeah, so you can have a healthcare card or a concession card. But basically, the government deems you to be in a certain threshold in terms of the income or if you're a full time student. So if you're in high school,
Scott Benner 7:33
you know, I don't want to fall down a rabbit hole this early in an episode. But concession means the same thing in Australia that it does everywhere else, right. Like, I would think so with your media, a confession, like Like, if you and I started, let's say we're married. And you point out something about me that is wrong. And I disagree with it. And eventually, through just browbeating and constant torture, I make the concession that you're correct. We're understanding the word concession correctly. Right.
Rachel Baker 8:04
You know, it's interesting, because yes, that is that is the meaning of the word, but I'm so used to associating it with a concession and a healthcare card that I've actually forgot that that is the meaning of the word. I associated with a certain a certain income bracket.
Scott Benner 8:18
It's funny, because then there's there's either a definition for it that I don't know, or the idea is that the the government of Australia is conceding that you can't afford your health care. I okay, this doesn't matter. But it really seriously, I'm so sorry. Like, I'm like, let's let's pick this word apart a little longer. It just really doesn't make any sense to me, but I'm gonna get past it. It's a concession card. And, and so but under, isn't it interesting how this works? When they put it into play for you? It's if you're under 21. So my thought there is they're saying a child. So they're saying, look, we don't want kids to suffer low blood sugar incidences, so we'll let them have it. Which is a complete undervaluing of what CGM does. And then they say if you're pregnant, because of course, you have to have a great agency while you're pregnant for the baby. But what about everyone else? Like, like, why is it not important for everyone else to have that level of health and outcome? You know what I mean, I know it's money, but still, it's it's a weird place to draw the line, I think.
Rachel Baker 9:30
Yeah, yeah, I work a lot with adolescents in that teenage years as they trician transition to their adulthood. And you know, 21 is the year that they're finishing uni and moving out of home. They're trying to get their first job, and it's awful when they hit that as soon as they have their 21st birthday, it's taken away, and they lose that subsidy. And they're not in a position, usually, you know, most of the time at that age of 21 to fork out an extra five grand a year on their diabetes. And that's of course, you know, that's on top of all the insulin and I'd count for anything else like that. So yeah, it is it is a huge issue that we're facing. But I mean, in the defense of the government each year, they are providing us with greater subsidies. So the pregnancy aspect is new. But like you mentioned with pregnancy, I have this real. I don't know what a complex with how tight we manage during pregnancy. And of course, I love that, you know, I love I love running tight. But why do we do that? When it's at the cost of another human being, you know, you're growing this fetus, you know, into utero? Why are we so good at managing diabetes so tightly when there's another life on the line? But if it's just your own life and your own diabetes, we seem to be Oh, that's fine. You know, a little bit Lexi Daisy, and we actually completely adjust the targets. So I don't understand why we have that double standard between pregnancy and just everyday management.
Scott Benner 10:53
It's confounding, isn't it? It really is that the same doctor who's telling you, you have to have this, this is what needs to be, this is what health looks like, the baby comes like, you know, slipping sliding out and it's out, then you show back up at your window. And they're like, Alright, well, back to whatever. Good for you.
Unknown Speaker 11:12
Yeah, you're gonna
Scott Benner 11:14
support it with saying things like, you know, there's a lot going on with the baby right now and you're tired and everything you don't want to burn out. Like it's always that you don't want to burn out. And I I really think that you can boil it down to the timing of the insulin right? Like you have to like having to think about Pre-Bolus Singh at a meal is a really strange thing. And if you can't get it into such practice that it just becomes common for you. And you don't think about it and and i don't see it happen for everybody. I don't even see it happening on home. Like I'm the one yelling Pre-Bolus all the time. And, and, you know, any problem that my wife ever has, while she's managing my daughter, it stems from not Pre-Bolus like she does everything else exactly the way she should. But she works from home sometimes. So if she finds herself around Arden she's working. So she's not. And her work is different than mine. Mine's a little more. I don't know, artsy, I guess in a strange way. Like, you don't mean like I'm in and out of my head a lot. But But she's in her head constantly. She's sitting and thinking and writing and, and, or talking to someone she doesn't have time to be considering? Oh, we have to Pre-Bolus. And I forced myself. Yeah. And so I think there's something in there with that. Like, if you didn't have to think about that one aspect. I would think that the burnout rate would change. Because I'm about to head back on. If you did you follow the woman who I had on who I talked to her through every trimester of her pregnancy. Have you heard that?
Rachel Baker 12:55
Yes, yes. So the first few years? Yeah, yeah. Yeah. So
Scott Benner 12:58
she's coming back on soon. Because I said, Let's, let's do one a few months after you've had the baby, and you're out of your mind. Okay, I thought that would be fun. And you're already just like, what did we do? Why? Why did we do this? And I've seen, I haven't spoken to her, but I'm seeing on our social media that she looks a little tired, and that it's making her diabetes more difficult. And I think that's really what we're talking about. I can't wait to speak to her to find out exactly if, if that's how she feels. But that, from my perspective, is the most difficult thing. And then I think the doctors believe that that's true. And don't want to, again, burn you out. So then they start saying, well, let's just be a little more loose with it. But you said you really don't like that. Can you tell me why?
Rachel Baker 13:49
Yeah, I think I personally, I think there is a middle ground. And my goal always in my own personal diabetes, and my patients as well, is to find that middle ground, where you can run that, that sort of tight management, but not always hit that burnout. And I think it comes down to you know, you know, how you mentioned about your timing of the Bolus 100% I think you can have your dose bang on. But if you miss that timing, that's everything. You know, that's everything, all your hard work essentially, is completely thrown off. And I always say, you know, if you can just aim because Pre-Bolus thing is hard in real life. Pre-Bolus thing is hard. So if you can aim for at least 80% of your day, you know, or two out of three of your meals per day, just to reduce that post meal spike, at least, you know, two out of three times a day. I think we can find some sort of, of a happy medium of living a life where your diabetes isn't taking over. But then not having that complete roller coaster on your CGM CGM rod, but I do agree, you know, it sort of sounds like a throwaway comment. Oh, why can't we just aim as tight as we do in pregnancy for the rest of our lives? Yeah, well, of course that's going to be going to be hard work, but I think that I really think There's a way that you can sort of meet in the middle, and not be too stringent with your management to sort of find that happy medium and at the times that you're experiencing burnout, and this is sort of what I do with my patients, you know, at times you're going to be over diabetes. I think it's okay, you know, if you have a week where you just don't Pre-Bolus that, wait, that's okay. As long as you sort of recognize it, sit with it, and then you can sort of rebuild and move on from there.
Scott Benner 15:25
Yeah, I guess the most difficult part as a person is to not get stuck in that new normal that you make for yourself, like, I'm just gonna ease up this week, becomes I'm just gonna ease up this month becomes Well, in the spring, like you don't even like and yeah, and that happens to people all the time. It really is interesting. Because what you're battling against is it's, it's architecture of people, like it's, it's different types of how people's minds work. You know, you, all you do is look online at people who are like, super into fitness. Right? And they're just, you look at them, and you're like, they're chiseled out of stone, these people, you know, like, they, they're talking about micronutrients. And, and, and I don't know, if, if I follow them for a lifetime, if they'd always be doing that, but some people would be some people are just wired, like, that's what they care about first. And so they do it. And so I don't think that a person who doesn't think the Pre-Bolus or really struggles with remembering it is a is a bad person. I'm not saying that I'm saying that they're just, they're wired differently. Maybe they're just a little more, you know, fanciful in their minds, and things just kind of float away on them. And you know, they're more in the moment and not as structured. And then it's easy to just look back and say, well make yourself more structured, it's your health. But, you know, I can agree with academically, but you can't just change how you how you function. The real answer to all of this is insulin that works more quickly. And oh, yeah, that that fixes everybody's problem. If you take away an eating to Pre-Bolus a, I lose my podcast, but, but, but that's okay. I'll be I'll be tired of it by that anyway. But it just changes everything. If you could eat and Bolus at the same time and have the same results you did is Pre-Bolus Singh and eating. It would change diabetes. You know? Yeah. Well, that's I mean, you really need a magic wand or you could just traipse out there into the whatever that is there where you guys live and find some bugs that we haven't discovered yet. And milk it Did you see that? Did you see that thing recently? The venom of something they're looking at for as insulin. What the hell Jenny sent it to me snail venom?
Rachel Baker 17:44
Hey, oh, did you see? Was it as usual? No, I didn't see this thing about the snail sees
Scott Benner 17:51
that I'm used to create a new type of insulin that could provide a safer, more effective treatment for type one diabetes. I don't know maybe, obviously.
Unknown Speaker 17:58
I didn't even click on it. I didn't click on it. I just saw it. I was like, No,
Scott Benner 18:02
because I saw it and thought the same thing. And then Jenny was like, emailing it to me. She's like, wouldn't this be fun? And I was like, Yes, Jenny would be very fun if cone snail spray insulin venom. Oh, here it is cone snails spray insulin venom into the water to lower the blood sugar of fish. Oh, the snail uses the insulin to slow so it makes the blood sugar low of the things around it so that it can either escape or attack it. And it's, it works more quickly. This snail insulin is faster acting than regular human insulin and quote ready to go. So what Wow, so so right now Rachel, quit your job and start raising cone snails. You're gonna be rich.
Rachel Baker 18:45
I'm gonna start putting that on my pump. I'm gonna get some snow you're gonna
Scott Benner 18:48
need you're gonna need a lot of them. And right. You know, a little quick thing. A little question to the Daily Mail. Why are the women on your website naked all the time? Jesus. I'm trying to find out about snails. Adam, there's a girl with a mink coat and it's not dressed. What is that? That's not the news. United Kingdom. That's pornography. My goodness.
Unknown Speaker 19:11
Jesus,
Scott Benner 19:13
that took me by surprise. That curl was like from the 70s Oh my gosh. Anyway, whoo. Sorry. I don't know that snail venom is, is the answer. But I love that people are now looking into it. Anyway. So you're teaching in first time we understand you. You are a CDE. And does that mean the same thing that it does here in America? Like, is there a doctor in the practice but you're doing most of the work?
Rachel Baker 19:45
Exactly. No, we got we got an excellent team of doctors. I work in the public in the private space. So I work in it. You know, sort of a large diabetes Hospital Center and then I also work privately and it's You know, there's a bit of different level of autonomy between the roles. Of course, privately, I'm just consulting the patients, and then just reporting back to me in the chronology. But I guess in the in the public base, it is more of a team team effort. But yeah, my answer to that question is yes.
Scott Benner 20:20
So I come in as a person with diabetes. I have my my visit I see you mostly Is that right? Is the doctor coming to see me at all? Or is it you? During the visit? You
Rachel Baker 20:31
know, interesting. Interestingly, it depends on the age depends on the age. So if you are coming into the adolescent, clinic, you know, the younger adult clinic or even you know, yeah, I mean, pediatrics is a lot more work with the parents. But if you're in the adolescent or the transition clinic, you spend a lot of time with the educator. And then of course, you have the psychologist and the dietitian as well. And then you'll have a little bit of time with a doctor, but more so your time is spent with the educator. But when they hit that adult space, it's quite the opposite. They don't really want to see the educator, they sort of just want to go in, see the doctor, they know what they know, get their scripts, and then go on,
Scott Benner 21:11
you really turn into more of the nice lady with the prescription pad, and then yesterday to get in and out. Now. Yeah. Is that from? What's my question here? Do we just make a concession that some adults have just fallen into a pattern and we can't help them anymore? So we just support them along the way they've decided to manage themselves? Or are you still trying to improve things for them? Because that's an interesting thing. Because adults can be very good at, at coming in. And, you know, what do I want to say, you know, presenting a story that they think you're going to accept, and it'll sound good enough to you that you let it go, but they may still be struggling? Is there less of the, of the picking through the situation and trying to help than there is with kids?
Rachel Baker 22:04
I think so I think because if you haven't got that level of engagement, it's hard. You know, it's hard, they really sometimes are not willing to sit and have a conversation about their diabetes. And it can be on two ends of the spectrum. Either one, they present this beautiful story, yeah, everything's fine. You know, I'm okay. You know, I changed my insulin cartridge. And every seven days, change my cannabis in those, but I'm fine you having fun? Or, you know, they just got to HBO, up in the 10s. Or it's gonna be the other way. And then there and then really want your help, you know, and then really ready to engage. But I would say more. So option A moreso, Option A, as you described, if they're absolutely at breaking point, no, I guess it's when they do that for a couple years. And then eventually, they sort of come back in and they're a breaking point, then they're, then they're ready to have a conversation.
Scott Benner 22:57
So that's what you're finding too is that, so do some people never, quote unquote, break. And by that, I mean, come to the realization that they need to do something more than they're doing just some people just cruise to the end with just whatever is just keeping them alive. But, but some people just have that, like, come to Jesus kind of moment was like, I have to do something about this. Is that basically how it goes?
Rachel Baker 23:23
Yeah. That is, yeah, yeah, that really is it is exactly like that.
Scott Benner 23:28
What do you see a difference? Between I know, this is a huge generalization. But do you see a difference between the person who's just okay with my a one sees nine? I, this is all I'm willing to do? And the people who have that moment? Is that a health scare? Or what? Was there something specific that pushes them? What do you see? I'm sure there's varying.
Rachel Baker 23:53
Yeah, yeah, I think it is either a health scare, or often they sort of present as in, I can't feel like this anymore, in terms of how tired or how exhausted they are. And I think it comes to a point where it all piles up in their body, you know, see running with a glucose, you know, up in a higher range for that period of time. I think eventually, they just sort of think, you know, what, I've had enough of feeling like this. And, and they sort of hit a turning point. You know, sometimes it can be something you know, they've gone through a divorce or something big happens in their life. But often, I think they just come in and they just feel like I've had enough, you know, I'm at breaking point and I've had enough and I need to change. Okay.
Scott Benner 24:36
Yeah. So, I see people doing it for others a lot. It's, it's it. It's always like, You know, I realize it's hurting my relationship or I want to be around for my children, or, like that kind of thing. Like there's always that. And it makes me wonder if there's not a way from the clinical side to create A relationship where they want to do it for you. And I'm gonna say something might be incredibly silly, but this is gonna sound weird, I guess. But my son's an incredible outfielder, you have baseball there, the guy you know, so he can, you know, it's fascinating how how good he is at catching a ball that is whacked around out of nowhere. Like if you and I stood next to him when the baseball was like struck, you know, 400 feet into a gap on a field, you and I would still be standing next to each other while he was handling the ball, catching the ball, we'd be like, I feel like Rachel. Wow, look, he ran all the way over there. That was amazing, wasn't it? You'd be like, did you even see the ball? I'd say No, I didn't. And and like, you know, like, that would be how it would go. But when he was young, and he was learning, he did it for his coach. When he was nine and 10 years old. I'd asked him like, how did you do that? And his his main, like, stressor, I guess was he didn't want to let this man down that he liked, who expected something from him. And it wasn't you know, it wasn't, it wasn't a crazy relationship was like you have to do this or, you know, you're off the team. They were little kids. But they had built a relationship together. And he didn't want to let the guy down. That was sort of it like he had he felt like he was I don't know what the word is responsible to someone other than himself. Or I don't know what that is. But I wonder about that a lot. If, you know, maybe the things that we ask people to do, aren't always reasonable, like, go catch it for yourself, make your make your ANC six, do it for you. A lot of people have self esteem issues and doing things for themselves is difficult. You know what I mean? And like, I don't know, I don't know if there's a way to build a team mentality into it or not. But I sometimes think the podcast does that a little bit? You know, I, I would say that in the beginning of the podcast, it flew in the face of what people thought of is how to share online. You know, there used to be I'm sure there still is. But I don't pay much attention to it. The idea of like, don't tell people your successes that will make them feel bad. And I don't buy into that I think your success should be looked at as possibility not as a winning and losing scenario. It's not like I succeeded, and you didn't, it's I succeeded, and you could look, it's possible that person is doing it. If that person can do it. You could do it. I don't know. I think there's something to that. Yeah, anyway.
Rachel Baker 27:42
Yeah. But listening to your podcast. That's what I, you know, took away from it way right back, like right back at the start. I was new to a CGM. You know, I was totally This is right back when I was starting my diabetes education course. Prior to that, I was I was a nurse and emergency and I never sort of specialized in diabetes. And I started using CGM. And you know, when you start with a CGM, and you see that rollercoaster, and you think there's got to be a way that this can be done differently, you know, and you try to talk to you diabetes team about it, but they get sort of a little bit stuck on insulin to carb ratio, insulin sensitivity factor. But listening to your podcast, gives you that ability to see that as another way, you know, and you're not the only one thinking it because I mean, how many people you don't look at, look at how many followers you've got now on this podcast, or how many listeners? Everyone can sort of, well, not everyone, but I guess it depends on if I've got that motivation. But if you can see that there's another way to manage your diabetes. And if you hear someone else achieve those results, it's it's inspirational, you want to do it, you know, you want to go after it because it feels possible.
