Scott Benner 5/21/21 Scott Benner 5/21/21

#482 Too Much Insulin?

Scott and Jenny Smith, CDE share insights on type 1 diabetes care.

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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 482 of the Juicebox Podcast. Guess who's on the show today?

Today on the podcast, I'm joined by Jenny Smith. Jenny, of course, is from all the defining diabetes episodes, and the pro tip series. And she's here today to answer a question that I have based on watching people. I have a watching people question. I listened to a lot of people who use insulin. Some of them say this thing that doesn't make sense to me. And I wanted to ask Jenny, her opinion. And while you're getting her opinion, please remember 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 healthcare plan, or becoming bold with insulin. You know, I'm wearing headphones, and I can hear myself and my voice sounds amazing right now. Jenny holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator, and a certified trainer on most makes and models of insulin pumps, and continuous glucose monitors. And she just celebrated her 33rd diversity.

The T one D exchange needs 6000 people to join the registry. And I have to keep saying this to you until you do it. So the T one D exchange is looking for T one D adults and T one D caregivers who are us residents. They want you to participate in a quick survey that can be completed in just a few minutes from your phone or computer after you finish the questions. And they are very simple. I completed the survey in about seven minutes. You may be contacted annually to update your information. And they may even ask you a couple more questions. But this is 100% anonymous, it is completely HIPAA compliant. And it does not require you to ever visit a doctor or go to a remote site. See, this is interesting. This is a way for you in just a few minutes to help other people living with Type One Diabetes. Past participants have helped bring increased coverage for test trips, Medicare coverage for CGM, and changes in the ADA guideline for pediatric a one c goals. These are important behind the scenes things that people with type one diabetes need, and you have a unique opportunity to help them. These are not deep probing personal questions. They're pretty simple basic surface diabetes stuff, but they just need the data. Help them at T one d exchange.org. forward slash juicebox. And at the very least, if 6000 of you go right now, but I don't have to say this again. Do it for me. I'm kidding. Do it for the other people living with Type One Diabetes. But I mean, if you want to think of me while you're doing it, it's fine. This topic, absolutely mesmerizes me I could because I can't make sense of it. And I know I can't make sense of it. Because I don't have diabetes. I know this is one of those things that I can't wrap my head around because of it. And it comes mostly from adults. Although I've seen parents lean into it a little bit too. And I'm really want to kind of dig into this with you. Why do some people think that there's an amount of insulin that's too much insulin to use? And that they're actually embarrassed if they use that amount? Or feel like they're failing? Where does that thought come from?

Unknown Speaker 3:52
It's a good question. First off,

Jennifer Smith, CDE 3:54
I would think that it probably starts with some like, sort of off the cuff kind of comment from a doctor. Not that the doctor is really implying what the person takes out of it. Like doses of insulin usually go along with each other, you're not going to have a Basal rate of point two, and have an insulin sensitivity factor of 20, which is unbelievably aggressive, right? I mean, that's not going to typically happen. So in terms of like evenness of insulin distribution, they may have heard the doctor say, well, you're on a lot of insulin. So your ratios should be such and such. Right? So it may initially come from something like that, but um, you know, they even might compare themselves to another person with diabetes, who they maybe they work out together or maybe they are close enough friends that they're just comparing things and they say, well, gosh, you know, I eat really well or I follow this type of exercise pattern and Gosh, it looks like I use like twice as much insulin as you and you're like a couch potato or whatever, you know,

Scott Benner 5:08
the, um, the closest I can come up with listening to people, and I really mean that this isn't from one or two people. This is over the years, I hear this constantly, like, I'm a bad diabetic. I use too much insulin, I've heard those words come out of like grown people's mouths. And sometimes it feels like, it's I don't know if this is gonna sound crazy, but sometimes it feels like it's impacting them almost like an eating disorder, but it's a it's like disordered insulin use it feels like, and no matter how many times I talked to them, and I'm like, Hey, you just need what you need, or your body has a need meet the need, whatever I ended up saying to them. It doesn't feel like it's enough. Like it feels like it's psychological. And you know what I mean? Like it really it's sad to,

Jennifer Smith, CDE 5:56
I think some of it to probably comes from those who are trying to manage weight. Because if you know really what insulin is, it's a storage hormone, right? Its job is to move food from one place your bloodstream into a place to either get used or get stored. So, you know, if that's the fact then a lot of people also don't see what is insulin do if you don't have diabetes, if it's really still being made from my pancreas, its job is still the same thing. So in terms of weight management, you may find that, well, gosh, I use an awful lot of insulin, if I was just using less insulin, maybe my body wouldn't pack away as many calories. And thus, you know, my insulin use would go down. And I also wouldn't be, you know, heavier than I maybe want to be. And it certainly brings into the discussion kind of the, the whole thing's like eating disorders within the realm of diabetes specifically, yeah.

Scott Benner 6:56
So I get the idea. But I've seen it a side of people who are concerned about their eating, like like this, you know, like, if somebody comes to me recently, and wouldn't use their name, but I don't think they'd mind being an example here. So they come in, and they're like, Hey, you know, lately, my, you know, my blood sugar's have been going up, right? Like my, my resting blood sugars are more like 170, they used to be more like 100. and showed me the graph, and I look at it pretty hard. And I'm like, it just feels like you need more basil here. And you know, like, and then we could look at the meals. And, well, that's a lot of insulin, the person said, I don't usually use that much insulin. And I was like, Is there a problem with that? And the person said, It's embarrassing, but couldn't tell me why it's embarrassing that I'm using more insulin. And I

Jennifer Smith, CDE 7:51
guess I would feel like maybe it's the thought that they're not managing well enough. So they need more insulin to compensate for their lack of management, which shouldn't be

Scott Benner 8:03
right. Be the piece of like thought, that's how it feels to me too, that somehow, if I'm using more insulin, I'm doing something wrong. I didn't even see it connected to eating in this person's example. Although it's funny, because when it is connected to eating, it's the last thing people see, when you know, like, I'm using more insulin because I'm taking in more carbs. Insulin makes me gain weight. Although insulin didn't make you gain weight, the calories made you gain weight, the insulin was helping you keep your blood sugar down, they conflate the two somehow, right? You know what I mean? And then it gets, but they're tortured by it. Yeah, like really, really. And I didn't know if you would talk to anybody that this would come up for or if you felt personally,

Jennifer Smith, CDE 8:47
I would say that more. I mean, at least once a week, I have somebody both young and old, meaning both parents of kids with diabetes as well as adults managing their own diabetes. I I'd say you know, their, their typical question is, well, what does somebody else this age use? Is this the right amount of insulin? For me? Am I supposed to be on I guess, this much insulin or, you know, is this too little insulin? I mean, that's kind of the opposite with some kids or whatever. But it's always a question of, shouldn't it be specific to like, my age, or where I am in life or whatnot. And really, there's a physiologic personal physiologic need for insulin for every body. Good. Good point is that I've got a really good friend who is she's tiny, she's like three inches, and I'm not tall. I'm only five three, and she's like three inches shorter than me and probably weighs 10 or 15 pounds less than me and she uses more insulin than me. She's single and more active than I am. So, you know, from that standpoint, it kind of gives you a visual that the right amount Insulin for you as the right amount of insulin for you, as long as it's keeping your glucose where you want it to be, is it in the target that you're aiming for. And in the case of the person that you talked to, you know, their needs had gone up? Why? I don't know, some variable in the picture that was new and causing something to happen, but then just need more. And sometimes it's figuring out, well, is the more going to stick? Like, is there a, is there a body reason like is thyroid? Is there something going on that's causing the need for more? And will it be short lived, while this other thing is going to be taken care of and managed and gotten into control as well? But overall, you know, it is? It's a good question. I know the other piece of that too much insulin, sometimes also comes from people who have sort of been scarred by really like, low blood sugars, in the aftermath of what they deemed was a big amount of insulin for a meal. Yeah. Right. They're very wary of Gosh, I mean, I've worked with a number of adults who won't take more than like two or three units of insulin at a given time, no matter what, no matter what. And so, you know, then it becomes Well, okay,

Unknown Speaker 11:19
well,

Jennifer Smith, CDE 11:20
what's your ratio covering then? Because you can only eat this much at a time. The way that it works.

Scott Benner 11:28
So you see people who spread like little meals out throughout the day? No kidding. Jenny is nodding at me. No. Okay, so so that they won't have to take too much. That's what? So you said, I haven't I have a thought. But I want to go back to something you said. The comparison to others, is huge. And I always thought of it as looking for the answer through somebody else. But when you brought it up, I thought maybe there is just a comparison in their head, like I don't want to do more or less than other people do. Like maybe there's a real human failing in this, it has nothing to do with diabetes, that like comparison thing.

Jennifer Smith, CDE 12:04
Right? And I would, I would say that that's, especially with the teens that I talked to the teens themselves are not really so concerned, it's more the parents that are concerned god, he's using so much insulin, I remember when he was diagnosed, he was six, and he was on this tiny, tiny amount of insulin. Now he's got like, you know, Basil rates that are like 1.9 units an hour. And I'm like, well, he's a T and he's growing. And he needs a lot more insulin. I mean, so comparison wise, you do have to look at time of life. But even with, you know, this T and let's say, compared to his friend, his needs may be very different. His friend might be getting along just fine. On your point nine units of Basal an hour versus his 1.9. Right. So yeah,

Scott Benner 12:52
yeah, I get that. It's interesting, too, because I think my brain I know yours does, my brain kind of slips into that like, slip back, go macro, look at the whole picture. See, like, you were like maybe your thyroids out of whack, or like, I don't think mostly people think about stuff like that. Right, and the impacts of other things on your blood sugar, the one that you just brought up now, which I'm always fascinated by is, you'll get a note from somebody who says, I don't understand, like, kids had diabetes for two years. You know, all of a sudden, his blood sugars are high all the time. And my first question is, have they gained weight last, like three months? Oh, yeah, he's put on like, 10 pounds, I was like, Well, you know, a gallon of gas moves a car that weighs 1000 pounds this far, it moves, it moves a car that weighs 1010 pounds, a little less, you know, like that. And, but they don't see that a lot. Everyone's so locked in on making a number. Be right, and holding on to some hope that it's just going to be like that forever. Maybe that has something to do with this as well, I have no idea. I know, all I can tell you is that when I hear adults say it, there is sadness in their voice. And they feel like they failed somehow. And the other thing that, that I hear too, that I want to know if you've heard and wondered where it comes from, if you know is the idea that you can use too much insulin, and it's not healthy for you. Not that it will make your blood sugar low, but using too much. It's almost like you ever meet a person is like, has pain and you say take an Advil and I go, I don't want to put medication in me like and you go all right, right on, you know, I it feels like that a little bit like they're almost I don't want to say irritated but they're disappointed that they have to take insulin law. And somehow by using less of it, it's going to be healthier for them when that's of course, the opposite. But I do you know what I mean by that?

Jennifer Smith, CDE 14:50
I do and you know, in terms of too much insulin. If you need a certain amount of insulin you need it. I mean, that's the base fact right? But Getting into the fact of where I remember years ago, even before I was I was working clinically. And I started a young girl teens on a pump. And prior to the training, we always go through, like, what's your insulin dosing, so I could figure out like the strategy for the pump settings, right? When she was telling me her doses, and I was like, you're going to be going through a reservoir a day, like, serious, that's how much insulin this this team girl was using. And I was like, we need better insulin. Yeah, you, you 100. At that point, I mean, you 500 was on the market. But it was not at all something that was typically used an insulin pump, we had to actually go about, like getting a doctor's order to use it off label in her pump, in order for her to actually get enough insulin. But at that point, there, there are other reasons. I mean, that's significant insulin resistance, then, if you're not a growing teen, or a growing child, or maybe you know, a woman going through pregnancy, or some other type of like body, like health issue that might be impacting, yes, there are certain doses of insulin that typically you will need for your own body. But if you have all of a sudden, like climbed in need, for some reason, that's a reason to get a check in with your doctor to see if something else is going on. But then Thankfully, there are, there are other meds on the market now that, you know, they're starting to be used. Thankfully, in type one, they started out mainly as type two because insulin resistance is a hallmark of type two specifically. But it's kind of becoming more visible now in the type one community. And so some of those meds that help with resistance, can actually help you get back to a more normal need for your own body of insulin. Because, yes, exorbitant doses of insulin. At some point, you know, as I think we've talked before, like large depots of insulin under the skin take a longer time to disperse and get absorbed. So while that active insulin time of let's call it three to five hours, or whatever, from a single one shot dose of insulin, if you've got two units, probably over the course of that time, you're going to see its action, the way that it was meant to be, if you've got a dose, that's like 30 units in a shot. That's a huge amount of insulin to get dispersed. So in terms of decreasing resistance, especially if it's climbed for you, you may want to explore the other medications that are on the market that are very helpful for that.

Scott Benner 17:56
Well, as as we're sitting here talking, I do think that there's this one aspect that that's kind of creeping into my mind and making sense to me that I've just never thought of, which is, if my insulin needs are going up, I know I'm eating more food or eating less healthy foods maybe? And possibly, it could, it could, that could be I shouldn't say I should I know that could be one of the reasons like say, say for a person, that is the reason instead of wanting to face head on the idea that I'm eating in a way that I'm not thrilled about. I focus on Oh, I don't want to take so much insulin. And then like you said, you have a higher blood sugar, which then keeps your body weight down. hurting you in other ways,

Jennifer Smith, CDE 18:45
right?

Scott Benner 18:47
Correct. I'm trying to like put myself in someone's shoes there. You know what I mean? That whole like,

Jennifer Smith, CDE 18:54
it's a difficult it's, it's it is it's very difficult. And I think even in this past year, with so much change to people's schedules. And I mean, even the people I've worked with, in like cities where they were used to doing their their commute and getting on a train and walking and walking to the office and like that disappeared. And that might have been like 5000 of their 10,000 necessary steps in a day out of the picture. And now you're just getting up in the morning sitting at your desk and look at that you gained some weight and hey, you're going to probably need more insulin. In that time period,

Scott Benner 19:31
I would imagine plus the activity itself. Put your insulin requirement down. Yes. So now there's maybe you're going to gain weight because you're not moving as much and you're lost as much. Yeah, blood sugar. Well, that all makes a lot of sense. Like I it didn't not make sense to me. It's just that it's happened so many times and people seem so sad when they say it. And I just wanted to really like have a conversation and try to understand it because I really I'm at a loss Because I just come at it from like a clinical way when they said, I'm like, Well, I just put more in, you know, we're exercise more, eat a little less sort of like these your options. It's that one specific sentence that I need more insulin, I don't want to use that much insulin, or insulin is not good. Too much insulin is not good for you. I always expect they're going to say, because I don't want to get low. I don't want to have a ton of insulin in me. But right, that's not always the concern.

Jennifer Smith, CDE 20:27
It's just the actual dose. That's the concern. Yes, the number,

Scott Benner 20:31
it's the number that messes them up. It's got nothing to do with anything out like if you, if you, I don't know, let's say I put you in charge of the world. And you decided that a unit of insulin was actually equivalent to two units of insulin. So we started calling two units one unit, then they'd be okay with it. Then they'd be like, Oh, I'm only using three. Right? Right. But you tell them it's six. And they're like, Oh, it's still it's still like in I'm putting my fingers on. But it's still this much insulin in the syringes this much in a little tube. But if the number was different, they'd be okay with it. And that's got to be psychological, right? Mm hmm. Yeah.

Jennifer Smith, CDE 21:12
And I think it kind of goes back to what you brought up initially, is just that, that feeling of, I need so much, I must be doing something wrong. Like the feeling of just you're like beating yourself up. Because why else would I need this much insulin? And that that's not normal? Why should I have to take 50 units every single day? Should I be more on like 20 units a day. I mean, from a standpoint of like, overall weight management, sure, doses of insulin can make a difference. But there are other lifestyle pieces that go into that. It's not just the management of the dose of the insulin.

Scott Benner 21:55
So the way we do it here is is interesting, like are no go through swings of you know, there'll be a day or two where suddenly there's just like, way more carbs than usual. And you don't notice it when it's happening. But then you do notice that if you're especially if you're on an on the pot or something with a cartridge in it when you're like, Oh, I have to change my pumps sooner than I thought I was going to. And yes, and so she used to be like, why are we changing it now? And I was like, it's empty. And then you know, and she goes, Oh, why? as like, why do you think she goes, Oh, I got nachos at Mo's yesterday. And I and I had a milkshake today. And I was like, that is why so I you know, in a very, like, simple way, it helps her go. I am maybe I'm, maybe I'm carb crazy right now and don't realize that I'll pay a little more attention to it. I see it as a kind of a, it doesn't well, because it doesn't impact her adversely. in her mind. I see it as a positive thing. Because she she can kind of see like, Oh, you know, pay attention. Look what's happening to me. But anyway, okay. I appreciate you talking about this with me. Yeah, I really did not meaningfully understand. And I think this helped a little bit. And I want people like I let me ask you this, though. If there aren't outside influences. In general, you're comfortable saying more insulin is not unhealthy for people.

Jennifer Smith, CDE 23:17
As long as it's managing their blood sugar, and everything is in target and they have no other health concerns, then the dose that they're taking, is obviously working to help them maintain control. Yes.

Scott Benner 23:30
So when I say meet the need on the podcast, that's what I mean. I just mean there's an amount of insulin you need. Use it. Use it. Yeah. Okay. Thank you.

