#296 Defying Gravity
Flight is Magical and Oren Liebermann loves it
Oren Liebermann is an American journalist who works as the Jerusalem correspondent for CNN. He's also a pilot, a T1 and an author. Read his book!
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Scott Benner 0:00
Hello, everyone, welcome to Episode 296 of the Juicebox Podcast. This episode of the show is sponsored by Dexcom Omni pod and dancing for diabetes. Please go to my Omni pod.com forward slash juice box to find out how to get a demonstration pod sent directly to you. Or go to dexcom.com forward slash juice box to find out all you need to know about the Dexcom g six continuous glucose monitor. And I'm going to throw you a curveball here to find out about dancing for diabetes go to touched by type one.org touched by type one.org. I have a treat for you today. Oren Lieberman is the CNN CORRESPONDENT in Jerusalem. He is a adult who has type one diabetes. And he's a pilot. So obviously, when I was looking for some clarification on the new FAA rules about flying with Type One Diabetes, I thought, let me get on the show and find out what he knows about it. Plus, a little background and some chitter chatter. You'll see it's a regular episode, where we actually touch on a topic that I decided to touch on before we got to it. It's kind of crazy for me, I don't normally start with the topic and actually get to it. Having said all of that, I do believe it took me about a half an hour to get to the topic about flight but I found what Oren was talking about to be incredibly interesting. So what are we in a rush? You got somewhere to be okay, I feel is getting confrontational even though I'm here by myself. So let me just say this nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always, please consult a physician before making any changes to your health care plan. We're becoming bold with insulin. Real quick before the show starts. huge shout out to the people of Oklahoma. Thank you for having me out. This past weekend. I had a terrific time getting to know all of you. And I hope you enjoyed the bowl with insulin talk that I gave.
Oren Lieberman 2:12
My name is Oren Lieberman. I'm lucky enough to be cnn Jerusalem correspondent. I also have type one diabetes. I was diagnosed about five and a half years ago, on Valentine's Day 2014. And what would be relevant to this podcast, I'm also lucky enough to be a private pilot. In my spare time, my dad was an aerospace engineer. So I grew up around airplanes. I wanted to be a pilot my whole life. And although I'm not a commercial pilot, my dad had the crazy idea of building a home build airplanes. So I'm lucky enough when I'm home in the US to fly that airplane. Right. So
Scott Benner 2:43
first of all, I'll decide what's pertinent to the
Unknown Speaker 2:45
podcast. You know,
Scott Benner 2:48
you You have no idea how many crazy directions we might end up going. Tell me something that you said five years ago, you were diagnosed, how old were you?
Oren Lieberman 2:56
I was 31. In fact, I was diagnosed my wife and I had quit our jobs and we were backpacking around the world. I was diagnosed in Nepal, of all places in Pokhara a city that does not, shall we say have the most advanced health care on the planet. So I was diagnosed, I lost a tremendous amount of weight and all the symptoms at this point we all know so well. And for about two months at kind of sort of sputtered along feeling terrible and awful and miserable and weak. Eventually, and we were volunteering there, we were teaching English at a monastery, actually, my wife and I, they canceled classes for a day I stepped on a scale and decided okay, maybe it's time to go to the doctor having just dropped 40 pounds in about two months. He the doctor initially said, nothing's wrong, you have a little infection, just, you know, eat more chicken and have some fruit juice. Following that, three days later, I went back and said something's very wrong. And that's how I was diagnosed. And then I spent a week in two different Nepali hospitals, which is something I wouldn't wish on anybody. I'm just gonna say that you just, you just said a lot. So
Scott Benner 4:00
are you nine feet tall? How did 40 pounds look coming off of you?
Oren Lieberman 4:04
So I was. I mean, by the end it was bad skin was hanging off of me. I was so dehydrated that that might be my wife's arms were were thicker than mine. They were stronger than mine. And within the first I think 24 to 48 hours at the hospital. I put on basically 15 pounds of just waterway. Yeah. Just on an IV was a little overweight. Yeah, but did I have 40 pounds to lose? Heck no. And by the time I went to the hospital, I was in pretty bad shape. Right?
Scott Benner 4:33
Is it? How scary is it being out of the country when you're that sick?
Oren Lieberman 4:39
It's horrifying. Yeah. At that point, I felt so awful. Near the end, it was almost a relief to get a diagnosis. And frankly, when when you're feeling that bad, there are a whole lot of things swirling through your mind. And I look I certainly thought am I about to be diagnosed with cancer here? Oh, yeah. So diabetes wasn't you know, I grew up with a friend who's at type one diabetes. And he was actually my second email. My first was to my family. My second was to him. And he's one of those guys, that's just super positive. And from the beginning, he put me on the right track. So although it certainly wasn't a fun experience being diagnosed in Nepal, he sent me sort of on the right track with the right attitude. The first hospital was rough. We were there for four nights, and all the all the medications, all the food, and the hospital bill came to about 100. And I think it was $198 or $189, or something like that. And it was worth about that much for four nights. The second hospital was a legitimate Western clinic. And that's, that's the place that got me well enough to fly home. And then the process of figuring out what the heck this is and how to live with it.
Scott Benner 5:43
So how long have you been the CNN CORRESPONDENT, drizzle?
Oren Lieberman 5:49
February 2015. So I'm nearing my five year mark.
Scott Benner 5:52
Okay. So did all of this sort of coalesce together like your diagnosis and you taking this job? And we're like, I guess maybe let me step back for a second. What were you doing prior to saying, I'm not going to work anymore, and I'm going to go backpacking with my wife.
Oren Lieberman 6:06
So I was in local TV news. I was actually a local TV news reporter in Philly at CBS three. Okay. So we quit in September 2013. At that point, we'd been married for a year, my wife was a teacher. And we backpack I really thought I was out of journalism. I was diagnosed halfway through the trip, we then got back on the road and finished the trip last four or five months, which was an incredibly important decision for me. And then I was doing a little freelance video work for four months. And suddenly cnn came calling and said, Do you want to interview for Jerusalem or Beijing? And having just been to both Jerusalem and Beijing? I said, heck, yeah. And the conversation very quickly led towards Jerusalem, and I began almost exactly a year after my diagnosis. Wow,
Scott Benner 6:47
what was it like backpacking with a new diagnosis?
Oren Lieberman 6:50
Very difficult. We talked to my doctor, we talked to my friend who has diabetes. One of the biggest challenges is how do you keep insulin cool. And we were heading to Southeast Asia where the temperature was in the high 90s every day. Okay. So I had to suddenly I had to carry around my insulin pens, Lantus and humalog. And I can't carry around a cool pack. And we need to make sure that hotels and hostels we were staying in had refrigerators to keep insulin cool. Logistically, it was a nightmare. It was incredibly difficult at times. But it was a it was totally worth it. I've often said it might not be the smartest decision I ever made to get back on the road. It was probably one of the dumber decisions in hindsight. But it was very important because I decided at that point, I wasn't ever going to say no because of diabetes. And that the rest of the trip was incredible. That's an excellent even for, you know, the challenges of managing blood sugars. Yeah,
Scott Benner 7:40
nice. It's just it's a wonderful story. Because, you know, so many people allow the tiniest thing to you know, knock them off track it when diabetes comes up. They're like, Oh, I don't you know, won't go in on plane. I mean, listen, I'm not gonna lie to you. There were times where I didn't feel like driving 20 minutes away from my house when my daughter was first diagnosed.
Oren Lieberman 7:57
You just I understand.
Scott Benner 7:58
Yeah, you're like, that's too far. Was it perseverance and stubbornness or a little bit of ignorance mixed enough of a mix of both? Or were you just really that brave what was happening and that's in your head? For two years, I've been telling you go to dancing for diabetes.com you know, I jumped on I'm like good at dancing number four, you know what I'm talking about. But beginning right now, I want you to go to touched by type one, please trust me. There'll be a reason why and then I will share that. Please trust me that there is a reason why and that one day soon, I will share that reason with you. But for now touched by type one.org the mix of both or were you just really that brave what was happening and that's in your head?
Oren Lieberman 8:44
Oh, no, I think I think that was a very good description, perseverance, stubbornness, ignorance stupidity determination. Part of it was an even little things factored in my wife was a teacher so she couldn't she couldn't just go back halfway through the school year and start teaching so we figured what the heck are even our doctor said, Look, you got the basics down, your blood sugar's low, eat your your blood sugar's high, take insulin, figuring out how it works for you is something something you're gonna have to do regardless whether you're at home or on the road. So when he said that, it's like, Alright, well, I'm just gonna go figure this out on the road.
Scott Benner 9:16
Did you have any real like health issues during that time? Did you have any scary lows or highs, you couldn't break stuff like that?
Oren Lieberman 9:23
A couple lows, not too many highs because I was very strict about what I was eating. In fact, the worst sort of health care wasn't I don't think related to diabetes. We were in Laos. And because it's a malaria zone, we cycled on to an anti malarial medication. And it wiped me out to the point where I couldn't hold food down for a couple days. To me, that was quite scary. I couldn't get my blood sugar up because I couldn't I couldn't hold food down. So that was two days of basically sitting in a hotel room waiting to figure out what was going on. And in the end, we didn't have any official diagnosis, but I think it was just, you know, going onto an antibiotic as an anti malarial, just mess with my system. But that was the, you know, the worst health scare we had. And in hindsight, that wasn't all that bad dealing with it.