Scott Benner 28:58
In the middle of this holiday season, while you're doing things for other people, don't forget to do something good for yourself. The easiest thing that I can think of, is to go to my omnipod.com forward slash juice box, fill out the tiniest bit of information. And to have on the pod send you a free, no obligation demo of the Omni pod to listens on top. That way when you get it, you can try it on or put it on your kid. So you can see what it's like. I just wore a Dexcom CGM for 10 days. forgot it was there and I've worn it on the pod in the past. Same thing happened to me. You just don't notice it after a little while. But that may be hard for you to believe. If you never try. Well, this is your opportunity to try try for free. Try with no obligation and it's a non functioning pod so there's nothing to worry about. You just put it on to get a feel for my omnipod.com forward slash juice box. If you're MDI right now and thinking about getting a pump, I think tubeless is the way Way to go. And if you're using another tube pump and you're thinking, I would like one without tubing? Well, one exists. And this is an easy way for you to see if it's right for you. The Dexcom g six continuous glucose monitor is fantastic for anyone using insulin, because you get to see the impact that food has on your blood sugar. And then you get to see how fast it moves in different directions. Just to make your blood sugar go up, does it go up fast? Is that as fast as eating an orange? Huh? Who would know? Well, I would know. And so Would everyone else who's ever want a Dexcom g six continuous glucose monitor, you owe it to yourself. If you're using insulin without a Dexcom, you're flying blind. Having a Dexcom is like having a co pilot on both sides of you. And one sitting on your head. Three co pilots, which I guess goes against the word co pilots, you'd have to call them try pilots. But now we're really getting off the subject. My point is, is that being able to see the direction and speed of blood sugar is monumental. And being able to get an alert that lets you know if you've left the range that you've set. That is the whole ballgame right there. Dexcom also allows you to share blood sugars with up to 10 followers. So that could be your spouse, your kid, your grandma, whoever you want. There's 10 of them, though. So you're probably give it to your school nurse if you wanted to. Or even if you've got like a well meaning neighbor, I'm kidding about that. But you could if you wanted to say you were the person with this neighbor that was like, Oh my god, this is greatest guy in the world, he could help me with my blood sugar, boom done. Android and iPhone. So that pretty much covers everyone holding the cell phone and everyone holding the cell phone pretty much covers everybody alive. It's worth checking out. And you can@dexcom.com forward slash juice box. If you want to learn more, you just fill out the little form at the bottom. If you currently get your insurance to the US military VA, you might really like what you hear. So go check it out. dexcom.com forward slash juice box, use the same continuous glucose monitor that my daughter does. And please don't forget T one d exchange.org. forward slash juicebox. Add your name to the registry help Type One Diabetes Research while supporting the podcast. Alright, let's get back to Rachel because there's a lot more coming.
I agree. I really do. I think Thank you. I'm glad it I'm glad it ended up being valuable for you. But I just can't I couldn't agree more like I don't hide success and nobody knows what it looks like. You mean like there's nothing to aspire to if there's nothing to aspire to. And so while everyone else is doing everyone who's doing well is just hiding because they don't want to quote unquote make anybody feel bad like well, these people already feel badly. They're a one Cesar eight and a half and they're spiking to 300 after every meal, they feel as badly as they're gonna feel, you know. And yeah, and I don't buy into that argument that, you know, there'll be somebody out there that can't handle seeing it. And and I don't disbelieve that, I do think there'll be somebody you know, that will look and it'll just be too much for them. But you say you're going to overwhelm one out of 10 people or 10 out of 100 people, and those people are going to be really hurt by seeing someone else's success. You can't ignore the 90 out of 100 people who may not be hurt by it, like why do we all? I mean, you don't want to leave anybody behind. And I don't think the podcast does leave people behind. I think even those 10 people who are gonna be like, Oh my gosh, like, this is impossible. And here's even more proof. It's impossible. I'm bad at this, and they're good at it. I think if they try the podcast, they'll find out that it could be them as well. You know,
Rachel Baker 34:14
yeah, yeah. And if I've got, you know, I've got my, I wear Dexcom. And I've got it running to my watch. And often I'll show patience. You know, I look you know, you can have your Dexcom run to your watch. You know, this is people that are considering CGM. And let's say the day that I've got a beautiful, lovely flatlines a dream. It's interesting to see their reactions. It's exactly as you said, they are they sit and they go, Oh, my goodness, you know, how do you keep yourself running steady for that period of time, and they're inspired by it? Or the reaction is, I could never do that. You know, you're a completely different person. To me. You're a diabetes educator. That's why you've got your nice steady flatline. So they create a disconnect between the difference of them to me, you know, and then I try and Sit for the next hour to break down that disparity that No, no, we're both just to, you know, normal people.
Scott Benner 35:08
And you have much as an opportunity to achieve a flatline as I do you know what I mean? And that's self esteem and self confidence. And the goal then is to show them. Look, I don't I'm not special, like, I just know a couple of things you don't know. But here's the good news. I can tell them to you, you know, and they're not Yeah, it's not, it's not gonna be trigonometry. Don't worry, it's, and that's the other problem is that they believe it's so completely, like, numbers oriented, and you're either a numbers person, or you're not. I've heard people talk about diabetes and such basic ways, like, Well, I'm not a numbers person, I can't do it. And I say to them, Look, this podcast exists for a number of reasons. One of them is because I don't like math. And you know, and one of the other reasons is, I don't want to count carbs. And another reason is, you know, like, there's all kinds of reasons why, like, This podcast is a is a, you know, it's the child of my laziness, basically, like, is things that people told me diabetes was, and I was like, I don't want to do that. But I don't want my daughter to be unhealthy. So couldn't there just be another way? And yeah, and those ways are really exciting to me. They're explainable. So are you? I'm not trying to take credit here. I'm really I'm trying to understand, are you? Are you using some of the things? Well, I guess, for the first question has to be how much of the podcast you use in your personal life?
Rachel Baker 36:33
A lot? A lot? A lot? Yeah, yeah, a lot. And I think it's a combination, you know, it is very similar to bumping in nudgee, using that sort of content, and then just personal experience, you know, I'm not afraid of, Okay, last time I was food, I went home. So I'm going to put an extra insurance time in, I'm not going to sit and count the carbohydrates of it. But I'm going to throw in an extra two units, because I know that I need it. And then I think listening to the podcast, gives me that push to do it. And then I think when I entered into being a diabetes educator, it's scary to then relay that to your patients, you know, because it's one thing for me to say, Oh, I'm happy to throw in an extra two units, but then to portray that to your pet or advise your patients. Okay, if you have that food next time, just throw in an extra couple of minutes, you know, see what happens, go with your gut, go with your diabetes, intuition, intuition, and see what happens. So I think I just kept coming back to the podcast is to listen, and to know that there's other diabetes in cars and other patients with type one, that confidently and safely can use those principles.
Scott Benner 37:45
Yeah, it was that part you just spoke about? That's where it happens. Like without that, it's useless to tell somebody because aside from being able to say to somebody just use more insulin, what you're going to tell them is, and you said it earlier? Well, maybe the insulin to carb ratio for that meal is different. And it is, but are you now asking people to on Tuesdays when they make meatloaf believe that they have a different insulin to carb ratio than they do on Wednesday when they have a Caesar salad? And am I really supposed to think about all that for the rest of my life? Wouldn't it just be easier if on meatloaf night, my blood sugar got higher? And you know, like that kind of thing, which is why, which is why the way I try to talk on the podcast is is so fluid, which is you know, I just did it the other day somebody online in the private Facebook group was like, I don't know what the problem is here. I was like, You didn't use enough insulin. And they said, but my, my carb ratio work works great for other meals, I'm like, I don't care for that one, it didn't work. So more, how much more I don't know, more, try more, and see what happens and keep playing with it until you figure it out. And the and the decision to speak that honestly, with people. I think that when this podcast is over, and when I look back, that decision, just to be honest with people might end up being the most important thing that I did here. Because that's the moment where everyone else just says, I don't know, you know, maybe we should look at your ratios or, you know, they get they take it back to technical and technicals not what you need in that situation. Because Because everyone's not living in a petri dish, right? They have a life they're trying to go through. It's not all clinical. It's easy to talk about it clinically. And I want people to understand it clinically. It's why we talked about glycemic load index so much and you know, but that's not, that's not a fun thing to remember, in the middle of, you know, in the middle of a beach vacation where you're like, I'm gonna get french fries at the beach like, you don't want to sit around and go. I wonder what the glycemic load index are of these fries and you know, you just want to you just want your brand to go French fries more longer. Yeah.
Rachel Baker 40:04
Yeah, exactly, exactly, yeah, there's two, there's two things that I often have taken away from your podcast, that I often drill into my console. And the first one is, if you're home, you need more insulin. That's it. If you're low, we need less. So we could sit around here, you know, for half an hour, and try and figure out why you had that particular high. But like you said, at the end of the day, it doesn't matter. We need more insurance. Let's do it and move on. And the second thing that you often talk about is, I think it was in one of your earlier podcast, you said, you know, I'm just, I'm just this guy. And I think, yeah, I look at the numbers, I see a number, and I don't have this big lot of emotion that's attached to it. You know, diabetes is such an emotional condition. Sometimes I just think because you know, the chronic nature of it, and how much it can sometimes wear you down, people can get so exhausted, and so emotionally attached to seeing those numbers each day. But if you can remove the emotion from it, and just look at a number and be like, Okay, I need more insulin here, or I need less, or I'm rising, let's work on this. It's a totally different. It feels like living with a totally different condition, when you can remove that emotional side from it.
Scott Benner 41:18
I'm glad you heard that. And I completely agree. Obviously, I said it. So it'd be weird if I didn't agree with it. I was just saying things in the back of my head going I don't think that at all. No, but I that sounds like something fun to say that the being the being disconnected from it is, is incredibly important. And it and I wasn't always there used to be times where I'd see a number and I was cursing sometimes out loud, sometimes just in my head. And I thought I screwed this up. It's and then it's a cascade, then I screwed this up. It's gonna hurt her she's gonna be Hi, this is you know, I knew it. Like I'm killing her, like, you know, like that whole stuff, just all that you have to stop your brain from doing that to you. You just you. You can't You can't let that happen. Because, listen, yes, the numbers not great. But no, I'm not killing her because her blood sugar went to 160. Right. So you know, I need to, the most important thing to do is to step back, see what happened, figure out how to fix it now. And how to keep it from happening next time, you know, is obviously the next step. But to feel badly about it is it's just madness. And it doesn't it's not going to stop it's going to make you crazier and crazier as it goes until your brain does you the ultimate kindness that a brain can do which is going to it's gonna make you stop worrying about it so that you don't make yourself crazy. And it's just it's a very human idea except, you know, not being upset that your neighbor cuts the lawn at 7am. like finding a way to let that go is different than letting go that your blood sugar's 200, after every meal that has real consequences. Yeah, and my neighbor is a lunatic in case you're wondering. So here's something really sad. I live across the street from people. And it's a weird mix. There's an old, a much older woman and what appears to be her nephew. But he's a grown man. He's older than I am. And they live together, which is already strange. But sometimes in the middle of the night, I am not making this up. You'll hear this metal snapping this just I can't do it. I don't have anything but it's just like, you hear this outside. And if you look, this woman in her 70s is outside on her knees with a pair of kitchen shears, cutting weeds. And that stabbing is the are the blades coming together? I don't want to make fun of people's mental illness. But I think there's something incredibly wrong.
Rachel Baker 44:02
That's the coping mechanism. Something's going on there.
Scott Benner 44:05
I said, Listen, no joking. At some point, her brain said I can't handle what I'm saying. Go take care of the week, didn't mean and I don't want that it's much different than I can't handle seeing these blood sugar's over and over and over again. I'm going to stop worrying about them. I'm going to let them go. Yep. And throw caught you know, you know, whatever people say to themselves, you know, I'll leave it up to you know, I'll leave it up to Jesus. So we'll see what happens, you know, and, you know, all the time I tell people, like, you know, I see people praying online about their budget and like, don't pray, Jesus doesn't have your meter. Just give yourself more insulin. Like, I'll tell you what your prayer you want. But I think if Jesus had EPDM in his hand, he'd be bolusing. So let's get to it. And so I don't know, I think there's something in there where it's simple to say. People need to be empowered, but that doesn't really yeah, that's Kind of a bullish statement like, right? Like it's a nice thing people say, and then some people are really good at it. And some people aren't you say, well, then you then you put it on the people aren't Well, I guess, you know, they didn't try hard enough, but that's not right. It's not about how hard you try. And there's no one with Type One Diabetes that wants to be unhealthy. That person doesn't exist, you know? Yeah. Anyway, so how do you help people, like, make these leaps? Like, I'm interested in some like, like real, like nuts and bolts, things? Like when people tell me they see good CDs, good doctors. I feel like you're one of them. So how do you end up being a a friendly person who gets people to places? What's the process?
Rachel Baker 45:45
I think, I think it comes from being a patient myself first, and having experienced the frustrations as a patient first, you know, some of my best consults and my most powerful or significant changes that come about is just by sitting, and listening, you know, and it sounds so basic. And it's like, you know, of course, right, of course, you just have to sit and listen to the patient and address their needs. But sometimes just sitting and listening to the struggles that they have, and validating them, and I just sit there, and I'm like, you know what, diabetes sucks. It just sucks. It's hard work, and it's annoying, and it sucks, and it's not gonna go away. And we might just sit there and have a conversation about all the things that we hate about diabetes, and how hard Some things are. And then that might be that's the console, you know, that's it, and they will walk away feeling better than they have ever felt walking away from appointment, you know, ever before. Just because they've had that time to sit and confront the feelings, you know, how you mentioned the talking in a way I often say you're putting your diabetes, you know, it's that can that can of beans and you're putting it at the father or father spot in your in your kitchen cupboard, you know, up in your kitchen cupboard, you've put it right at the back. And today, we're going to get up on the stool in your kitchen cupboard, in your pantry and get that can back out. Because it's so easy to just talk back the back of it, you do the bare minimum, keep yourself alive. But at one day, you know, I'm always going to be here. One day, we're going to pull that out and we're just going to open it, you know, and the day that you can open it, you can just sit and read confront it confront the thing that you're feeling, that's the day that you're gonna be able to move forward.
Scott Benner 47:25
I feel like you saw me buy pinto beans three weeks ago.
just soak beans overnight.
Rachel Baker 47:48
On the top shelf,
Scott Benner 47:49
I just I had such good intentions when I bought them. I was like No, I'm not. I'm just like, and I think I could do a really good job with them. Right? Like, I think I can make my own baked beans, basically. And then I looked at a recipe and I was like 12 hours soak them overnight. What are you talking about?