How about Jenny. I love Jenny. You love Jenny, who doesn't love Jenny? There's no one. No one law. I mean, maybe once in her life, she kind of guy off in traffic and that guy still like a person to cut me off in traffic, but they don't really know. It's Jenny. They knew this Jenny. They want that. They'd be like, God cut me off. You're fine. Anyway, Jenny does this for a living it integrated diabetes comm and you can check her out there. There's the link in the show notes. Alright, look, one last time in this 25 minutes that you've been with me, the T one D exchange needs your help. And the help they need is super simple to give. You just go to T one d exchange.org. forward slash juicebox. That's my link, use that link. And then when you get there, click on join our registering now. And after that, you complete this simple, quick survey. It's for us residents only. But it's so easy. Like right now, if you did it right now look at your watch. Or you probably want to watch to pick up your phone, touch the face of it. If you did it right now you'd be done in less than 10 minutes. It took me three hours. To bring you this episode, and this is all I'm asking in return one day exchange.org forward slash juice box. I mean, seriously, I the book Jenny, record the thing, edited it. I mean, you notice how there's no like pops and clicks and noises and nothing distracting while you're listening. You're welcome. That was me. Scott, click, click click with the mouse, I fixed the whole thing for you. hours it took like, you're just like, Oh, it was a quick 25 minute episode. It was nice. God said insulins important, blah, blah, no, no, it's more than that. It's deep. It's deep. It's building a narrative in your life about type one diabetes, giving you the tools and the access to information for the free. And all I ask is that you go to T one d exchange.org. forward slash juicebox. I only need 6000 of you to do it. I mean, there were hundreds of 1000s of downloads last month, I just need six of you. And I'm saying of the hundreds of 1000s of downloads. I need 6000. I'm tired of saying it too. I know you're tired of hearing it. I'm tired of saying it. But I mean, at some point, one of us has got to pick up the mantle and do their part. I can only do this I filled out the survey is easy. Alright, I'm gonna stop. I apologize. That was I that was too much, too much. I should just say T one d exchange.org. forward slash juicebox. You need to be a US resident who has type one, or is the caregiver of someone with type one. Please go fill it out if you have the chance. I mean, that's that's how I should say it. But I mean, come on this podcast is amazing. And it's free. Free. And what do I say to you? You know, if you want to try out an omni pod, go to Omni pod.com forward slash juice box I say if you want to check out the Dexcom go to dexcom.com forward slash juice box. I say want to get a great meter contour next comm forward slash juice box I say hey, my daughter's got this G Volk. hypo pan, you should check it out. That's it. I mean, you don't have to check it out. I'm not telling you to buy an ami. But it's not like if you don't buy an ami bike, and I love to listen to him. I'm just saying if you're going to go check it out. But this T one D exchange thing. I mean, you're on the internet constantly. I see the people in my life. I know you don't put the phone down. And I'm not judging you. I'm just saying why you're doing it. You don't I mean, p one d exchange.org. forward slash juicebox. Help a guy out a little bit. Make me beg you what's embarrassing? I'll tell you what, if the T one D exchange contacts me at the end of the month, next month at the end of June and says we've added 1000 new people to the registry. Thanks to you. If they say that, what will I do? I will do an online talk about using insulin. Once a week, in July, once a week. Okay, I'll come on. I'll do it on zoom. It'll be free, obviously, because you helped me out with the D one D exchange thing. And I will answer everyone's questions as long as I can. If we reach 1000. Now if we reach 1500 I'll get Jenny on one of those calls. If you do 2000 I'll do the call. Right? Every day every what I say every week in July, Jenny wants and what else will I do? I'll do something else. That's cool. I don't know what yet, but trust me, I'll come through T one d exchange.org. forward slash juicebox. Use the link. complete the survey. That's it.

#481 Diabetes Veterinarian

Kari is a D-Mom and a veterinarian who treats animals living with type 1 diabetes.

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Scott Benner 0:00
Friends, did you ever sit down to do something having an idea that it would be a certain way? And then when it was over, it was way different than you expected? If that has happened to you, then you know what I felt like when I got done recording this episode.

Hello, everyone, and welcome to Episode 481 of the Juicebox Podcast. If I seem like I'm not as enthusiastic as I usually am, I'm doing something a little differently this week. I'm getting ready to go away with my son for a few days. So I'm editing a ton of episodes and getting them ready to like they're going to go up automatically because I won't be here. And I'm having trouble like, you know, bring in the Zoom Zoom for every one of these intros and outros, so I'm not a I'm okay. Anyway, this episode is really cool. It's Carrie, she's the mom of a type one. She's a veterinarian. She's the person who handles all the type one animals in her practice. And somewhere in this episode, she told me something that I didn't expect to hear. And it made it really a full conversation much more than I expected. I really appreciate it. 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. We're becoming bold with insulin.

This show is sponsored today by the glucagon that my daughter carries g vo hypo pen, Find out more at G Vogue glucagon.com forward slash juicebox. The episode is also sponsored by the Contour Next One blood glucose meter. It is in fact, the most accurate, easy to use, easy to carry easy to read blood glucose meter that I have ever personally held used. We're talking about. I am not kidding. Contour Next one.com forward slash juice box. And I'll tell you this, too. It's a really great website. It's not, you know, when you get on a website and like who made this, like did the person who made this website? Have they ever been on the internet you ever had that feeling you will not have that feeling at Contour Next One forward slash juice box. I'm holding up my hand like they do in court. Because I am telling the truth of the whole truth and nothing but the truth.

Kari 2:47
I am Kari I'm a veterinarian, and just general practitioner and I see a lot of cases and I tend to get a lot of our diabetics, because obviously we all know it's a pretty complex disease on the human side and equally complex but a bit different on the animal side. So a lot of the other doctors I work with are sometimes intimidated or or frustrated with the cases. So I I see a lot of them.

Scott Benner 3:19
What's your connection personally to type two diabetes?

Kari 3:23
My daughter is 14 and she was diagnosed at age seven with type one.

Scott Benner 3:28
Okay. So we're not gonna say your daughter's name. Is that right? Yep. Correct. Your daughter. That's how I'll handle it. Okay, how old was your daughter when she was not how old Excuse me, but what was the care like when she was diagnosed seven years ago. Seems like you might have been pump CGM time.

Kari 3:47
Yeah. So when she was diagnosed, it was 2014. And we got the Dexcom. couple months in and it was not in the cloud. And then somewhere along the way, in our first four, six months, we got the super expensive little base station so that when she was sleeping, it would the data would get sent to me my phone, whatnot. That was super exciting. And then seemed like shortly after that. It all just ramped up into total lead app and the receiver and the cloud and all that. And so then she went on a pump probably like six months after diagnosis. Gotcha. We started with animus and move to Medtronic and now t slim and chill like we've experienced a lot of the technology

Scott Benner 4:38
on the pumps. One thing I think either your hair or jewelry might be brushing the phone.

Unknown Speaker 4:44
Okay, I know that

Scott Benner 4:45
sounds crazy, but and I have a Dexcom cradle right in front of me. Do you all the old stuff that I've tossed that you know becomes, you know, unnecessary as the years go by? I can't seem to get rid of this one thing. Yeah. Because it, it worked out so oddly, that I mean Dexcom clearly produced these cradles because they thought it was going to take longer than it did. Yeah. To get that next device approved.

Kari 5:12
Yeah, I feel like it. I remember being pricey. Like, I don't know, 100 200 300 I don't know. And then within months, it was useless because things were better. But I mean, it was it was worth it while I had it. I guess.

Scott Benner 5:27
I imagined them all over desks at Dexcom with business cards in them. So that's how I say it in my head. But yeah, I mean, for people who don't go back that far. It was absolutely insane. Right, this little thing came out, and you would take your Dexcom receiver, slide it into it, and somehow then attach it to the cloud and somebody could follow you. Yeah, yeah. Yeah. Such a big deal. Just Yeah, big deal. And he could only use it really at night, right. Like it was kind of by them. Yes, I'd feeling.

Kari 5:57
Yeah. It was too complicated to like, get it to school. And we had our teachers trains to monitor and yeah, so it's just by our bed, but it was such a great thing to be able to just sleep and wait for the alarms. Yeah.

Scott Benner 6:13
Do you wonder now most people probably don't even know there's a receiver. They just use their phone? I would imagine. Yeah, that's fascinating. It really is. And then the the part that of course, was both kind of frustrating if you paid for it. And otherwise, is that that the new receiver that kind of had the chip built into it that could go to the cloud? it Oh, my god, it couldn't have been three months maybe. And it was available.

Kari 6:36
Yeah, that's what I remember. It was super quick. Well, that was a big investment for a couple months.

Scott Benner 6:43
But I can't believe I totally remember that. In that time. I guess I want to know a little bit about your, you know, your ideas around management. Like I mean, sevens pretty young. I imagine you were pretty involved with your daughter.

Kari 6:55
Yeah, for sure. Um, and because I am medical. I mean, I just jumped right in, I totally understood it. And she was so young. And it was first day of summer break. So I ended up spending a lot of days that summer going on her little field trips, the summer camp field trips, and I just hardly let her out of my sight. The the manager or whatnot. At the daycare she was with learned diabetes, no one there had ever had it in their recollection in recent years. So she took it on and helped me out quite a bit but any field trip dosing for carbs, you know, this and that. I was always there. So, and then we were fortunate enough when she entered second grade, we had the most amazing teacher ever, of all my kids years at school and she like took it on like a second mother and she was amazing. So so it went pretty well. All things considered. As much as pretty well could be.

Unknown Speaker 8:02
Yeah,

Scott Benner 8:03
back then something like this. What did you take to it pretty well? Where did you find Yeah, wishing she had kennel cough because that you understand?

Kari 8:11
Um, yeah, I mean it. It was different. I mean, it's managed very differently and animals and humans so but I understood all the science behind it so easily and but yeah, it's it's it's way different. I feel like we manage animals, like we did. 20 years ago. I remember. I remember a type one diabetic. Kind of a friend of a friend back when I was in college, and like they were doing, you know, twice a day shots and carrying a cooler. I remember going to Cedar Point they had the big lunch cooler. And you know, the glucometer and no, no remote Ma, you know, no CGM. And he had multiple seizures. And I just felt like, was so poorly managed 20 years ago compared to humans today. And unfortunately, that's kind of where we are with the animals not because we're behind the curve, but because it's just not super realistic to do all the intense carb counting and CGM and all that and all the animals. You just

Scott Benner 9:15
made me You just really made me focus on the idea that back then with like, regular and mph and those those kinds of things, that that that probably, I wonder, like, if you spoke to a doctor behind the scenes back then if they were just thinking, how will this person's pancreas stop working? So we're just going to do our best to keep them alive for as long as we can until stuff starts going wrong? Because that's Yeah, that's the vibe of the dogs. Right. And the animals Yeah.

Kari 9:42
Yeah, pretty much. I mean, we. Yeah, I mean, we do the best we can twice a day dosing and we have started playing it Some of us have started playing around with the freestyle lever or whatnot. And I've only had one Clients religiously try it, like, begging clients to try. But yeah, I mean, we just for lack of better terms, if somewhat winging it, I don't have owners do blood sugar's at home very often because they get too worked up on, you know, a blood sugar of 300 they all of a sudden want to increase insulin. But, you know, we don't we have a much wider curve. Yeah, on our dogs and cats, then some well controlled humans, not necessarily my dad or these things with hormones, but you know, they can fluctuate 100 to 300, and be pretty acceptable, we hardly blink an eye if the average is okay, so we don't micromanage it as much. So yeah, we just kind of do the best we can and educate the owners, but obviously, it's very overwhelming for many of them. And we try to dumb it down almost to to, you know, reduce their stress, and yet still do the best we can for the animal.

Scott Benner 11:04
So carry that sum. It sounds it sounds sad, I guess is the word I want. Like, like, the understanding that there's this thing that I guess that really is medicine, in general, though, right? isn't like we're getting better and better at it as time moves forward. But a lot of it is maintenance. Like just Yes. And when you mean maintenance, you mean maintenance, trying to stave off something, whether it be right a problem or the end, or whatever it is, you're just trying to slow the progression to this thing. Yes. And you can you tell owners of pets that or is that not something you've kind of freely share?

Kari 11:40
Um, I mean, I'm always very optimistic that, you know, we can give them a relatively normal life that the hard part, the hardest part probably is some of these dogs are just picky eaters. And to to have an owner at home kind of treating blindly without regular blood sugar, checks, blood glucose checks, you know, and all sudden, the dog doesn't eat breakfast, what do they do, and, you know, to try to give partial doses and to educate them on all that. So I try to just encourage them that, you know, we're going to do our best to give them a pretty happy healthy life. And one of the biggest fears is the needles and even the most scared clients realize the needles, no big deal. And, you know, I try not to overload them with all the heavy, potential negative stuff. But um, you know, main, a large portion of the dogs develop cataracts. So I do tell them that right off the bat dogs more than cats, and you know, I tell them, they're going to be frequent visits back to see me and it's, it's not cheap, paying, you know, full price for insulin and blood tests, you know, without, most of them don't have insurance. And so I kind of prep on that. A little bit of expensive disease, but you can do it and they're gonna feel great. And, you know, there may be complications down the road, there may be certain lifespan, but we'll deal with each one as it comes. And I try to keep things as light as I can. But still, you know, this is something to be taken seriously. And we can do this together. We're Team call me any time

Scott Benner 13:27
trying to make them feel a part of like the process of doing a good job. Yeah. How do you get a cat or dog to drink a juice box? While you're talking?

Kari 13:41
Yeah, so our go to is like Kira syrup or maple syrup on the gums. You know that, that sort of thing and, and call us if they're not coming around in 510 minutes.

Scott Benner 13:54
It's fun. It's funny how the problems are mimicking both sides, like I have two dogs. And one of them one of them's older. And there are some mornings, you know, like the process, you know, the morning goes exactly the way it goes every time and he comes back in from out back. And he's like, oh, man put the food down. And he comes over and eats the food. And some days he looks at it. It's not now and then he goes over and lays back down, which he never did when he was younger. And I'm trying to imagine I'm trying to imagine talking a dog into eating I guess. Yeah, I'm trying to wrap my head around. And it's making me think back to when my daughter was young as well. So

Kari 14:32
it's hard when there are picky eaters and you know, a lot of these dogs, like schnauzers are notoriously type ones and are you know, diabetics, dogs are more often type one and cats marfin type two, interestingly enough, but you know, these little dogs are not always big eaters, labs are prone to it. Also, and that usually goes well because they eat anything you give them. But yeah, some of these little ones. One of my most intensive cases is a little Chihuahua, and Elvis. He's an old man. And he's had cataract surgery and all kinds of stuff. She's the one actually who tried the the CGM, the lever. And he Yeah, so she's mastered it because she is all in as most of us are parents to type one. So we're all in and we're micromanaging. She, she lives her life to manage this dog diabetes, I swear. So what's my point? Oh, he's not, he's not the best eater. So she's, you know, always trying to finagle what he eats. And she's well aware of all the complexities of carb counts that I don't overwhelm my most of my clients with. So she knows like, what's high carbs, low carbs, and how that affects his insulin needs. And but yeah, when they're not good eaters, it's hard. So it's, it's a battle for them for sure.

Scott Benner 15:55
So I'm sorry, you, you've got me off, you've got me off kilter a little bit, because I literally am just picturing someone on their knees with a handful of kibble going, just have five of them, just please eat fine. I gave you your insulin already. How long does it take the dogs and cats to get used to getting a needle?

Kari 16:13
Honestly, they don't know what to set. Okay, they do great. So I have the owners, if possible, I have them feed twice a day dose twice a day. And I tell them, it, every vet does it differently. And I've tried to cope. My clinic that's to kind of do it similar to me, because there's such differences I've seen, I've seen some that say I'll do some An hour later. And you know, I use the food as a distraction. Once it looks like they're eating most of their food just give the full dose and most donors are shocked that the dogs never, and cats to never even act like they feel it. So they do really well. And it's done a little differently. We don't use the pen needles, we actually tent the skin and kind of angle it 45 degrees with a more traditional insulin syringe. Although I had one Schnauzer that was vicious to the owner, and they literally had to kind of just Dart the dog as it walked by his name was lucky enough, you should never name your animals lucky because it never works. It's always opposite. But um, so

Scott Benner 17:30
I know won't get back to this in a second. But it puts you in the position of attending to a dog who's passing away and having to turn to somebody who loves it and goes and sell them. Yeah, Lucky's gonna die.

Kari 17:41
Yeah. lackeys are there now never lucky. They're they hit by cars. They're the bad diseases. But yeah, this dog is the only patient and 20 years of practice that I've ever had us live little pen needles, and like literally just start them as he walks by. And it works. She kept them alive for quite a while. But yeah, they don't notice the needles. Honestly, they do so well. You know, the owners are more freaked out, but we demo it.

Scott Benner 18:13
They can kind of see it's not a big deal.

Kari 18:15
Yeah, we have them give them some sealing as a practice once, twice, three times whatever they're comfortable with. And they go off on their own. And almost every single owner is shocked how easy it ends up to actually inject to them and the pet

Scott Benner 18:30
that you said that you when you brought up type two, it made me think so in the I mean, how many years Do I have to go back into veterinary medicine before no one would ever consider giving a pet insulin?

Kari 18:44
Yeah, good question. I mean, my whole 20 years we've all been on board, okay. I don't know. I still have clients that occasionally request euthanasia when they're diagnosed. And it just breaks my heart because it's close to home and I just I've done I've probably given in and done to maybe in recent years but I do everything I can to talk them out of it and yeah, I don't know at what point you know it progressed through to little more effective treatment and the animals I would assume it's been quite a while I mean if this insulin spin out

Scott Benner 19:26
do you imagine that and I'm This is me guessing so if I'm wrong you stopped me but do you imagine that people who are able to seek frequent and regular care through a veterinarian for a dog Are you know better financial place than other people and does that not make us believe that people who can afford it still have pets?

Kari 19:45
Um, so yes and no funny enough. We My practice is like the edge of a big city and so we we pull in clients from the wealthy suburbs. Inner City I have learned through the years you cannot judge where they live, what car they drive for anything. We have, you know, clients with the fancy cars. I mean, no offense to anyone listening. But they're just absolutely appalled that I asked them to buy $110 lantis pen, we use the pens in cats as a vial, basically. So they don't have to buy a $380 vial of Lantus to use two units twice a day, we we buy packages of the pens and break them up and sell them for 110. And, I mean, people are just absolutely upset either with us or with, you know, insulin, crazy pharmaceuticals in general. And then we have, you know, people driving beaters and just not looking as well to do and that they don't blink an eye and they'll do it. So I've learned long ago like not to prejudge anyone, you lay it out there and let them know. Yeah,

Unknown Speaker 21:04
yeah.