Scott Benner 10:05
So when I hear that you guys as adults, sort of like, we're like, hey, well quit our jobs and go do this thing. You seem like free spirited people. So this next question probably doesn't need to get asked, but was your diagnosis hard on your marriage?
Oren Lieberman 10:18
No, not at all. My wife very supportive of me from the very beginning, and because because we were both traveling, we didn't have jobs. She was with me in the hospital. 24 seven. So when I started trying to figure out my dosage, I figured out with her, and she'd look at it and say, Look, I think this is two or three units or four units. And she knew my diabetes just as well as I did. And she still does. Yeah. So that it brings us closer together. Yeah, certainly, in a way, it was one more challenge we had to overcome. But she's been great about it from the very beginning. That's excellent.
Scott Benner 10:47
Now, I mean, I didn't expect any different from your sort of how you laid out the beginning. But it's still it could be, you know, it could be shocking to someone in a way that maybe throws them off course, a little bit. So I just I wasn't sure. Also, I wasn't sure if he would admit to it out loud. If she was like running around going, Oh, my God, what I do? This guy, there are other guys.
Oren Lieberman 11:08
None of that. None of that.
Scott Benner 11:11
So okay, so there's the diabetes, help you make the decision about cnn? Or was that just such a good opportunity that you thought like, I guess my question is, are you at a local CBS thinking this isn't going where I want it to go? and CNN is where you wanted it to go? So it It felt like you just kind of you found the back on the path you were looking for? Or was it like, what makes you go out of something and go right back into it? Again, I guess is the question.
Oren Lieberman 11:37
The offer essentially was just too good and too interesting. And having just traveled it was it was too much of a draw to get back on the road. In a sense. I really thought I'd left journalism for Goodwin when I left my job at CVS in Philly. And then cnn came calling and I figured what the heck, let's see where this leads. And it's been incredible. You know, I live in Jerusalem, my family's here, my kids were born here. But with CNN, I've reported in, let me think about this Serbia, Russia, Poland, France, Jordan, England. And and so having having, having the love for travel so much. And the opportunity to keep doing that while Hey, also doing it as a living was absolutely incredible. And I was never gonna pass it up.
Scott Benner 12:20
Does this job give you the feeling? Like are you? Do you? Do you understand what's happening in the world in a different way than I do? Like, do you have to keep track of it? I guess my question is there's is as a reporter, are you really are you steeped in it? Like you're not just saying the words on a page, right? Like your, your, your
Unknown Speaker 12:40
God, I hope not.
Scott Benner 12:42
Like, like, I don't I don't get this feeling from you. I'm just trying to get you to explain it to somebody else. Like you're not a talking head, you're not reading a script, you're there understanding around stuff and reporting back on it.
Oren Lieberman 12:53
Yeah, so my job, my full time job is to be here in Jerusalem and fully understand the story and keep track of it. Even if I'm not giving you every little update on our website and on air, I have to know what's going on. So that when I am called, and when it is time to get on air, I know fluidly, what I'm talking about and can can analyze it and discuss how we got here, where we're going from here. The more difficult is, for example, when I go to Moscow, and I've been there about six or seven times now. Because although I keep track of that, to some extent, I don't follow it on a day to day basis. So that's getting in there catching up, you know, was it what is it I've missed in the last six months. And then doing that and kind of just keeping an eye on what's going on all over the place in case I get sent in. Certainly, whenever you're sent to a story that is not your full time story, there is a process of catching up as quickly as possible. And then we always have teams on the ground who are there to help you out and sort of answer questions and fill in the blanks of the knowledge that we don't have because we don't follow it day to day on different stories. Are there things happening all over the world that intersect with us in ways we don't even understand?
Yeah, oh, definitely.
You know, some of it's fascinating to talk about some of it gets very minute and and very tiny, but it affects policy all over the world. And and the interplay is fascinating to see. And just sort of try to follow it. Does that mean I'm great at it? I'm not sure about that. But you know, I enjoy my job. And I enjoy doing that and trying to follow how policy here affects policy there and, and decisions are all tied together.
Scott Benner 14:22
But what about you and your past made you feel like this was something that was just too good to pass up? Is it Do you have a love for for global politics or history? Or are you I'm dying to know, I just I'm sorry, we'll get to diabetes at some point. But I just I really want to understand
Oren Lieberman 14:38
Oh, good. Yeah, of course. No, like, I've never had a good answer to this question and certainly not the answer that people kind of expected me to have. I think when I was in college, and I went to University of Virginia, I decided on the spot watching basketball that I was going to do the radio play by play for the Sacramento Kings. Very specific except I had no idea how to do that. So I went back to back to New Jersey got a job. But I got an internship at an FM radio station. And one of the DJs sat me down and said, What are you doing here? So I told him, I want to do radio sports. And he said, Look, go back to school, call up the local am station and beg to get on air, just do it. So I did it. And then I went to grad school at Syracuse to get better at Radio sports. And one of my professors sat me down. And he said, Look, you don't want to work in radio, you don't know anything about sports, you're going to do TV news. So I said, Okay, not knowing any better. And that's how I got the TV news. And then I've always found it fun, right? It's not a job behind the desk. I'm out in the field, I meet new people. And I haven't been fired yet.
Unknown Speaker 15:34
So is it possible to have that man
Scott Benner 15:36
said, You, I really see you aren't as more of a poodle? groomer you would have been like, Alright, and, or,
Oren Lieberman 15:42
look, I can't rule it out. Maybe that's where I'd be.
Scott Benner 15:46
That's hilarious. Well, I think that the people you meet along the way, obviously help you, you know, especially when you're younger, right? You don't really know what you want to do. You just like my, my son, just, um, he's like, a sophomore in college. And the other day is like, I'm gonna have to, you know, go lock down my major with the school. And, you know, we're like, yeah, maybe get to that, if you don't mind. Excuse me. And I was like, you know, do you still have any idea what you want? He has no idea. Like, and I don't think it's reasonable to expect that a 20 year old would just, you know, like, Oh, yeah, sure. Here's all the things I want to do in life. And this is going to be perfectly correct. My wife was telling my daughter the other day, she's like, if, you know, the plans of the 19, or 20 year old me came true, none of you would exist, because I thought I was gonna live in an apartment by myself and do this. And, you know, she's like, you know, we met people on the way and kind of veered around and made decisions, but you're in a place now, you look very comfortable. Which is amazing. What's it like raising kids overseas? Are you? Are there any drawbacks, or you don't feel that way?
Oren Lieberman 16:46
Oh, my God, what I wouldn't give for grandparents near us to help us out or even, you know, my siblings to help us out. It's tough. We're a 12 hour flight away from home. Our kids don't get to see their grandparents that often. It's a great opportunity. My kids are learning multiple languages and meeting people from all over the world. But it's it's still difficult. And certainly at some point, the goal is get back to the US. Okay. You know, to your son, you can tell him, Look, I'm still making it up. as I go along. I do what's fun, and so far, it's led me down the right path.
Scott Benner 17:15
I just told him Look, man, like you're good at math. You know, get better at that and see if it leads you somewhere. And if it doesn't, it doesn't, you know, but you'll be educated. You'll have seen the world for four years, you'll at least be able to prove to an employer one day, look, I can sit down and do things that I don't really want to do. That's how I got this degree. I can work hard for you. So yeah, so your parents are actually close to me, but not to you, which was crazy when we reached out and then we're trying to set this up. And so you grew up incredibly close to where I'm at right now. Is that right?
Oren Lieberman 17:48
Yeah, I grew up on the Jersey Shore. My first job ever, I was a cabana boy at a beach club. And I've tried to move up in the world since then.
Scott Benner 17:55
But it's it seems like you may have all the fans not as good in tourism, but I mean, you know, what are you gonna do? So okay, so are you managing your diabetes now still with pens? Or have you changed how you're doing that?
Oren Lieberman 18:08
No, I still do pens. I have a lot of friends who've told me eventually everyone switches to a pump. And I said, Look, you're probably right. I'm just not there yet. I do have a CGM. I have a freestyle libri. I love that it's on my left arm at the moment. But I've decided not to go with an insulin pump yet and I I still carry around my pens that I inject in my arms and I don't care who sees
Scott Benner 18:30
that's First of all, that's fantastic. And you shouldn't care. I'm a huge proponent of just you know, handle yourself in public. Like why go into the dirtiest broom in a restaurant to? You know, open a hole? That's exactly. Yeah, I have to poke a hole on myself. Where should I go? The public restroom? That makes total sense. So you're you're pretty old school for 2019? Are you getting? Are you having the the results you're hoping for? Like your management is where you'd like it to be?
Oren Lieberman 19:00
Yeah, I have to admit, I haven't checked my a once in a while. But at last check. It was about 5.8. Wow. Which I'm very happy with. One of the things I think is easier about being diagnosed later in life is it's easier to be disciplined, right for for 31 years, I ate whatever I wanted for for 10 years, I drank whatever I wanted. And now Okay, now it's time to get a little serious on that. You know, I think it could be much harder going through the teenage years where you want to rebel a little bit, college could be difficult. So in that sense, I feel very lucky that I was diagnosed later and it's just buckling down. For two years. I wrote down every single one of my blood sugars in a notebook and what I had, how much insulin I took and what my reading was before and after. And although I even my doctor said look, this is nuts you're going to burn yourself out and that's very dangerous and diabetes. So even he told me to back off but that let's say that set the pace right and set a good direction for trying to eat right and exercise and and and look at my blood sugar's I'm not ashamed to keep that Keep injecting in front of people until it's where I want it to be. It's what you got to do.