Unknown Speaker 48:07
Yeah, yeah, that's
Rachel Baker 48:08
a diabetes console, often that the diabetes comes up, people walk in, yeah, we change my calibration, I'm gonna do this and they walk away and they feel great. And the moment they walk out of the door, they don't often do any of the things, you know, they don't do any of the things because then they think that the 12 hours, you know, and then and then it sort of hits them in a reality and it's because they've never I think they I think you just need to front it and have have that conversation where you're gonna sit down and face that it's hard and it's not gonna be easy, and there's gonna be bumps in the road. And to that there's no such thing as perfection. I think that's something that keeps people with type one diabetes down is that I've got patients that will make huge progress, and then they'll come to me and they'll show me the report. And they'll be like, Oh, you know, I don't I don't think this is gonna be a good read. I don't think these reports are going to be too good to look at any look at it. And you know, it's good. You know, it's good. I don't know if they're expecting to have 100% time in range, or unicorn stable flatline CGM every day but I think just to be reminded that you're not that there's no such thing is perfect. You're not always going to have the perfect day. They need to be told that
Scott Benner 49:16
hey, Rachel, make the beans Leave me alone. Jesus. Just gonna donate them to a food kitchen or throw them away or something. But I mean, I guess pressure me like this. I'll take care of myself. Fine. Yeah. No, I think that's an it's very, very important that that to realize as a person who's trying to educate somebody about something, that it's not really something they're excited to hear about. And it's not something that sounds simple to them. And the traditional ways that it's been spoken about are confusing. And, and not exactly something that makes you want to go like yeah, I'm gonna do this. I you know, I when I'm speaking in public, and I look out into the audience, there is always a couple of old time diabetics out there, just like people who've been in the fight for a long time, you know, and they were there before glucose monitors, and probably they were there before decent insulin and decent meters and everything else. And every once in a while, I'll speak and I'll have somebody come up to me who's you know, in their 60s, they're like, this is just a revolution. I'm like, okay, you know, I'm, I've been doing it for a while, but I hear what you're saying, you know, and, and they're excited by it, and they hear it. But there are some people who just turn their nose up at it. Like, it's like it's fell. And they do not want to hear that, this thing that they that overwhelm them for so long and been so difficult. And it is as easy as I don't know, I would try more insulin here. If I was you. And they don't. It's, I think it I think it breaks their heart to hear it kind of in their reaction is just one that it's there to protect their psyche. Like the he's wrong. Because,
Rachel Baker 51:12
yeah, yeah, oh, he doesn't understand. He doesn't know this, right? It's more than that. Because if
Scott Benner 51:16
I'm right, then 30 years ago, someone could have just said that to them. There wasn't somebody saying these things 30 years ago, so it's not really possible, but it feels like a lot of wasted time. And I mean, I don't know about the rest of you. But here's a little insight to who I really am. wasted time is about the worst thing I can imagine. It really makes me upset. I don't like when people are. Like, if you ever been together with friends, you remember when people used to get together with friends. And there'd be people in rooms. I like your Australia, you guys probably aren't even afraid to COVID-19 right? Actually, just a bunch of criminals. prison populations are doing great with it. Because these people are probably they're around each other in such close quarters. Probably nothing makes them sick. But But nevertheless, I don't think everyone in Australia is a criminal. And let's move forward.
I think I've lost my train of thought. We can't do these things. So early in the morning for me, right? I was about to make a point of Ah, no, it was good. It was good. I think your brain is trying to save you. Do you know? You mean, because when you hear that your health has been the way it has been for so many decades? And there was an easier answer. I think that reality could break you. Do you know? I mean, like, I just don't i don't think it's good. I've spoken to people where I've watched it happen, where they just they're like, why did no one tell me this? And it's crushing? And I can't say that I blame them. You know, it's um, yeah, it's tough. So I, you know, I, I'll be the bad guy. Sometimes I'll stand up there and just go all right, yeah, you know, I'm wrong, it's fine. But some of those people have sway within the community. And that's when I don't, that's when it becomes dangerous for people moving forward when you're a person who's lived with diabetes for 30 years, either as a caregiver or as a person in in general, and you've got the ear of someone, and you start saying things like, Oh, you know, that's dangerous talk, you know, more insulin. What's that? You know, like, that's measurement, people are going to hurt themselves. People aren't hurting themselves. Now, whether a one sees is nine. Like, what's your point? Like? You really think if you're a one sees nine, that an extra unit somewhere is going to be the ruination of you. Do you know what I mean? Like the beginning of understanding that you need more insulin, and then you can see it happening? and say, oh, wow, I used to go to 180. But now I'm going to 160 I wonder what a little more of a do I wonder what a little more of a do I wonder what a little sooner would do and then you're there one day, it's just? Yeah, I want to say it's easy. But Rachel, isn't it kind of easy? You know what I mean? Once you start doing it, yeah.
Rachel Baker 54:09
Yeah. You know, I'm interested in SCADA. If this was, you know, we were talking back 2030 years ago. And I think what the concepts that you talked about, I think it matches the time that we're in, that's where our technology is at. And that's what we can do. But uh, we had this conversation before we had CGM. I don't think we'd be here. I don't think you'd have your podcast the same way that you have it now because I think this but because we have that CGM. We can be both, you know, so I don't know if people you know, maybe they might look back 30 years ago, they can't think that they've been ripped off because no one told them this. I think back to when I was a teenager and and i resent I resent how much I struggled as a teenager with With my type one, and how much I felt like, my medical team couldn't help me, you know, I felt like every time I went in, and everything's completely up and down and run around around, I felt like I left just feeling even more hopeless. because they'd be like, well, there's no patterns here. So I'm not too sure what what ratio or sensitivity factor I want to change. So let's not make any changes, and you go away and you monitor you five times a day for the next two weeks. And Simba You know, I think that was just something that happened every time. But I wonder if I had CGM back then would would I be doing what I'm doing now?
Scott Benner 55:37
question would be figure it out somehow. You really would. And yeah, and that's, listen, I hear you, you're 100%. Right, that if I, if I was in a time machine, and I started saying these things in the 70s people be like, I don't know what you're talking about. I don't know, I can't even see what my blood sugar is. I can't just give myself too much insulin, you know, that's how they would do it feel to them. But what I'm saying is that in present day, now that we know what we know, and have what we have, for someone to sit in roadblock of other people's happiness, in order to prevent someone else's psyche is a weird decision to make like, I don't want someone who's had diabetes for 40 years to feel badly. I'm not saying that. But that person is still alive now. And they can move forward in a different space. Like why do we keep pretending it's 1980? Is that it so that the person who lived through 1980 doesn't feel bad? What about all the people who are here in 2020? Who don't need to be living? Like it's 1980? Like there's, yeah, if I'm good at being dispassionate about the diabetes and the numbers. I'm also good about being dispassionate about that. Like, and and some people aren't, some people are so worried about protecting feelings, that they don't think about all the new people, they're hurting by talking about this thing. Like it's 30 years ago, that that's all I just yeah, that's how I yeah,
Rachel Baker 56:58
some people definitely stuck. Yeah, I'm 100%. Yeah, I made a lot of different educated endocrinologist. Look at all different disciplines that are just stuck. I agree that they're stuck in 1980. And they're not moving forward with with what we're learning.
Scott Benner 57:15
It's just there's so much good stuff that exists right now. It's, it's fascinating. It's fascinating to me that you'd want to ignore it or not learn it, or, or whatever other reasons happen, like I get for the people who are living with it. But I mean, if you're teaching someone, if you if you're teaching someone how to live with diabetes, and you see that there's a better way, and you don't know that way, I don't know how it's not your full force in life to figure out that new way so that you can help those people. I don't know how in good conscience, you keep telling people. All the information? That seems strange to me.
Rachel Baker 57:50
Yeah. I think I think they're just scared of the hypose. That's one thing that I it's a common thing. People are just scared of their patients having hypose.
Unknown Speaker 57:59
Yeah, I understand. Just,
Unknown Speaker 58:02
yeah, well, I
Scott Benner 58:03
mean, it, why are we not scared of the other part? I guess that doesn't make any sense. Ya know, we've chosen I heard someone say the other day, that they're, you know, obviously, I know, people say this in the community, medical community. But I haven't heard it in so long that it shocked me. My endo told me, it's better to be high than low. And now I'm listening to your podcast, and I don't know what to do. And I said, Well, I'm not your doctor. And I am not. I'm not even a doctor. I have no medical, you know, I'm not giving you any advice I was like, but all I can tell you is that I wake up every day. And the first thing that I think about diabetes is I'd rather stop a lower falling blood sugar than fight with a high one. Like, I have to remember that. Yeah, that's just that's got to be the first thought in your mind with diabetes. I'd rather I want to be down here. I want to be playing down here, not up here. And, you know, if if somebody has to have a juice box, or has to do something to stop a low, it is far better than fighting with highs. And by the way, don't make that your norm for the rest of your life. figure out why you're getting low and stop it at some point. But, you know, in a world where everyone gets low Anyway, why not get low? This is gonna sound weird, because I don't mean this exactly this way. I was gonna say why don't why not get low on purpose? I'm not saying that people are getting low on purpose. I'm saying I'd rather you don't I mean, if you're going to be super high, eventually you're going to over Bolus it and, and crashed down low and have no idea how much insulin is in you and be in a complete just freefall that starts to eat the kitchen situation that throws you onto the roller coaster, you know, so why not just be at and go oh, it's Yeah, it's not working out this one time. I'm 65 before bad I'm gonna have to do something. You know, like, that's, yeah, that just makes that just makes sense to me. You know, I don't know. I'm glad it makes sense to you.
Rachel Baker 1:00:02
Yeah, no. But people when they're on that roller coaster, you're never on the roller coaster and they're up and down. I often just sit there with the report. And I'm like you on the roller coaster, and you've got no idea how hard you're making this for yourself, because you're stuck on that up and that down. And like you said, that is just as dangerous and just as scary to be on that up and down roller coaster. But also, to when you're on that because everything's harder. When you're up, you're up there for hours, it takes so long to get back down, you finally get back down and think, Okay, great. Now I'm going to hide, and then you end up having a hard time and then you're over trading in Europe on the other end. But when you bring it all in, I always said are you gonna think I'm crazy? I think it's absolutely crazy. But the tighter that you manage it, and the more that you sort of bump and nudge your levels, the easier your management actually is. Because if you're fighting just you know, an angled arrow up or a straight up, it's so much easier than fighting. And I know you guys don't use me more but you know, a $15 million with a double our but it actually becomes so much easier when you pull away from that fist up and down. roller coaster.
Scott Benner 1:01:09
Yep, it's pretty easy. Like it's just an it's really, there's not much to it, you know, don't get high, you won't get high. And if you don't get high, you want to crush it with insulin, it's most definitely going to make you low and scare you and rightfully so into eating more food than you need. At some point, you have to say enough's enough. I gotta stop this somewhere. And, and not just keep this going forever. And it doesn't even stop. It goes into overnights like now you're getting super high overnight, or super low overnight. It's at the point now, where if someone shows me a graph, I'm like, I mean, do you not see what's happening here? Yeah. But but they don't they see. They see randomness, it all looks like chaos to them. And I mean, I'm glad to be able to see it. But I think everyone can see it. Eventually, I'm telling you, the longer this podcast goes, and the more people it reaches, the more experiences I get to watch people have. And those experiences prove over and over and over again, how doable This is for large variations of people. It's not just one kind of person who gets it like, you know, with the way diabetes is taught. Traditionally, it is one person it's that person who can put themselves in rock hard shape and stay in it and go to the gym at 5am no matter what, like that that person. Diabetes is easy to them, they just put that kind of focus on to the diabetes. But for everyone else, to make them feel like oh, this isn't for me that good health isn't for me, is just a lie. It's not true. And I think I think that if you, you know, I swear to you, I think those pro tip episodes are it's like a Master's class in 30 hours on diabetes. And it really Oh yeah,
Unknown Speaker 1:03:05
yeah, yeah.
Unknown Speaker 1:03:07
Do you listen, have you I will
Rachel Baker 1:03:08
just I will just tell. Yes. Yeah. And I will just tell my patients, you know, go and listen to, you know, Scott's protests. And Jenny, you know, I think you guys are incredible at summarizing just the real key concepts for optimal diabetes management, and then just portraying in a way that you seem so simple, you know, I would happily just have my patients who sit and listen to a podcast, I mean, out of a job, surely. And the thing is, if it didn't work, your podcast would not be where it is today.
Scott Benner 1:03:41
Oh, no, right. If we were just talking, just trying to podcast, you know, obviously, people would tell away from it at some point. But listen, Jenny, yes. Yeah. Here's the secret about Jenny, is that she's so wrapped in this Midwestern feeling, and she's, you know, she's got that kind of like, it's a little all shaxi. But when you talk to her, like, personally, like, I know, Jenny, Jenny's just me in a nicer wrapping. So like, when it comes to diabetes, like she was, like, I think if you were alone with her, she'd be like, I don't use more insulin there. That just makes sense, doesn't it? And, and so she's, I just very much I love her and so happy. I actually just spoke the other day to ginger Vieira, who is the person who introduced me to Jenny and I thanked her again and it's been years now. It's like, I really have to thank you. Because ginger sent me a note one day and said, You should have Jenny on your podcast, you guys really? You agree about diabetes, you should you know, you should have her on. And, and if it wasn't for that, I never would have met her honestly. So yeah, I just think that it's um, it's very cool that you as a as a person who's educating somebody would say to somebody Hey, listen, have you heard about this podcast? You know, all the pro tips or diabetes pro tips calm once you go check them out like that thing to me is huge. And not just because it helps the podcast, which it really does, and I appreciate but not just because it helps people. But because he it, it moves us closer to my end goal, which is that the way you're talking to people is how educators should be talking to people. And that one day, you know, not just this podcast won't be necessary, but people won't have to struggle and have these horrible decisions to make. Am I gonna trade today for tomorrow? That is not something we should ask people to have to cognitively decide, like, Am I just going to enjoy today but, but give away the last 15 years of my life? You know, is that what this is? That was that that's not the only choice? And it's bizarre That, to me, it's bizarre that a lot of people feel like that is a choice. Like I'm just gonna, you know, live fast and die hard. That's a Did I get that saying wrong? What is that saying? Live fast and die young. That you don't know you're from Australia, you say concession? It doesn't even mean that
all your animals have pockets? And you're trying to tell me you understand?
Unknown Speaker 1:06:27
Do you sit here and think that you're I think good.
Unknown Speaker 1:06:32
Go on? No, you
Scott Benner 1:06:32
were gonna agree with me. I never stopped anybody from agreeing with me. You were
Rachel Baker 1:06:38
gonna say, I agree, I think there is a huge opportunity to change the landscape of diabetes, health care, I think I think it means that's the reason I got into becoming a diabetes educator. Because we need we need to change the health scape, the landscape of diabetes education, I have 100% there's a whole other way that it can be done a completely different way. So I have the same vision, I have the exact same vision. But if
Scott Benner 1:07:06
I have a phone call tomorrow with a large organization that is very much in charge of how health care educators are directed. And I am going to put my full excitement and and thought into that phone call and then they're going to ignore me. But just so you know, I'm not giving
Unknown Speaker 1:07:25
you I do that every day,
Scott Benner 1:07:28
every day. I booked this phone call and I was like, here's an example of me talking for 20 minutes. Everybody going Oh, yeah, that hang up the phone and going. That guy's a lunatic. It's so but I'm not gonna say he's crazy. Oh, please, we can't tell people that that'll kill them. Sure. Yeah, the podcast is, is reaching all the people it's reaching because, you know, it's not like to your point like it. It is what it is it works. If it didn't work, it wouldn't work. By the way. I want you to know that. I have completely decided to find Halina Sophia Hammami, who is part of the snail venom study and I'm going to get her on the damn. I'm gonna kill myself to get this woman on the podcast. Tell me about this. She was she was she got her PhD at the University of Melbourne. But she's on staff of Nova and I just loved the way you set out the way I said again, by the way, all that really thoughtful stuff you just said about the state of health care. I was going to say Do you ever sit in Australia and wonder why our animals don't have pockets?
Unknown Speaker 1:08:40
I've never I've never considered that animal if
Scott Benner 1:08:45
you've never looked at American than like, why did those deer not have pockets on them somewhere? Where's the Tigers pocket? I mean, you're closer to Africa. You ever just be like we're the lions pockets that I don't understand. How does a caribou not have a pocket? See? You gotta flip things around once in a while.
Unknown Speaker 1:09:07
Oh, my life has changed. Yeah. Yeah,
Scott Benner 1:09:09
tell me. Tell me how I just mispronounced that city. What should I have said?
Unknown Speaker 1:09:16
Melbourne.
Scott Benner 1:09:18
You just swallowed like five of the letters. Just so you know. You just you and Nolan. Did I get closer?
Rachel Baker 1:09:24
just just just Melvin. Yeah, that was close. I
Scott Benner 1:09:27
think you fell asleep. Well, where are you from? Melbourne? Yeah, I said it more correctly mumbling it then than I did when I was pronouncing the letters and you're from like, Where are you from Brisbane. Where's that from? Okay. How did this happen to people? Because you're all like surrounded by the water isn't scary being surrounded by water.
Rachel Baker 1:09:53
It's great because we get less Coronavirus. It's excellent isn't the best time to be living on an island when that
Scott Benner 1:09:59
place caught fire. never once thought there's nowhere to run.
Rachel Baker 1:10:04
That's fine. You just go to the water, we got plenty of water. Just run to the edge.
Scott Benner 1:10:10
Run to the sharks. Is that what you just said? Run out to the great white shark week wouldn't exist without and just, yeah, good luck. You better start building the raft. That's all I'm saying. And where are you gonna go? You don't have to go to New Zealand?
Unknown Speaker 1:10:26
Yeah, look, I
Unknown Speaker 1:10:27
hadn't thought that Yeah, well, you better figure it out.