Scott Benner 21:04
So do you people ever, like how harsh does it get? Like you said, they'll they like, has anyone ever said to you, you want me to spend $110 on something that cost me 20 bucks. Like is Does that ever get that harsh? Or do they not say that to you?

Kari 21:17
Um, so what do you mean? So what do you mean? 110? That cost me 20 bucks. So like, yeah, like,

Scott Benner 21:24
some people don't know that. I think there's some people that don't see a cat. I think they see it as a belonging sometimes and not a Does that make sense? And now Yeah, suddenly, like here, let's spend a lot of money to Medicaid, something that you paid $20 for at some point like that.

Kari 21:38
Oh, I see what you Yeah. Yeah, absolutely. Um, and again, that goes across the whole range, like, wonderful parents, you know, the shoe, the kids are there, and they're like, we're not doing this. Well go get them another cat next month, or, you know, whatever. And vice versa. You know, it's, uh, yeah, I mean, people just range I've had so many people say, Oh, I grew up on the farm, or, you know, we never treated our cats and dogs, they live to be teen. And, you know, you don't need to do this. And, you know, again, just recommend what's medically best, but then your medicine has evolved to be more intensive and more high quality. It's, we're actually built building a new building right now. And we have someone trying to sell us on a CT scanner, because that's the norm for dentistry, it's better. We thought we were doing great because we had dental x rays, but now the norm is to CT that the jaw, and it's just things are evolving so much, you know, just better care better technology. And, as a result, often higher bills and people do it, they love these pets, and you know, most of them will do whatever it takes, they may complain. But we, we My practice is always pretty good at kind of giving them options. You know, diabetes probably isn't a good example. Because there's not a lot of options you treated or you don't but you know, if you dogs vomiting, and it's prone to foreign bodies, but you're pretty sure didn't get into the sax. today. You know, if you want to just treat for virus and wait for an X ray, that's your choice. Or you can spend, you know, 180 bucks for x rays and see if there's a sock and its stomach. So we kind of give plan a plan B and so many people go with the full workup and I mean, they they want to take care of their pets. It's lovely.

Scott Benner 23:41
Really, I'm trying to decide what the number is for me not to take care of my kid. Like I'm like, What number would someone at this Happy Friday when I don't like them? Yeah. I'm sure there isn't one but it's a very, it's what I'm thinking too is that you don't get into veterinary medicine. Like by mistake, right? Like you weren't like trying to decide whether or not to be an accountant or a veterinarian. This was a calling for you. I would imagine.

This isn't much of a cliffhanger. I mean, Kerry's going to say that veterinary medicine was a calling. I mean imagine if she didn't imagine if she was just like, now I hate animals. That is not what happens. But anyway, that's neither here nor there. You'll find out all about that in a second. For now, I need you to know this. g vo hypo pen has no visible needle, and it's the first pre mixed autoinjector 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 Vogue glucagon.com Ford slash juicebox g Vogue shouldn't be used in patients with insulin, Noma or pheochromocytoma, visit je Vogue glucagon.com slash risk. I wish you all could have been here the day I learned to say pheochromocytoma, it was hilarious. Anyway, I need you to go to Contour Next one.com forward slash juicebox. Why are you going to do that? Well, it's easy. When you get there, you're gonna find a blood glucose meter that is accurate. Understand, it's easy to use, easy to hold easy to read has a nice bright light for nighttime viewing. And it has Second Chance test strips. Second Chance is exactly what it sounds like. You take a chance dip in the blood. Right? What other add in the world do you hear dip in the blood as part of the words you have put the test strip in the blood and say you don't get enough. Oh, that was your first chance. Now you get a second chance to go back and try it again. without interfering with the quality of the test. And you don't ruin a strip. Not bad, huh? Plus the things easy to use. I love it. I mean, as much as you can love a blood glucose meter. I love this one. That's an accurate, that's an accurate and honest statement for me. I mean, you know, like if you said to me, Scott, what do you love more sunny days are blood glucose meters I've been I kind of like glucose meters good I can do with or without the sun. But I mean, if it got down to my family, and you're like Scott, here's your wife and a blood glucose meter. I'm gonna go with Kelly. That's not the point. The point is, I love this meter. And you may too. You may also love a lot of the things going on at Contour Next One comm forward slash juice boxes. So head over and find out they have a test trip savings program. A lot is going on. It's a really I mentioned at the beginning of the episode. I don't mean to jump around in the middle of the ad, I'm sure right now that people are contour like, could you stay on topic, buddy, we're paying you here. But I am. It's a great website gets really well laid out. It's easy to find. And there's a ton of information on it. It's not overwhelming or confusing. It's worth your time. Contour. Next One comm forward slash juice box. You know, I got a bit of time left here in the music. So let me just say this. Find me on Instagram, find me on Facebook on bold with insulin on Facebook. I'm Juicebox Podcast on Instagram, and the private Facebook group where there are now 811 1000 users, a lot of them active every day. It's a jump in Facebook group full of cool people talking about type one diabetes, it's called Juicebox Podcast type one diabetes. That's it, you go there and you chat with other people just like you other listeners. 100% free nothing to do just, you know, ask answer a couple of questions. Make sure you're not a robot, or somebody trying to sell t shirts or other scams, that seems to be a big thing in the diabetes community. People come in and they go, Oh, ah, I have diabetes. And look at my brand new t shirt. Isn't it amazing? And they just take a picture. I'm gonna keep talking here for a second because this really pisses me off. So I'm just gonna take a second to share it with you. And I mean, pisses me off is harsh. It pisses me off. It's just it's a well done spam. Do you mean? So somebody takes a picture of themselves. And they're like, I have diabetes. And I know how hard it is. And it is hard. And my shirt says that I'm tough or whatever I want to call it, the shirt says, and then they don't. They don't like pimp it. They don't put a link up, right? They're not like me. They're not like Juicebox Podcast like they, they don't do anything. They wait for someone to say, Oh, I love your shirt. Where did you get it? And then they're like, oh, let me just give you this link, which goes to their store. These people don't have diabetes, they're preying on you, they're trying to sell you diabetes t shirts. Now, if people want to sell you a diabetes t shirt, they should just tell you, I'm selling your diabetes t shirt or I'm selling you another t shirt. That's fine with me. I'm all about capitalism. I'm good with that. But don't try to trick people. I'll try to make it look like it's one thing when it's not. I don't like that. So anyway, I try to keep those people out. And I do a pretty good job of it. So don't be afraid to check out the Facebook page. Well, this was long winded wasn't it? Let's get back to carry. This was a calling for you. I would imagine.

Kari 29:11
Yeah, I wanted to be a vet my whole life and you know of course growing up all your friends do too We all did at one point right? Probably. But they drifted away to other things and I was a senior in high school or junior whenever applying to undergrad and like I've never thought about anything else maybe I should. So I looked into of all things architecture, and special ed and I thought well those are cool careers but now I won't be event so and then went on from there and some people because that school is kind of hard to get in. Depending on the school the average is one out of 10 applicants. So some people after not getting in move on to like the human side because I don't know if it's good or bad that it's easier to get into med school but I Couldn't do humans humans are kind of gross medically and and luckily I got in so I didn't have to think about what else to do or how many times would I apply, I get on first try by some miracle. And here we go. If

Scott Benner 30:16
I have to say that the first time I saw a veterinarian, express my dog's anal glands, I thought she really likes this is her calling? There's no way she's just doing this for money.

Unknown Speaker 30:30
You know, like, yeah,

Kari 30:32
there's some gross parts, definitely, we're pretty well staffed. So we've delegated out to your skill level and what you're trained at, so my unfortunate technicians get to do most of the ina glands. Unless they're busy, and I don't want to wait, then I'll do it. But no, yeah, no,

Scott Benner 30:50
I was asking. Because, I mean, I would think that a person who I'm guessing loves animals as much as you who went into a profession to keep them healthy, that when someone says to you, Hey, I don't want to give this thing insulin, let's just let it die, or can you put it to sleep? I don't imagine that you see much of a difference between that. And and if I were to come up to you and tell you, you know, we're not going to bother with your daughter. She's a lot of work. Like, I don't think you Yes, I would I am I right about that?

Kari 31:20
Yes, yeah, I agree. Um, and, you know, my, my partner's my associates, they, I think they accept that request easier than me, and the only one with a type one family member. But because it is pricey, and it's high stress, and it's high maintenance, and, you know, so when an owner is just not willing, you know, I find my we are all in it to help animals, but we also have a lot of really emotional hard things every day. So, of people who don't want to treat something, or people who, you know, think it's a charity, and their dog was hit by car, and they need free surgery. You know, it's a very emotionally draining career. It's not all petting cute dogs and cats and saving their lives every day. There's a lot of human emotion and ranges of quality of care and willingness to be compliant. And you know, a lot of difficult stuff like guilt trips, or blame or this or that. So anyway, I find the other doctors you know, if they diagnose a diabetic and the owner is just not willing, they sadly agree versus I put my foot down and like, absolutely not, am I euthanizing your dog? I can't, I cannot, I cannot, we are going to treat it. We're going to find a way.

Scott Benner 32:50
I did not want this turn into a therapy session for you. But the whole time, this is where I've been heading. So just say, okay, because I really felt like how is it possible that she could? Like, I didn't think you could disconnect that feeling from your personal life? And like, you don't I mean, like I couldn't I just don't know how, if I'm, I mean, I, I've been a pet owner most of my life. And I can't, and I can't fathom how somebody would just be like, Oh, it's sick. I forget it. Like, I don't understand that. But I'm also not, um, I don't know how to put this like, I'm not a crazy pet owner. Do you know what I mean? Like, again? Yeah. Like, I think there's a line, like you're saying, like, I kind of believe if my dog got hit by a car, and I brought him in, and he looked really bad. And you said, this is gonna cost $10,000 he's probably gonna die. I might be like, Oh, you know, me, like, that probably would hit me. But that would be because I feel like that would be because of the money. If I couldn't afford it, I think it's just a weird thing to look inside yourself to try to decide, you know,

Kari 33:53
yeah, yeah. It's hard. I mean, it's a daily battle. And it's hard. The owners, it's hard on owners to like you said you would love your dog. Can you do 10 grand, and there's a guarded prognosis. And, I mean, it's hard on them. And most of them are very understanding of the situation we're put in, and we come to a decision together, but there's, there's a lot of tough points where, you know, they they don't agree with, you know, our estimate, or they feel that this is an animal and we're, like, we're in it to help animals, we're obligated to do whatever it takes, and why are we trying to make a fortune and, you know, it also there's, there's hard stuff and there's owners, you know, that just don't understand why it's such a big deal that their dog has a, you know, a tumor that's probably malignant, the sooner we get it off, the more chance that we can prevent fatal outcomes. And now they're just going to watch it and you know, so we have to go with that. That's their choice, and we have to go home at night and let it go. And it's It's a hard, it's hard things sometimes. But I, I've learned through the years and this may sound cold, but I love these animals. I love the science, but I have emotionally distanced myself a little bit from the bond that these animals have with their owners and the owners lives. And I, I try, I try to be very thorough, very friendly, very helpful. But I try not to get too connected or too bonded to some of these pets. And there's always those ones that sneak through and I when they die, or when they're sick, I cry like, it's my own child that, but I think that's what's hard. In our profession. We actually have a very high suicide rate, we're ranked the highest in all professions, apparently. And it's like three times what an average american is. And yeah, it's it's a very emotionally difficult career because of all that stuff. So again, it may sound cold, but I kind of, I still absolutely love my job. And I find it's because I enjoy the animals, I enjoy the science, but I I try not to get too attached to each individual patient because I just, you can't handle it, you can't keep your chin up and deal with all these tough decisions and financial limitations. And, you know, it's just it's tough. So I, I do the best I can, but again, certain patients get through and certain causes like diabetes gets through, and I am absolutely attached to every diabetic patient I have and

Scott Benner 36:38
are you the diabetes doctor? Like is it is it that simple? Like you just hear from other rooms I carry? This one's yours?

Kari 36:43
Yeah, yeah, pretty much. Yeah. Yeah, because it's an ergonomic endocrinology is super tough. I mean, it was my hardest class and med school. And it's it's complex, all the hormones interact with each other and everything else in between. and, you know, as general practitioners, we treat everything and we treat minimum of two species, cats and dogs in, you know, small animal practice. I do some exotics, too, but so, you know, you have to know, everything possible about the heart and the kidneys and all the endocrinology and musculoskeletal and we do surgery and neurology and so yeah, these doctors who aren't living type one like I do with my daughter. Yeah, are like, okay, I just died. I died. The dose is this and oops, I don't understand why his blood sugar's not well controlled. Carry. Oh,

Unknown Speaker 37:43
I'm starting to wonder if everybody's endo doesn't feel that way. If

Unknown Speaker 37:48
that's true. I wish I

Scott Benner 37:49
could call someone else to come in here and help you. Yeah. Are there any odd animals that get diabetes? Like, I assume, not frequently, but what's the

Kari 37:59
I've diagnosed a couple of guinea pigs. And other than that, I don't know. I mean, I'm assuming every animal can, but we mainly just do cats and dogs. And, you know, back in vet school, we had to learn six species. The exotics, were kind of separate from that. But you know, cows and goats and horses and sheep and cows, goats or sheep. Yeah, cats, dogs. So those are the six. And I remember some endocrinology from the rest of them, but not a lot. To be honest with

Scott Benner 38:35
you, and I'm embarrassed I can't believe I'm going to admit this. People shouldn't don't get a podcast because if you don't tell people the truth, they won't listen. You said guinea pig and I thought, well, there's there's my line. I found it. Okay.

Unknown Speaker 38:51
Goodbye hundreds of dollars worth of insulin for a guinea pig. It's I think you may have found my line. I'm really not just embarrassed and ashamed. And yet I'm saying it so

Kari 39:00
No, it's fine. Yeah, and that's that's the thing because I do see exotics. I have a lot. A lot more clients probably that I'm, what am I saying? I mean, the ones that will bring a guinea pig in with a urinary issue and we're actually pay surgery to remove a Bladder Stone. It's shocking. But think about how many households have hamsters and gerbils and guinea pigs and rabbits and you don't see 99% of those. I mean, they all stay home and when they're sick, they the poor little kid holds them and cries and they die. But you know, the ones that come in those owners will do anything.

Scott Benner 39:43
You think, Mike because I'm so sorry. I cut you off.

Kari 39:47
Yeah, no, you're fine because they do make the effort to come and vet to begin with versus most owners do not and that's understandable. I mean, that's part of our job. I'm not going to make someone feel bad because they don't Yeah. supposed to do something? And also diabetes, then

Scott Benner 40:03
you will? Absolutely. So if any of you out there have a diabetic hamster or gerbil and you're not getting it treated, this person is not gonna let you off the hook, just saying. Where did you feel this way prior to your daughter's diagnosis? How was it different prior to that?

Kari 40:19
Um, as far as like binary medicine and the overall No,

Scott Benner 40:22
I look, you did that? Yeah, with the diabetes specifically in animals like, like, 10 years ago, if somebody's dog had type one in there, like, I don't want to do this, where you just like, Yeah, right. Or, like, you

Kari 40:32
know, cuz I've always been, so I have this theory that, that's get into many medicine for one of three reasons. And I think we all start off with a high compassion for animals. But almost equally common is the interest in science and, and the third is money. But believe it or not, we are a very low paid profession compared to other doctorate degrees. And that goes all the way through our entire staff, technicians, everyone, I mean, when I graduated, I got off track, but when I graduated med school, the average starting salary was 45, grand. And Ohio State there was for doctorate programs. And the next highest, I think, was dentistry, or whatever it was, it was 90. So that gives you example, it's a very low paid profession. So a lot of people feel we get into it for the money, but we don't make awesome money compared to human MDS and whatnot. So anyway, back to my, my philosophy on this, a lot of us are in it for the science too. So I definitely feel like you know, I'm equally compassion for these animals in science. So I always loved like, the internal medicine stuff, I actually had myself all set up to kind of become a specialist, I was hoping for internal medicine, there's two tracks to be a specialist of enter medicine, you can do the residencies, you know, and work at the vet schools or the you know, the referral hospitals or you can kind of do an in clinic, you almost self study for boards, and you have to have a couple mentors that are specialists, you have to present case studies and stuff like that. So I always loved all the science and I was definitely not an expert on diabetes, but I enjoyed all that stuff a lot. So I had my timeline, I had my mentors and one of my two case studies to apply all that stuff set up. And I love school I miss school I miss learning I was super excited. Had my books ordered.

Scott Benner 42:33
You are exactly like my wife by the way. Like this. Yeah, my wife has a is a biology major. And she she very much was was on the way to go into medical school when some things in our life kind of throw her sideways. But she talks about science and and the medicine that she also thinks people are achy, I don't think she ever would have been a doctor who would have practiced.

Kari 42:56
Yeah, just can't do it. Yeah, but I was all set. And then my daughter was diagnosed and it just took the wind out of my sails. So I still claim to be kind of the narrative the group I kind of have a very informal title of medical director I love I love implementing new things and learning new things. I'm the one who reads every magazine that comes through I'm the one who actually enjoys going to see continuing education. So I love all that stuff. But I don't think I I don't predict I'll ever have the energy to go through the program.

Scott Benner 43:32
If I said to you, money wasn't a necessity. And you could do whatever you want right now. You'd go back to school.

Unknown Speaker 43:38
Oh, absolutely. Yeah, I

Unknown Speaker 43:39
know your type. Okay.