Scott Benner 20:03
Well, that's pretty cool. And you said your wife still involved like she you think if you just shut down for a day, she could handle your blood sugars and things like that and like this dosing decisions and stuff, but she that involved or is it just more peripherally? No,
Oren Lieberman 20:18
no, I think she'd be pretty close. She might be a unit off here and there, but I think she'd be pretty darn close the risk there is there, she want to stab me over and over again, she might want to in which case we have bigger issues to work on. But she's still very involved in and checks that I've supplies when we go traveling and make sure I have the right supplies and everything I need. So she is still very involved in. In my diabetes. I think the only thing that frustrates her is now with two kids. I'm always scared, you know, when they're a little sick, oh, my God is a diabetes. And there she tells me Look, you got to calm down. And that's tough.
Scott Benner 20:49
I was gonna ask you, you have two two children? Yeah. Do you consider like trial net? Like, where are you with the idea of wanting to know if they have antibodies or not? Do you?
Oren Lieberman 20:59
So we did trial that with my daughter, who's now three and a half years old, we did that to children with diabetes? Three years ago? She was a or maybe two years ago, I forget. So I'm all for that. I'm curious. And if certainly if it helps science beyond just my family, that's great. So I'm all for that. She hasn't fought me on that. We're just in Jerusalem. So it's a little hard to keep in touch with all of that and keep up on it.
Scott Benner 21:23
No, of course, no, I've just spoken to people who have, you know, they seem to fall in one or two camps. And, you know, I have to know, I want to know, I want to be ready. That that feeling I don't want to wonder and then there's other people are like, Look, if it happens, it happens. You know, I can't I can't impact it. Everybody's got like a different feeling. I bring this up a lot. But Sam fold. Who is a coach with the Phillies now but used to play? He was in the he played Major League Baseball for eight years. He told me, like, you know, my life is perfectly well like this, like, why would I use like, I don't want my kids to have diabetes. But if they do, you know, it hasn't, it hasn't stopped me at all. And, and I thought that was really interesting. A really interesting perspective, just like, Look, I'm a person, would they not be a person anymore? If I if they had diabetes? No, you know, and I said, Wow, that's really, that's very clear headed. And when he said that, so yeah, I don't think there's a rule. I just was wondering what you were doing. Okay, so your life is really different than most people's. But no more so I think, than the idea of wanting to put yourself off the ground. I don't understand it. I think you're probably crazy. And everyone who wants to fly a plane I think has some sort of a there's something they're lacking in their brain that says, um, it's fine. We'll float up off the ground. I can handle that. That makes me that.
Unknown Speaker 22:41
Oh, come on.
Scott Benner 22:43
nervous. But I'm impressed by it. incredibly impressed by the idea how old were you when you thought I want to fly a plane. Have you always wanted to move to an insulin pump just waiting for the right time. Try today. Go to my Omni pod.com Ford slash juice box to request a free experience kit. From Omni pod, you'll be able to try a pod for free. So if you've if you're considering insulin pump therapy, the best way to understand the comfort and convenience the pod offers is to try it firsthand. So get a free experience kit which includes a sample nonfunctioning pod and see what you think there's absolutely no obligation to buy, you'll be able to wear a non functioning pod to see how it feels fine for you on your body or on your child's body and experience the freedom you could have with the on the pod tubeless insulin pump. Oh, that's right. There's no tubes. Unlike every other insulin pump on the market, the AMI pod is tubeless. It is completely a self contained unit. There's nothing for you to stuff in your bra or to clip on your belt, just this tiny little insulin pump. It just, you know, goes with you right on your skin. Everything you need inside of it, including the insulin. And when you want to tell it what to do, you just use the personal diabetes manager. Just a little thing you hold with you, right? Keep it with you push some buttons, and then it speaks wirelessly to the pump. It's magic, like through the air. Anyway, you understand it's 2020 how things can talk to each other. I don't think you're that crazed by it. But I'm just saying at least there's no long piece of tubing that goes from a controlling unit to your infusion set. Everything's just self contained Lafave. This is the exact same insulin pump My daughter has been wearing since she was four years old for over 11 years now. Miami pod.com forward slash juicebox. Check it out today. There's absolutely no obligation. The other sponsor I'll be talking about today is Dexcom. makers of the day g six continuous glucose monitor. Now this thing is, well, it's the bee's knees. Let's be the dexcom g six will tell you the speed and direction of your blood sugar. Right? Not just speed in the direction but what it is. So imagine knowing that your blood sugar is 126 and that it's moving up at a rate of three points per minute. Hmm, think about it mulling over, what could I do with that information? Well, I can tell you what we do with it. Now, our results are ours, of course, and yours may vary. But what we do with that information, in that scenario, we put in some insulin, or if we find out Arden's blood sugar's falling, maybe we take in some food, or cut back some bazel. There's so many options when you understand what your blood sugar is doing in real time. And those options for caregivers exist even when the person with diabetes isn't with you. Now, how could that happen? Right? smoke signals, the dexcom g six sends up a smoke signal when you read it at home. No. Please don't be ridiculous. will take forever. How about Apple and Android phones, having the dexcom share and follow features. That means if your kids off at school or a playground at a friend's house, and their blood sugar starts to change, you'll see it on your phone when you're following them. be kidding me? Don't have to say more. I mean, aren't you already scrambling around going to dexcom.com? forward slash juicebox? I would think you would be listen to the next column is how we make decisions every day. And you've heard me here and I've said it before and I think I've even said it in this episode. Or a one C is spectacular. Her variability. Amazing for health. Excellent. How's that happen? Beck's comment on the pot? Check out dex calm right now. The G six continuous glucose monitor dexcom.com forward slash juice box with the links in your show notes right there in your podcast player for the ones available at Juicebox podcast.com. And while you're clicking around on the internet, have on the pod send you one of those no obligation samples.
old were you when you thought I want to fly a plane?
Oren Lieberman 27:25
Two years old, three years old as young as I can remember no kid always, always wanted to be a pilot.
Scott Benner 27:30
All right. Okay, so let's dig into this. How do you become a pilot? Like what did you want me? I'm assuming lessons is where you start?
Oren Lieberman 27:37
Right? So when I was in high school, my dad started building a home built airplane. And my dad has a PhD in aerospace engineering. He's very smart. And he loves working with his hands. So he said this will take me three years. 11 years later, the plane is finally finished. And as we were getting near to completion, and we could see completion was on the horizon of our home built two seat airplane. I started taking flight lessons at the time I was in Delaware took me about six months, flying roughly twice a week. And that's it on March 14 2007. I became a certified pilot in the US. And my wife knows this very well. That was the most important day of my life until my daughter was born. It was pilot's license, number one, marriage number two. Now it's my son, my daughter is born, my son is born pilot's license marriage, it's that important to me that I'm that I'm able to be a pilot, did it ever occur to you to join the military, she could fly more?
Unknown Speaker 28:32
Yes.
Oren Lieberman 28:34
I told my dad that I wanted to be a fighter pilot. But he said look, you're gonna go to college, you're gonna get a degree. So I did that. And and by that point, that kind of set me off in the direction of, you know, my current job and broadcast journalism. But in 2008, or 2009, I actually applied to Air National Guard units to fly fighter jets. Okay. And I got an interview with Maryland. And as I sit down, and the the application is quite exhaustive in there a lot of tests you have to go through as I sit down for the interview. The first question is, we see here on your application, it says your right eye is 2400. Is that a typo? Should that say 2040? And I said no, my right is 2400. But with with contacts and glasses, it's correctable to 2020 I knew the interview was over at that point. Okay, I knew the second I told him I didn't have anywhere close to perfect vision in one eye The interview was over. And that's when I decided I will not be a fighter pilot or a commercial pilot and interesting that that's that's simple of an idea. Yeah, they don't want that.
Scott Benner 29:32
I guess you don't want to lose your contacts while you're going mock something. And yeah. Well, this thing's really bothering me today. My allergies. Was that devastating or no, you were kindness.
Oren Lieberman 29:45
No, I remember thinking and the interview continued for half an hour or so it was weird to sit there knowing full well The interview was really over but they wanted to go through the formality of it. There was something that almost put me at peace like okay, this dream is not happening. I can Now get back to full time being a reporter and, and pursue this because I because I still enjoy it, obviously. And they were really great guys that certainly helped. There was no like, it wasn't like you suck at this move on and get out of here it was, you know, they were encouraging and supportive. But I remember feeling like this is a moment of peace I can now move on from this dream. And I will just be a private pilot and do this for fun. Hmm.
Scott Benner 30:21
Well, I before we, I felt myself moving on. But I need to ask this question before I do. Your father made a lot of things that you trusted. Like Like he he built a car, your house by hand, things like that, or just the plane and then you got into it and flew away? Which is Does he still own that plane?