Unknown Speaker 1:10:32
I need a plan,
Scott Benner 1:10:32
we have to save you. You're the only one helping people? Well, that's not true. But you're helping people with diabetes and in Australia that we need to save you. So do you think that the popular I'm gonna let you go in a second? But do you think the popularity of the podcast in Australia can specifically be attributed to the fact that this is not the kind of information you can get there? Or is there a rise in diabetes? They're like, I am starting to look at where diabetes is more prevalent and where the podcast is more popular? And there is I guess, not unsurprisingly, a correlation. It just wasn't something I ever considered before.
Rachel Baker 1:11:11
Yet, I think it was the former of what you said that they can't You can't get this information. This is not like a freely accessible information. You can go to hundreds of different diabetes doctors or diabetes nurses. But the information that you get on this podcast is it's another level you can't you just can't access that.
Scott Benner 1:11:34
I wish you knew me my whole life. So you know how ridiculous that feels. To for me to hear.
Rachel Baker 1:11:41
Unless, of course if they come and see me. But otherwise,
Scott Benner 1:11:44
let me just tell you the opposite of this. If you and I grew up together, and you felt like that now, when you explain to somebody you would say something like this. Can you believe that? That idiot Scott? You remember Scott right from school? Yeah, he's doing it. It's weird. Like people listen, and it's helping them. It doesn't make any How was it? Him? It just it trust me, it doesn't make any sense that it shouldn't be me, which I think is or even a person like me, I don't think but I think that's why it is because I had no preconceived notion of what was right. And when I heard things that are right, just like I had been doing my entire life. I was like, that doesn't make sense. I'm not doing that. Like I can remember being a little kid. And my dad saying, you know, you need to be nice to him. He's your elder. And even at like nine years old, I pulled my father aside and I was like, Listen, I don't know if you realize there's not, that guy's a jackass. And I am not I am not willing to give him any kind of respect or time just because he was born before I was like, those things that don't make sense to me have never made sense to me. And I do not spend any time with both. Really like that just is it's not okay for me. So when I saw things about diabetes, that didn't make sense, I got trapped like everybody else that's like, this is right, this is what I'm being told. But it did not take me long to say I am not going to let this make me crazy. Or make me give up on my daughter's health. So I am going to throw away everything that everyone's saying and think of something else. Because this is just not okay. Yeah. You know, so,
Unknown Speaker 1:13:20
yeah, happy. Yeah. But I
Rachel Baker 1:13:22
think that that's, that's what makes it so relatable. But you know, as an Australian, I would say you're just you're just an honest, genuine bloke, you know, that's how I would describe you. And I think having that having those traits makes it feel all the more achievable. You know, it's just I think that's part of it.
Scott Benner 1:13:44
You're just saying that because I'm wearing pants with pockets and I love the plugins you love the pockets Really? Got me. By the way, Rachel loves the pockets. Pretty close to the title of this episode. Just so you know. Listen, I really appreciate that. And I'm gonna have to start telling my wife listen be nicer to me, because I could just throw myself back on the market to people with diabetes, and I could get a nice line of ladies. So but that you, I'm not saying you I'm just saying in general, there are people who are people who respect me. Just none of them live with me. That's just everybody. I think right? Like I always imagine, like Peyton Manning, or wait, I need to Australian like Do you have any famous people there? I got it. Imagine that Hemsworth guy, right. Is he okay? Yeah. Yeah. By the way, we like it. Which one do you prefer? The Thor the other one.
Rachel Baker 1:14:44
Liam, the other one. The other one.
Scott Benner 1:14:46
Let's imagine Liam has some children. Did he not date the Miley Cyrus? That must have brought you down a little bit? Yeah.
Rachel Baker 1:14:53
Oh, yeah.
Unknown Speaker 1:14:54
Yeah. Although
Scott Benner 1:14:56
I like her. I'm just saying, you know, she seems a little strange.
Rachel Baker 1:14:59
But that's it. wouldn't think it Yeah, yeah, yeah.
Scott Benner 1:15:01
So anyway, he comes in in the morning like a wrecking ball. He's got these children, and he's gonna bring them breakfast. And he does. I don't think the kids sit there and think Liam Hemsworth just brought us breakfast. I think that idiot made my cereal soggy. Like, that's how they you know, like, you don't mean like nobody in your own home sees you. Not that I'm Liam Hemsworth. I'm just saying Trust me. I'm probably the furthest thing from Liam Hemsworth. I don't even know who he is. But all this is making me think of is that inappropriate? joke that I've heard so many women who loved the Marvel movies tell they they talk about Chris Hemsworth? And they say I'd let him make me Thor. Did that even resonate with you did that? Did that get to you? Should I swallow the last few words? You just went for like that? Would
Unknown Speaker 1:15:51
you understood better?
Scott Benner 1:15:54
All right, listen, this is getting off the rails. I've already recorded a weird episode this week. So I can't, I can't do too many more. I think I'm getting too comfortable doing this. By the way, in case you're wondering. I used to feel like there was a need for the podcast episodes to have some sort of, I don't know, like conformity, and now I don't even care. Let's just keep talking. Anyway, did you? Did we not say anything that you meant to say that, that I talked over or made pocket jokes around it? Or we go?
Rachel Baker 1:16:29
No, no, no, I came in with no no intention. So no, no.
Unknown Speaker 1:16:34
There you go.
Rachel Baker 1:16:35
I just got i got i was I'll come in with no idea. No idea we're gonna talk about and see what happens
Scott Benner 1:16:41
when people over prepare for the podcast. It makes me nervous when they start talking. And I think they're more prepared for this than I started feeling inadequate. It's like, Oh, geez, should I have made a list? I didn't think oh, sometimes I'll be talking to somebody. No, I hold on a second. I'll be talking to somebody and I'll hear like, paper rattle in the background. I'm like, use paper. Or like, like what's written on it? And they started telling me like, Oh, my gosh, Wow, thank you. Actually, you're taking this so seriously. I hear I'll give you this. And then I'll let you go. This is Don't let this be crushing. Five seconds. Before I record with people, I do a search in my inbox for their name, look for their email and go, Oh, yeah, Australia CD. I remember this, that I go, hi, Rachel. And then we start talking. And I think that's part of my genius. So whatever. And I don't mean genius. In the standard sense, the word I mean genius in the Australian sense, sort of like concession. So I need you to look into that for me and find out why they're called concession.
Rachel Baker 1:17:49
I'm going to I'm abs, that's my first goal. As soon as I get off it.
Scott Benner 1:17:53
Thank you. I have six you have six months to tell me. But if you could just send me an email and tell me why they're called concession cards. I'm going to like plug it in at the end of the episode. All right, listen, go to bed. It's late there. You have to rest up so you can run away from wild animals and snakes and things like that. You live in a city, right?
Unknown Speaker 1:18:13
Yes, yes. You don't like
Scott Benner 1:18:14
normally see a snake? Is that right?
Rachel Baker 1:18:18
A snake? Oh, yeah. No, there's still snakes in the backyard?
Scott Benner 1:18:22
Are they big and scary? Can they hurt you? Or are they just regular ones?
Rachel Baker 1:18:27
Depends, I mean, most of them that I get most of them like a green train, and I'm not going to hurt you. But definitely, I would say, you know, at least once a year, you'll have a brown snake in the pool or in the back garden or something. And now that we're
Scott Benner 1:18:38
in the pool, sounds like a little kid took a poll. But that's not what you're saying. You're saying? No, no, you're saying you're saying and so when there's a brown snake or a venomous snake in your pool? How do you what do you do? What what's the next step?
Rachel Baker 1:18:56
You get the pool net, you know, the pool cleaner. And try and just sort of flick it away. Get it out, take it away
Unknown Speaker 1:19:05
once it goes in your house.
Rachel Baker 1:19:08
When you close the doors, I feel like people have such an interesting imagination about Australia.
Scott Benner 1:19:15
To me, here's what you just said to me. I live on Mars. That's what you just said to me. Yeah, we can't even breathe. The atmosphere here is not hospitable to life. Like that's what you just said. Like my brain is yelling. Why won't this woman move out of that wasteland? Like Like, like a snake in your butt? I realized there are places in America where like, you know, bears wander into people's yards and there are rattles?
Unknown Speaker 1:19:42
Exactly. I don't understand
Scott Benner 1:19:43
why people don't leave those places, either. Just I gotta be honest with you. If I woke up one day, and there was a bear at my back door. I wouldn't live here three days from now. Just be like, I
Unknown Speaker 1:19:57
gotta go
Scott Benner 1:19:58
gosh, oh, yeah. But I am Maybe a word that I shouldn't say on the puck. I'm gonna stop the recording and tell you that I was gonna say that. That seems unfair, doesn't it? Thanks so much to Rachel for coming on the show and sharing her story. And given the chitchat with me, I had a great time. Thanks also to the Dexcom g six continuous glucose monitor, and the Omni pod tubeless insulin pump, find out more@dexcom.com forward slash juice box, my Omni pod.com forward slash juice box and don't forget the T one D exchange T one d exchange.org. forward slash juice box.
Looking for those diabetes pro tip episodes that you hear everybody talking about? You can find them right there and your podcast player or diabetes pro tip.com. I'll be back very soon with another episode made just for you. How about a little bonus chitchat from right before we started recording this episode to talk when you were speaking prior with the video and it just went on. So I wasn't really hearing you. All my bad jokes about like what part of the Australian jungle you live in, started popping
up somewhere on a koala bear farm the middle of that island.
Unknown Speaker 1:21:35
That's exactly accurate representation.
Scott Benner 1:21:38
Thank you so much. I really I like to show off my geography during the pot. hasn't done it since then. So that's good. Not that it wasn't okay. But it will be more important if people can hear I actually left a little bit in the episode I put up yesterday, which I think I recorded like six months ago. But I left a little bit of an end of us talking in the beginning about that. And the truth is with a podcast if it doesn't sound right, it doesn't matter what you're saying. People will flake out and just leave it they won't listen to you. It doesn't matter what you're talking about. You could be like so this is how you become a billionaire. And people be like not if it's gonna go in and out. It's not I'm not listening. So interesting what people will spend their time with and not. Although I have to agree with them. I don't I don't like it to. to sound poorly either.
Rachel Baker 1:22:38
Yeah, no, I'm great. Thank you
Unknown Speaker 1:22:40
going and
Unknown Speaker 1:22:45
what time is it there?
Unknown Speaker 1:22:48
It's 9pm
Scott Benner 1:22:51
for some reason, it's Australia week here. So you are the third person from Australia I've recorded within less than a week. So you got a lot to go to here because I'm completely out of stupid things to say about Australia. So you and I are gonna have to have a real conversation.
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#420 Fox in the Loop House - Part 3
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends and welcome to Episode 420 of the Juicebox Podcast today is another episode about the Do It Yourself algorithm called loop.
If you've been following along in this series, it began back in April of 2019, with Episode 227, and that one's called diabetes concierge. Then I spoke about loop again in August 2019. In Episode 252, a loopy few months, February 10 2020, Episode 304, a loop de loop. And then in March of 2020, we had a two parter number 312 and 313. Fox in the loop house parts one and two. And that fox we're talking about is Kenny Fox, gentlemen has been on the show a couple of times, and who you may know, I really liked Kenny because he understands the loop. And he talks about it in a way that I dig on. So I asked Kenny to come back because I think I've made some big improvements with how I think about loop. And I wanted to check in with Kenny. With all that considered. This is Episode 420. Fox in the loop house, part three. Please remember while you're listening, that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan, or becoming bold with loop.
This show is sponsored today by the glucagon that my daughter carries g Volk hypo pen, Find out more at G Vogue glucagon.com forward slash juicebox. Have you ever wondered if that blood glucose meter that you're using is accurate? Well, it might not be. But I can tell you for certain that we love the Contour Next One blood glucose meter for exactly that reason, its accuracy. I also love its bright light for nighttime checks how easy it is to use and carry. And of course, those Second Chance test strips. Check it out at Contour Next one.com forward slash juicebox. And if you're a US resident living with type one or caring for someone with Type One Diabetes, please consider supporting the T one D exchange by going to T one d exchange.org. forward slash juicebox. And joining the registry, you too can help T one D research. All these links are at Juicebox Podcast comm or right there in the show notes of your podcast player. Let's get to Kenny right now. I'm just gonna cut the music off and start no messing around.
Recording when I start the recording. All right. Last night, I ordered a new mic for the house here. Because finally after what feels like about two years, Arden's like, Okay, I'm gonna come on the podcast. And I was like, finally, geez. So, so I'm gonna get another microphone, like so if I buy this microphone, that's it, you're definitely doing this right, because she's vacillated a great deal. I don't know if she's embarrassed, or she's afraid of what she thinks she's gonna say, I have no idea. I was like, I don't care what you say. You can say whatever you want. You know, like, I just want to chat with you a little bit. And then I want to talk about, you know, what you've learned so far about diabetes and what you think you still need to know. And we'll go over some stuff. I was like, that's all I just want to talk. She's like, Okay, all right, I'm gonna do it. But I think she's planning on using it as a they have to do a certain amount of Oh, my God, why can I not think of a very simple word. If you send somebody out into the world to do a nice thing. In exchange for that, you get hours to put in the service or somebody service hours, they have to have a certain amount of community service hours to get it done, to get to graduate. So she's like, do you think that would be community service? I said, Ask your you know, ask your counselor, the counselors like it would definitely be
Kenny Fox 4:30
nice, nice.
Scott Benner 4:31
Anyway, Kenny, you're back. I am back. It feels like it's been a minute since you've been here. But that is sometimes on purpose. I feel like I could talk to you every month and it would be valuable. But your last two episodes. The Fox in the loop house episodes have been very popular. People tell me about them a lot. And I've grown in my understanding of the loop and how I use it. I know you have. So I thought end of the year would be a great time to have you back. So thanks very much. Yeah, I appreciate it. I think we should probably start. Do you agree with the beginning of the pandemic? Yeah. Is that a good place to start? It is. Alright. So I was perplexed by Arden's blood sugars for about three or four days. And I was feeding her insulin almost constantly. And not a little bit a lot. It was bad. And I don't know, you know, for all the things I say on the podcast, and the things I mean, are the things I usually do, I should have just turned her insulin back. But instead, I just kept thinking, you know, something odd happened, or this was gonna be momentary. And finally, like, two, three days into it, I realized that the, you know, stressors of being at school, and getting up and going to school and all the things that come with leaving the house, disappeared for Arden, like she's more comfortable in our home, on a laptop talking to her teacher, and maybe comfortable is not even the word I'll have to ask her when she comes on the show. She might not even be aware of it, right? But there's just not that adrenaline I guess from being up and being moving and having to run from class to class. And it turned out that Arden's insulin needs, at least at her basil level, had significantly dropped because she wasn't at school. And I was in the middle of trying to figure it out. And you just kind of messaged me, I don't know, we were just talking, I guess about something. And I mentioned that this was happening and you're like, Hey, I'll I'll lend a hand if you want. I was like, Okay, sure. Sounds good. It's one of the perks to having my podcast Ken. Right. You are literally one of the perks of my podcast, for me personally, and for everyone listening. And so we looked at it for a while. And you said let's try and what did you want to try?
Kenny Fox 6:59
We tried to cut and basil was looking at just your nightscout graph and look like he had a lot of negative. It shows the nightscout as negative iob. In Salaam born overnight, especially but like EDC Arden's blood sugar was dropping, but it wasn't just dropping with positive insulin it was dropping with negative. So Luke thought, hey, you based on the basil rates you have in here, we should have taken away enough insulin that she should be going up. And she wasn't. So that was kind of an easy indicator that basil was too much. And so we ended up cutting it back, I think at the from where you had it in the daytime, like for handling that school stress was I was almost in half, it was a lot It was like 30 or 40%. And then I think I just also happen to coincide with a because you know, Arden loves that we talked about this herd cycle where she needed less insulin too. So it kind of compounded the effect of having Basal too high very temporarily, but we cut it back quite a bit.
Scott Benner 7:59
The Kenny's on a storyteller he took he told the end at the beginning, but that's fine. So first, I want to ask you to describe negative insulin on board for loop. But how people can think about that as well away from loop.