Kari 43:42
But I don't want another profession. So I would just have to be a specialist. Yeah, I don't I don't have any other desire to do anything different. Maybe like business school because it is there's so much better medicine that's business oriented, that we just don't learn. They're implementing more business classes probably a very small amount but in that programs these days but there was zero when I was there so that would be maybe interesting but more so would just be to specialize and learn more stuff. Yeah,

Scott Benner 44:17
I know. Trust me, I know your world. I know at least this part of you if that's for certain I'm can we shift gears for a second to something you said back in the first couple of minutes? talked about I think you were alluding to things have been tougher management wise for your daughter since hormones is that seem like where you're headed? Um, what are you seeing is it just generally blood sugars that are just generally higher than normal? Worse spikes?

Unknown Speaker 44:48
Yeah,

Unknown Speaker 44:49
yeah, we

Unknown Speaker 44:50
already have it.

Kari 44:51
Yeah, all the above, higher blood sugars, irregularities, and honestly, I would say the biggest problem is Just she's 14, and she doesn't want to be bothered. And she's not total, like Debbie Downer about diabetes, she actually more days than not and that's that she kind of enjoys it. She has like, tons of awesome friends. She loves camp. You know, she's proud of her hard work on it. She loves the tight relationship she and I have we're a team, you know, so. But could I bother her to like Pre-Bolus for a meal at the end of the world? Or you know, if I'm not there to Nagar, you know, she's at a friend's house or at her dad's house or whatever. All of a sudden, she's 350. I text her Did you eat Did you Bolus? No, I forgot. So I think it's mine. It's hormones and just what that does to all the, again, endocrinology is complex, everything works together. So how it's affecting everything, but also just the teenage boy has a attitude of whenever I'll be fine, mom. Yeah, my a Wednesday is 8.2. But it doesn't matter. It's fine. And you're

Scott Benner 46:11
like, no, it's not

Unknown Speaker 46:15
killing yourself.

Scott Benner 46:16
I got a Schnauzer named Butch living better than you over here. This is not okay.

Unknown Speaker 46:20
Yeah.

Scott Benner 46:21
Do you take a onesies from pets? How do you know you're doing okay? Just because it's alive?

Kari 46:30
So, uh, yeah, we I mean, we just we question and monitor. So the best test we do is for Tosa mean, for dogs and cats checks. Like I tell owners, it's a lot like a one C, because so many owners are familiar with that. You know, it just gives us the two to three week average, basically. You know, and I question them? Do they drink a lot? Or they pee a lot? Are they maintaining their way? You know, just stuff like that. And if they're happy and perky and fructose means acceptable. We check it off as a win.

Unknown Speaker 47:03
How do you?

Scott Benner 47:06
Do their lives get shortened? Like, is there any way to know if they're if they're losing a little off the end? or?

Kari 47:13
Yeah, I mean, statistically they kind of do. Yeah, I'm just because I don't think we can regulate them as well as hopefully most of us are on the human side. Unless you have a 14 year old stubborn girl. Um, yeah, I think their lifespans are shortened I would say so. Just it, it takes its toll on the body for sure.

Scott Benner 47:38
Can you kennel a dog that has like, like, I'm trying to imagine like, how do I go on vacation, if my dog has diabetes, it will look like handled give injections, some of them maybe

Kari 47:49
typical kennels walls. So in our area we have we have a couple like pet sitting services that have registered Tech's on staff and they can do you know, home visits. We do medical morning, we don't do regular morning, but any of our clients that have intense cases like seizure dogs, or or diabetics, will, will do medical boarding and manage them there. But then that implements a whole other problem of the eating. You know, a lot of the dogs and cats don't want to eat well, when they're there. Their stress is changing their numbers and, you know, so it's it's hard for

Scott Benner 48:24
exactly the same for a dog or a cat as it is for a person.

Kari 48:28
Yeah, so it's hard on the owners. There's some others that have like, an amazing neighbor who can give shots or you know, whatever. You know, there's there's creative ways to go about it. But it's hard. It ties them down for sure. And then you want them to be pretty close to 12 hours apart. Which how many of us are home exactly? 12 hours apart every day of our lives? Yeah.

Scott Benner 48:48
Yeah, right. Hey, can dogs do inhalers?

Kari 48:54
No, I'm, well, we have I have not heard of any inhaled insulin going for dogs yet. We do inhalers or asthma on cats. So I've never actually thought of that. I wonder if it'll evolve to be a cat treatment or even a dog treatment. But yeah, as of right now I have. This is the first I've ever thought of that or heard of it. No, I just

Scott Benner 49:21
sit here thinking if somebody can make it happen, it might be you. And I physically understand if like a animal could do an inhaler. Like because, like, yeah, the idea of an inhaler is you know, to push the button and then breathe.

Kari 49:33
Yeah. So we have those. Those chambers for us are called Aero cats. And I can't I don't know what they're called on the human side. But I know like my son had one for his. He had like temporary asthma when he was younger. And that those little tubular chambers with that little rubber mask at the end. So yeah, so when we use like Flo vent or something for asthma for cats. Dogs don't tend to get asthma. So I have Never use some hidden dog but cats. Yeah, we we just kind of hold that little mask up to shake it up and we'll push the plunger or let them take four or five breaths and they're done. So yeah, I don't know, let me know. You hear me?

Scott Benner 50:15
Yeah, let me put this right here just in case if anybody out there ever finds themselves giving their cat or dog a frezza, I did it. Okay, I made it happen. Because this might be years from now, it might take a while for my idea to get through the through the mainstream. But I'm taking I'm taking credit for this right now, March 31 2021.

Kari 50:35
Some interesting idea, now we're gonna have to look into it. I swear,

Scott Benner 50:39
if this ends up happening, I would like a procedure named after me, you. You and I get together and decide on the name later. So what do you I know this is going all over the place, but I'm having a good time. By the way. Thank you for being chatty. I think I could have started this off and gone. Hey, everyone, this is Carrie. She's a vet, her kids got diabetes. And then I could have maybe left the room and come back because she we're good at this. Thank you, please. So now I'm gleaning from our conversation that you have like, you know, your your daughter, your kids go back and forth between two households. Are they with you more than they are in the other place? Or vice versa?

Kari 51:15
Yeah, they're with me maybe like three fourths? Two thirds, three fourths? Yeah.

Scott Benner 51:20
So that presents its own management issues? I would imagine, right? Because you don't think about diabetes? I mean, nobody thinks about it exactly the same way. So I'm imagining your acts, and you don't have the same ideas about it. Yeah, okay.

Kari 51:32
That's a good point.

Scott Benner 51:34
Sorry, I don't want to get you in a fight on a podcast. But okay. And so, I've done I've done episodes about divorce, and diabetes. And there, you got to find the exact right person, they want to talk about it. And and I did want to actually guy came on, he was terrific. And his ex wife said he could talk about and everything he was so like, good about it. But the point is, is that he had one management style. And then his his ex did not have the same understanding of it. And so I'm wondering, when you're when, when a child's already kind of like, I don't really, I'm not all that interested in this? Because one household make that easier than the other. And then does that put you in a weird position where you want to say something, but you feel like it's not your place? But you know, it is?

Kari 52:18
Yeah, absolutely. And luckily, my kids didn't have to split households till like a year ago. So you know, if it if she was seven, or eight, and I think it'd be super hard, but but I mean, she has her phone, she she knows it better than him. I don't hope he never listens to this, but she knows the whole disease and everything she needs to do better than him. She knows how to change your pump site or CGM better than him. So I kind of just worked directly through her while she's over there. And once in a while, I've had some, you know, some issues where I can't reach her or this or that I have to reach out to him. And you know, he says he's on it. But, you know, humans have different opinions. But yeah, luckily, again, she's a trooper, even though she doesn't want to be bothered a lot of the time she she accepts, at this point, her diagnosis and heard her need to take care of herself. And so I and we, she and I are very tight and very good together. So we, you know, I just worked directly through her for the most part. But yeah, her numbers are not usually as good over there. But I just gotta pick my battles.

Scott Benner 53:44
Aside of the pick the battles vibe, does it? Are you heartbroken while it's happening? Like, how do you deal with because if you told me right now that I couldn't text my daughter and tell her that her blood sugar was 139, and I wanted it to be at five. I would I would have, I believe what they call Arjuna the entire time. Does it bother

Kari 54:04
you? I Yeah, it does. But I also have to just kind of choose to let some stuff go. I mean, there was one time a couple weeks ago, I was just infuriated. And she was over 400 for six hours. And I couldn't reach her and or she was with the girlfriend and she hates being around her and she doesn't want to talk to her. And she didn't want to answer the phone because she didn't want to talk to me in front of her. You know, blah, blah, blah. It's just this whole ordeal. So her dad and I don't talk a lot. But I did end up reaching out. We use a court order to App our family wizard. I reached out to that and I kind of was pretty straightforward. I'm like, This is unacceptable. She's do this. You Do that, you know? And he's like, Oh, well, I just I just now after I reached out to him, just check ketone. She's fine. She feels fine. She forgot to dose her cereal this morning. We've been chasing the numbers ever since. So six and a half hours later. Yeah. Like, you know, Chase and Miss Bolus cereal for six numbers.

Scott Benner 55:21
I don't want to misrepresent why you're here. And then. But you just said something. Now I have to tell you. I'd stop this recording right now and then say the words to you court ordered app and then let you talk for an hour. Because I would love to understand what that is. More importantly, I'd love to hear the story about how you got to it. But that's neither here nor there. So yeah, but I am imagining something that when you look back on you both cringe and laugh, that's all I'm saying. Well,

Kari 55:49
I cringe and laugh, he probably cringes and doesn't laugh. has an anchor. Yeah, hold

Scott Benner 55:58
other story. Yeah. That's not why you're here. But you fascinated me when you use the words court ordered app. I was like, Oh, my god, there's such a story behind that.

Unknown Speaker 56:06
Yeah.

Kari 56:08
It's been a rough road. Better better.

Scott Benner 56:12
Yeah, I am really, I am super Sorry to hear it. I grew up like, you know, in a divorced house. And I understand all the serious parts of it. And I don't understand I do want to ask you this one question. You don't have to elaborate. But if you're comfortable answering, do you think the diabetes make it harder to be married?

Kari 56:34
Yes. So that is a great question. I love to analyze, you know, think about stuff. So I would never want my daughter to feel this way. But I feel, you know, big battles in our lives, either bring us closer, or break us up. And I felt with her and me and even my son, he's an amazing support for her. And he adores her. I mean, it's strengthen the family significantly. And my ex for the first year was all on board. And I mean, we were a team of four, we battled this, we're doing great. He has a history of mental illness and stuff like that. After about a year, he just kind of tanked. And I feel it led to a lot of troubles within himself and within us. And it just went downhill downhill downhill from there. So yeah, unfortunately, I think that first year, it was just this almost weird blessing. I don't want to call it that. But it was, I mean, we were tapes, and nothing would stop us. And we were upbeat. We weren't when those families that you know, just kind of break down in tears every day about this, we were like, We got this, you can do it. We're gonna do it good. I immediately got involved with jdrf. And that's progressed to the point of like a board seat on the board. And you know, my daughter, and I do tons of advocacy. And I mean, it's become like a new way of life. And for her and me, we've stuck to it, but it it spiraled for him. And I think that affected his mental well being and our marriage and everything.

Scott Benner 58:21
So yeah, I'm sorry, is is there? Um, is there autoimmune on either your side of the family or his?

Kari 58:28
Yes. So no type ones? Well, there were no type ones. I have two or three autoimmune conditions, celiac and then a rare one called poly myositis. And then little stuff like Rhino ads and x month stuff like that. My mom had scleroderma, my aunt had lupus and krones tons of autoimmune and my daughter was diagnosed with hypothyroid at the same time as diabetes. And she doesn't know it better bloodwork last week showed a high celiac antibody. So I have to deal with that. But um, and then my, her dad side had none. But interestingly enough, a young child was diagnosed on his side. And it is his half sister's granddaughter. So I don't know if there's some genetic stuff there. But that's she was diagnosed within the year, last this year. You know, so I don't know if there's any sort of link there. But

Scott Benner 59:34
the reason I asked initially is because I've I'm starting to get a larger number of people who come on to talk about that they have type one and they're bipolar. And it started making me wonder if bipolar was autoimmune, and there are some writings that seem to feel like it may be and and I was so interested by that when you said that

Kari 59:54
but interesting. Yeah, yeah. Well, that that could relate to her father.

Scott Benner 1:00:07
Have you come from like an Irish background ish? Do you have any of that?

Kari 1:00:12
No, I'm I'm Swedish and German. He's a mix of everything.

Scott Benner 1:00:21
Yeah, type ones. Is it is sweden, sweden, one of those places where it barely exists? Or where it's prevalent?

Kari 1:00:27
I am lucky. Good. Good question. But I feel like it's low,

Scott Benner 1:00:32
most common chronic diseases affect you on? Yeah, Type One Diabetes is one of the most common chronic diseases that affect children in Sweden.

Kari 1:00:39
Oh, really? Oh, good to see,

Scott Benner 1:00:41
I just I, after you talk to enough people about this over and over again, you just start seeing connections, you know, like certain certain backgrounds, certain places on the globe, like it just, you know, like with that you've got a number of autoimmune and that your daughter might have celiac? Does she show any symptoms?

Kari 1:01:01
No. So interestingly enough, you know, they screener once or twice a year for all that stuff. She had one of the antibody levels was high, oh, three or four years ago, and it was kind of a rough patch of time as a family. And I was also switching her pump. I think that's when we went from animus to Medtronic. And, you know, she was relatively young, and she wasn't symptomatic. And I talked to her doctor and like, Can we like, you know, for this hurdle, the pomp and you know, just take a few months to kind of settle back down, and then we'll address it. She said, Sure. So by the time we got around to considering scoping her, she's like, you know what, let's run bloodwork again, and her values are normal. Okay, so we never scope, but I feel like she's been on that trajectory. And I'm an optimistic person. But I'm a realist. And I kind of in the back of my mind, she's just been on that trajectory. And it's coming. And so yeah, I haven't heard from the doctor yet. About the blood results, but they post online thought, Oh, no, here we are again. And I haven't told her.

Scott Benner 1:02:15
Yeah, I would think that's not gonna be fun. I yeah, I've had to tell my kids a number of medical things. And it's heartbreaking leading up to it. And then yeah, and you got to be that cheerleader and help them get through it the whole way. And it takes months for it to like sit in and

Unknown Speaker 1:02:31
yeah.

Kari 1:02:33
Feel, and maybe, you know, grass is greener, I don't know. I have celiac. Like I said, You know, I would rather have type one than celiac. I can handle a needle, I can handle carb counts. And granted, I I'm not living it like she is. So that's probably a very flippant thing to say. But you know, the celiac it's, I'm so ultra sensitive. And she is such a picky eater, such a picky eater. It's going to be super rough if she has to go gluten free. And

Unknown Speaker 1:03:09
I don't know. Well, I have

Scott Benner 1:03:09
I have a number of number of episodes with people who really leaned into it and did a great job with it and would now tell you, it doesn't impact their life in any of the ways that you're scared of. So

Kari 1:03:23
this celiac, yeah, yeah, it's Yeah. I mean, I just, I don't know. I mean, I'm not one of those celiacs that, like, are afraid to eat out or anything, but I am really leery because I'll have them flagged my meal and, and I'll still get sick. And you know, it makes it kind of difficult to work or difficult to leave the house or do you know, it's just, uh, I just hate the unknown. And the, the,

Unknown Speaker 1:03:52
you know,

Scott Benner 1:03:53
no, I can't imagine but I do think I understand what you're saying. Like the idea like, at some point, you might just take a bite of something that throws your days off, like not just a couple of hours, right, but a stretch of time.

Kari 1:04:06
Yeah, I mean, I get I get crazy sick. And I can't even pinpoint where but I know it's gluten because I feel a certain way for gluten exposure. And it doesn't have to be like, a one time early on. I kind of forgot I was cooking hamburgers on the grill for the kids and all their friends. And you know, next thing I know, I had eaten a hamburger on a bun and I'm like, Oh my gosh, what the heck am I doing and I didn't get out. My friends are like, Oh, I was so sick. But I mean, that was a big exposure, but just small stuff. Like, you know, I can tell when it's gluten exposure versus just, you know, flu or a little, you know, too much coffee or you know, whatever. And it's it's unexpected and it's frequent. And it's I just dread with her picky eating and her social life. From her,

Scott Benner 1:05:02
does she see? I mean, she obviously sees you live this way to sit. Does it look burdensome to her? through your eyes?

Kari 1:05:09
Um, it does. But she's super supportive. Like, like, if I make something gluten free, I don't have a gluten free household, I feed them and me separately sometimes. But if I make something gluten free, she wants to try it. She never likes it. But so she's very supportive. She thinks it's unfortunate, but I think she feeds off of my, you know, I'm not one to like, Woe is me, I'm gonna have a pity party. My life sucks. And so I think she realizes it's just another burden in life. And, you know, what doesn't make us makes us stronger, makes us stronger. And, you know, I remind her that I'm healthier for being gluten free, because that's what I need. And, you know, she's okay with it. But yeah, it'd be a whole nother story if

Scott Benner 1:06:06
all of a sudden she's like, Listen, I know, we have a rah rah on you. But for me, boohoo, like, I feel that way. You know, I think I think anybody feels that way when something is kind of, quote unquote, taken from them. But, you know, it sucks to, I mean, that you've got the experience that you're not, you know, you're not having a great time of celiac. So it's not like, you know what I mean, it's not like you've like, oh, I've got it all straight, and it works great. And I never get sick. And I'm sure it happens to everybody. And then she's seen. Yeah, you're right. She's not gonna have a great reaction. I do not. I'm sorry for you that you're gonna have to give her that.

Kari 1:06:46
Yeah. I mean, we'll see. I it was, it was mildly elevated, and just one value, but nice port girl.

Scott Benner 1:06:55
I really do. It sucks. I have to tell you, I really appreciate this. I did not know how this was going to go. But I just want to ask you just a couple of drill down questions at the end. So the people whose dogs like So one more time, like what would people notice in their pets that would make them feel like they have diabetes?