Oren Lieberman 30:41
Yeah, we still have the plane, it's still waiting for me when I go home. He built our house, he at one point at a company that was building houses. So he did build our house. I shouldn't say this. But he also his fascination. He started building remote control airplanes. And he crashed a lot of them. But the upside to that is I saw him fix a lot of them. So I knew there was handiwork somewhere in there. It was just did it come in the initial build or the let's fix this later. We look I think the first time I climbed into that plane, he was probably terrified.
Unknown Speaker 31:15
Like your taxi and he's like, I wonder if I just killed that kid? Like, I mean,
Unknown Speaker 31:20
does he fly? Is he a pilot?
Oren Lieberman 31:23
No, he's not. He is he loves to build airplanes that fly. I love to fly airplanes he built. So it's a wonderful relationship. In that sense. I fly with him. I take him flying as often as I can. He's actually taken lessons and can do everything. He just doesn't have the the pilot's certificate. Okay. And I have something I think I have something like 250 or 260 hours in our plane in our family plane. Wow.
Scott Benner 31:46
So being up in the air in a plane? Is it is everything? gage related, like how do you like that, that's what throws me off. Like here, I'm gonna give you a ticket on a different road for a second. My kid was playing baseball at Princeton one day he was he was working out trying to trying to get a college taken play baseball. And I'm off to the side. And there's a guy there with a drone. So I'm using this example because I know you know the space. So we are standing at the football stadium at Princeton University. And he flew his drone out to the traffic circle on Route one. And then brought it back. And I was flipped out by that. But that doesn't seem crazy to you, I imagine.
Oren Lieberman 32:29
No, I I assume the airspace there is perfectly legal. If it wasn't, he probably wouldn't have been able to fly the drone there, the drone probably wouldn't have even gotten off the ground, or entered that airspace.
Scott Benner 32:39
He just Hey, head on a pair of like, virtual reality goggles. And it just went up in the air and he was able to like see or and you're so like, aware of this that you're not following my my incredulous discussion? Like, how the hell did he find something and bring it back? Like I don't like none of that makes sense to me. But he had gauges in front of them. And he was able to do that. And Is that how you flight? Like how would you describe being up in the air in a cloud not being able to really see anything and still go where you mean to go.
Oren Lieberman 33:11
So I do have an instrument rating, I'm allowed to fly in the clouds. I don't generally I don't fly. If it's not good weather. I like flying on beautiful clear days, I like not having to look at my instruments at all. In an emergency. Of course, if I fly into a cloud, or suddenly the weather turns to crap i can i can instantly look down at my gauges and fly off of them. Normally, I fly in beautiful clear days. And when I take you flying, we're gonna do it on a beautiful clear day. And you're going to see that this is how airplanes work. I did get my instrument rating specifically so that if the weather turns bad, I can still fly and I can make it safely back onto the ground. It's difficult, because you need to trust the gauges. ignore everything your body is telling you. But also know to look out for what happens if the gauges malfunction. or stop working when it stops feeling right
Scott Benner 33:58
like so. So trust the gauges right up until it doesn't feel right.
Oren Lieberman 34:03
No trust the gauges. It's not based on your feeling. But there are checks for the instrument. So what happens if the instruments don't agree? It's not based on what you're feeling sort of in your body because that's completely unreliable in a cloud. It's based on the instruments versus themselves and checking that and double checking. It's difficult instrument flying is is a challenge. I haven't done much of it. But I got the instrument rating for basically for safety. Okay,
Scott Benner 34:28
yeah, no, I would imagine so when you're in a cloud and you can see your brain is telling you Yo man we're in trouble like you you get that so you have to ignore that feeling of this isn't right and lean on the on the gauges and then the redundancy I guess about what some gauges tell other gauges tell you about other gauges. That is the basic idea.
Oren Lieberman 34:48
Yeah, and when I when I did my instrument rating before you before you would do a flight in the cloud, it shouldn't surprise you right? You check the weather, you know, okay, this flight is going to be probably in the clouds because this is the weather forecast. So you know ignore what your body's telling you focus on the gauges and fly off of that. And obviously, the more you do it, the better you get at it, the more comfortable it gets. I haven't done a lot of it. And frankly, I haven't done it in years. So I wait for my good clear, beautiful days to fly in those days. I stick with it now.
Scott Benner 35:19
Gotcha. Now, larger airliners, do they, from what you know, do they fly them? I mean, I don't want to use this term. It feels weird. But I, I had, I knew someone once that flew, like, you know, large people movers, you know, hundreds, right? And he's like, Look, man, you basically push a button I think takes off, you push another button that thing lands it's you know, you're there in case something goes wrong. That's how he described flying an airliner but his I don't know if he was being flippant or showing off? Like, I can't tell because I've never spoken to another, you know, pilots since then. maybe one or two? Is that how do those planes work? And, and I know you don't fly them, but what is your knowledge of them.
Oren Lieberman 35:59
I mean, the level of automation on those on commercial airliners is incredible. The the auto pilots are fantastic. The what's called the FMS, the flight management system is incredible. And you get the airplane off the ground, you can hit a button, and the plane will do almost the rest. And some planes can even land themselves. So there it is possible to do that. And that's how some pilots approach it. Some pilots take the approach that we're there to make sure nothing goes wrong. Let the plane fly itself. Others like the hand fly, and you can hand fly for portions of a flight. So it depends on the pilot. But yes, mot your modern commercial airliner is an incredible piece of technology that can largely fly itself are.
Scott Benner 36:42
Okay, so all right. So now let's get to more of why I should have gone on the podcast. I don't know if you've ever heard but 150 episodes ago, I had a man on named john. And he came on to tell his story of how his career was completely taken from him. When he was diagnosed with Type One Diabetes. He was a pilot. And in like the blink of an eye, his entire what he loved what he did what you know, the way he made his money and supported himself was gone in an instant. And so my question is has How long has it been a state is? Has this standing rule been that people with type one diabetes? can't fly? Is that certain certain larger airplanes? Like how long has that been in effect? Is it? Is it an always thing? Or always?
Oren Lieberman 37:29
Yes. Since the dawn of aviation. Okay.
When commercial, as far as I know, and I'd have to check this to be 100% sure, but I'm sure that, you know, once we created the commercial airliner system, and once the authorities and the regular regulators created the the pilot system to make sure somebody is fit for flight, if you had type one diabetes, or insulin dependent diabetes, you were not going to be a commercial pilot. Okay. And I think that was probably that way from the very beginning.
Scott Benner 37:56
And so you could fly your own private plane. Is that right?
Oren Lieberman 38:01
Even that, I'd have to check on the history of that. That was allowed in the US, I believe in the 90s. You can fly your own private plane within certain parameters. But you couldn't fly commercially, you were never going to be a commercial pilot. You could just get your own license for yourself. And even that wasn't standard. So other countries simply said, Nope, not happening. You're not allowed.
Scott Benner 38:20
Okay. And obviously, I mean, obviously, the idea is that if you have mismanaged your insulin too much your blood sugar could plummet quickly. And, you know, when exactly we're not looking for you to crash an airplane.
Unknown Speaker 38:33
And it's exactly yeah.
Scott Benner 38:36
And I'm sure there were people back then, too, who, whose management was amazing. And they're like, Look, that's not gonna happen to me. But you know, I mean, think about it, from their perspective, from the people making the decisions perspective, a large plane up there, you have lives in your hands. And you've got to whip out a meter and test your blood sugar. And you know, what, if you are getting low, and how long it would take to come back, like it makes sense, like, you know, basically, from an outsider's point of view, it makes sense that like you don't I mean, like, it doesn't seem like the most egregious thing in the world to say that somebody using manmade insulin 50 years ago, wouldn't be able to fly a plane, or do you feel differently about that?
Oren Lieberman 39:13
No, I get it as a blanket rule. I agree with you as a blanket rule, especially. You know, before we had the technologies that are so common to us, these days, CGM and insulin pumps and, and all sorts of other tools and devices to make our management better. I understand it as a blanket rule. I think we're frustrated a lot of pilots is when the technology got better. And when when when pilots with diabetes, were able to show look at how good my management is. I haven't had a dangerous low. That was when it became frustrating that the FAA wouldn't consider a case by case exemption.
Scott Benner 39:47
They were like no, we have a rule and that's that.
Oren Lieberman 39:50
Yeah. And that's, that's what frustrated a lot of people and that's what a lot of people were also advocating for from the American Diabetes Association to to the aircraft owners and Pilots Association. And they were all pushing for the FAA to take a second look at this.
Scott Benner 40:03
Yeah. Is it the advent of technology that move this along? Or is it just people pushing? What do you think got us to where we are now, which is, you know, the rule being overturned?
Oren Lieberman 40:15
Both, I think there's a lot of banging on doors from a lot of people. But also in in writing his decision, the Federal air surgeon wrote, the technology has gotten to the point where this is manageable, you can manage and manage very well, your your diabetes, with insulin in flight. So what what the change now has done is it used to be that you that if you had insulin dependent diabetes, you couldn't apply for first or second class medical. And that's the sort of level of medical required to fly commercially, to fly commercial airliners. And now they'll say, we'll consider this on a case by case basis. And that's the big change, that they're even willing to consider the application.