Kenny Fox 8:15
Yeah, so basil, if you think of basil as like we've talked about before just meeting the body's need for insulin like just normal sugar production. If you can find that spot where you're just matching the body's insulin needs, then you should be fairly level and that would be a situation like overnight, you'd have zero. Insulin on board insulin on board would be any insulin above or in the case of negative insulin or below the basil needs of your body. So it's any extra or in loops case, less. So what that means is in an order, like if you didn't have any food or anything stress or whatever, trying to raise your blood sugar, then most of the time when you have positive insulin on board, you give a bolus or the system increases loop gives more insulin, you should expect at some point your blood sugar to come down. And then once you hit zero insulin on board, you've kind of reached that status level where you've your body's insulin needs are being met with the amount of insulin in your in your body delivered in the background as basil so that should be level your blood sugar should mostly level out. Negative insulin on board would mean that this that you've reduced how much like you're not meeting the body's need for insulin at some point. Often because like in loops case, they've it's reduced. The basil rates pick something lower than your scheduled normal need for insulin to the point where you have less in your body than what you should need to keep you level. And if all that's right, if your basal rates are right, what should correspond with that negative insulin board is your blood sugar will start to rise Because you don't have enough, sometimes it happens right away. Sometimes it's a little bit of a delay, maybe you're exercising or something. And once you slow down, it kind of catches up with you. But the idea is that if you have negative insulin on board, your blood sugar should go up. And that for like a normal pumping situation, just like these in the PDM. For example, if you're waiting, if you have really good basil, and you're flat overnight, and in the morning, you wake up. But let's say you want to be a little bit higher before you give a nice big bolus for a bowl of cereal or something in an hour, you could turn your basil rate down, you could do a Temp Basal have zero, for example, for an hour, well, that would should make your blood sugar drift up because you're you've turned off the basil, you've cut it off, you don't have enough in your body. And it's not enough to just let it turn back on to level you out. Once that Temp Basal of zero is is off, you actually need to give the insulin you're missing that last hour to level it out. So in that situation, you would have a negative insulin onboard situation, even though you're not looping, you might not call it that, but you'd kind of need to give that last hour of basil. plus whatever your you know, that would level you out. And then you're gonna need to give the insulin you need for your food. And loops, just tracking all of that for you by modulating the basil rates up and
Scott Benner 11:19
down. And so if we had Arden settings correct, when she was showing negative insulin, there's just no way she should be falling her blood sugar, it should at least be stable and most likely rising. Correct? Yep.
Kenny Fox 11:33
Yep. So that's a nice, objective way. It's one of the few objective things in diabetes, it seems like and loop helps extrapolate that is like, oh, our basil is wrong. And there are a couple situations where that might not be the case. Like if you're, you know, laying on a sensor at night and dropping, because of a compression, but, or maybe even exercising, it might not drift up as fast as you'd think. But other than that, like it really should be, you should really see up when you see it and negative insulin on board, but at a minimum, Yeah, a little bit of a levelness, as you shouldn't be dropping anymore. And so it's nice is like, okay, that's, that means basil somewhere, is too strong. So if you have multiple rates, then you might have to look, in the last, you know, five or six hours insulin last six hours. So you might want to look at your basal rates in the last four to six hours and try to figure out which one is the culprit, you know, How bad is it how fast you dropping? I have
Scott Benner 12:30
to say that this whole concept has, for me, raised my understanding of insulin significantly. And again, I 100% have to thank first the loop, you know, algorithm, because I began to see these things. As soon as Arden went to loop and you, if you go back in the podcast, you've definitely heard me talk about how fascinating I found it to watch the loop takeaway basil, to give it back, you know, just to sort of, it was like a self driving car, you know, it was seeing that it was seeing the road curve a little down or a little up and it was just going with it. And it was and it was not just going with it. But it felt like it had it felt like it had a crystal ball. You know, like it was like, Well, I'm gonna give her more now. But our number really had only moved a little bit. You know, blood sugar goes from 85 to 89. And all of a sudden, her basil goes up a little bit, and you're like, let's not even arise. And it can be scary at first because you think No, don't give more. She's only 89. But it It knows. And you know, and it knows based on what it's done in the past, and what the expectation is based on the setting you put in. And I think this is important for people if they're gonna use an algorithm or not to really understand basil insulin in a different way. And not just how much basil insulin Do you need, oh, I use 20 units a day, that you know, I inject basil and I use 2020 units a day or I have a pump. And my basil is point five an hour, but it's point four an hour overnight. And that's it that that is I now understand that that in itself is such a rudimentary way of thinking about basal insulin, you really have to step back and believe that in every moment of your life, your basal insulin needs are slightly different. They might almost be in perceivably different, but they're constantly fluctuating somehow sometimes they get real super stable. You know, when you're sleeping, or you know, you just haven't had a lot of activity, there's no food and you know, no insulin you But the truth is, is that the needs change almost constantly. And you can see that because the algorithm is like ooh, more or less, more or less. It's not something you could ever duplicate with your you know, with your hands and your eyes. It would just be it would be your entire life. You know, you'd have to sit there and stare forever and you still wouldn't know that things needed to know to make the decisions in a timely way you could kind of catch them. But it would never be out of head like this is. So I don't really know another way to say that for the people listening. But you have to get it out of your head that your basal insulins definitely point five, or it's definitely a unit, because it very well may not be. And then you can extrapolate that idea to when you have food in your system. And I just did this last night because Arden had a cheeseburger and french fries from five guys. And I crushed it with a good Bolus up front. Her first two and a half hours after the food bank, there was a milkshake in there too, by the way, Kenny, actually double bacon cheeseburger, barbecue sauce, Cajun fries, and a milkshake with Oreo cream and Oreo cookies, the crumble part. So I crushed it the first two and a half hours. And then she got into this 130 space that was trying to go up. I tell you, if I did nothing, her blood sugar could have easily been 300. But I kept adding carbs. And this is still where I have a shortcoming. I need to figure out a way to translate fat and protein into a number, a carb number. That's still something I'm trying to figure out. But I just and
Kenny Fox 16:22
that's that's important, because loop is expecting. So it like kind of, I don't know, it sees in carbs, I guess that it understands the world and understand your blood sugar movement based on carbs. So yeah, figure out your way. And it changes I think for everyone and even meal to meal, it's a little bit of a, maybe there's an exact science to it. But we've kind of settled on 25% or so of all the fat grams and the protein grams. So if you had like a nutrition label, I would like take that, add it all up divided by four and add that as some extra carbs into the carb entry. And usually, if you're adding in fat and protein, you'd either want to do a four hour entry to mix all those carbs together. So that way the because the fat and protein is going to hang out a while. So use the pizza icon to make it longer. Or you can do kind of what you ended up doing in reaction last night, which is you could take kind of that fat protein representation and entering the cars. But you could do it ahead of time you could enter change the time on the entry and put it out in the future by like an hour and a half or two hours where you think that fat and protein is going to kind of show its head. And so you could you could put that number out out ahead of you. And then as she starts to come up, we'll see Oh, I have carbs coming. I can go ahead and give more insulin ahead of time. But you ended up doing it reactively, which is you know, sometimes that happens. We get that with Cassidy as a torturously underestimate the delayed impact of the cheese in a case of DHEA. So I, I tried to add more upfront, but oftentimes it's just like, Oh, she's going up. So then I just add some carbs and, and Bolus and I wouldn't call those fake carbs. It's, it's how Lupe sees everything. You can't call it fat and protein. And so he legitimately needs to be handled with some representation of carbs. So I think, I think what she did was was perfect. I mean, pica added more, but that's I
Scott Benner 18:21
didn't do enough, because I ended up fighting with it for an hour or so where she was kind of that 150 160 back to 150, where I could see the the Bolus pushing her down. But it wasn't winning the fight to bring her back to normal and the fat and the protein still existed. And so yeah, you're telling me just for fun, just to make a round number. If I thought, if I could count 100 grams of fat and protein in a meal, I take 25 divided by four, make it 25 and tell the loop, there's 25 carbs during the fat and protein rise, and that probably would have done it for me.
Kenny Fox 19:01
Yeah, something like that could be, you know, good. Some people use like I used to use 50% of protein and 30% of fat. You know, but I think like 25% is a good start, if people find that their carb ratio works well with basic carbs. And then when they add the fat and protein things get out of whack and 25% isn't enough and try 30 you know, like, whatever it is, or do more for protein. But yeah, find a balance some number that represents that as best you can. 25% just a good starting point. Just add it all up and divided by Ford
Scott Benner 19:34
inserted in there. So this meals like mind numbing to people because I think it was like 85 carbs I put in for the food. Right? And so you're telling me that I could have said 85 carbs now you know, let's say noon. And then I could have let that pump in and then told it 25 carbs for the fat and protein but given it a time of 230 You too, right? And it would not have given her the insulin. But at 230, if she would have rose, it would have got more aggressive.
Kenny Fox 20:08
So you would look at the, it's best to experiment with this at home, rather than sending a kid to school and trying it for the first time. But you'll see the prediction will adjust it'll, it'll see a rise coming. And so it will sometimes or usually offer insulin upfront, I usually don't take it, I say I just don't Bolus after I enter that future carb entry. And then I let Luke kind of spread it out over time, because then as soon as your blood sugar starts to dip a little, it'll pull basil back. And then when that starts to come up, usually corresponding with that rise that you're expecting, then it'll start, it'll start giving insulin right away. So it won't, it will give insulin before the 230 mark that you answered it. If the prediction allows it, if it says you're going to be high enough, and not go underneath your suspend or whatever you can do that sometimes what people have to do for certain longer meals, like maybe a pasta or something that doesn't have as many carbs up front. You may it may be safer to use an override, we've talked about overrides before. That is 100% insulin needs, it doesn't change anything around your insulin needs. But it just has a higher correction range, like maybe like I think yours is like 85 9095, somewhere in there, less than 100, maybe you would have a correction range, then you could set an override that would have a range of 95 to 105, maybe a little bit higher than normal for like an hour or two. And you could turn that on. And what that would do is loop wouldn't would be would not be giving you extra insulin for that future rise until your blood sugar came up high enough into that range. So instead of at 85 or 90, it would have to wait until your blood sugar was into or above that range of 95, let's say before it gave extra insulin. So sometimes you're like, well, it's hard to model how you think every meal is gonna go. So sometimes you just need loop to chill out in the middle, right the first couple hours. Yeah, so raising that correction range for an hour, a loop can't give more insulin until your blood sugars into that range. So you might just want to wait, you might want to wait it out. Like we do that with pasta. pasta is just I don't know, depends on the process. Sometimes it hits right away, most of the time it waits, it's seems like it's almost free for a few hours in my daughter. So we'll set a higher correction range, but I still want to have all the carbs entered because they will show up, it just might show up later. So same with fat and protein, you might, it might be safer to just kind of add that buffer for an hour, if you're worried about a low coming so and the other way you could answer it would be either that like a 230. Or you could have put, you know, the 85 plus the 25. all into one entry and just made it have an absorption time of four or even five hours. And so that would naturally give less, it wouldn't give the insulin for all 100 carbs or 105 carbs up front. I guess it'd be a little more than that. But you know, it wouldn't give all the insulin up front because I would expect it to be spread out a little more. So either either way is fine. Whatever people find easiest or most representative of the food, I think for like the meal you're talking about having it separated would be good. I always separate the carbs from the fat and protein and make a future entry for donuts from a donut shop. Yeah. Because if I give it all up front, she'll drop like a stone in the beginning. But there's always a rise like 90 minutes later. So not that we have done it's a lot. So
Scott Benner 23:46
I like I said at the beginning of this. Whereas when I was talking about putting in the 25 and telling it two and a half hours later, you said do that, but then don't give any insulin that it suggests for it, which is basically like giving the loop walking around money that it can spend wherever it wants to.
Kenny Fox 24:04
Exactly Yeah, yeah, you get to let the blood sugar play out a little bit. Before Luke gives too much insulin like it's because it's going to use the trending information if she started. If Arden started dropping a couple of points, a couple of readings right after you gave the 8087 carbs for the meal. It would be wouldn't give as much insulin or may not give any extra until she starts trending back up again. For those extra 25 cards we talked about,
Scott Benner 24:32
let me ask if I do that. If I say hey, 25 more carbs. Not till 230 it says I don't know let's say it says that's six units and I say no no zero don't put anything in. Even if 230 comes and for some reason I was wrong about that need and her blood sugar never goes up. It doesn't give her the insulin.
Kenny Fox 24:53
So even five minutes after you said no loops gonna check the prediction if the prediction still says needs, maybe she starts dropping the next reading and says, Okay, well, instead of six units, she probably needs two, it will give, you won't give the two, but it'll give as much of the two as it can, right. So in the case of like normal loop with Temp Basal, it'll kick up the Temp Basal rate, and it'll start trying to give that to, and then if she drops again, in the next five minutes, it'll probably say, Oh, nevermind, and cut it back to trying to give one. So that basil rate of shift down in the case of auto Bolus, it would give whatever percentage you're, you're letting it so you know, maybe it'll give half if you have it set at 50%. So if she needed 60 units, in the next five minutes, if it still thought she needed six units, it would give her three minutes, which is why I suggested increasing the correction range, because sometimes, sometimes you need it to play out a little bit. So But typically, if you're putting it out two and a half hours, there's usually kind of a dip in the middle, in the prediction, that will be low enough that it will restrict loot from giving too much. But that's why it's an experiment based on the food I think in the case of, of your meal last night, I think, yeah, maybe it would have given a little bit more insulin upfront, if you said, Hey, don't Bolus for it. If so would have given some decent deliveries, but it wouldn't have been a ton and she didn't drop. So she probably wouldn't have dropped very much either. probably would have been timed just enough to kind of catch that rise that was coming. Yeah,
Scott Benner 26:22
actually, as we're talking about this, I realize this is a similar way to how I handle Pre-Bolus Singh meals when her blood sugar is lower. So if Arden's blood sugar is like 65, and we're eating in 20 minutes, but she's not dropping. We don't you know, she doesn't do anything about that she just waits to eat, but we still want to get some insulin going. And so sometimes you'll tell the little part of it. Yeah, right, you totally pay, like this meal is going to be 10 and carbs gonna be 25 carbs. And it you know, I guess for art and let me just use a round number for a it's a it's a 10 carb meal would probably want, I don't know, Arden gets a unit per for carbs. So you'd probably want like two and a half or so units. But I don't want you to have the whole two and a half. It doesn't matter because it's not gonna want her to have any. Because yes, because she's under the number. So what I usually tell her to do is even though it says zero, go ahead and Bolus a unit, like you put manually inserted unit. If there are times when I forget all the time, yeah, there. But there are times when you forget to look back. But it doesn't matter because as soon as she pumps hits 85, it puts the rest of it in for me.
Kenny Fox 27:33
Correct, because that's where your correction range starts. Yes. And so now it has the green light, as long as the the rest of the prediction, as well as her current blood sugar is all above her correction range of 85. Plus, then it's like, Alright, I'm allowed to give insulin and I know you need some. So here it goes. And that's why correction range is an interesting one. And I did took me a long time to realize that's what it was doing. So there are some people who may be usually they have little ones, they may set the correction range up at 120. So then they start a meal at 75. And it loop won't give insulin for you until their blood sugar is going to be up to 120. So that can sometimes be a long amount of time for the food to really get ahead of the insulin. So then they get upset to the end of highlighter. But what you're watching is that there's there's a bigger space for you to kind of see this happening where your blood sugar is at 75. But Luke can't give more until you're over 120. And so that's the correction range in effect. And that's it's not just or lupus aiming to put you. It's also a restriction on when and how it can give insulin,
Scott Benner 28:45
you basically gave them momentum away.
Kenny Fox 28:48
Well, yeah, in that case you did because it's so much higher. But you also get to see that that's why sometimes bumping up the correction range with an override is useful is maybe you you want that to happen. Or maybe in the case of someone with a blood sugar a child with a correction range of 120, they may want to have temporarily have a lower correction range at the beginning of a meal, they might want to just set it you know, to like 90 or something for an hour. And then and then once she once that person crosses 90, then loop can start giving the insolence here getting a little bit ahead of it that way, or do what you did, and which which we do too is just, we know a little bit better than loop loops, really concerned about that suspend, like don't don't give any insulin if they're too low, but we know they're eating so it's fine. Just give a little bit of insulin anyways, manually. That way you're not totally behind when the food kicks in.