Kari 1:07:15
Um, so pretty similar. I mean, lots of thirst. accidents in the house. Sometimes vomiting, definite weight loss. So all the kind of the same things really. Okay. lethargic. Yeah, same stuff.

Scott Benner 1:07:33
All right. And then they go to you and say, I'm seeing what looks like diabetes, you do a quick test, I guess and then they're on their way.

Kari 1:07:42
Yeah, so for most of these people diabetes isn't on the radar. There's like a it doesn't feel that he's been laying around and then a lot of times they don't mention that they're drinking like crazy. But I have my list of questions for every sick patient, like how, you know water consumption up or down any bombing any, you know, and I check a weight and I almost always No, I mean, there's a distinct difference between, say a cat and kidney failure and a diabetic cat like there's there's just a drastic difference. But similarity they both drink more, right? You know, so I tell them well, I you know, I usually do a full blood panel, we run it in house, we have results in half an hour. Like I'd like to check the kidneys and the blood sugar and there's some other stuff. Let's

Unknown Speaker 1:08:23
see what's going on. And,

Unknown Speaker 1:08:24
you know,

Unknown Speaker 1:08:25
there it is. Cool. Well, I

Scott Benner 1:08:27
really appreciate this. I'm going to say thank you and stop. I have something I'm going to tell you personally that I think your daughter might like this comes to the podcast so I'm not gonna bother the people listening because they already know but I want you to know and you can do whatever you want with it. So thank you very very much for doing this. It was delightful now you're very flexible with time and everything and I appreciate that very much.

Unknown Speaker 1:08:51
Sure. No problem all right.

Scott Benner 1:08:58
Huge thanks to carry carry What am I doing I carry carry carry carry Jesus This is what happens we let me do this late at night. A huge thanks to Carrie for coming on the carry a huge thanks to carry carry carry a huge thanks to carry carry. What a huge thanks. How do you sell? Oh my god, I just talked myself out of saying her name. A huge thanks to khari I don't even know I'm forgetting. I give up. I could go back and listen to her say it again. It might be something to do with a Midwest accent. I can't tell you. But one way or the other. I really appreciate her coming on and it's late at night. So coming in. A huge thank you to one of today's sponsors. Je Vogue glucagon, find out more about chivo hypo pen at G Vogue glucagon.com forward slash juicebox you spell that g v o KEGL Uc ag o n.com. forward slash juicebox. I'd also like to thank the Contour Next One blood glucose meter. I know it's not really a person, I can't thank the meter. But you know, it's the Contour Next One blood glucose meter. That's what you're supposed to know about. But it's made by assenza. So if I was really thanking somebody be like, I'd like to thank assenza then you'd be like, who in the hell is ascencio? Scott, which is why just say, I'd like to thank the Contour Next One blood glucose meter, check out there Second Chance test strips, by the way that the meter itself, it might actually be cheaper to buy in cash than than other meters are through your insurance. That's like another thing you can find out on that website. The website rocks, Contour Next One comm forward slash juice box head over and take a look around. While making the ads for this episode, I learned about myself that if you come on the podcast and say to me, hey, Scott, tell me what you think about people who scam people on Facebook and try to get them to buy t shirts. I could probably rant and rave about it for about 40 minutes. Which I didn't know until just now. I'm assuming you know, you're like Oh, yeah. That's not surprising to me, Scott. But to me, it was surprising. I was like, Oh, I have a lot of feelings about this. Yeah, right. That's pretty much it.

#480 How We Eat: Bernstein

Alex has type 1 diabetes and follows the Bernstein Diet.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends. Welcome to Episode 480 of the Juicebox Podcast.

In today's episode, we're going to be speaking with Alex. Alex is a type one in the way she eats is why she's here. That's right. It's another episode of how we eat. And as you saw on your podcast player just now, today's topic, Dr. Bernstein. In the past, I've spoken with someone who eats a vegan lifestyle. Dr. Paul Saladino is here to tell us about the carnivore diet. We've had plant based people gluten free low carb today is Dr. Bernstein coming up soon keto, and fodmap. And I'm super excited to be telling you, I'll be recording one about intermittent fasting pretty soon. So excited. I'm excited. I love talking about how people eat. It's interesting. 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 insulin.

This episode of The Juicebox Podcast is sponsored by Omni pod Dexcom and touched by type one, you can learn more about touched by type one at touched by type one.org. Or find them on Instagram, or Facebook. They're a wonderful organization doing incredible things for people with type one. I hope you check them out the Omni pod dash boot Did you know about this, let me tell you real quickly, you may be eligible for a free 30 day trial of the Omni pod dash find out at Omni pod.com forward slash juice box. And to get started with the Dexcom g six continuous glucose monitor. Or to find out more about it. All you need to do is go to dexcom.com forward slash juice box. I want to tell you before we start because I don't even know how much of your name you're going to use. But it doesn't it doesn't matter to me. But I want to tell you that every time I see your name, I think if I was going to be like a writer like that wrote like a kind of like exciting almost trashy novels. I would I would want your name,

Unknown Speaker 2:42
but I love it.

Scott Benner 2:44
Don't you think it just is like, now we won't tell anybody your last name and it'll be great. Nobody will wonder. But anyway.

Alex Quinn 2:51
I say my name sounds like a pseudo name for like a trashy novel writer or something to that effect. Yes.

Scott Benner 2:58
Even if, yeah, like writing like, I don't know, like, spy thrillers even or something like that.

Alex Quinn 3:05
Yes. I love that. That makes me happy. Thank you.

Scott Benner 3:08
I would feel very good about that. If that was my name, and I was writing a spy thriller anyway, and that I feel like 40 years from now, Tom Cruise in his 90s would play the main character in the movie.

Alex Quinn 3:22
Alright, I'll get to writing that and I'll let you know when it gets made into a movie.

Scott Benner 3:26
We have plenty of time. He's not aging, so don't worry about it. I heard I heard someone say the other day. This is such a strange way to start this off. But Tom Cruise is the same age. While he's making like Mission Impossible movies that Wilford Brimley was in the movie. Were they all in cocoon? I think or something like that.

Unknown Speaker 3:46
Wow, that crazy? Yes, that's that's quite the juxtaposition of characters.

Scott Benner 3:51
So you're on your balcony. Where do you live? ish?

Unknown Speaker 3:54
I live in Atlanta. Oh, cool. Yeah.

Scott Benner 3:58
Oh, and it's March so it must be at seven degrees there already?

Alex Quinn 4:02
No, it's in the 60s today but the sun is out and it's beautiful.

Scott Benner 4:06
hottest I've ever been in my life. I was in Georgia.

Unknown Speaker 4:09
Really?

Scott Benner 4:10
See I grew up in the desert in southern Arizona and I feel like that is way hotter. Maybe I've never been there. So my appendix almost a burst. Almost a burst. Ooh, English is going to be a problem today by my my appendix. Almost burst the night before I was supposed to go to Arizona for the noun. And I've since then I've been there once but only to fly in like be shuttled to something speak and fly out again. Gotcha. But Georgia was terrible.

Alex Quinn 4:42
What time of year did you come? Oh,

Scott Benner 4:44
it was summertime. My son was playing baseball. at its worst moment. I stood next to a telephone pole and circled it as the sun moves across the sky to stay in the small strip of shadow on

Alex Quinn 4:58
the pole. direct sun in Georgia summers pretty brutal,

Scott Benner 5:03
almost kill me. I'm not gonna, the boy almost died too. But I was worried about myself by that, you know, when you get into self preservation mode and you're like,

Alex Quinn 5:10
yeah, I hear it. You know, I lived in the desert for my like, from 10 to 22. So my youth and then moved to Georgia, and I never once had any sort of like heatstroke or anything like that until I moved to Georgia. The humidity, right? It was Yeah. Well, it was also the hottest day of the year and I was working in an amphitheater outside in like a bowl with indirect sunlight. So, you know, just a radiator just banging sudden heat around on those brutal

Scott Benner 5:46
Okay, anyway, well, now that we're five minutes into this, can you tell me your name, please?

Alex Quinn 5:51
Okay, my name is Alex. It's short for Alexandra. Alex Quinn is usually what I go by.

Scott Benner 6:01
And if you were an author, you would definitely go like that for certain totally, totally. Yes. I just don't know why it just every time like your name is Monica. We had to reschedule once, right. So it as it stuff bumps around in my inbox. I'm like, that's a great name for a book author. I love it anyway. Okay, so you're on? I'll tell you why. Well, not that you don't know. But um, basically, I don't know if this is a secret to people, Alex, I'm not really telling you. I'm telling the people listening. But I've been doing the how we eat series through the podcast, and people have been coming on talking about the different ways that they eat. And you were recommended to me by someone else. And when you emailed me to tell me how you eat, you said, you use the words Dr. Bernstein. I was like, Oh, that's interesting, because you're the first person who's ever come out and said, I like those words. Like some people say I'm low carb or stuff like that. But I was like, Sure, I would love this. So well. Yeah.

Alex Quinn 6:58
Thank you. Thank you. Yeah, I'm excited to be here. Oh,

Scott Benner 7:01
well, that's odd. But thank you. I appreciate that letter.

Unknown Speaker 7:03
Why is that odd?

Scott Benner 7:05
Well, I mean, it's just me. I'm in a room. You don't I mean, like somebody was telling me the other day, like, they saw like somebody prepping to be on the show. And they were nervous. And I thought, well, that's so strange. Because I'm in Costco right now. And if you were, if there was anything to be nervous about talking to me, I wouldn't have to be in Costco. Like, that's how it occurred to me.

Alex Quinn 7:29
Right? I think I think it's because this carries the potential for it to be more in a public eye. And it's not just you and me. shooting on my back porch. Yeah, sorry. I suppose I shouldn't say shooting the breeze. There we go. Okay.

Scott Benner 7:46
Don't worry, I'll just cut it out. I'll be like, Okay, cool. I'll be like shooting, and it'll get really boring from it. Alright, I used to do beeps, and then I realized, why am I bothering with that it was extra time. And it was bored by it. So anyway, I, I'm happy about this. And yeah, the more of these I record, the happier I get about them, because I think that I think that as people we are very inclined to get into groups. Yes. Get on a team, where color that kind of stuff. Right? Okay. And then I think you bring in this sort of extra added layer of people feeling like they're saving your life when they're telling you something, right? They've been through a thing, and they don't, you don't have to go through it. And this is the thing that saved me. And, and then there's somebody on the other side, just like you're trying to take a thing from me or I have a different idea about how to write a view. And then it just becomes tribal. And it's very interesting.

Alex Quinn 8:46
Sure. And the the potential for like, dogma is enormous. And I I don't ascribe to that. I don't feel like that really helps anybody find their own way to living with type one and what it looks like for them.

Scott Benner 9:04
Yeah, no, I completely agree. And I'm, I'm so I'm excited that you're that you're here to talk about. So first, let's start slow with how old were you when you were diagnosed?

Alex Quinn 9:13
So I was three years old. That was in 1992. Wow.

Unknown Speaker 9:20
I'm sorry. I'm remembering when I graduated from high school and feeling badly about myself, but good.

Alex Quinn 9:26
It's all good. Don't worry. My my partner is 12 years older than me. So we have conversations like that a lot. Yeah,

Scott Benner 9:31
no, can you just I mean, you just threw out a number. You were three years old, like three years after I graduated from high school. And I was like, Oh,

Alex Quinn 9:39
well, hopefully I don't make you feel old during this conversation. Other than that,

Scott Benner 9:42
no, I don't worry about that. If you do, I that might be more on me than you. So. So you're three you're diagnosed. I mean, 30 ish years ago, right? Okay.

Alex Quinn 9:52
It'll be 29 years this year.

Scott Benner 9:55
And your parents are obviously on board taking care of you. But you're In God 30 years ago was like regular and mph days, right?

Alex Quinn 10:04
Yeah. The analogs hadn't become available yet. So yes, I was on regular an MPH. But um, I'll tell you this. So my mother's two older brothers. Both have type one. Okay. And it wasn't, it wasn't unfamiliar to my family. And so my mom was actually the one who caught it first, because she grew up with brothers who had it. So she recognized, you know, the symptoms and took me to the doctor and, you know, made sure that they got the testing done that needed to be.

Scott Benner 10:41
Well, it makes sense that she saw it, she doesn't have Does your mom have any autoimmune stuff?

Alex Quinn 10:46
As far as we know, she does not, but she has had several rounds of skin cancer and breast cancer. So I don't, I don't think she got the autoimmune stuff. But pretty much every woman in my family on both sides has either an autoimmune disorder or cancer or both. So I find your neck a lot was doomed.

Scott Benner 11:16
I was just gonna, well, I was just gonna say it's incredibly interesting how people who live with chronic illness see the the roll of the dice of life, you were just like, Yeah, she didn't get diabetes, but she got something else. We're all screwed over here. It is. Pretty much. Yeah, no, it's, um, it's a telling statement. Because there's no other world where I would say to somebody, like, Hey, does your you know, you have a car? Does your mom have a car? And you were like, No, she doesn't have a car. But she does have an airplane. And it's, you would never say that. Right? Right. Right. But it feels very connected. And it's, um, and I don't know that. I don't feel the same way honestly. Feels like he got bit by some sort of a bug that other people don't get bit by or something like that.

Alex Quinn 11:59
For sure. Yeah, definitely. You know, I've actually, I've thought about that a lot over my life. Just because, you know, I have family members with it. And one of my uncle's died from type one complications. And I really feel like, and this is going to get a bit meta here. But like, my role here is to change the story. And really take my life with type one and do something with it. You know, like, I'm here to live well, and to, you know, take that story and turn it around, and, and prove that I don't have to die from complications or be like, riddled with them. You know, I can live a good life and still have the right one.

Scott Benner 12:46
Yeah, without giving away too much of somebody else's details. Do your uncle's not have a good go of it.

Alex Quinn 12:52
So they were diagnosed in the 60s. And blood sugar monitoring was, you know, the urine dipsticks back then. So they didn't have the tools to manage blood sugars when they were young, the way that we do now. So Well, I didn't imagine because to be honest, you were born in a time where it still wasn't terrific, either. Yeah. Yeah. Yeah, totally. I mean, I know that I had it a little better than they did just because we had blood glucose monitors. By the time I was diagnosed, but I think that they didn't. My uncles and I were still on the same types of insulin. You know, 30 years later.

Scott Benner 13:40
Yeah, yeah. Well, such a leap now.

Unknown Speaker 13:43
Sure, yeah.

Scott Benner 13:44
Just It's a crazy difference. I'm going to revisit that idea while we're talking at some point, but so your mom is just I can't, by the way, I'm trying to imagine using that regular and mph and just like thinking like this babies on the schedule has to eat at certain times. Yeah. And because what are you gonna do? You're three, you're gonna be like, Hey, I feel dizzy,

Alex Quinn 14:05
you know? Right. Right. And I can clearly remember as a child, you know, having these like horrible low blood sugar episodes in the middle of the night where I just wake up, just totally disoriented, like vomiting and just, you know, out of my mind, and my parents would have to, like, force me to drink orange juice, or whatever they could get me into me at the time. And to this day, I still can't do oranges. Like, being forced to drink orange juice. Well, in that state as a child so many times I can't eat them. No,

Scott Benner 14:41
I understand. I really do. I had a piece of chicken from a certain place right before my appendix when I can't believe that came up twice. And I still can't like stomach the smell of the chicken even though it had literally nothing to do with my appendix.

Alex Quinn 14:56
Sure, but man, those associations get deep down in your psyche.

Scott Benner 14:59
They don't go away. Okay. Okay, so you, it's a tough go. Do you? Do you have context for your health outcomes? How did you measure them back then? Or did people are just being alive and not dizzy? constituted when?

Alex Quinn 15:16
I think, you know, as a toddler, it was basically like, Are you alive? And are you happy overall? You know, we're cool with that. But I, I don't have too much data on like specifics of blood sugars and eight, one C from when I was a child. I'm sure I could go back and dig it up. But I don't really, I don't really have that information. But my parents have told me that, you know, my a one sees when I was a kid were mostly like in the eight to 10 range. It got up to as high as 14 when I was a stubborn teenager who couldn't be bothered to take care of myself. But I've slowly and steadily improved things since then.

Scott Benner 16:04
Isn't it interesting, too, that no matter where you start, the idea of ignoring it just seems to exponentially make it grow. Like Like, there's like, I mean, what are you really ignoring as a team shooting twice a day? and eating certain times? That was it. Right?

Alex Quinn 16:23
Um, when I was a teenager, homologue had come out. And I was on Lantus as well. So I don't, it wasn't just, you know, twice a day injections and a rigid eating schedule by that time. So I think I was like, maybe five or six when the analogs became available, and they put me on those as soon as they could. Oh, good. Okay.

Scott Benner 16:45
And so you just can you describe a little bit about what it means to just ignore it when you're a teenager?

Alex Quinn 16:52
Sure. Um, so I think for me, I just deeply rejected the notion that I had to do this. And it was just, it was painful for me, because I didn't want to deal with it. And I didn't want to be, you know, the freak with needles, because that's how my peers viewed me when I was a child and I got bullied a lot for my diabetes, had a lot of like, really not pleasant experiences with my peers about my being the only person in the entire school who has type one. So by the time I got to be a teenager, I was like, EFF this, I do not want to deal with it. I'm weird enough as it is without this in my life. So, you know, I just don't care. I don't want to you can't make me and I was, I'm a stubborn person. And when I was a teenager, I was even more stubborn. And you know, you couldn't get me to do something I didn't want to do. So, at that point, my parents were kind of like, Okay, well, if you don't take your insulin, you're gonna end up in the hospital, in decay. So let's put you on the pump to at least make sure that you get something in you. So I think when I was 14, they put me on an insulin pump. And I am convinced that that insulin pump kept me out of the hospital from like 14 to 21. You know, I would not have taken care of myself at that point.