Scott Benner 40:55
That's an enormous change. It's not a no, it's a huge, it's a huge step for but it's not a blanket, it's not like, it's not like if you have diabetes, right now, you just say, I have diabetes on my medical form, and they go, that's fine. And you get you get this distinction. It's still it's case by case, they're gonna they're gonna sit and review every person with type one diabetes who who wants to have this this license? Is that right?
Oren Lieberman 41:19
Exactly. And I haven't talked to anybody going through the process, although I know there are a few who have begun to go through the process. But I imagine it will not be pain free, quite exhaustive, even especially as they start doing maybe even quite difficult. They want to see, I'd imagine they want to see your records, they want to make sure you weren't hospitalized with a low blood sugar.
And, frankly, all of this paperwork just takes time to dig up.
Unknown Speaker 41:43
will outlast them.
Oren Lieberman 41:46
But But you know, but the process is there. Yeah. So what
Scott Benner 41:50
I was thinking is that, you know, the advent of the technology makes them think of it differently. But they're not saying you have to use the technology. So I could still roll in with my pens and my meter and be like, Look, I hear my records, I've been fine. And they'd still have to consider me it's not like they're saying, look, you have to work at Dexcom, if you want to do this is that? That's
Oren Lieberman 42:10
a good question. I don't know they may require. They may require a CGM. Instead of simply you know, an old school, one touch where you're pricking your finger every hour, they require you to be able to check instantly and know not only your current blood sugar, but the last X amount of hours. So you know what? Your trending? Yeah, I don't know. I don't know specifically how they're going to do that. But something like that wouldn't surprise me. Because they want to be exact on this. There are other countries that allow insulin dependent diabetes to fly commercial aircraft that require two pilots. So one of them has insulin dependent diabetes, the other does not. So for example, Canada, I believe, allows that
Scott Benner 42:47
they're so nice.
Oren Lieberman 42:48
And that's I think the direction the US is going in the US won't allow you to fly plan on yourself, but by yourself with somebody else. You know, if you're if your blood sugars are carefully managed, they've decided it could be safe enough with another pilot in the
Scott Benner 43:02
cockpit. But again, that doesn't seem unreasonable to me. It's you know, you can't ignore the fact that I mean, listen, I'll warn you my daughter's 15 she's had diabetes since she was two. I am you know, it. Cheese. I just tripped over my own words, because I don't want to sound like a douchebag. But I'm incredibly type one diabetes. Okay. And so my daughter's a once he's been between five to six to for over five years, or variable. Wow, terrific, or stability. You and I have been talking right now her blood sugar has been 85 the entire time we're talking she's at school. And and I know how to do this pretty well. There are several times when out of nowhere, I'm like, Why is her blood sugar falling like that, like I, you know, in a million years could not have predicted, you know, today is going to be the day that this is going to happen out of nowhere. And I have a fairly good handle on it. But, you know, it also comes down to, in my mind also like, like civil liberties. You know, there's, you know, I think it's, uh, you know, we say MIT, you know, there's a lot of jokes about different people's professions, but, you know, drinking amongst pilots is, is something that I think is a is not unheard of. And yet, you know, that happens. And there's no, like, hard and fast rule that you have to, you know, blow into a breathalyzer before you go into a plane. So, I mean, where do you draw the line for people who, you know, not to, again, I'm not it's not apples to apples. alcoholism and
Unknown Speaker 44:34
but I'm saying like, you
Scott Benner 44:36
know, what, I was saying oranges, you're pretty Yeah, alcoholic here with you there. You know, I'm just saying like, you know, this is something that's known. And it's not like everyone's being cut away. And so you get, you know, you get a chance to prove yourself that's, that's, that's America right? At the same time, I don't want you proven yourself while me and my family are trying to get to Disney World. Maybe Great Day, but but it's a really interesting conversation. And I think it's moving in the right direction. I'm incredibly excited about where it's going. Because after listening to john talk about this thing that he loved so much, and hearing you talk about how much you not only love flying, but you've wanted to do it your entire life, it seems incredibly arbitrary to just take it from somebody like that.
Oren Lieberman 45:23
I agree. And and look, certainly I'm frustrated that the process is taking this long, but the FDA is now on board. Like I said, the first few through the system, I'm sure it's gonna be a pain in the neck, and it might be a pain in the neck for everybody. But at least it can be a pain in life, at least the option is there. Yeah. And you can pursue this.
Scott Benner 45:40
Yeah, get into the fight, try to make it work. I do find myself wondering while we're talking, if there isn't going to be just sort of an institutional bias because this has always been this way. And, okay, we've given you guys your attempt to, you know, you're allowed to get into this now and try to get through the system. But we don't really want I wonder if there is that we don't really want you here, and we're gonna make this really difficult feeling or if it is an open feeling, and they are looking for people who were are great candidates for this. I hope it's the latter. But, you know, sometimes there's boys clubs that, you know, I mean, sometimes people, you know, you know what I'm saying like, it could be that situation where they're like, Alright, we let you apply, but no, and that's it. I'm dying to find out like, I can't wait for people's applications to get through and, and to see how it goes. Because I'm hoping for, I'm hoping that it's just case by case and get your license back. That'd be amazing.
Oren Lieberman 46:33
Yeah, that would be incredible. And the one thing from that perspective we have going for us is there's a massive pilot shortage in the US. So at some point, massive pilot shortage over the over the course of the next decade or two decades. As somebody might be, it might, you know, the airlines might not think this is the greatest idea right now. Look, if the FAA has signed off on you and giving you the permission to fly with insulin dependent diabetes, the need is there, you're signed off, they gave you your medical get in the cockpit and start flying.
Scott Benner 47:03
I got in a plane the other day, and the pilot didn't, he was so old that I thought someone must have carried him into the cockpit right now. I'm just gonna hope that means, you know that he's got a lot of experience. But I'm expecting like, at that age to the nappy, you know?
Oren Lieberman 47:23
It's got that's a bit harsh. That's a bit hard to come on. Come on.
Scott Benner 47:26
I don't know I get sleepy. Now. I'm not even 50.
Unknown Speaker 47:29
So.
Scott Benner 47:31
But But no, I mean, it's, it's, it's really, again, there's a shortage, what popped into my brain was what we have now is the glut of common sense.
Unknown Speaker 47:39
Because
Scott Benner 47:42
Do you know why there's a shortage? Is there something that they can point to?
Oren Lieberman 47:48
There are a lot of reasons. It's not the glamour job at once was, you know, sort of the 50s 60s and 70s. It's a very difficult industry. You know, you start your holiday in the middle of the night flights and small airplanes to try to build up your hours. It also takes a lot of time to build up the hours necessary to be a commercial airliner, all of that just makes it more difficult to be a pilot and fewer, fewer and fewer people are interested in going that direction. That plus so many other reasons, has led to just a massive shortage of pilots over the course of the next, you know, decades, especially as air travel itself is growing and growing continuously. Yeah,
Scott Benner 48:26
it's funny, you made me think if I'm remembering correctly, when john was on, he talked about he is was still able to, like fly cargo, I guess. or in small, I guess in smaller planes if I'm remembering right, that's but you know, but he would describe it as like, these long overnight flights, like over mountain ranges and just you know, not not what he was doing prior. I do think to his airline allowed him to do training for people, which I think he still found, like, satisfying, but obviously not the same as flying.
Unknown Speaker 48:59
Right? What isn't? It could very well be Yeah. What is
Scott Benner 49:02
it about? The Can you put it into words like what's amazing about flying, if I said to you, if I took this from you, you would miss? Like, what is that thing for you?
Oren Lieberman 49:12
It's magic. It's the closest thing to real magic, you will get on God's green earth, the ability to hop into an airplane, flip a switch, you know, crank the engine over and take off. That's it. I don't I don't have to worry about gravity anymore. Until I run out of fuel. It there's nothing like it in the world. Just being able to take off and do what you want fly up and down the East Coast. I've taken our family's home built airplane up to Lake Placid down to Jacksonville, as far west as Nashville.
And it's everything about is incredible.
Scott Benner 49:45
So and I grew up fairly broke. So we didn't go on vacations or you know, smile. I'm just kidding. But we didn't go on vacation. And I didn't fly as you know, a child. So I'm going to tell you this brief story. I don't think have ever told this story. But it belongs here. So it's late at night. We're in outside in northeast Philly, all hanging out of the movie theater. We're friends of ours work. And it's got to be like one o'clock in the morning. And this one of our friends comes pulling up super, like fast like, this comes to a screeching halt. We're all outside, it's a summer night. And he's like, yo, you guys got to come down to the northeast airport, stuttering john from the Howard Stern Show is going to be there in an hour, and he's flying out, we can meet him. And you know, we're like 19. So that's the right thing to do. And you know, and so we get in the car, we drive down to this little airport. And we're all hanging out, you know, in the office waiting. And sure enough, here comes, you know, this guy who works on the Howard Stern Show, and later, I guess, was on The Tonight Show with Jay Leno. And he's with a friend. And it turns out, they had a band and they were playing locally in the city. And he had to go to Albany, because howard stern was running for governor or something like that. And they were doing this thing, and he had to fly away. So we're all just standing there like talking a little bit. And we kind of just walked with Him out on the tarmac to this, you know, small plane. And he climbs up the stairs to get on the plane. And he turns around to realize that his buddy was not with him. And he looks at his friend, and he says, Yo, man, come on, and the guy goes, I can't go with you. I have to go back to the gig and clean up our stuff. And john says, I'm not getting on this plane by myself. And he makes eye contact with me. He goes, you want to go to Albany? And I went, Yes, I do. And I walked, right. I walked forward, and I and I start going up on the plane. And I realized I'm there with five or six friends who I'm just abandoning, like with no thought whatsoever.