Scott Benner 29:41
To me, that's just the loop version of how do I used to talk about it? So you're basically you're, you know, she's 65 In this scenario, you know, she's not falling, you still need the Pre-Bolus so you just, you know, you Just override the pump and do it anyway, you're just like, Okay, well, the
Kenny Fox 30:03
pumps not gonna suggest that either right into the blood sugar, and they're gonna say, Nope, zero, but then you have to remember to come back and give it and the beauty with loop is you told loop about the carbs, right? It's expecting the rise. And so when it shows up, it will take action, but it takes action based on what it knows the carbs and also and basil and everything else, but also the correction range when it can engage. So that's another restriction. Yeah,
Scott Benner 30:28
that's also a situation where I trade a lot of the Pre-Bolus time for the number. So if she's 65, I don't need like a 15 or 20 minute Pre-Bolus anymore, because the 65 is the Pre-Bolus. Meaning if I was going to put the insulin in at 5pm, and I didn't expect to just start working until 515. And she was going to eat at 520 or 525. And her blood sugar was 100. Well, then I like that because then by 515 are blood sugar's moving a little bit, she's 98, you can tell it's getting ready to kind of it's drifting down. By the time she puts the food in her mouth, maybe she's 95, and the insulin is really coming on board. So that's where a nice Pre-Bolus works, because her blood sugar help is helping by being 100. But if your blood sugar 65, you can almost push the button five minutes before you eat. And that way the food goes in turns the 65 into a 7585 95. Right, as the insulin comes on board, then you start the fight around there. It's all about where you're starting the fight between exactly
Kenny Fox 31:30
yeah. And and loop is very sensitive to where that fight happens. I think that's kind of the most frustrating thing for people when they start looping is two things, one, the fat and protein, you really have to accommodate for that and loop. If you don't want to be really angry with loop and being high, especially when you're listening to this podcast, you're used to, you know, correcting if you need to, but keeping things in line. And loops recommendations can often be a little light upfront if you're on the lower end of the spectrum. And so it's gonna give insulin later, but then that fight might happen at a higher number in this case you wanted it to but in other cases it won't. And then once that battle happens, it loops usually pretty happy with it, because it's waiting for the entire meal to resolve over the next few hours. It's not in any hurry to bump it down. And so it just happens. Whereas if you with you can do this with loop or with the PDM or MDI Either way, it's easier with with loop, you can give a little bit of a manual Bolus, if that fight that tug of war is happening at 160. And you'd prefer it to be a little lower, or you see it starting to get up there earlier, you can catch it the better, right? Yeah, you can give a little bit of insulin loops going to disagree with you and not recommend anything. So in return, it will cut the basil back it'll it'll turn the basil either off or lower after you manually Bolus, but that's okay. Because you're you're wanting to kind of reset the fight you're wanting to kind of push it back down a little bit. And by Luke cutting basil, it should prevent the low that would happen later from all that extra insulin you gave that you're usually not patient enough to wait for anyways. So yeah, it can it helps balance it. But where that fight happens, loops, usually fairly content with just letting it resolve because eventually, according to what it knows, you'll be back in range. But we would prefer to have the most of the meal at a number. That's a little bit lower sometimes. So yeah, it is. It's all about the timing.
Scott Benner 33:33
Do you imagine that in the beginning when people start using the loop, and it happened to me as well? Where if I'm not considering protein and fat and later rises, or I've got my settings wrong, and then I try to do that thing where I come back and I try to fake carb, I'm like, Oh, she had 10 more carbs. And then it takes away the basil because it's trying to do its thing now it believes these 10 carbs are going in, and you keep going up and up that frustration really does come from I think I got it through not not specifically understanding how the algorithm was working and what it was trying to accomplish. And then I just couldn't imagine it. I couldn't break free from my, my, my knowledge of how it worked when I was pumping, and that if I gave extra insulin, I still had the basil. And you know, so I think that now that I understand better. I don't run into that as often. I think I'm incredibly good at using loop now.
Kenny Fox 34:32
But yeah, I mean, your last few weeks have been great.
Scott Benner 34:35
Yeah, I just I you know, and it's interesting you say that because maybe two or so weeks ago, Arden started using a birth control pill to regulate her periods. So she's getting this very low dose of estrogen I guess or hormones. I think I'm right when I say
Unknown Speaker 34:53
less, you should probably look
Scott Benner 34:54
at me and it did increase her needs. So Arden's basil need one From like point nine to 1.5 to combat the pill, but her meal ratio didn't change. And her correction ratio didn't change the insulin sensitivity, actually, excuse me, I did have to make it slightly stronger. Maybe
Kenny Fox 35:17
not a lot, though. It did a few points. Yeah,
Scott Benner 35:19
from like 43 to 40, or something like that, if I'm remembering correctly. It took me about two days to figure it out after the pillow kicked in. So the first couple days were wonky than about day three and four of the pill I could really, like make the adjustments. And I think by day five, I
Unknown Speaker 35:34
had it.
Kenny Fox 35:35
Yeah, I mean, I think a lot of the challenge people have with at the beginning is their bezels are often wrong. Like we've talked about before, I I prefer the idea of at least starting with a single Basal rate so that it's easy for you to see at least the lowest parts of the day, where that negative insulin on board might show up, or you may have the basil off, or maybe it's too strong. I do find that that number of basil typically for most people does apply. All day like it's it's kind of a, I call it a floor like I don't have a metabolic metabolic floor, where if you give no matter what you should see blood sugar stop falling when you hit zero, and so on board or negative at pretty much every hour of the day. But there are situations where you would need more than one. But if you start with one tune to that like weakest part of the day, and then you know that you're pretty close, typically, secondary basal rates are not that far off from the main one that you find. And then at least that gets you in the ballpark. And now, what like like what we found with Arden, when we started at being in the pandemic is, after pulling away that stress that you were trying to combat, you're actually combating that stress and other stuff with basil. So her carb ratio ended up being almost half of what you had it. And that's actually not uncommon, from what I see with those with teens is the not in your case, necessarily. But a lot of people are too afraid of or just can't fathom that their kid went from 10 or 12 to one carb ratio. And a couple years later, they're down to like a four or five, six to one carb ratio. So instead they increase the basil. And then when you get to loop, you find that the basil is a little bit too weak for part of the meals, and then it causes lows later, because your Basal is too strong. And you're you're definitely not winning with loop because it's expecting to see carbs, and you're not matching it with the appropriate amount of insulin and the settings are off and all this stuff goes on. That's so yeah, that's a big problem.
Scott Benner 37:42
Yeah, I end up saying that to people privately all the time. Because though, first they come in there, the telltale is always a real jagad graph real high, low, real high real low,
Kenny Fox 37:53
and not enough insulin with the beginning of the meal, and then too much at the end with basil being too high.
Scott Benner 37:58
And then so you just say, look, this is either it's gonna be I always say we're gonna start with your basil, we're gonna find out if it's too high, or it's too low. And I just asked this simple fishing question like, do you find yourself feeding insulin more frequently, or bolusing for highs more frequently, because I can't be there. And I can't just sit and watch it forever, right. So if they find themselves feeding lows, I go, okay. And that to me, says, you know, maybe the bass was too high. And if it's, we're always bolusing ago, maybe the bass was too low, and we just start there. And then I just, I take the person's weight, and it gives me an average understanding of about where their basil is gonna fall for most people. Some people don't correlate to their weight at all. But I find that many people do around point one per 10 pounds. But then once you get over a unit that seems to not play out exactly the same angry, right? And so but again, there's nothing scientific about that. It's just just experiencing a lot of people's graphs, right? So you know, you my kid weighs 50 pounds, you know, they're not in, you know, puberty yet. All right, so you've got their Basal at point, one, five, probably not enough. So let's try point three, and then you see it get a little better. And I keep moving up, we'll go point four, you know, maybe point four or five. Now this looks pretty stable. Okay, now we have some stability at a lower number. Let's look at how long your Pre-Bolus in. A lot of people like to say they Pre-Bolus but then they always say, You know when I can? And I'm like, yeah,
Kenny Fox 39:29
that means not that off. That's what that means.
Scott Benner 39:31
And so Mike Well, we're definitely going to Pre-Bolus now, five minutes. Yeah, let's start at 15 minutes. Now you need to remember we just took your basil from point 152 point four, five, your meal ratios are probably going to be lower, you know, weaker than you think. So if you're doing one to 10 it might end up being I don't know, one to 12 or 13. I don't know we're gonna find out you know, so pick a meal that you're really good at bolusing at and You know, let's cut it back a little bit, cut it back a little bit. Now we get the Bolus, right, then all jump up, they don't have to correct later the corrections don't cause lows. And they stay off that whole roller coaster. And that's it. Like I'm, there are times that I help somebody. And when it's over, like, you know, you know, it's like two or three days later, and you've talked to me a handful of times for a couple of minutes. And they're like, look at this graph. There are times where I act like Yeah, that's great. You did a great job. Isn't this wonderful? And why hang up the phone? I think I can't believe I did.
Kenny Fox 40:31
I have a lot of those conversations. My wife is you gotta you gotta come look at this. I just replied back. Oh, yeah, good job. And then I see what I just didn't like 24 hours or 48 hours. That's pretty cool. Because it's really important that people understand that when your settings are off that when you're, it's like your meals are like mediocre, they're okay ish. But yours, you know, late, low, later, high, early, whatever, but generally not too bad, then we need to increase basil, or decrease. So you got to trade it with the current ratio, you do often flip those up and down in reverse of each other. So it's important to as long as you're in a pretty decent spot of control. Most of the time, it's really important that they remember that. So if they find that looking at negative insulin on board or learning, excuse me track the iob. overnight and Luke because you have so much more data than just a graph to look at. And you figure out what your basil is. And I can do that with a fair amount of precision. If you're running a single basil rate, it's pretty easy for me to figure out how much higher or lower you need to be based on the exact amount of insulin on board. And that happens in those waves overnight. Yeah. You just once you make that change, so you don't have a so much struggle the rest of the day, you got to make sure you're adjusting your carb ratio after you're like, Oh, look, I found my basal rate. You got to make sure you change your carb ratios, or you can be fighting highs or lows depending on where you're at. And
Scott Benner 41:55
I think it's important to know that we're talking about right now if you're in a place of just dumpster fire, and you're trying to find it, that all counts for that if you're in a situation like Arden was recently where she started the birth control pill, but she still it but her settings were rock solid before then her all of her needs just increased. Like Yes, there's a concrete thing that happened. It's not variance or, you know, what we alluded to, you know, when we started and never got back to which was when Kenny and I were looking at Arden's numbers way back at the beginning of the pandemic, she was in her easy week. So Arden has like three different weeks every month, she has an easy week where her blood sugar is super simple to take care of. Then she has sort of a pre menstrual week where it's more difficult, it kind of ramps up and gets more difficult as her period approaches. And then as the period begins, it actually starts to get easier again. And then it gets easier and easier as the period progresses. And then it goes back into that easy week. So we were in the easy week when we set it up. And Kenny set up a single basil system, which What do you think it for five or six days? It looked like Arden didn't have diabetes? Right?
Kenny Fox 43:09
Yeah, I mean, you had he had standard deviation. And like the 20s, you had super high time and range. You know, I like I didn't I don't have that many weeks that are for that length of time that are that stable. And that was that was pretty good. And like we figured it out. I mean, we had to dial things back a little bit every day. Right. And, and it but it was Yeah, it was pretty solid. It was much different than the days you before when you were struggling.
Scott Benner 43:36
But but it was super steady and super low. And and before I get into this, I want to I want to ask a question, and I'll answer it as well. How frequently does your daughter's blood sugar out of nowhere surprising to you drop low.
Kenny Fox 43:53
Drop low. Yeah. Oh, hardly ever
Scott Benner 43:55
meet. So
Kenny Fox 43:56
I find that when you have basil pretty steady and you trust. And you've seen over time, especially with the precise loop data you get in terms of insulin on board. When you see a drop in like like 3am, for example. It's I mean, I, I don't even get out of bed, if it's a 55. And it won't go from 85 to 55 in two or three readings. unless she's laying on the sensor. Something's wrong. It just doesn't happen. So I tried to explain it to people that once they have a good basil rate, good settings, those drops are not something you run and treat, like maybe you fingerstick that's probably a good idea. But you're going to have much more consistency than you thought some people are struggling enough that that dumpster fire situation where they're used to seeing ups and downs so much that Yeah, but once you have good settings there's I mean, there's not she doesn't just drop, right isn't unless the stem usually when I'm struggling with the technology itself. It's not It's not our blood sugar.
Scott Benner 44:55
Right, right. I had to yell into the shower for my wife. The other morning. We were up earlier and the kids are still sleeping, and I just yelled, she's not really 55. And I just kept Oh, yeah. Yeah, she doesn't worry when it beeps,
Kenny Fox 45:07
my wife doesn't wake up to the beeping. So I roll over and look at the drop and look at her in some onboard on my phone and go and not worried about it. And then I go back to sleep. And then if it beeps again, then I'll get up and check because it means we're struggling with the sensor. It's what actually grandma's dealing with right now we have my wife's 94 year old grandmother living with us. And she has type one diabetes, and I have her looping. And the sensor we put on your sensor last night and just ended up it's reading low a bunch, so we just had to go figure out if it was real or not. But it was it's unusual for us to see those kinds of drops unless it's the sensor kind of just having its moment.
Scott Benner 45:45
I'm actually gonna put a G six on as soon as you and I are done. Awesome. Yeah, this is gonna go up after the other ones. I can just say whatever I want here. And then I'll get back to my thought. Kevin Sayer, I'm going to record with Kevin Sarah this afternoon, Kevin's going to talk about some things that Dexcom is doing. I'm going to kind of in tandem be wearing a G six, two. So people who listen to the podcast can see what a functioning pancreas looks like, I pushed Dexcom to to let me do that. Because I think it's going to be incredibly helpful for people who have stress about small rises and things like that, where they think if that lines not completely straight that, you know, it's very unhealthy where it's very helpful.
Kenny Fox 46:31
I mean, I've worn a sensor, you know, with a little bit of time left on my daughter's transmitter before. Yeah. And, and I've had one of my oldest son when my daughter was first diagnosed were one. And just to kind of get an idea of like, what is normal, like, I'm a little overweight. So like, well, I'll check my son too. And these numbers are very close to mine, like, you know, it's, it's comforting to see that, you know, you can hit like higher numbers 130 4050 very briefly, then some of these patterns that you see, are real, like they're not just something you're doing wrong. So for example, if I ate a bunch of ice cream, right before I went to sleep, I stayed higher for many hours, longer than I would have if I had just stayed awake, you know, that growth hormone idea when you your body's doing its thing, when you go to sleep, your digestion is affected and all kinds of stuffs happening. Yep, that will keep you higher, I wasn't just making up that my daughter was shooting up out of nowhere. It wasn't something I was gonna attack with basil. It was it was variable based on the food and the she ate and how close to sleep. She ate it. Because I saw the same thing for me. And so now it's like, okay, and it's not. It's not unusual, it's not different. When other people are telling me you have to increase basil or whatever, they don't really know what they're talking about, like this is what a normal pancreas would do for an eight year old or,
Scott Benner 48:00
or someone who's older than that. So it doesn't really matter. Jenny said this recently that when you fall asleep, all your body functions slow down.
Kenny Fox 48:08
Yeah. And I was like, everything's just different.
Scott Benner 48:09
Yeah, it's why you get heartburn, if you eat something, and then go to sleep, because your body's in the middle of processing the food. And suddenly you take the power away from it that it needs to process the food? And it's Yes, and just, you know, I'm sure that's not a very technical explanation of it. But yes, so I, I just thought, you know, there are so many people listening this podcast, it's just gonna give a great opportunity for a lot of people to have that experience that would not normally have that experience. So I contacted Josh from sugar mate who I didn't know previously. And he set me up so that I can live stream my blood sugar on my blog, so that people can actually go right to it, watch it all and put the foods that I'm eating so that people can see what happens. And yeah, and then I thought,
Unknown Speaker 48:52
wow,
Scott Benner 48:54
what if, after that, I took volunteers who were like, I'm really good at bolusing for pizza, or I'm really good at doing this and let them kind of run like little, you know, basically showcases where they say, Alright, I'm gonna Bolus this pizza here. And you get to watch it if you want to, and then see where the insulin goes. And so people can kind of have that experience. But But back to just me wearing one without diabetes. It just really occurs to me that people need to see that because there are too many people freaking out about a 130 blood sugar that lasted for 45 minutes. Like, there are some people who put graphs up in my Facebook page. And they're like, I don't know what I did wrong. And I look at it. I think they put the wrong graph up. I don't see where you did anything wrong. You know, like it went to 130. And it came back down and it didn't get low. It looks pretty good. You know,
Unknown Speaker 49:43
how do I say that? Yeah.
Scott Benner 49:45
How do I stop that from happening to me be more perfect, I guess. But that wasn't terrible. And right. And a lot of the things you're achieving with insulin are superhuman compared to what a pancreas would do.