Scott Benner 18:33
I'm really interested that you said it that way. Because I've gotten the feeling over the years talking to adults who have had type one for a long time. That that is what an insulin pump was considered. In the beginning, it was like, Alright, this is for people who are just not going to take care of this. So we'll get them at least their basil in through the pump, and maybe once in a while for lucky, they'll push some buttons with me. Mm hmm. Right.

Alex Quinn 18:56
Yeah, totally. That was that was exactly how it was for me. And I think part of my rejection of everything was because of my family history with type one. My mom's brother died when he was 37. And I was seven. And he died of type one complications. And my family kind of used that as the example of what not to do. And they were like, you know, finger wagging. Take care of yourself, or you're gonna end up like your uncle. So in my little seven year old brain, I was like, Oh, I'm gonna die like my uncle. So why does it matter? And by the time I hit teenage years, I was like, I can't even care. You know, if that's what my adult life is gonna look like, why should I even bother you a third

Scott Benner 19:48
of the way to death already? 14, right.

Unknown Speaker 19:51
Yeah,

Scott Benner 19:52
I'm almost there. And I'm doing it. Like you're getting up in the morning and nobody's staring at you and nobody's making fun of you. If you're not showing them your needles and everything is right. There was somebody on once I wish I could remember their name, who told me that they had a person bullying them about their diabetes, who would just say to them die? diabetes?

Unknown Speaker 20:09
Oh, yeah.

Scott Benner 20:10
That was like, wow, how? I mean, try harder at the very least. But you know, yeah. But you mentioned being I mean, I almost say, Can you imagine being a kid? Like, yes, Scott, I

Alex Quinn 20:24
can. I can. Yeah, for sure. I mean, I can't remember. Like, I went to Pizza Hut one time with my soccer team when I was 10. And I went to the bathroom to go test my blood sugar and take a shot. And I'm standing at the counter in the bathroom, and drawing up my insulin. And one of my teammates walked in and saw me with a needle and just started hysterically screaming. And her mother came in, and she was like, Why are you screaming? She sees me with a needle, and then she starts freaking out about me in the bathroom with a needle. And I got so upset that I just, like stormed out of the bathroom. And I went, and I got my mom. And I was like, Mom, I need you to deal with this. And my mom had to come in and be like, What is wrong with two of you? You know, like, she's 10? Yeah, well, you know,

Scott Benner 21:22
20 years later, you would have just looked at them and said, Hey, Karen's calm down. Right? Right. Diabetes, just chill out a second. I'd like to know, I just tried to do my business here.

Unknown Speaker 21:33
Sure. Yeah. No, actually, sorry. Go ahead. I

Scott Benner 21:36
just was gonna say it bothers me when I hear that people used to get driven into bathrooms to give themselves insulin,

Alex Quinn 21:41
right? Well, I you know, and that bothers me too. Because I've gotten to the point in my life where I just don't care, I have to do this. And if it makes somebody else uncomfortable, they can just not watch I'm gonna do it whenever and wherever I have to, because other people's pancreas is are doing it whenever and wherever they have to. So you know, my pancreas just lives in a bag that I carry around? Well, the truth is,

Scott Benner 22:07
you have to care more about your health than you do about what other people think. It just exactly just ends up being very important. You can't, you can't just you can't, I mean, imagine, it's so hard for me, because I don't have a personality like that, where my wife and I were talking the other day about. She got a she's looking for cars a couple years ago, and I really thought she was going to buy a jeep. And yesterday, I said to her, I was really, I'm not sure how we got back on the topic. Maybe it's, you know, I'm not certain. And I said, I was really surprised when you didn't buy a jeep. And she said, Yeah, I did want one but and she started talking about the experience she was having with the salesperson, and how it kind of led her out of the place. And I can't make sense of that. Like, if if I had a, I can't explain to you there, there'd be no situation where a salesperson could do or say or create a scenario where I would leave and then go buy a car that I didn't want, because that was so bad. But my wife's like, in part that happened. You know, she's like I was, it was early in the process. And I didn't I wasn't invested enough to push through this scenario. And I thought, Oh, my God, like, that would never happen to me. But But I recognize that it's, it's a it's a reality for a lot of people that you just, I mean, and so that's why I try to say on here, the that idea that I think your health just has to be more important to you than what other people think you just can't. Yeah.

Alex Quinn 23:38
100%. And, you know, I think that i think that that ties in a lot to the pressure against eating low carb and following Bernstein because there's, there is, like, almost vitriol against it in some circles. And, you know, you have to be steadfast in your convictions that, you know, this is a choice that I made for myself, and I'm not doing it for anyone else. And I really don't care what you think. Yeah.

Scott Benner 24:11
I I'm in a unique situation where I feel like I understand both sides of this, like, fight that you see happen online sometimes. And, and I don't know that there's, I don't really think there's a fight. I think there's these Anyway, we'll get to it as we're talking. I think it's interesting how it works, but and I agree with you, you know, and Listen, I've had enough adults on who eat low carb, then I there's a commonality through your stories usually, which Yeah, you know what I mean? And it is, I've noticed that too. Yeah, it's it's Look, I was diagnosed at a time where I didn't have a sensor that could tell me that for carbs, maybe go from 86 to 104. And you know, and I, we sometimes were using insulin that was inexact. Nobody ever told me to, you know, you don't Pre-Bolus you know, regular and mph. So that's not how I grew up and then you get not stuck even but you're just indoctrinated into this is how diabetes is handled, and then people bring you a newer insulin. And that's frightening to see, you're like, you got it younger, you got him a lot younger. But I watched a buddy, I watched that a friend of mine happened to he had to go through regular and mph to, you know, humor blog novolog. And that stuff might as well have been rocket fuel that they were putting in him.

Alex Quinn 25:34
Sure. And they are they are not the same, or not the same, like completely different action profile, completely different effect completely different timeframe. Like, it's, it's, yeah,

Scott Benner 25:48
I think there's nothing the same about using that older insulin and the newer insulin?

Alex Quinn 25:52
No, not at all. And you know, I'll I'll say this. Yeah, to that point, when I first started following Dr. Bernstein, I had to, like, take everything I thought I knew about diabetes management and kind of put it in a box over there for a second, and then focus solely on learning an entirely new way of doing things. And it was really challenging for me, because I had at that time, you know, 23 years under my belt.

Scott Benner 26:37
I'm going to start today with the Omni pod and tell you that you may be eligible for a free 30 day trial of the Omni pod dash, this is an exceptional possibility for you. And I hope you check it out. Omni pod comm forward slash juice box, get there and see if you're eligible. Now, what are we talking about here? a 30 day trial, this is a usable thing, like they're gonna send you the dash enough for you to I mean, you get it right for 30 days, it's pretty crazy. On the pod does other stuff. Like if you don't want to try the dash for 30 days for free, or you're not eligible, you can ask them for a free, no obligation demo pod will they'll just send you out one pod, but it's nonfunctioning, and I know you're like, well, what am I gonna do with that? Well, what you're gonna do with it is where, and you get a real good vibe for it. Like, this is what it feels like to have on you know, you'll notice, I mean, at least for me, when I've worn it in the past, that you just stopped noticing it. And this, this demo pod is really great for that. I think they call it a pod experience kit. So you can you know, alright, look, that's a lot, right? There's two things, but Omni pod.com forward slash juicebox, you may be eligible for a free 30 day trial of the Omni pod dash, or at the very least, everyone can get a demo pod. I feel like I can hear you and you're like Scott, why would I do that? couple of reasons. You're on MDI and you're looking for a pump. This is a great way to try. You have a pump that has a tube on it. And every day of your life You think I don't want this to pump. There's so much tubing, why is there tubing going through my underwear, maybe that's your heart. This would be another good reason why the Omni pod is tubeless. It doesn't have to point to bling. That's not a word tubing. It's worth looking into on the pod.com forward slash juice box. My daughter Arden has been wearing it on the pod since she was four years old. She's about to turn 17 she's worn one every day. It's been a real friend in this. And I think maybe it could be for you as well. Now another thing I don't know what I would do without is the Dexcom g six continuous glucose monitor being able to see Arden's blood sugar, the number like what it is the direction and the speed, it's moving, it's moving all in real time is crazy bananas. Now I know that Arden's blood sugar right now is 127. She's having some popcorn, and we might have missed on the Pre-Bolus a little bit. But it's kind of Alright, because we'll watch this, see what's up, make an adjustment if necessary, and have a lot of comfort doing it because again, I can see the speed direction and number of her blood sugar all the time. I can see it on my iPhone. If I had an Android phone, I'd be able to see it on my Android phone. Arden can see it by the way on her phone as well. And if we wanted up to 10 people could be watching Arden's blood sugar. I mean, I don't even know 10 people, but if I did, and I wanted them to see my daughter's blood sugar, we could do that with the Dexcom. You may be thinking about people who you'd like to be able to see your child's blood sugar or perhaps your own. And you're thinking Oh, Scott, I see what you're getting. That is a good idea. And you're right it is. Now what do you do? You go to dexcom.com forward slash juicebox and while you're out there on the internet, check out touched by type one.org. There are links to these sponsors and all the sponsors at Juicebox Podcast comm or right there in the show notes of your podcast player. Have you ever really looked around on that podcast player? Which by the way, if you're listening to one, please subscriber, follow the show.

so dramatic. Okay, let's get back to Alex.

Alex Quinn 30:34
How do you take 23 years of thinking that this is how I do this, and put it aside for a second to learn something new, it just, it's like learning a new language. That's in it. I did it. But it was hard. People should,

Scott Benner 30:50
people might find commonality in this idea. There are people who go from MDI, to a pump, right? And the common, the commonality, there's people will tell you, hey, that's it's like learning diabetes all over again, like you'll, you'll feel like you have it all worked out. And by the way, who all worked out usually just means there's a pace and a balance to your life that you're accustomed to. Not that not that you're walking around with a five to a once that you've got it all worked out. Because I would imagine someone with a five to whose MD is like, I don't need a pump. And that would make sense to me. Right? So you move from that. That would be me. Yeah. So you'd move from MDI, to a pump? And it's like learning it all over again.

Unknown Speaker 31:30
It is Yeah, sure.

Scott Benner 31:31
So the same would be from going from, you know, humalog. And, you know, some needles to I'm going to remove, like most of the carbohydrate impact out of my life. It's like starting over again.

Unknown Speaker 31:44
Yeah, it was for sure.

Unknown Speaker 31:45
How long did it take you to figure it out?

Alex Quinn 31:47
Oh, man. So okay, for context. When I started Bernstein, it was out of sheer desperation, because I had been diagnosed with retinopathy. And I was 25 at the time, and it scared the daylights out of me. He and I had, I didn't know it at the time, I got this diagnosis later, but it also had gastroparesis and neuropathy. So in my mid 20s, you know, showing long term complications, and I was like, I have to do anything and everything I possibly can to make this not happen, because I know where this leads. And so my, my health was not great. So adjusting to a whole new diet and asking my metabolism to do something that it had never done before. And learning how to manage my insulin around that was enormously challenging. So I think I took about six months to just lean myself down slowly off of carbs, because I tried to do it cold turkey, and it made me like violently ill to the point where I thought I needed to go to the hospital. So I backtracked. And I was like, Oh, okay. Oh, no, no, don't do that.

Scott Benner 33:17
Have a Do you have a CGM now? And did you have one then?

Alex Quinn 33:20
Um, I don't have one. Now. I didn't have one when I started, but I got one shortly thereafter. Okay. And I'll, I'll explain my stance on CGM. I'm allergic to medical adhesives. So I had one I used it. I took all the data I could possibly glean from all of that for as long as I could stand to wear it. And then I got to the point where I was like, I'm covered in rashes that never heal, and they drive me insane. And I just can't do this anymore. So I got rid of it.

Scott Benner 34:00
Yeah, I have to say about that, that it really is unfair, that seriously autoimmune issues that that end you up with a disease that could really be greatly benefited by something that has adhesive on it. And you might also have an adhesive allergy because of autoimmune issues is like right, double suck. You know, it's just like, Wow, thanks.

Alex Quinn 34:24
Trust me. If I wasn't allergic to medical adhesives, I probably have built my own DIY closed loop rig by now and just be like killing it, but I can't wear them. I could not figure out a way to not have an allergic reaction to so I got rid of

Scott Benner 34:42
I understand how did you try all the barrier creams and stuff like that?

Alex Quinn 34:45
Everything. Everything I could possibly find. I joined groups on Facebook specifically for people who have allergic reactions to these products. like yeah, it's Yeah, I tried everything. I could I just it wasn't worth it, you know,

Scott Benner 35:03
feels like walking through a desert and finding a well full assault water. You're just

Unknown Speaker 35:08
yeah,

Alex Quinn 35:10
you know, so no, because Okay, here's my thing like I, I think CGM are amazing technology. But I didn't grow up with one. And I don't need it.

Scott Benner 35:22
Now you figured something else out?

Alex Quinn 35:24
Right? And I understand why other people feel like they absolutely need it. But I don't, I don't have that push for myself. You know, I think that the data is really interesting. And I find a lot of value in being able to see the trend lines and the graphs and you know, adjust like that. But I can do that, with my glucose meter, poking my finger, and I don't care about finger sticks. They don't bother me. I've been doing it since I was three. So

Scott Benner 35:56
well, I would imagine also with the small amount of carbs that you're taking in that the variability is much less and so you're using insulin to stop the spikes. And you and of course, I say all the time that the lessons when you use, the less chance you're going to have have a low later. So for sure, yeah, you're in that in that space?

Alex Quinn 36:16
I am definitely. And I honestly, I think that's, that, to me, the stability that you just described is the number one thing that keeps me doing what I do. Because

Scott Benner 36:29
Yeah, I would say that I'm sorry, one second, I'm going to tell you that our connection is just a little bumpy, or I'm stepping on you and I apologize, but I'll finish and let you get right back to it. I think if Arden my daughter ate low carb, like a real low carb diet, I think I can pretty comfortably put her a one C in the mid fours. I don't think yeah, it would be hard, honestly.

Alex Quinn 36:51
Yeah. Um, I have some long term complications that make that tight control a little more challenging for me. Like the the gastro precice really affects my digestion. So, you know, there are some days where everything works great. And then the next day, you know, I wake up with food that I ate 12 hours ago still sitting in my stomach, and it doesn't I can't do anything about it, except kind of do damage control. So I would love to be able to achieve that. But I've had I have accepted that. You know where I'm at right now is still really really good.

Scott Benner 37:34
Yeah. My my point wasn't that what you're doing isn't good. My point was that I know what my daughter eats a whatever she wants. Okay, so she doesn't have like a like a limit on what kind of food she's taking in. And I have her a once he really settled in the mid fives. And that's cool. Yeah. And like Saturday, she you know, got up and last minute said to me, can you go to the corner to the bagel place and get me a blueberry crunch bagel. Have them toasted put butter on it. And I was like, and she was on her way to a lesson she's taking. She's taking sewing lessons. I don't know if I should say that here if she'd be anyway, she's taking. And so I roll out. I grabbed the you know, as I leave I think her blood sugar's about 94. Yeah, I said, Okay, I'm gonna go I'll be back in like 20 minutes, just Bolus 10 carbs right now. So she puts it in a little Bolus, get some insulin working as I'm driving back and fairly comfortable, I won't be killed in a car accident. I text her again. And I say you know, Bolus this much now. And, and we stayed on top of that bagel for the first. I don't think it came back to try to bite us again for maybe about three hours. And then you use the CGM data to say to myself, okay, here comes the second round of this bagel. And then right, you hit it again, and it stops it from spiking again. So like, given that, that, you know, a five and a half is amazing. But if you took away all those carbs and how I understand how to use insulin, I just think that it would, I don't think I don't think I'd have trouble with I think it would kind of be it might be easy, honestly. So yeah,

Alex Quinn 39:12
for sure. It really takes a lot of the cognitive processes out of things. Like I don't, I don't have to pay attention like that. And I do just because I want to I like keeping on top of things and being proactive about stuff. But you know, I I Bolus right before I eat a check again an hour later, and I'm usually like, pretty dead on right where I was before I ate something. Yeah. And I really appreciate that stability in my life because it allows me to do other things. And that's what's most important. There's no

Scott Benner 39:57
calm to it, I would imagine.

Alex Quinn 39:59
Oh man So I was, I was starting to tell you a story earlier. But um, so when I had been following Dr. Bernstein, or a couple months and had really like, hit my stride with it and started understanding what the hell I was doing. I was at work one day, and I tested my blood sugar. And it was in the 90s. And I stopped, and I thought about it. And I realized that my blood sugar had been in the 90s, consistently for over a week. And that was the first time in my entire life that I had ever felt that and I just cried. I'm getting teary eyed now thinking about it, because it's still such a profound moment for me, you know? Like, I had never, ever experienced that kind of internal stability before. Yeah. And it just, it was like, somebody hit me over the head, and I just started crying happy tears, and like, my boss came over. And she's like, are you okay? And I was like, No, no, it's

Unknown Speaker 41:03
a good thing. It's a good thing.

Unknown Speaker 41:05
I'm healthy.

Alex Quinn 41:07
But I 26 for the first time in my life. Yeah. Wait, that. I like there are no words to describe how profound that was for me. And I'm doing my best right now.

Scott Benner 41:21
I can't imagine Honestly, it seems like it would have been, it would have been like a moment where you saw the sun for the first time, right? Just Just a man.

Alex Quinn 41:30
Yeah, it was it was so profound. And having experienced that, I was like, oh, man, I'm I cannot go back to how my life was before. I can't.

Scott Benner 41:41
So we don't really. So I have some theories about the world. I think that media, social Li, the social kind, is incredibly valuable. Because without social media, no one would ever hear your story, I wouldn't be able to talk about the things I talked about. And at the same time, it opens up avenues for people to I always think it's be scared, and then react to the fear. Like that's how, how it seems to me you hear something that's uncommon or different to you. And your brain immediately goes for Oh, well, what about this? Or this? You know, like, yeah, it's just, it's, I mean, it's how my brain works. I work backwards from now. Like, my kids could come to me and say, Hey, Dad, we have a foolproof plan to make $100 today, and I would go, No. And then I would ask, and then I would ask questions, and to see if they could get me off of now. Sure, some people are, you know, not like that. But I think that in social media, you get you get shown things that are so far from how you think that it can be shocking. And when I when I see it, I'm always like, Oh, that's interesting. Like somebody does something like this. But that's not that's not common for everybody.