Unknown Speaker 51:41
And I said, I said to him,
Scott Benner 51:42
I said, Can I bring somebody with me? He was asked the pilot, I said, can we bring more people and the guy goes, you bring one more. So I turned around, made the hardest decision of my life, pick my friend Mike over other people who I really love. We get on the plane, we're, you know, he said, Thank you, I didn't want to fly by myself. I would have been nervous. And we're taxiing down the runway. And this plane is picking up speed and it gets ready to look off the ground with off the ground and my buddy looks me right in the eye. And he goes, you've never been in a plane before. And I didn't realize it until he told me because of the moment I had never flown I had never been off the ground. And I had my friend not told me I would not have realized that as the plane got up. Because it was just such a bizarre set of circumstances, you know? Anyway, we get to Albany and and it was a really cool flight and asked him all kinds of questions about his life and stuff like that. And but it was before cell phones and you know, anything. So my friend and I are in Albany, New York with no wallet, no phone, no anything. And he and he's like, so what we'll do now and I'm like, oh, man, we got to go back. You know, like I can't stay like a city at least tomorrow, you know, and he couldn't promise that so he looks at the pilots because we take these guys back and the pilots are all like trying to you know be nice to john like of course of course, we get on the plane and and they shut the heat off. They didn't care about it. Like we were not employed we were returned into cargo on the way back but my buddy and I got we landed it like sun sunrise and then walked three and a half miles home because we were abandoned at the airport by our by our friends. But it was a really incredible night and the first time I'd ever been on the plane now I fly a lot to go to speaking stuff but and you know vacationing and things like that once in a while. But yeah, I hadn't I'd never thought about being in a plane until I was in one.
Oren Lieberman 53:30
So how do we get from there to you not liking flying all that much? It's not good. That seems like a pretty, pretty good start.
Scott Benner 53:37
I don't mind flying. I don't mind being in a plane actually at all. I just can't imagine the idea that I would want to be in charge of the plane. Like that's the thing that I can't wrap my head around. Like I was in Costco yesterday looking for something. And I realized that I'd walk down the same aisle three times. And that doesn't to me seem like the kind of person who should be in charge of flying something through the
Unknown Speaker 53:57
through the air.
Scott Benner 53:58
I just don't think I have the focus it would take to do that. It just seems like it like you said it's it seems magical. I don't think I'm magical. I think I'm a good driver. I just I don't I don't think I could be in charge of a plane.
Oren Lieberman 54:13
Look, there's much less to hit up there. You don't have to worry about driving vs flying. So you've never had the controls in your hands of an airplane. Never. No,
Scott Benner 54:21
no, that seems that seems otherworldly to me. It really does. Like
Unknown Speaker 54:25
Alright, I'm gonna take you flying G's or you're gonna kill me just for this podcast. That's fine. And
Oren Lieberman 54:31
it'll be it'll be a later podcast. But I realized I live in Jerusalem and I'm not home that often. But hopefully over summer, we'll put the controls in your hands. I'll do takeoff and landing. I'll take care of that. You do everything else.
Scott Benner 54:42
I'll tell you when you were email and you said ask Arden if she'd like to go and I told her and she's like, yeah, I'm not doing that.
Oren Lieberman 54:49
Come on. That's not fair.
Scott Benner 54:50
But I guess fair. Whatever is in me is in her because she was like, Who? I don't know. Um, no, thank you. And I was like, it is really well, you know, it's sort of it's Sort of society to like, you know, a fan go to an airport and a company owns the plane all the sudden that seems more. I don't know what legitimate, you know, but it's not like a like, what's the difference between I also live through john Denver crashing so I've been I was alive for.
Oren Lieberman 55:17
So, Scott, you're easy to convince because all I need to do is tell you the best sandwich shop I've ever been to. Is it an airport in Virginia and I'll fly you there.
Scott Benner 55:25
I I'm not gonna lie, it would probably be pretty cool. I have a funny you said that because I have a speaking thing in Virginia in August. And I said to them, like, you're not gonna expect me to drive to that, right? Like, I have to fly and they're like, No, no, we'll fly. You don't say okay, I said, because I'm not driving that far. And and it's only a few hours. You know, I have no problem. I'm gonna be in a plane. Five, six times in the next six months. I've no thought I don't I'm not a nervous flier. Like nothing about flying bothers me whatsoever. I have a real Zen feeling about life and death. Like I'm up there. Now. It's either going to get on the ground, or it's not like I'm not going to spend time worrying about it. That I'm okay with. I have no trouble with that. Alright, so we'll see what happens. How and you do? How often do you get home? Is it just to visit family, usually
Oren Lieberman 56:10
three or four times a year and my number one priority? I tell people that seeing my family. My number one priority is seeing my airplane is is scheduling a day to go to the airport and get in getting some flying? Can you fly in Jerusalem at all? Theoretically, I could try to transfer my license. But everything is here. Everything. Everything here is military airspace, which means there's no like freedom of flying like there is in the US in the US. I can take off from Old Bridge New Jersey and go just about wherever I want. Here. It's there's none of that here. It's you're doing this, you're doing it at this altitude, go here, do this. I'll save my flying for the US.
Scott Benner 56:49
Wow. Okay, so a couple other questions before I let you go.
Unknown Speaker 56:53
Of course, you wrote
Scott Benner 56:54
a book called the insulin express what? What got you to do that?
Oren Lieberman 57:00
So when we started traveling, I decided I wanted to write a book. The problem is everyone who decides to travel decides they want to write a book. So I didn't actually know what made my story, a good story. And then I was diagnosed with diabetes while traveling. And I decided okay, now I have a story. And it ended up being It was supposed to be a book about travel. And now I think in the end, it's more a book about travel with diabetes, the diagnosis, the symptoms that I ignored, until until it was almost too late. And then getting back on the road. And it's intended to be funny, hopefully a little inspirational for those who read it and just sort of have a good time and, and hopefully it inspired a few people to get out there and travel. Excellent.
Scott Benner 57:42
Well, I I'm a big proponent, actually some Joking aside of, of people not being afraid with their diabetes. So I'm gonna I'll put a link with the podcast episode to your book. Is Amazon the place you'd want them to go get it? Yeah, thank you. No, of course. No. That's Isn't it funny you think? Because of your job, right? I guess who you are. It's like your story. you consider yourself a storyteller? Like, like, take the Yeah, write the news and turn it into something that people would be interested in listening to.
Oren Lieberman 58:13
Yeah, I've always viewed Our job is part of my job is to gather information. And the other part of that is to make make that information presentable and interesting. That whole part is the storytelling part. And, and that's the part I enjoy is making something, you know, making something compelling and interesting, and I hope I did that with the insulin Express. Yeah,
Scott Benner 58:31
I have to say, like, I'm, I'm proud of the podcast for that. Because, you know, when I, when I first started doing this, like, five years ago, somebody told me, you're gonna run out of things to talk about about diabetes, and I was like, No, you're thinking about it wrong. You know, like, it's not just a it's not just a way to say things that people that is, you know, medicine things that they should hear, but they don't want to hear like, this is a way to have conversations about things. And, and open it exactly right. You know, and I think that I think of myself that way a little bit too. Like there's a way to take diabetes, and turn it into something you want to hear about. And and I think that's a, I think that's something that everyone should be doing, instead of just delivering dry information. Like I don't know, I couldn't listen to like I always say if it you know, you could put the secret to life at the end of a one hour podcast, but if it was boring, I probably wouldn't exactly know if I need to know that badly, you know, to listen straight through. But I just, I think that's a really incredible thing. So I don't know how comfortable you are with this. But I am incredibly interested about this and like I know somebody who's a professor at Princeton who does a lot of travel to Israel, and I every time I'm with her I asked her like explain the conflict in Israel to me in like layman's terms. And would you Oh God, would you can you do it? Can you turn it into a like a five minute after school special version of what it is that's happening in Israel like and why it's important. Are you too big of it? Wow. Is it too big of an ask?
Oren Lieberman 1:00:03
I may, let me think of is it too big of an ask this is basically describe everything I talked about.
Unknown Speaker 1:00:11
Like why should I?
Scott Benner 1:00:12
Why should someone who doesn't normally care, care about what's happening there? Maybe that's a more fair question.
Oren Lieberman 1:00:22
Well, that that's an easier question, because what happens here very much ties now into the US in the US foreign policy, to some extent in the US domestic policy. And that's because of the relationship between not only President Donald Trump and Prime Minister Benjamin Netanyahu, but also between Trump and Israel. His relationship with Israel is very important to his voters, to evangelicals and, and, and some, you know, many religious Christian voters. So in that sense, the two are very much linked. I may live in a you know, in a different country, but they are very closely linked from the perspective of modern US policy and modern US politics and the history of the conflict question and sort of what it's all about that what that will push off, that's a, that's a long, long discussion, I can send you guys a whole bunch of links of stories I've written and that will only be a fraction of, of catching you up to speed on what it is we follow here. It's too big, because of just time and how long it's been going on, and that there are two distinct, am I right, that there are two distinct points of views? Yeah, absolutely. And, and beyond that, two distinct narratives of events view different ways. Decisions viewed as taken for different reasons. claims of connection to the land, almost kind of who was here first, and, and why I have a right to be here, and you don't have as much of a right to be here. It all goes into that. And then the context of, of what's what's important, and what's not. All of that comes from two entirely different perspectives. And it's, it's my job or part of my job to consider all of that when we decide what it is we're going to say and and how to say it.