Kenny Fox 49:57
Yeah, the idea you get the people that are shooting for like an 80s blood sugar. They think that means all day every day, and that's what would normally happen. And that's not really what would happen with a functioning pancreas either. And, you know, some people have it's, I found it useful for me because I put it on my son who kind of a similar build. So I'm assuming similar genetics to my daughter. And you know, where does he fast overnight? Well, his fasting blood sugars like in the 90s, not in the 80s. So here's a one see, if I got it, check is probably a little bit higher, probably in the high fours, low fives. So I don't think my daughter would normally be someone who would have a four and a half or a four a one see that some people try to shoot for that, or I think a little bit crazy. But some people would my third child, he, his blood sugar will be tested as always lower 70s and 80s. So you know, some people would and some people wouldn't have a certain number. So I thought it was comforting for me to say, Oh, I can keep my daughter's a one C, you know, like between five and five, six so far. That's probably where she would be without diabetes. So that was comforting to me. I don't need to try and push the envelope lower. I have no desire to do that. Because especially after watching my son, like his average blood sugar was kind of in that. That same range. So I'm like, Okay, well, I'm I'm doing okay, so
Scott Benner 51:21
yeah, well, if, if people want to check it out, it's Juicebox Podcast comm forward slash CGM live. And whenever I have a volunteer, there'll be a live graph there. So
Kenny Fox 51:33
yeah, it's pretty cool. Yeah,
Scott Benner 51:35
I thought that that was a good use of it. And Dexcom has this. It's, it's, you know, text. The reason I have it is because Dexcom starting a program that I actually think they announced they're announcing today, that is called Hello, Dexcom. And so you'll be able to go into a doctor's office, if you had type two diabetes, and just say, I'd like to try a Dexcom CGM. And they'll give you this little package that has a sensor, an applicator and a transmitter in it. And you can try it for 10 days without a just like that. That's wonderful. Yeah. So that, you know, was like, Well, let me take advantage of that. I was like, Can I get one I have an idea.
Kenny Fox 52:15
A family members that are struggling with type two M just started wearing, like a Libra or something. And when they see test gear, and they understand that, like, you get readings all the time, and those benefits, they, they, they kind of want it, but it's hard for them to get started. So and see and try to measure if the additional cost or whatever might be worth the change. And I think being able to try it out would be a big deal.
Scott Benner 52:40
Yeah, I also think that Dexcom is gonna make a pretty big push into the type to market. So maybe that maybe they'll be able to get bonuses though, to cover and I agree, my brother has type two, and I wish I could get him a CGM. He definitely needs one. Anyway, give me give me one second before you get to your thought. Sure. All the stuff we just talked about, about basil and, you know, settings and everything. It's why and tell me if I'm wrong. When people say to me during activity, my blood sugar falls all the time, like how am I ever gonna get my blood sugar to stay up? During, you know, my kids, you know, soccer game or something like that? And my my core answer, the thing I just want to say is, we'll get all your settings right, and your blood sugar won't fall when you're running around. Do you feel that that's
Kenny Fox 53:28
true? I feel it, that's critical to having a chance at getting it right. So again, understanding of insulin on board is as critical and it's really only super valuable if your basil is right. Because then you know how much more insulin is in your body. What I find with exercise, something I cover when I'm helping people is exercise does a couple things, right? It slows down your digestion because all the blood flow goes out to your muscles instead of your stomach. So what you were eating is no longer being processed as quickly. So that insulin on board and the active carbs as represented in loop are going to be mismatched plus you're moving around so that increases your sensitivity. So going into activity with insulin on board, you can kind of gauge like how much is too much based on the activity that's more of the art form of it. But you know, if you have more than a maybe one hour of basil equivalent insulin on board going into some fairly intense activity, you're likely to drop even if you have carbs on board. So what I do in loop is is I will take any active carbs My daughter has especially if it's not planned, I'll take the any kind of active carb entries, I'll make them longer, like go from three hour to four hour for example. And then I might even cut back some of those carbs or if I plan to the activity ahead of time, I would probably enter fewer carbs for the meal prior to any activity because Because activity also consumes some carbs for energy. So it's going to eat up some of those, as well as stretch out what we have. So I will, I will enter fewer carbs ahead of time, I'll stretch them out. And then if there's still a decent amount of insulin on board going into the activity, I'll maybe give a couple of carbs on an entered are not going to put them into a loop, I might put one gram in as an entry, just so I know, hey, that's where I gave the granola bar or something. And then if I miscalculated chins up high later, I know which were to go in and add a couple more carbs. And for that granola bar, whatever, it is a caver. And so it's just balancing that food and insulin, but your your food impact slows down at the insulin is a little more effective. But if you can enter with if you have really good basil settings, and you can go into activity, you know, with zero insulin on board, like waking up in the morning and going for a run, I would tell you that with loop you, you could set a higher correction range, and you probably should when you're exercising, but you might not have to like you could probably do a run at 90, and not worry about dropping if your insulin on board is zero and your basil is right, especially with loop in case there is a little bit of a dip, it will pull it back, you might see a little bit of negative insulin on board and you might kind of stay flat and then once you stop running loop will give you the extra insulin for that negative on board if you end up having a little bit. But and people can exercise pretty stable if you can, like I'm talking about use the insulin on board to find your basil almost every time. And if it's too if your basil is too much, even just by one click of the basil rate. It has dramatic impact on activity actually just helped. Someone has a CDE with her, I think six or seven year old, having crushes at recess at school. And we simplified the basil rates and mostly dropped the ones that were running during the day at school to match what was working overnight. And then she gave us a couple of carbs on entered. And recess was fine. Like that was that was in less than 24 hours. I was after school in the afternoon, she was posting a message, we chit chatted across Facebook overnight, and then by the next day like it was looking better. And she understood the mechanics after I explained what I just said, like what happens during activity. So yeah, I think with the right settings, you have a much better chance of not crashing during activity and being nicely in range and being able to perform your best, right
Scott Benner 57:32
and settings means not just your basil, but your carb ratios understanding the impact of the foods that you're using the correct amount of insulin, so that you don't have a bunch of insulin leftover after a meal. And that's it. I feel so badly by the way. Great job that that's really cool. So you're telling me the kids blood sugar wasn't just magically falling at 9:45am? It's not about that the the diabetes fairy was not tapping him on the shoulder or on the shoulder as they're running around.
Unknown Speaker 58:01
Right? Um,
Scott Benner 58:02
I just I feel badly. When when I understand and it happens, it gets thrown in my face almost every day, like how many people are just either struggling wildly with these fluctuations, or almost as odd to me having success by mistake? Yeah, like the people who use who are MDI who use way too much basal insulin, and just basically are feeding their lows at mealtimes before they happen. Yep, you ever seen that? Like, every meal is do or die. And it has to go into the rarely certain time or they experience a low because they're, they've blanketed themselves with so much basal insulin, that it's just a matter of time before they crash. But they can find a way to put the food and that to me seems absolutely just, I would think that would take every ounce of energy out of me if I had to live that way.
Kenny Fox 58:58
The two wrongs to make a right or multiple wrongs to make a right. The chance goes up with something like a like loop. Because you can have your ISF off to you have more settings to kind of mixed together in the wrong way. Something that we'll maybe we'll talk about some of the time because it takes a while and I'm going to try and do we have a YouTube page the group of us have it's called looping learn on YouTube. And then we have a Facebook group too. But I'm trying to put together some shorter videos on this instead of my long, long presentations I've done before but ISF is, is critical in loop because it loop is tracking when you enter a meal. I'll give the short version when you enter a meal and you Bolus for it based on the carb ratio, that's great. But then as soon as the meal progresses loop is trying to track like how many of those carbs have shown up again why it's important to have fat and protein in the mix is astounding. To see like you told me this is a 30 gram meal. When are those 30 grams done? And it does that based on your basil has to be right. Otherwise it might be hiding carbs or showing more carbs. If your basil is not right, it'll use the carb ratio. How much insulin Have you given or how much insulin does it take to kind of counter what's happening, but it's also using ISF how much your blood sugar is moving. And that concept a little bit hard to explain. But it's using ISF also as a measure for if your blood sugar goes up or down, how many carbs has it seen. And so as the meal progresses, once you once it's seen 30 carbs, it thinks your meal is over. So if your ISF is too low, let's say dramatically too low, and you enter 30 carbs, you Bolus the full amount and loop. If you have a way off, it may be inside of an hour loop will say oh, I've seen all 30 carbs. Well, we all know there's not really anything but maybe juice that you could have a 30 grams, that would be completely done affecting your blood sugar in an hour. But based on your settings, lupus said Oh, it's over now. So it's probably thinking you're going to go low, because you have all this insulin leftover from your meal Bolus, and the food's gone. So at least what it thinks is gone, and then you end up drifting high. So then what people often do is they will lower their ISF more thinking, Oh, it's a sensitivity problem. And eventually, they can kind of get it to where it's not awful because they have their ISF solo at the meals absorbing a radical amount of time very short. But then it's low enough that Luke can still correct that rise. Because it thinks your sensitivity so low, it'll give more insulin to kind of keep that that rise from happening even though loop is saying your meal was over in an hour or hour and a half and that's not really realistic. So that you can end up with two wrongs make a right and that situation same with having your basil too high to compensate for maybe not enough carb ratio that can help for most of the day you can kind of be okay if you had ISF too low basil too high and carb ratio too weak, you can sometimes get a balance where, you know most meals are like okay, but you're not really seeing the success you'd like to see and consistency that you'd like to see. So it's to me it's more levers to mix up. Now.
Scott Benner 1:02:13
Can you put into words for me what you look at when you're adjusting someone's basil insulin on loop?
Unknown Speaker 1:02:19
Sure, yeah.
Scott Benner 1:02:26
We don't usually think about that meter that we use, right? I know for us Arden's doctor just gave it to us and walked around with it for years, used it all the time counted on it, and never once asked myself, is there a meter that's more accurate than this is the one I'm using even accurate at all. And then I checked into it. And when I did, I immediately went to the Contour Next One blood glucose meter. Eventually they became sponsors. And here I am today talking about them. Go to Contour Next one.com forward slash juicebox. To learn all about the Contour Next One meter, the strip programs that they have, and you may even be eligible for a free meter. There's a lot to learn on the webpage. Really good stuff there. I love the meter because it's easy to use, and even easier to use in the dock. It's simple for Arden to carry and the test trips allow for a second chance test without interfering with accuracy. So that means you hit some blood don't get enough, you can go back and get more and still get a great test. I'm telling you this meter is absolutely terrific. This stuff is completely inexpensive and there's just no excuse to be carrying around a janky old busted up meter that you've never even looked into when you can have the Contour Next One. g vo Kibo pen has no visible needle, and it's the first premixed auto injector of glucagon for very low blood sugar and adults and kids with diabetes ages two and above. Not only is chivo hypo pen simple to administer, but it's simple to learn more about. All you have to do is go to G Volk glucagon.com forward slash juicebox g vo shouldn't be used in patients with insulinoma or pheochromocytoma. Visit evoke glucagon.com slash risk.
Can you put into words for me what you look at when you're adjusting someone's basal insulin on loop?
Kenny Fox 1:04:34
I kind of created like a quick four step process. But there's a lot buried in each one of those steps. So first thing is always
Scott Benner 1:04:43
candidates. Do you have a quick four step process that has 75 sub steps?
Kenny Fox 1:04:48
Right? Yeah. And once you understand how to work that's it. I kind of just do it without thinking but essentially it's a look at their settings. So the Profile Editor in nightscout will tell you what their settings are And then I go look at Basal. So we'll scroll back and nightscout, the first 24 hours. And you can also run this report and knightscope, call it day to day report. But you have to check the iob box, you can see what's the iob, that loops reporting all day long. And I'll look for negative and so important, if I can find some and see that they're dropping, when that's happening, then we know it's a basil problem. So then we'll try to like, estimate what the basil rate should be if they have multiple rates, kind of take an average of that time frame where we saw that situation occur. And we'll pick a number in there. If we're really not sure, you can just take all your basil rates and look at your total amount of insulin and just take the average for the whole day and start there. But we always always check basil using the insulin on board, so I check for negative insulin on board, adjust basil. And then if you check the CLB box in the day to day report, or you like hover over that loop pill and nightscout obsessively after meals, you can kind of see how many carbs loop is reporting back at a given timeframe. And so if meals look like the carbs on board is just happening really quickly, like the meals are being sucked up and absorbed very fast. But blood sugar is still higher than most likely you start with needing more insulin. So we'll usually adjust the carb ratio to be more aggressive in that case. If you're seeing lows at the beginning, then we'll weaken the carb ratio. But again, this all depends on how much we just changed basil during the day, so we might have to let it play out first and then adjust. And then I also look at ISF. It my rule that I have that seems to work pretty well is one to you know, maybe to basil rates what we start with one, and then is a carb ratio should be pretty close to the same like breakfast and lunch and dinner like maybe breakfast will be a little stronger and dinner could be a little bit weaker. But I mean really they should be fairly close for most people unless they are fighting significant morning rise situations that you've covered in other podcasts. And then ISF should be you should have it's easier to just dial in your settings if you have one ISF that covers your whole mealtimes anytime you could be entering carbs, so kind of wake up to go to sleep one ISF. And then I tend to encourage people, what I find works is to have a couple of blocks of ISF overnight, maybe like in two or three hour blocks, and the strongest or lowest ISF setting will probably be right after you go to sleep. And then it could get weaker, and every couple hours until you wake up and then you have that that weak one. Now some people don't need that. But that's kind of like a starting place is just make a couple of ISF blocks. So we do that. And then the last one is pretty much like we talked about the beginning, fat and protein, like you have to have some representation of fat and protein in and then you know in your carbs. And then you also have to make sure that you're using, like I noticed you were doing these last couple weeks is mostly just using the three hour absorption time I used to when we started use the two hour absorption time thinking Oh, a bigger spike loop sees a bigger spike, it'll give me more insulin. Want to Be bold with insulin. So I want to give more upfront, but you find out that a lot of foods lasts a little bit longer than that. And so you need that three hour time is really good for most things. And because I talked about how carbs absorb as you go, in theory, you could have a five or a 10 hour absorption time on your meal. And if it was really, you know, an apple that was done in an hour to
about two hours loop will seal those carbs in two hours and you'll be fine. So you could have a longer absorption time and get in less trouble than if you had to short and then all of a sudden there's still carbs around but loop thinks well you said it was only two hours long and it's lasting for then it's not going to try and help you anymore because it thinks well that carb entry has timed out so yeah, yeah, Basil carb ratios, a couple ISF blocks mace mostly one during the day, and then adding fat and protein in for for for that stuff. And then the last kind of pro tip one is more like a what I call being bold with loop would be super bolusing. Like it's okay, to manually Bolus if something's not going right. And if you're starting a meal and you think it's going to be kind of spiky, it's okay to give a little bit more upfront with a meal like for cereal. I'll give a Pre-Bolus and then I'll give an once you start sit down to eat. I'll give about three hours equivalent of her basil because I figured that food will last three to four hours. So I'll give her all three hours of her basil, insulin. Right now as a Bolus, as she starts eating a loop turns off the basil for those three hours. And she ends up having a pretty steady line through the whole thing. So
Scott Benner 1:10:07
you put that basil in, and then let the loop backwards manage.
Kenny Fox 1:10:11
Exactly, yeah, cuz it's not gonna be bold for you. It's not, it doesn't care if you're gonna go if you're predicted to go to 250, as long as you're going to come back down where you're supposed to come down. So I've just come to be okay with saying, you know, what I know a little bit better than looping the situation. So we'll be a team will work together, I'll give the insulin I think she needs now to fight that high glycemic food, that initial spike the carb count still, right? It's just how fast and hard it's going to hit. So I'm going to hit back. And I'll let Luke kind of balance it. And the risk is that you have to keep her it link near her. So that that keeps working. And the whole system has to stay functioning. But I know I did it. And so if something went wrong, I didn't know what to do to fix it. So you just build your kind of the things I I'll step people through over a period of a day or two.
Scott Benner 1:10:58
Yeah, you just made me think of like, I'm always like, how do you walk away from this thing after pancakes, but stay with it after a salad? Like Like, I need the connectivity right now. Like we need the kids stay with
Kenny Fox 1:11:11
me. But that's the word the horizon stuff will be nice to stay connected. No
Scott Benner 1:11:15
kidding. Hey, a couple things. First of all, there's a pro tip I did with Jenny Smith. It's Episode 263. It's called diabetes, pro tip fat and protein. If all this fat and protein talk has rattled your brain a little bit, Jenny, and I kind of simplify why fat and protein are important in Episode 263. And I want to say that what Kenny was just talking about putting in, you know, to kind of be bold and crush some sort of a number, if you have to, you can't just put in, you know, you can't look at a 160 blood sugar and know that a unit would make it 90 and put in just the unit because then loop believes that it has too much insulin that takes away your basil. So you're basically they're just trading the basil for the Bolus, and you're not affecting the number. I used to just open the loop up. So basically put the, you know, make it impossible for the loop to turn off the basil. And then correct until the last time you and I spoke and you were like, Listen, you can just you can just over Bolus, this whole thing. And that way even when it takes the basil away. You've still replaced it. You still win. Yeah. And that works terrifically.