Alex Quinn 42:57
No, it isn't. And I think that knee jerk reaction really prevents people from accessing things that could actually help them.

Scott Benner 43:07
Yeah. And it's interesting to watch the things that you'll be able to believe and the things you'll be able to display, like, like, I'm going to just tell you right now, like, I don't think my daughter would ever eat low carb, okay. And that's neither here nor there for this conversation for us. Because what I see people do is a number of different things. And you've probably seen them all too. I eat low carb and my blood sugar's super stable. I've been I was in the 90s, once for two weeks, eating just protein is not healthy. I'm assuming you've heard that. Right. And then you think, Well, how do you know? Like, so. So you heard eating just proteins not healthy, that you believe I tell you, I'm eating just protein? And look how well I'm doing that you disbelieve? That's got nothing to do with protein and the health of protein? It's no,

Alex Quinn 43:55
that's just cognitive dissonance rearing its ugly head. Yeah.

Scott Benner 43:58
It's very interesting. Like, I'm going to disagree with this now, because it's different than mine. And to go deeper, not to make everybody think too deeply about themselves, because that can be painful sometimes. But I think what it really says is, oh, gosh, what if I'm doing it wrong? Oh, yeah. hurting myself? Or what if I'm doing it wrong and hurting my kid? Yep. And then you don't want to feel that way. So then you have to fight the other person, because this is the thing you're doing. Now. I'm not saying it. I'm not saying eating carbs is hurting anybody. I obviously don't feel that way. Because, you know, my daughter is doing it

Alex Quinn 44:38
right now. But I understand what you're saying. Because people want to feel like they're doing the best thing they can for themselves or their children. And when presented with information that might possibly contradict that idea. It can be painful that they have to admit that hey, maybe I could be doing better, even though I thought I was so

Scott Benner 45:00
Because there's no time machine. And yeah, and you're and you're running towards listening, we are all running towards our death. Okay? I don't mean to be too like deep here. But if if you have been making decisions for the past 10 years that have been running you faster To that end, and suddenly you're you realize, Oh gosh, this is wrong. Do you put your head down and run faster? Because you don't want to feel badly about what happened? Or do you look up and stop and go, okay, maybe I should be doing something differently. And again, I'm not making that this or that discerning comment about low carb and not low carb. I'm just telling to tell you why people react the way they do.

Alex Quinn 45:36
Sure, sure. And, you know, I run into that enough times that I recognize that pattern. And, you know, everybody deals with new information differently.

Scott Benner 45:48
Yep. And I'll say this, too. Because of the internet again, the internet draws in lost, lost people and new people in health space all the time, right? I either I need an answer, maybe these people will have it. Or, you know, I'm brand new with this. I don't know what I'm talking about. Let me see if I can go find out. So when you keep bringing in the new people over and over again, they keep having the same reactions, because they're at the same space in their progress. Right. That's why it seems like people are always arguing about the same things, not because the world is overwhelmed with people who are carb versus no carb or republican versus Democrat. But because these people are constantly brought together for the first time around this. I mean, you're in your 30s I'm almost 50. It's comical, around political season to hear people talk about politics as if it is a brand new thing that just heard for the first time, right? Yeah, or really anything really, like, you know, racism, you're like, oh, my god, there's racism. I've known I've been alive longer than you have. I've been in this space longer. But when people first find out about it, it's so shocking. And by the way, in some worlds, it's the lighting to see how motivated they are. To do something, it's amazing. It's as an older person, you look back and go look young people some energy, thank god get in there and scream about racism. We need Yeah. Like, yeah,

Alex Quinn 47:22
totally. You know, I I have that same mindset when people start talking about we need a cure. I'm like, Alright, get it. Yeah, I don't care.

Scott Benner 47:30
No, you're right. We definitely need one. And if you get it call me, but yeah, yeah,

Unknown Speaker 47:35
I've already been

Alex Quinn 47:36
in the meantime, I, I've been there. I've done that. I've gotten over it. And I have better things to consider myself.

Scott Benner 47:42
I, I've already been at this part. And now and now you're at that part and great. But the problem is, is that when people look inward, they'll say things like, well, we're as divided as we've ever been. mean? Or I'm sorry. I've misspoken. I think we're as divided as we've ever been. People are like this is as divided as we've ever been. And I don't think that's true. I think that it's all been the same forever. There's more people.

Alex Quinn 48:09
I think that it's more that we're now aware of all of the opinions as opposed to, you know, existing inside of an echo chamber. Exactly. And the internet, the internet really brings all of the opinions together. Yes. And that's why you get so much infighting and argument. And it's like, Look, we all have our own experience, and have drawn our own conclusions from it. And all of us are operating from a place where we think we are right,

Scott Benner 48:37
your friend circle is built of people who you either feel superior to, or agree with. sorry to tell you.

Unknown Speaker 48:47
No,

Scott Benner 48:49
like, well, you ever noticed some people just like to feel like they're in charge of the friend circle? Yes. And so they put themselves with people, they feel like that's reasonable for them to do. And but my bigger point not to get I don't want to go down a different rabbit hole. But But the idea, yeah, you bring you you surround yourself with people who agree with you. And so when you hear of an outside influence, everybody poopoo it and suddenly you don't hear about the outside influences any longer because you're so surrounded with people who agree. And then the internet to your point makes it impossible to avoid other people's opinions. Sure. And then we say stupid things like oh my god, we're as divided as we've ever been. We just have more cons. It's the world's not a more dangerous place. It's not a more racist place. It's not a more anything place. It's, you're just aware of it now, in 1949, if there was a tornado in Kansas, you did not know about it if you lived in New York, right? That kind of stuff. So, so so back to car versus no car. I think what can happen already, we'll play like, we'll take sides. Okay. And then we'll, we'll have a little conversation. You'll be the low car person because you're doing an RD. My kids just diagnosed, I feel like normalcy has been taken from them. You have been saved by eating a low carb lifestyle. Someone that comes from your perspective swoops in sees this newly diagnosed person and thinks I can save them all the pain that I went through. Mm hmm. Right. And then you come in you say, Dr. Bernstein, and other words that you know, mean low carb, and some and their their feeling is either Oh my god, I'm so scared by this. I'm gonna go try that. Or you can't take my kids normalcy from me and cupcakes at their birthday.

Alex Quinn 50:40
Right? Right, right? Yes, I would agree with that. And I'm actually pretty active in a newly diagnosed parents of type one kids group. For that reason, but not because I want to prove that I'm right. But just because there's so much knowledge of managing diabetes that you have to wrap your head around. And the learning curve is extremely steep. And, you know, a lot of people have never even been exposed to type one until their kid is diagnosed. And then they're just confused. And they have no idea what the EFF they're doing. And so, I come along, after almost 30 years, and I'm like, hey, you're going to be okay. And here's what I've learned about how to live with this stuff. And I'm not there to prove that I'm right. But I think that mentors are extremely important with this kind of thing. Yeah. And, you know, I had him growing up. My mom's two older brothers were type one. So I had a family member, I could call if I wanted to, to just be like, this is happening. And, you know, I think we need that. But I think you're right to like, the Don't take my kids last sense of normalcy away from them is is a really powerful driving force,

Scott Benner 52:06
right? And then they'll hear all kinds of different things. If you if you came to me and said that privately, like, forget the internet, if you came to me and said, Oh, my God, normalcy it's gone, Bob, I'd say, hey, look, I think that there's a way for you to eat a cupcake. And for it not to make your blood sugar crazy and lead to a bunch of long term issues here. And and if you start laying those things out, like you said, they're overwhelming. So yes, I, if you understand the, the, the place I came from, because we have a pretty firm understanding of where you came from. So the place I came from was, I had a kid with diabetes, no real attachment to it. Nobody told me how to do it. I started a blog where I was talking about it. And so I was watching it happen and seeing what I needed to happen differently, that I figured out how to make it happen differently. And then I thought, okay, here it is, excuse me, once I get the spring. Here, here's this stuff, read it if you want, I don't care. Doesn't matter to me. It's here if you want it. And then I watched it help people. I thought, Okay, why is it not helping people faster? Well, it's not as digestible as it needs to be, I can break this down farther and farther and farther into simple to understand concepts. And I feel like I've basically done that by now. And so then you go to audio. And it turns out, it's way easier to listen to this kind of stuff than it is to read about it, my and, and so now you see it helps one people, it helps 10 people have 100. And then once you get to the 10,000, and the 20,000, and you start having millions of people listening, then you go, Okay, this really power this works, right, like so keep it simple, like keep the ideas simple. And now now I'm completely comfortable telling you that I could see somebody get diagnosed, be lost, and inside of those same handful of months that you're talking to just understand it, and they can use the insight. So if that's what they want, I'm cool with that, if they want to use those same tools to eat low carb or vegetarian or just fish eyeballs, or I don't give people I so don't care. It's it's hard for you to wrap but might be hard for you to wrap your head around. I genuinely don't care what people do.

Unknown Speaker 54:21
I don't either,

Scott Benner 54:22
right. I just want them to be healthy as they can be and as happy as you can be. Whatever.

Unknown Speaker 54:26
Yes. Same.

Unknown Speaker 54:27
Yes.

Alex Quinn 54:28
So you know, you mentioned tools. And honestly, to me, that is the most important thing that I got from reading Dr. Bernstein's book, and, you know, listening to his teleseminars and YouTube videos and stuff. It wasn't the, you know, the regimen to do this. Do that. It was here are the tools to understand how to make these things work for you. Yeah. You know how you manipulate the insulin dosing to match what you're going to eat or your activity level and how to do Basal testing and cover meals. Like, those were essential skills that I didn't learn in that way. Until I was like 26. Yeah. And I think those are, those are more important to me than, you know, cut out the carb only eat protein and non starchy vegetables like, I mean, if you can learn how to understand the insulin, and how to interpret the data, you've got, like, that's the leg up you need.

Scott Benner 55:38
That's exactly what I say all the time. Just to understand how the insulin works. I tell people, Type One Diabetes is about understanding how insulin works. And moreover, the timing and amount that you should use. You need to have your basil, right, understand how to Pre-Bolus meals and the difference between the impacts and different carbs. And that's pretty much the whole game right there.

Alex Quinn 55:56
Yeah, for sure. And protein,

Scott Benner 55:58
right? And then you go eat protein, if you want in fat and protein, get a rise later from that kind of stuff. It's I mean, but at its basis, if you were like I always say like if I was falling off a cliff and you're like, Scott, the secret to diabetes, I just scream those four things out before I splattered on the chair. If I was falling an extra 500 feet, I'd be like, and fat and protein will make your blood sugar rise two hours.

Unknown Speaker 56:22
Right. But

Scott Benner 56:23
I just don't see. I Well, I am lying. I do see. I do see how people get embroiled in the thing. I do see how the thing looks bigger than it is. And I understand people's fervency behind it because I imagine that the way you feel when you see somebody say I can't control my blood sugar's my Awan sees 10 is the exact same way that I feel when I see somebody say it.

Alex Quinn 56:51
Yeah, yeah, for sure. Because I've been there, and I know what that feels like. And I want those people to have that same profound moment of realizing that stability that I have, because it changes your life. And if you want to do that by eating blueberry crunch bagels, like get after it, you know, but let's figure out how to make that work for you. 100%

Scott Benner 57:15
I don't just don't care what people eat. I care if they're healthy. And I'm thrilled that you're the one that ended up here. Because Because you're you have the exact you have my aesthetic You are in my Viber exactly the same. Yes, totally from two completely different places, as far as the the input of what food is. And that's why I think that's exciting. And that's why I want people to hear conversations like this because you're not mad at Alex because she eats the way Dr. Bernstein describes. And by the way, the man should be lauded for figuring out what he did. Because, right, especially at that time, when the tools were, what they were, as far as insulin was and technology and everything. He really figured out a thing that saved people like listen to you, right, you did what you were told to do, and you have gastroparesis, and other issues coming along. And if you don't meet this man's ideas, I gotta think your heart starts getting funky in your 40s. Right. not pretty, right? Yeah,

Alex Quinn 58:18
yeah, totally. I mean, I started to go blind when I was in my 20s. Like, if I hadn't found Bernstein's methods, I would probably not have any eyesight left. And, and that's profound. It is, yeah, it really is. So, you know, I understand if, if it's not the choice that somebody else wants to make, but it is the choice that made my life better. And that's just the message I keep blasting out into the ether. Like, this works. For me, okay. It worked for me.

Scott Benner 58:53
100%, I say all the time, if you if you listen to this podcast, then go eat low carb, actually, there are some pretty successful low carb eaters that listen to the podcast. And I mean, their their health is a reflection of their success. It's amazing. It doesn't, you know, it takes a while because dogmatic might be one way to think of but everybody just gets on a team. Like all of a sudden, if you say Bernstein out loud, that just means you're some militant, no car beating person. And if

Unknown Speaker 59:20
Oh, I know.

Scott Benner 59:22
And I didn't recognize Alex until more recently that if somebody said, oh, there's a podcast, they say bold with insulin, that meant that I think you should eat everything in the world. And I was like, I don't think that I've never even said that. But it's I'm sure that there are things attached to Dr. Bernstein and other people that they've never said or intended out loud. Just like it happens to me as well. You know? Yeah.

Alex Quinn 59:45
It's for sure. It's I mean, there are some groups on the internet where you mentioned Bernstein and they will mute you and kick you

Scott Benner 59:51
out. Yes, you are not allowed to share the podcast on almost every Facebook group that exists. If you haven't talked about it. It just gets you Like shutdown. And then if people come back to my Facebook page and say, Hey, I tried to, you know, somebody had a thing, and I said, Oh, you should try this podcast, I got kicked out. If they start talking about it on my Facebook page, people from that Facebook page will come and ask me, please stop them from talking badly about my Facebook page. And I'm like, you guys have way too much free time. just way too much free time. You know, I

Alex Quinn 1:00:23
mean, like, I love talking about diabetes, because I enjoy the intellectual exercise behind all of it. But like, as far as my day to day stuff, like, I don't have time to care like that.

Scott Benner 1:00:38
Yeah, well, you know, the wall, tell us a person who's you know, who created the thing that we're talking about, right? Is that it took me I had to swallow hard The first time I saw it happen. So imagine, I have, I've always had a public Facebook page. It's always just sort of been like, there's an episode out here the links, I don't put, like, I'm a 50 year old guy. I'm not really into Facebook. I don't know if that's obvious or not. But I'm just like, you know, here it is. And one day listener said, Could you make a private group because we'd like to talk more about like, like, management stuff? And I was like, Yeah, sure. I said, but I'm not going to moderate it. And I'm not your mom, you know, so I made it. And there it is, right. And today is You and I are talking I think it's about ready to go over like 10,000 like, and it's incredibly active, like 85% of the people are active. Like, every, it's amazing how many people are, right. It's very nice. But the first time someone came in, and somebody said, Hey, I'm having this issue, what should I do? And someone left a link for something that wasn't the podcast? I was like, Oh, yeah, I'm not the only person with information about this. But I do have an episode about this. And it's hard not to jump in and be like, Hey, I see you're directing them over here. But what about Episode 295? You know, and it took me a little while I didn't do it. But I, I laid back and I'm like, this doesn't matter. If they go somewhere else and find out about it, it doesn't matter as long as there. Okay, so people will will say, you should try this low carb thing, or you should try this, or you should try that. And I'm like, cool. That's fine. Just I want everybody to be okay.

Alex Quinn 1:02:16
But make sure. I also feel like my approaches is all information is valid, but not all information is applicable. Sure. So, you know, I want to be aware of all the ways in which people go about doing things and, you know, I think that there's just as much merit in you know, protein focused, low carb eating for Bernstein as there is in the, you know, Whole Foods plant based no fat thing. Yeah, I wouldn't make that choice. I don't agree with it. But it exists, and I can't deny that it exists. So at least I can be aware of it and and learn enough about it to understand why somebody would make that choice. Yeah.

Scott Benner 1:03:04
If you ask me my personal opinion, I think that rush, restrict is not the right word specific, specific eating is has a likelihood of falling apart over time, no matter what it is, like, if I if I told you I was gonna eat ice cream every day, I could probably make it like a day and a half. I was like, oh, Christ, I can't come every day.

Alex Quinn 1:03:28
Okay, so I wrote out some talking points for myself before we started this. And the word restriction is one of the things I wanted to talk about, because restriction and deprivation get thrown around a lot in the conversation about eating low carb. And I feel like that sort of takes away the autonomous choice of the individual. If you if you look at it as I choose to eat this, I consciously am aware of what I am about to eat and I am deliberately making this choice for myself for an intended outcome. Yeah. You're not restricted, and you're not surprised. What's the word then? So

Scott Benner 1:04:15
help. Seriously, here's it. Here's a real world issue. If I go to a thing, and I speak at something, I have about three sentences, they put in a blurb, Scott benders those to the Juicebox Podcast, a va, his daughter's a one C has been between five, two and 6247 years without any diet restrictions. Now that those are all the words I have, I get that the word restrictions not great, but how do I say she eats anything she wants? Without using that, like, what's the word I need?

Alex Quinn 1:04:43
That's a good question. That's I honestly, I don't have an answer to that. Um, you know,

Scott Benner 1:04:48
because I don't mean it the way you just said it. But I get why you heard it that way.

Alex Quinn 1:04:55
Right. Right. For sure. I mean, I don't know. Does you No telling your kid regardless of whether they have diabetes, no, you can. subsist only on grilled cheese and candy every day. Like, is that restrictive? Or is that just like parenting for better health?