Scott Benner 1:02:03
So when people are delivering the news, or there's, in my mind, there's two ways to deliver it. Right? You deliver the facts, or some people deliver the facts with their personal feelings involved. Right, like and you are you would you consider yourself? The former, you're just delivering the facts.
Oren Lieberman 1:02:21
That's my job. And that's what I try to do. Yeah, I try not to let my personal feelings get involved in any way. I do try to add analysis and that goes beyond just the facts. That's, that's kind of the facts. Plus, how does this figure into the current situation? Or, or sort of how did we get here? Or where's this going? That's beyond the facts. But that's, you know, I try to be as sort of cold and unemotional in my analysis, as I can be. Yeah. But that's, you know, in a sense, that's just part of the story. The facts are one part and the analysis around it tries to make it more interesting and put it in some sort of context.
Scott Benner 1:02:53
Yeah. So for me, I think that if everyone has whatever the facts are, then it'll shake out over time. And I think the problem is, is that we all want things to be fixed so quickly, like we, you know, we don't want to wait a week, we want to wait an hour, we don't want to wait a year, we want to wait a week, like everybody wants it to be quick. And I'm sort of of the opinion that if everyone just understood what was happening, that slowly over time, things would work out the way they're going to work out, when you start trying to manipulate what's happening to to get to an end, then you get to that end artificially, and you're never going to be there comfortably. Even if you get them there. I don't know if that's convoluted or not, but, but you can't get to something in a false manner, because it won't be true. And then it'll just it'll, it's never going to be something we can move on from I guess or to build on top of like, I just feel like you have to let the chips fall where they may. And and I'm very happy for people like you who are able to deliver that information and let people make their own decisions or let it impact the world the way it's going to.
Oren Lieberman 1:04:01
I try. You know, I hope I hope my viewers think I'm doing a good job. I hope our viewers think I'm doing a good job. But it's just but at the end of the day, that's certainly my goal.
Scott Benner 1:04:10
Yeah. And and do you do you find enough? This is difficult for you? I'm not sure. And I know I didn't say I was gonna toss but is it? Is it difficult to be doing this job right now? Is it more difficult to be doing it now than it has been in the past?
Oren Lieberman 1:04:23
Yeah, I think so.
Yeah, I think so. And part of that is, you know, we want to build on the facts, but when we can't agree upon the facts, it's a, you know, that's a whole different world of problems, right?
Scott Benner 1:04:40
No, no, I it's difficult to talk about because you feel like it's interesting. In the past, you feel like you could have a conversation. And now it feels like if I say something, I'm going to alienate half of the people listening. And and it's hard because then I think we stop having honest conversations and then it's tough to, to know what happens next. Like, right if we If, if you're in a, if you're on one side of a paywall, and I'm on the other side of a paywall, and I'm just seeing what I want to see, and you're seeing what you want to see, and then how do we, how either of us understand what's happening anymore? It's I don't know. It's interesting. It's a very interesting problem.
Oren Lieberman 1:05:16
Yeah, I agree with you. From my perspective, you know, I think this gets at what you're pointing out, the middle ground is missing, you know, let's meet and discuss in the middle ground, except when when the middle ground is missing. It's tough to even begin that conversation. And and, you know, it turns toxic when it shouldn't. Right.
Scott Benner 1:05:32
Yeah, you know, yeah, if that's well put, it really is. I'm sorry, I didn't mean to put you on the spot. I'm just it's fascinating. Like, I could have talked to you about a completely different thing today. I just I you know, what I think it happened to me is that the big report came out this morning. And it got me thinking about all that, right. I was always jumping on with you. And I was like, Oh, see, look, here's the report of what happened. someone's like, that's not what happened. I'm like, What the hell? Yeah. It's like, exactly. It's like, I feel like it's snowing and someone's telling me I'm on the beach. And I'm just like, I don't know what to do. Did I? Did I leave anything out of this, that I should have brought up that I that I'm a miss for not?
Oren Lieberman 1:06:16
I don't think so. Other than the ironclad commitment that you're gonna come flying with me. All right. All right. All right. Okay. All right.
Scott Benner 1:06:23
So when we, but when we land, and we go to chickies and pizza afterwards, or we're gonna be close to
Oren Lieberman 1:06:28
Oh my God, I miss chickies and pizza. There's so many things that I miss. And there's the stupid things right? I miss Chinese food. There's an Asian restaurant here, a new one. That's fancy, and it's like General Tso's Chicken is 20 bucks. And it's like, No, I want to pay $6 for this and I want to feel horrible after I eat it. That's what I miss. I miss dunkin donuts. I want a large watered down American coffee. That's the thing.
Scott Benner 1:06:50
That's amazing. I know already. So there is an airport in my town. So I guess I'm gonna have a hard time making up an excuse for this. But okay, let's stay in touch. And you can you can you can drop me out of the sky in a rock if you want to. I don't.
Oren Lieberman 1:07:07
I don't have that kind of range. So you're safe.
Scott Benner 1:07:10
It's amazing. So do you like do you plan ideas around the idea that you can fly like both fly here and then do this or?
Oren Lieberman 1:07:17
Yeah, look, if the weather in a perfect world.
You know, we'd fly to Delaware, but a 45 minute flight. We'd have lunch and fly back. Okay.
Scott Benner 1:07:26
All right. All right. I'm in.
Oren Lieberman 1:07:28
If you're having a good time, we can fly to Virginia and fly to my sandwich shop. That's about two hours in the air. that's a that's a bit much for sort of a first flight when I'm giving you the controls. Yeah.
Scott Benner 1:07:36
Oh, yeah. I'm not looking to. Plus you. You heard me earlier. I could get sleepy at any point. And we have an autopilot. Okay. All right. All right. I'm in. Alright, you back and then that'll be it. I really appreciate you doing this so much. Give me one second to say goodbye to you without the recording,
Unknown Speaker 1:07:53
of course.
Scott Benner 1:07:54
Or in Lieberman's book, the insulin Express one backpack, five continents, and the diabetes diagnosis that changed everything is available@amazon.com. Except they say amazon.com. And I don't feel like re recording that. So there's a link in the show notes to get the book or to check it out. And just kind of gotta live with my terrible pronunciation there for a second. I want to thank dancing for diabetes, you can find them at touched by type one.org. I want to thank Dexcom for their sponsorship and support of the Juicebox Podcast and of course on the pod the world's only tubeless insulin pump. The combination of Dexcom and Omni pod in our lives has been astounding, impactful, lovely, comforting,
Unknown Speaker 1:08:49
and much more.
Scott Benner 1:08:51
But it was very feeling Did you feel that I really meant that. Anyway, I hope you check them out dexcom.com forward slash juice box, my omnipod.com forward slash juice box links in the show notes for your podcast player the links that are available at Juicebox podcast.com. Or of course you could just type these things in your browser. We appreciate you supporting the podcast by supporting the advertisers. Here's a little bonus for listening through to the end. This is from the FAA faa.gov the Federal Aviation
Unknown Speaker 1:09:25
Administration
Scott Benner 1:09:25
guide for aviation medical examiner's decisions considerations, decision considerations, right this stuff, decision considerations disease protocols, diabetes mellitus type one and type two insulin treated non CGM third class option, consideration will be given only to those individuals who have been clinically stable on their current treatment regimen for a period of six months or more. The FAA has an established policy that permits this special issue Medical certificates and God's name Why don't they just say this in English this special issuance medical certification to some insulin treated applicants. Individuals certified under this policy will be required to provide medical documentation regarding their history or treatment, accidents and current medical status. If certified, they will be required to adhere to monitoring requirements. There are no restrictions regarding flight outside of the United States airspace. airman with a current third class certification will have the limitation removed with their next certification or their next certificate. I guess that could have said either not not with their next either but their next certificate or certification just happens to say certificate I picture ledger hung out for this. If they need the limitation removed sooner, they should contact a MMCD for an updated certificate without the limitation. The following is a summary of the evaluation protocol and an outline of the condition that the FAA will apply for third class applications first and second class applications will be evaluated on a case by case basis by the Federal air surgeon's office. That was right there on faa.gov. At the bottom in parentheses, it says note insulin pumps are acceptable. This page was last modified November 7 2019 4:06pm.
Unknown Speaker 1:11:34
In the afternoon, Eastern time. Well,
Unknown Speaker 1:11:40
that was something
Unknown Speaker 1:11:43
I think we've learned that I can't read.
Scott Benner 1:11:46
Alright, I'll see you guys soon.
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#295 Defining Diabetes: Insulin Resistance/Overbolus
Defining Diabetes: Insulin Resistance/Overbolus
Scott and Jenny Smith, CDE define the terms that are at the center of your type 1 diabetes care.