Kenny Fox 1:12:22
It's nice because you don't have to remember to close the loop again. That's that's the biggest hassles, you can't just remotely open and close it. So yeah, that's, that's a big deal. And the other, you know, humping that I hope people try to pick up as they go into loop and you can balance how much time you end up spending on it. But when you're high, just like when you are using an MDI or pump or whatever, it doesn't really matter. If you can try and figure out why. Again, once you get that stability, and you figure out your basil is it's most of the time is the food to blame, right? It's you didn't you underestimated the carbs or the fat and the protein. And so you just need more insulin. And if that's the case, you can go back into loop and either add carbs like you did yesterday. Or you can edit the current carb entry and just add some more carbs to that. Or maybe you need to make it longer. Maybe it was a three hour entry. It used to be a four because of the fat and protein. You can do those kinds of things and and fix the situation if you can figure out what's wrong. If you can't figure out what's wrong. That's where you need to kind of guess as to how much more maybe to give as a correction Bolus, just the way I do it. And let Luke kind of just take the basil away. And then we'll kind of find a happy medium at some point. Like sometimes it's more than a couple hours of basil Holmes, this four or five hours of basil. Because I know when other meals coming same thing I would do on MDI, like if she was 160, and didn't seem like she was coming down, but we know we're going to eat an hour or two, then I'll just give most of what I think she'll need for dinner, for example, now in the afternoon. And then whatever incident on board is present. When you start the meal, you can say okay, well, that's not her carb ratio, she needs a little bit more because you've used up some of that insulin on board, but you can check the insulin on board right before a meal. But with lube, it's doing that for you you've Bolus manually, it turned off the basil. And then when you go to enter carbs for dinner, it's like oh, you need more. So I took away too much. But it didn't know about the carbs. So people freak out when they manually Bolus or if they were to manually Bolus a high and I just call it an early Pre-Bolus for whatever's next. It freaks out because the prediction shows such a low number maybe like a negative 150 or something. But that's not that scary because you know, you're going to be inserting carbs in an hour when you're going to eat well, that number will come right back.
Scott Benner 1:14:39
That's funny you bring that up because what I was gonna say is I think I did my first episode about looping back in April of 2019. You and I are talking in December of 2020. And for the first at least six months, I felt like I was fighting with it the entire time. And right now I can tell you that I feel like I use lube as well as I use the other You know, the bolt with insulin system if we're gonna call it something that I talked about on the podcast, I can do either of those things equally well at this point. And to prove it. I will tell you about Thanksgiving morning, which will roll into what you just said. So on Thanksgiving morning, my family has a my wife's family had this tradition of eating these cinnamon rolls in the morning. And I'm not talking about their mom was not some master Baker. They were buying like, you know, those really crappy cinnamon rolls that come in like the cardboard tube and you just dump icing on top of them. So my wife buys them because I think it makes her feel like she's eight years old. And should we have them on some holidays? I figured out how to Bolus from there. No problem. So Arden's upstairs getting dressed the cinnamon rolls in the oven, and I give her a text. I'm like, Hey, we're gonna Bolus for the cinnamon rolls now. And I gave her a number. Well, she responds back, I can't. I'm like, I don't know what that means. Like what is I can't mean you know, and and so I'm like, just Bolus this. And what I thought when she said I can't, I thought maybe it didn't want to give her the insulin like I don't know, I was cooking. You know what I mean, for for Thanksgiving candies, I wasn't really paying much attention to anything. So I was just like, just manually put it in, like tell it to manually Bolus seven carbs. And a little more time passes. You know, and while we're having this exchange in, you know, on text messages, time is passing. And as time is passing, the muffins or the cinnamon rolls are baking. And then she finally says, No, I don't have enough insulin, this pump is empty. I can't and I was like, Oh, geez, I was like, Alright, well, Bolus is much of it is this left in the pump, and then get down here and we'll switch. And I thought I did a good job at the pod that came with a pod change. But I'm telling you, she's eating this cinnamon roll that was just him. I said, 60 carbs in it, you know what I mean. And for the first hour, I was I had it, her blood sugar wasn't moving, everything was great, then all of a sudden, it jumped and we had the highest blood sugar we've had in forever, it must have been close to like 280 with dinner coming in a couple of hours. And I just I turned that 280 back into a 94. And I didn't even think twice about it. I was just like, here's what we're gonna do. We're gonna go back to manual open the loop up Bolus this much. I'm basically going to put you into a nosedive, and we're gonna pull it up with dinner. And it's exactly what we did. It worked phenomenally. And that on Thanksgiving was the time I thought I really do understand all this now, because I close that loop back up went right back into loop and her blood sugar never went up from there.
Kenny Fox 1:17:39
Yeah, I mean, it's it's a, I was trying to actually explain that same concept to my test endo. Just last week is this Yeah, I mean, if you're hi Bolus for the next thing coming and create that nosedive and put the food in at the right time. And you're okay. And then it works. Not looping. And looping and looping, you may have to give a little bit more or you went to a little bit more patient, because if you do it manually, if you didn't open the loop, then then loops gonna pull the basil back, right, which is fine, it might just tag us to take a little bit longer to create that nosedive, or you may just need to give a little bit more. But in either case, the beauty of it that is easier for people to access, being that bold, is that loops done the math for the most part. So when you go into enter the carbs, it'll tell you how much more or less you might need. So I recommend zero, or whatever it is, that might be okay, but you'll you don't have to worry about, well, how much is left? And how much do they really need? And how many carbs did I give earlier? You don't have to track all that math, the math is in the system. So but you can but you have to create the nosedive loops, not going to do it right.
Scott Benner 1:18:47
So I've learned that a dive and did exactly what you said, close the loop up before the meal, and then put in the carbs. I was still I was still Pre-Bolus thing in my mind. You know, I put in the amount of carbs that I thought she was going to eat about 15 minutes before even though she was dropping, and then loop she was just like, well, I'm only I only want like a unit right now. And I was like go tell it the bullet. So she's like 130 and she's falling. And it wanted a unit. It's like it must feel pretty comfortable that she's gonna stop. So I'm like, Okay, put in the unit. close that up. And then as she was eating and she leveled out, I said, Hey, check for suggested insulin. And there was a bunch of suggested insulin. I said, Go ahead, put that in now. And then that was it. So it was a kind of a hybrid, I use the loop and I used what I knew from before it.
Kenny Fox 1:19:35
You have to be willing to accept the fact that you can no more than loop sometimes. And sometimes you'll find out that you know what you entered plays out and what was in the prediction was actually more accurate than you care to admit that they were going to in fact come down in another 20 or 30 minutes on their own. You didn't need to give them an extra unit manually, but but you sometimes need to know better than Luke because for example with food, when your settings and everything else, if you don't put enough in, you're gonna be high. If you know the food is spike here, it's gonna hit sooner lube only has one model for carbs, it just assumes all carb entries are going to impact your blood sugar in the same way in the same timing. So you have to know if it's a, if you need more upfront, like super bolusing, or you expect to spike and you need to give insulin anyways, even though it doesn't suggest any more, you need to give less, because it's a slower meal, you may have to still know just just enough to be a little bit smarter than loop. And then you can work together when you know where it shortcomings are.
Scott Benner 1:20:38
Can I ask you one last question that before I let you go? How much of all this that, you know, and now I know and other people know about using loop, which, you know, is, is quite a steep learning curve, how much of it's going to apply to control like you or on the pot horizon or some of the other, or I'm sure Medtronic will have one at some point that people will like, and and you know, how much of this knowledge will translate out to those retail systems.
Kenny Fox 1:21:10
Yeah, so we have a on the loop and learn YouTube, we had a recorded meeting with someone I forget their name, but they're really deep into this closed loop predictive stuff. And he walks through the different kind of methods for building these closed loop systems, the approaches. And loop is more of a with a called predictive model, where it's basically you tell it everything, and it's trying to predict out what's going to happen over the next six hours. And some of these other systems have, they like to take a hybrid approach where they're a little bit predictive based on what you've told it. And then in other areas, it tries to do its own calculation, like risk analysis, if it can give you more or less. And so control IQ and horizon both and we just had an interview with someone at Omni pod that talked about that one that's kind of VP over horizon has done all the clinical trials. And she talked about how it works a little bit. And so the system to try to do their own learning. I'm not a big fan of because I don't feel like they're not going to show you behind the curtain and you're not really going to understand what's happening. But they're, they're mostly controlling Q and horizon both seem to heavily rely on the total daily dose that it either sees, or that you give it to start with more than your settings, control. IQ uses your settings as a starting point. I think horizon does as well. And I don't know for sure, but I think control IQ leverages those settings, pretty like it uses it a fair amount. But at some point, after a few days in or weeks in the system, we'll use more of what it's seen, and your total daily dose that you're getting, as its guide for how much you can give the correct and suspend and all of that. And you pretty much are setting your car ratio. So that's important to set your carb ratio. But it's not necessarily totally relying on your sensitivity and basil as much as you'd like. But those basil settings and all that stuff will kick in, in a open loop situation where the Dexcom is not giving you readings are something where it can't do its thing that's its fallback. So it's still important to make sure that those settings are tested every once in a while. But not as much as I would like I guess is my answer, but they still use it. And so that's my concern about the upcoming commercial systems is there, they're going to be better for most people, because most people are not listening to this podcast or looping Yeah, and understanding insulin and how to use it. And so they're begging these systems to basically handle bad settings from doctors and people and just trying to take it over, as best they can and learn you. But the downside of that is that you can't be as precise and if you end up being sick or you have hormone swings, or other situations where your needs overall you're gonna be using more or less in a significant way. Those systems will take days to catch up with you. And so you'll probably be like she mentioned the lady mentioned with the horizon interview, is you just have to make your carb ratio lower and Bolus a little bit more change your correction factor and and just manually Bolus until it figures you out. So it'll use some of our settings and I think the principles and understanding that we know about insulin will still be useful but if they're trying to make something that you can mostly just enter carbs and walk away from it and achieve a moderate a one C and timing range and not go low.
Scott Benner 1:24:50
I do think it's gonna be amazing for most people, honestly.
Kenny Fox 1:24:52
Oh, yeah, I mean, you're gonna get people that you know, a win seasons 789 and more or there's highly variable and it's going to stable them quite a bit. And you can see the data from the horizon clinical trials that she was able to share. There'll be more as they publish. And same with control IQ that they achieve pretty good results. I mean, it's, we would love it if you could lower the targets and take a little more risk of potential hypose. I think some of us would prefer that, but they're doing really good work at all the closed loop system so far that I've seen other than, you know, the older Medtronic con is doing really well in that regard.
Scott Benner 1:25:29
Yeah, I mean, you're trying to, but you have to think of the bigger picture you're trying to reach the masses of people with with type one, and give them all successes that will lead to long life like it really is what you're shooting for, right is to make their day to days easier and make their life longer and healthier. And they're definitely I listen, I sent an email. I'm, I don't know how you got Dr. Lai. I've been trying to get trying to lie on the show for a while I don't get anybody response, your Facebook,
Kenny Fox 1:25:57
talk to Joanne
Scott Benner 1:25:59
Facebook pages swinging a pretty big, you know what I mean? Over there. And so I don't know, I might ask the wrong person. But anyway, that's, that's pretty much how I've thought about it too. And, and I definitely want to listen, horizons got the algorithm built in to the circuit board, which means you don't have to have any connectivity to your phone for the algorithm to run. moment, the most Bolus and a set
Kenny Fox 1:26:29
change settings,
Scott Benner 1:26:31
and styrofoam that is absolutely huge. So I would like that I'm going to be
Kenny Fox 1:26:36
if I could push the lube algorithm onto the pot, and then I I'd be much happier.
Scott Benner 1:26:40
Like you could sneak sneak into on the pot up there in Boston and make yourself a couple you should see, Kenny, I've seen their production facility. It's automated. And it's stunning. It looks like it's out of the future. It's absolutely amazing. Trust me, if you snuck in there, you just get wide eyed and go, Holy God, this is crazy. And you definitely would not figure out how to do what you wanted to do. But it's really cool. I hope to see it again. One day really. I actually tried to interview the guy who set the whole floor up. Because he I think he might be brilliant. He's just a manufacturing guy. I think they got him from Pepsi. I think he used to set up the manufacturing floors for Pepsi Cola. And
Kenny Fox 1:27:23
that's intense. Yeah, I
Scott Benner 1:27:24
think that's who I gotta try harder for him. Actually, I'm gonna get him in 2021. He's an interesting person. I met him once. Anyway, all right, well, let me let you get back to your life and tell you thank you very much for doing this. I hope you have a Merry Christmas and a Happy New Year. This is gonna come out in December very soon. And I just really appreciate you giving so much time and and sharing so much of what you've learned about loop. It's really been valuable for me and for a lot of people who are listening.
Kenny Fox 1:27:50
Thanks. And for those juice boxes out there, you know, feel free to practice with that super Bolus as you come up on holiday meals. Depending on how the holidays look for you. Yeah,
Unknown Speaker 1:27:59
get a little bold with loop, right?
Unknown Speaker 1:28:01
Yeah. All right.
Scott Benner 1:28:02
Did you just name the episode a little while ago, Kenny. You might not you knocked your name right off the episode. Good job. This was gonna be something you know, cutesy about Fox. And instead, I'm calling it bold with loop.
Kenny Fox 1:28:20
I guess you could do Fox and loop house three bolt with loop. But it's a long title.
Scott Benner 1:28:24
It's not a Schwarzenegger film.
Kenny Fox 1:28:27
But you gotta be able to find all of them. Right. So
Scott Benner 1:28:29
yeah, I see. I got to keep it together. You're right. All right, Kenny.
Kenny Fox 1:28:33
Bolus loop. That's kind of what I've been. I've make a little like, out of my mind. My little catchphrase that I've been trying to share with people sometimes it listened to the podcast and lupino
Scott Benner 1:28:42
Yeah, no, I listen, I I tell people all the time. That's absolutely true. I have a mantra, it's, it's I'd rather stop a lower falling blood sugar than fight with a high one. That Yeah, everyday with diabetes, thinking about that.
Kenny Fox 1:28:54
And it's about finding a way to become a team with loop rather than feel like you're fighting it. You know,
Scott Benner 1:28:59
I'm there. I have to be honest, I want to thank Gina who forced me to do this a year and a half or more ago, and you who've come on and talk about and all the other loop users who came on helped me work through it and Katie for coming on and explaining what loop was, I just, it's been a process and I think we've been able to pull a lot of other people along with us. So and I hope for everyone else, they're hearing the value of, of algorithm based pumping. I think it's a, it's gonna change everybody's life and 2020 one's gonna, I think it's gonna really explode for people with type one. It's exciting.
I'd like to sincerely thank Kenny and all the people who've been on the show over the last year and a half for helping me understand the loop DUI algorithm better. And they do really hope that all of you listening understand that as these algorithms become more and more available in retail pumps. It's gonna be lifetime Thanks also to the Contour Next One blood glucose meter. You can check them out at Contour Next one.com forward slash juicebox. And of course, the T one D exchange can be found at T one d exchange.org. forward slash juice box. I'd also like to say a huge thank you to one of today's sponsors, g Vogue glucagon, find out more about chivo Kibo pen at G Vogue glucagon.com forward slash juice box, you spell that GVOKEGL Uc ag o n.com forward slash juicebox. At this point, there are a lot of series within the podcast I mentioned at the beginning. And I'd like to mention again, the algorithm pumping series, which goes Episode 227-252-3043 12 313 326 and of course this episode 420 but I'd also like to tell you about the after dark series 274 about drinking with type one 283 about weed smoking 305 about trauma and addiction 319 about having sex with Type One Diabetes from the female perspective. Episode 336 is about depression and self harm. Episode 365 is sex again, but this time from the male perspective. Episode 372 talks about co parenting and divorce Episode 384 bipolar disorder Episode 393, bulimia and depression and Episode 399. A tea one who was addicted to heroin, I really think the series within the podcast are incredibly valuable. Don't forget to also look for the pro tip episodes that begin at Episode 210. And of course, sprinkled throughout defining diabetes short episodes to take everyday diabetes terms and put them into an easy to understand definitions. And they're not just definitions, but Jenny Smith and I talk them through. And if you don't know, Jenny, you really have to find those defining diabetes, pro tip episodes. And even the Ask Scott and Jenny. Thanks so much for listening. As the sixth season of the Juicebox Podcast winds to a close I find myself really looking back and reflecting. And I'm just very grateful for everyone listening for all the hard work you do sharing the show and for this connection that we've built. I'll be back soon with another episode.
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