Scott Benner 1:05:13
100%? Yeah. And do you think that when I told you I used an example of the bagel that my daughter eats bagels every day, now cuz she doesn't like she has bagels, like every once in a while, I just know how to Bolus for them. Like they're the day before she had a chef's out. So it's like it really is. And I try to be careful too, when I talk. This is the one thing that I it took me a minute to say, in the podcast, but I finally saw how important it was. I started telling people look, just because you've learned to Bolus for tiramisu doesn't mean you should eat it every day. Like don't confuse good blood sugars with good health.

Alex Quinn 1:05:54
Yes, yes, I wholeheartedly and adamantly agree with that. I also feel like, you know, just because you can eat the tiramisu doesn't mean that you should have a boatload of insulin floating around in your system, like those lead to long term and potentially short term like detrimental consequences. And, you know, so I can also make a tiramisu out of ingredients that don't cause me to have a boatload of insulin in my system and the potential for a major spike and then drop later,

Scott Benner 1:06:32
right. And that's where you start getting into the weeds. And it's hard to like sort through the whole thing, because I've had very respected people on here that said that, that have said that using more insulin, it's not dangerous. And they're not connected to a pharma company or anything weird like that, right. And at the same time, I mean, if you mitt unbalanced the insulin and have a whole bunch left over, when the impact of the carbs goes away, you are going to drop down really low. So that's the short term you're talking about. I also feel like the podcast does a pretty good job of describing how to not let that happen. But at the same time, I would be lying if I didn't tell you that my favorite brownies are a gluten free mix that is made by like King Arthur bakery, I like I like them better than brownies that you would make with flour. And at the same time, I mean, they're not low carb or anything like that. I'm just trying to use the example of like alternate ingredients can sure can sometimes make the same exact thing. For sure.

Alex Quinn 1:07:29
I think I think that choosing the alternate ingredients part is something that kind of gets left out of the conversation. Like when you bring up low carb, what I find most common is people hear what they can't eat. And they're like, but if you take away my bread, and my pasta and my potatoes and my cake, what's left. And you know, I had to go through that mental shift, too. And when I first went low carb, I made myself a promise. And I said, you know, my food has to taste good. It has to look good. And it has to be good for me. Otherwise, I will set myself up for failure. So how can I make these changes in such a way that I still enjoy my food? And I mean, I've been eating low carb for six years now. And I still eat like brownies and pasta, and cake and ice cream. And, you know, was Anya, I still have all of those things. I just change what goes in it a little bit

Scott Benner 1:08:31
right. Now, I don't disagree if anyone listening has ever thought like I've heard people say you just get lost when you're trying to quantify something. And there's so much I mean, you're going to be on episode like, I don't know, like 480 you know what I mean? Like, so there's so many words that have been spoken already. And when you ask somebody to like, real quick, what's that Juicebox Podcast about? I have to be honest with you. If you asked me what it was about. I can't quantify it. So I don't know how someone else would. So I hear people say that. Oh, you know, most, most often I hear people say he talks about how to use insulin so you can eat what you want. And I'm like, that's fair. And I've heard low carb people say he pushes carbs on people. And I'm like, that seems unfair. But okay. Like, I also, you know,

Alex Quinn 1:09:19
my interpretation of that question is you talk about living with diabetes.

Scott Benner 1:09:26
Yeah, that's it. I'm gonna tell you right now that I don't see any other established diabetes hub. And so I think of the podcast as a as a as its own sort of media hub, right? Like it's, that's no different than a television channel that only has one show on right. It's like any other established hub, whether it be in print online, or audio or whatever it is. I don't see anybody else having a diversity of conversations like this. They pin thing and they stay in their lane, and I get right Like I get the fear, like I understand like shark, you know, the idea of like, people are so scared not to be canceled and stuff like that. But

Alex Quinn 1:10:08
I think also they stay in their lane because a lot of people want what they're doing to be the right way to do it. And it sort of takes out of the equation that there is no like one right way to do anything because you lose your clickbait. Yeah,

Scott Benner 1:10:29
that is really how it feels. I'll tell you that. The part I left out about the Facebook page thing is the my real belief. And I'm this is just me speculating. But I think that the reason most people don't want Dr. Bernstein's name, or this podcast or anything else to be left in their Facebook group is because they are very afraid that somebody will click on a link, go find something that works for them and never come back. And I just don't have that fear. Like, I am confident in what this podcast is. And by the way, if you don't need it, or want it, that's also fine with me.

Unknown Speaker 1:11:01
Yeah, for sure.

Scott Benner 1:11:02
But that confidence comes. So it's not real confidence, it's, it's I get to be confident because of how popular the podcast is. If it's a smaller group of people listening, I can honestly tell you, I might be more fervently trying to keep people in my little group. But I don't feel like that. Personally, I have to say, I don't think I would do that. I really, I really do want people to do what works for them. But I can see the draw to I started this thing, I built this thing. I you know, think of them think of a listener or reader as a customer for a second, like imagine you had a gas station. And the guy a guy pulls in, grabs the hose, and right before he's about to put the gas and the guy at the gas station across the street screams over with a bullhorn. You don't want to be at Alex's gas station. It's a bad guest. But I put all this effort to get him this close. Like you can't steal him now, like it could feel that way. But you have to have people's better interest at the core of what you're saying and just say, Alright, look, if you want to go find something different, and it works for you, then I need to be happy for you about that.

Alex Quinn 1:12:07
Yeah, for sure. That's why you're allowed to go get a second opinion. When you get a diagnosis at a doctor's office, you know,

Scott Benner 1:12:13
go figure something out. And if you and by the way, too, if you go out and you see other stuff, and it works. That's great for you, I miss you goodbye. And if you go out and see it and gone, like go back to the podcast thing. Well then Welcome back. Like I've no harm, no foul, like you don't even like you and I completely agree. I even eat steak the way you do. I don't like a lot of stuff. I just I'm gonna make a statement eat the steak. I don't need it to have stuff with it. Look,

Alex Quinn 1:12:39
I don't know if we eat steak the same way because I go to Costco and I get monster steaks and I put them on the grill and then eat that. Well, that's what

Scott Benner 1:12:47
I would do. I would go to Costco, I would get a steak. I would smoke. Yeah, I would smoke it and then I would see it. And then I would cut it open and I would put a little pink salt and some crack pepper I would eat.

Unknown Speaker 1:12:57
What kind of wood Do you like to smoke your steaks with?

Scott Benner 1:12:59
I just use a it's just like a competition blend? I don't I don't pick like a specific flavor. Not that far into it. All right, gotcha. But I might also if I'm being honest, I might make a little compound butter the day before.

Alex Quinn 1:13:14
Yeah. I went to the farmers market probably a couple of months ago. And this guy that I go to who makes hot sauces have this thing called black garlic. You know what black garlic is?

Scott Benner 1:13:27
No, but I'm listening.

Alex Quinn 1:13:28
Oh my, okay, it's a fermented garlic and basically, they just take a whole head or a bunch of them. You put it in a low heat like rice cooker, and you put the lid on top and you let it ferment in that warm environment for like a month and it takes the garlic and turns it into this sort of like caramelly like rayson sort of flavor but it's got garlic notes to it and it's it's really popular in like Asian dishes, but it's just got this like rich depth of flavor to it. That is phenomenal. And you put that in some butter and put it on a steak oh

Scott Benner 1:14:09
I made ribeyes like i i splurge I'm incredibly cheap. So I splurged on Father's Day, and I made revised last year. And I you know they came off the smoker. I sear them. I soaked them in butter as I was eating them. Like this is literally taking a year off my life and I didn't care. I was like this is the greatest thing ever. It must have been a pound of butter, like so.

Unknown Speaker 1:14:29
Oh, man,

Scott Benner 1:14:30
it was so good. It was good. Yeah, so you know, I'm right there with you. Having said that, you know I also might go make a pizza at some point and you should say whatever you want, but a low carb pizza crust. You it's not I can't tell you wouldn't be good or that it couldn't be enjoyable or whatever. But it's not pizza in in my context of what pizza is. So

Alex Quinn 1:14:54
I understand. Like, don't get me wrong, man. I grew up on eating right Little pizza. And if I could eat regular pizza and not experience terrible effects from it, trust me, I would. But I have to make choices for my long term benefit. So there's actually Um, there's a chain restaurant called blaze pizza. Have you ever heard of them? I haven't. Okay, so there's a chain restaurant called blaze pizza. And they have a keto crust. And I discovered this, thanks to Facebook. And now we do Friday night pizza night with my stepdaughter on the regular and it's great because it brought pizza back into my life. It's excellent.

Scott Benner 1:15:35
I don't have it a lot. But when I have it, I I turn it into a thing. I make dough, I cold fermented over news, and then I could you know, it's it's an event, not a natural meal. If and having said that, if if I was a person eating pizza three times a week, I would look at myself and go, I have a problem.

Unknown Speaker 1:15:52
Totally.

Scott Benner 1:15:54
Okay. Because you had no, it's all ask you. Is there anything that you wanted to talk about that we didn't? And I will tell you why you're looking that I'm incredibly happy with this conversation. I thought it was.

Alex Quinn 1:16:06
Yeah, for sure. Oh, okay. So one of my things was the social aspects of eating a particular way. And this, I feel like can translate across the board, you know, be it low carb, vegan, high carb, whatever. Um, there's a lot of questions about how do you handle eating at a restaurant? How do you handle parties or holidays and this kind of thing? And that takes us back to one of the points we made earlier in this conversation about you have to not care what other people think. Yeah. Because when you stop caring what other people think then these questions to me become a moot point. You know, if I, like example, I went to a Thanksgiving holiday dinner with my partner's adopted brother's adopted family.

Scott Benner 1:17:07
Go ahead, people. I gotcha.

Alex Quinn 1:17:09
Yep. People, people I'd never met before they live out in rural Georgia. So they're not going to eat the same way that I do, you know. And I respect that. So what I did was I brought a dish that I could eat, that everybody would enjoy. And then I stuck to Turkey. And that, and I had a great time, and everything was wonderful. And like nobody even questioned what was on my plate. Yeah. And, you know, that's how I do it at parties to like, you know, I'll bring a baggie of bacon in my purse and eat that at a party if I have to, like, um, I don't know, I'm just not afraid of people thinking that it's weird to do what I'm doing or feel like I have to justify any of my choices to somebody else.

Scott Benner 1:17:57
I don't I don't get I don't get feeling that way at all about anything. Like, I here's the way I think about it. Imagine your mind right now everybody's listening. All the people in the world you'd go to with a life or death situation, how many people do you really know? You'd be like, I what you think is important, right? Yeah. A list of 100 people has not popped in everyone's head. Oh, yeah. I know all the people. There's three people who you're like, yeah, this guy is bright. That one's a little stupid, but seems to make good decisions for some reason. And, and you know, and I got a common sense, friend. And that's pretty much it. But yet, you'll let you'll let a stranger make you feel weird about how you eat, how you look how you smell who you are. I don't understand that. I just don't get there. Right. So

Alex Quinn 1:18:41
like, even my own parents, when I went low carb were like, what are you doing? And I was like, I don't care. Trust me, you know.

Scott Benner 1:18:49
And when it's the internet, I don't know, if you're all aware of how the internet works. You don't have to look at it. It's not like it's not seared in your eyeballs, you could just look away and go, Oh, look, it's not there anymore. Like you can literally make the internet disappear. It's as if it doesn't exist.

Alex Quinn 1:19:05
Right? I mean, isn't that funny how we have such like, amazing relationships with people that like, aren't in our reality, like they don't exist, it's a relationship through a person in your phone,

Scott Benner 1:19:19
everybody should get the benefit of doing something like this once and what I mean by that is like, I wrote a book one time, and it was interesting to see people review it. And and once you realize that somebody is going to like it, and somebody is not going to like it. And that doesn't make it that doesn't change what it is or how you felt about it or what your intention was. It's a freeing feeling like even with this, even with this podcast, you know, people will like joke with me all the time. Like they'll say like, I'm in my house, and I'll say to my husband, the guy on the podcast said or Scott would do it like this. And And listen, I'm not you know, I'm not Don't know, like pick the most famous person, you know, right? I'm not being spoken about all around the world with the with the same, you know, frequency as those people, but there are people saying something I said or my name out loud in their homes and almost unaware of it, you have to be able to just think, okay, whatever. Like that's good. Like, if it works for them, I'm glad if they're saying it because they don't like me, there's nothing I can do about it. Like I like to be able to have that freedom is is I wish everybody could could experience something that would force them to give up on caring about those things.

Alex Quinn 1:20:34
Yeah, for sure. Much. Well, look, I've I have, I don't know if you've experienced it to this level, but I've legitimately gotten death threats in my inbox about what I had to say about managing diabetes. And like, it rattled me for about a day. And then I blocked that person and went on about my life.

Scott Benner 1:20:58
realize they've now gone Yeah, I No one's ever threatened me. And this is not a this is not a an offer for you to start. Please don't do.

Unknown Speaker 1:21:06
Yeah, no, don't

Unknown Speaker 1:21:07
invite.

Scott Benner 1:21:09
But I mean, I I'll get an email once in a while. It's mostly about my, are you gonna make me say this out loud? It's mostly my personality, Alex, like, I get periodically, from adults with type one, generally ones who have had a tough go. I don't think it's I don't think it's very comfortable sometimes to hear a person who does not have Type One Diabetes tell you that they understand how to manage it, when you are struggling with it. And you. And I understand that I've and I do my best to do my best to make sure that people know that. But I get caught up sometimes in language like I'll sometimes I'll be doing like something with Jenny. And I'll be like, so say I have diabetes. And this happened. I'm just trying to set up a scenario. And I don't mean to say I have it like I don't. It's a colloquial way of speaking, you know, right.

Unknown Speaker 1:21:58
Yeah.

Scott Benner 1:22:00
And but yeah, it has happened and people have really horrible notes to me. And I read them and I try to take from them what I think is valuable. And then I let the rest of it go cuz

Alex Quinn 1:22:14
you can't please everybody.

Scott Benner 1:22:15
You know, like, you can't, that it is what it is right that some of my favorite reviews are the ones that are like, I love that podcast and hate that guy to me.

Unknown Speaker 1:22:26
That's funny.

Scott Benner 1:22:26
I love that so much. Because here's what it says to me that the podcast is so valuable that they're willing to listen, even though they hate me. I'm like, that's fantastic. All right, you were terrific. And the birds behind you were an added bonus. I thought,

Unknown Speaker 1:22:41
are they I love it. Yeah,

Scott Benner 1:22:43
yours is the second episode that will have bird singing in the background. And people really liked it the first time so I thought it was very cool. Well, I appreciate you very much doing this. I really don't I'm sorry. We had some trouble, like sinking up at one point. But

Alex Quinn 1:23:00
well, my fault my email is full. Well, then I'm not sorry. Yeah, no. 100%.

Scott Benner 1:23:06
Actually, Alex, what I meant to say is I would appreciate if you would apologize.

Unknown Speaker 1:23:10
Well, I'm sorry. And you're welcome.

Scott Benner 1:23:12
They're excellent. Couple things First, let's thank Alex for coming on the show and talking to us about how she eats. Thank you Alex. Then let's thank Omni pod and Dexcom Oh, and you're not really supposed to use n twice but I don't feel like editing this out so end touched by type one. Checkout touched by type one.org find them on Facebook or Instagram. Look into the Dexcom g six continuous glucose monitor@dexcom.com forward slash juicebox or check into those offerings from Omni pod at Omni pod comm forward slash juicebox links of course in the show notes of your podcast player worth Juicebox Podcast comm also let me remind you very quickly I mean number one out music I'll just remind you quickly if you're looking for the diabetes pro tip episodes there diabetes pro tip calm or at Juicebox Podcast calm. Let me tell you this too. If you're looking for some really great people talking about type one diabetes, the way we talked about it on the show, you are looking for the Facebook page for the podcast. It is of course completely free. I know some places like the charger to be in their Facebook page. That seems weird to me. It's called Juicebox Podcast type one diabetes. It's a private Facebook group. There are 11,000 people in it. And it's great, really is a wonderful place to talk about type one. Check it out, head on over if you're on the Facebook. Last thing I enjoyed this conversation about the way Alex eats and timely because I just saw online, somebody I would love it if Dr. Burns theme came on the podcast. Meanwhile, I don't know if Dr. Bernstein knows about this podcast or not, I wouldn't imagine he would man in his 80s. But if he did, or if somebody knew him, I have to tell you, I'd love to talk to him. It's a fascinating conversation. Even if you don't eat the way, Alex does or want to eat the way Dr. Bernstein talks about, I still think it's a great, great story. And I'd love to hear it. So if you know Dr. Bernstein. Get him on the podcast. If you're enjoying the show, please subscribe in the podcast app that you're listening in. Did I just say in twice? It's not important. I'm just saying if you're listening in a podcast app, and you're not subscribed or following the show, could you do me a solid and subscribe? If you are subscribed, thank you. That's lovely. Tell a friend, tell two friends, tell people you don't know, grab people's cell phones when they're not looking. Open up the podcast app and subscribe to my show. And then just give it back to them. I don't think that's illegal. I'm not a lawyer. So don't take my word for it. This is not like legal advice, obviously. But I would like you to do that if you could. I'm not asking you to just saying that. If you told me like if I got an email it said, Scott. I have a friend has diabetes. I picked up his phone. I opened it up, listened to all these podcasts. I was like, boom Juicebox Podcast, and I just subscribed. I'd be like, No, thank you. That's how I would respond to that email, if you like thank you. And then I say something nice. And that would probably be the end of email correspondence. This has gotten away from us. But anyway, subscribe to the podcast and a podcast player. If you listen online, it's alright with me. But come on, right. Let's get a podcast player. By the way, they should be free. I shouldn't even say a podcast player. You could listen anywhere you get audio like Spotify for example. Or Pandora do people still use that's not the point. The point is if you get audio in a thing, you can probably get the buy cast in that thing. And buy that thing. I mean an app. It's an app world, people.