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+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
This episode of defining diabetes is sponsored by our newest sponsor the Contour Next One blood glucose meter. This is the blood glucose meter that Arden has been using for well over a year, maybe a year and a half. And it is without a doubt noble, the best, most accurate blood glucose meter. Arden has used in what is now 14 plus years of diabetes 14 Plus I love math widow. She's two inches, I've noticed 15 she's almost 68345 678-910-1112 I lost count for like 13 years when I say it's been so long, I forgot what I said. She's 15 she was diagnosed which too, anyway said a lot of meters since then. A lot of years, a lot of meters. This one is without a doubt. absolutely the best. You know what, I'm just going to tell you why right now sample size, not a lot. If you miss with your little like you know, you touch the button or sometimes you touch it, it doesn't work that doesn't waste a strip, you have a nice long time to put it back on again and get more blood without affecting the test that of course, amazing. If you want the Contour Next One has a app that comes with it, which is a darn handy, you can check that out. I can tell you from personal experience that Arden has never had a meter that has more closely and more frequently agreed with her Dexcom JSX really gives you a lot of good feeling when that happens. The meter is an industry leader in accuracy. And I will actually share some of those numbers with you in a future episode. The app by the way is available on the Google Play Store and the App Store. By Contour Next One is compatible with Apple Health. And those of you using an omni pod dash, the Contour Next One will send the information right into the dash magic, Bluetooth magic. All right, listen, for now, I want you to go to Contour Next one.com. Now contour spelled the classic way CLN to you our next again, only one way to spell Next one is the word not the digit. So Contour Next one.com head over there today. Check them out. But you know, if you're going to do it, here's the link in the show notes or the one that you'll find at Juicebox podcast.com get Arden's meter today, it is spectacular.
Jenny Smith is back today Jenny and I are going to define insulin resistance. And it's not exactly the way you think of it, which is why we're bothering to take the time to talk about it. We're not just like, whoo, pick something everybody knows. You think you know about insulin resistance Jenny gonna shine a bright light, a bright light on what it means. While you're listening to Jenni spin her genius. Try not to forget that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And that you should always consult a physician before making any changes to your health care plan. or becoming bold with insulin. I could say that my sleep by the way. All right, I'm not gonna make you a bag. We're gonna get right to Jenny. Don't forget, by the way, if you want to hire Jenny, she works for integrated diabetes, you go to integrated diabetes.com to find out about Jenny. Jenny is not a sponsor. Jenny is my person. So I don't get anything out of it if you go except good feelings. So you can go through my link if you want. If it makes it easier for you. You just type right into the browser don't matter. Here we go. Here we go. There we go. Here we go.
I would like to define insulin resistance
Jennifer Smith, CDE 3:59
and insulin resistance. That's a good one a very good one. And I'll tell you why.
Scott Benner 4:03
Why does this one come up on my list? It's because again, I think it's the same thing as brittle in a different in a different avenue, the same idea? Maybe not always. But I think I think there's insulin resistance and there's reasons for it. But first, can we define it?
Jennifer Smith, CDE 4:21
Sure. I mean, insulin resistance is essentially the body's pushback, a simple, I guess, simple definition, the body's pushed back in appropriately using insulin, right? It's just not it appears that insulin is just not working the way that it's supposed to people with insulin resistance and that which is a technically a hallmark of type two diabetes is insulin resistance because in the early phases of type two development, there's actually a huge output of the pancreas producing more insulin like loads of insulin to actually overcome the higher blood sugar levels, but their body's cells are not responding to the insulin, the right way to the body just keeps pumping out more and more and more insulin and offense. Eventually, with type two, the pancreas gets pooped out. I mean, those cells are like God, we just we can't put out like more and more and more, we're doing enough and it's just not working. It's a bit different in type one diabetes. I mean, there are, there are some hallmark, like diagnostic reasons for true insulin resistance in type one. One of them is weight management, the the heavier that you are above, your body's like, target healthy weight, the more resistant you're going to be to using insulin, the insulin is just not going to work as well in the body. Another one specific to women is something called pcls, polycystic ovarian syndrome, and that, that actually causes a whole like series of metabolic changes, one of which, however, is insulin resistance. A woman with pcls will usually need a lot more insulin to manage. And it's based on a hormonal component to the ovarian syndrome that's kind of going on.
Unknown Speaker 6:20
So
Jennifer Smith, CDE 6:23
in general, though, insulin resistance with Type One Diabetes, if you are, you know, your healthy weight, active and whatnot, everybody's insulin needs are very different. So when we talk about insulin resistance, I think a lot of people might look at a friend of theirs, who's the same height, weight, you know, doing the same kinds of things. And you're like, Well, why am I using double the amount of insulin is dumb? What's the deal, I must be insulin resistant. That's not the case at all. I mean, I've got a friend who's actually, she's tiny. She's had diabetes several years longer than me. And I've had 31 years, and she actually uses more insulin than I use. She's only five feet tall, and she probably weighs 10 or 15 pounds less than I weigh. And, but she us and she's very active. Um, she's actually roller derby. She's done a couple of like, full distance Ironman, you know, events. And so, in that, I think sometimes there's a lot of confusion, confusion around how much insulin Should I personally be using? It's different for everybody. Gotcha.
Scott Benner 7:31
Okay. So I brought it up. Because engineer, can we slide your phone slightly away from the microphone, I think, yeah, absolutely. I think I brought it up. Because I know it's a real thing. And I wanted you to explain what it really was. But I also know that people default to saying it too frequently, when I don't think that that's what's going on. Right. So a great example would be if you're dehydrated, and you know, you're using insulin, and it's not giving you the you know, the response that you expect. And then you hear people say, Oh, I was, I was really insulin resistant today, but you weren't really insulin resistant. Today, you were really dehydrated today. And so and it because and the reason I bring it up is because I think the idea of insulin resistance allows people to think this is something beyond my control. So I'll just accept it. That's what that's why I brought it up. Because that worries me for people when that happens, right? Great example, is I've been helping this really wonderful family recently with a 16 year old boy who's, you know, an athlete plays ice hockey. And yesterday, the kid went to an ice hockey game and got to play the game, like right around like 95 the whole time, you know, didn't cross out crash low afterwards or anything like that. And I realized that prior to that, they were doing the like, will get his blood sugar higher thing. And you know, and he didn't feel well, he feels so much better now. And all this stuff is great. And it's really cool. But they were living in a false narrative before, right? Like, this is what's happening to me. And so I have to accept it, or I have to do this thing that I don't want to do, because this is what's happening. And and I don't think people should. I don't, I don't want to say I don't think it makes me sad. Honestly, when that's happening, you don't mean like, I don't like the idea of someone running around going, Oh, my blood sugar was 250. Today, I was just insulin resistant, when there could have been a real reason for it. So try to just keep in your head. The difference between what Jenny just explained with insulin resistance really is like for instance, a pregnant person could use a significant amount of insulin right then then they would even have five seconds before they're pregnant. We're in their first trimester versus their third trimester, like all these different ideas, but that's not that's so that's that. Okay, so I just please
Jennifer Smith, CDE 9:53
and I think a good thing to kind of put in there with that is that there may be times when Insulin resistance is a piece of what is happening, like you just brought up pregnancy, right? There is a piece of points in pregnancy where Yes, insulin resistance comes into the picture. But why is it there? It's not that you're going to be insulin resistant for the next 90 years after the child is born. It's the fact that there's a hormone piece in the picture that's causing you to actually you need more insulin, you just need the hormones are causing that issue. So it's not like a type two, where the cellular level of response to insulin is actually a piece of
Scott Benner 10:34
your so is it fair for me to say that, like I bring up on the show your body is for whatever reason, telling you, I have more of an insulin need in this moment. And you need, you just need to meet it. So if you are insulin resistant in that moment, there is enough insulin to use to overcome that blood sugar, right? It just it gets to a scary point for most people. And they're like I can't, the numbers get wrong, the numbers get wrong in their head. Like, I'm usually my base is usually a unit an hour. And I've never bolus more than four units for food. So they just won't go bigger than that guy. And people who and people who haven't gotten their bazel right and done all the things we talked about in the podcast probably shouldn't start crazy bolusing like that, because they are going to have a heart problem. But but the breath but the reason I bring up the boy with the hockey is because he can stay stable while skating and playing hockey now because his bazel insulins, right? Because he's bolusing on time with his meals because he doesn't have any unbalanced active insulin in his system that just pops up at weird times. And doesn't have a fight with food anymore. So it just kicks his ass instead. Like, right, correct. Okay. All right. Thank you. This is my my, my defining diabetes list is about like, all the sad things I hear people say. Can unit
Jennifer Smith, CDE 11:52
No, let's clear that up. No, that's not right. Let's make sure you understand that better. Yeah, I
Scott Benner 11:57
just I look and I think oh, it's sad that that's what, what what is thought? Right.
Listen, I'll give you a quick story, right? And then I'll ask you to define overbought listening. I made a diabetes podcast, the very, very beginning of 2007. And because of Excuse me, I made a diabetes blog in the very beginning of 2007. And because of the nature of the internet at that point, I didn't really know the other diabetes box. Like there was a little while where I thought to myself, Hmm, I am doing something so cool that no one else is doing Why did no one else think of doing this? I am a genius. I felt like the Magellan of like diabetes blogs. Right? I was just looking around. I'm like, why couldn't know how Scott's idea is so much stronger than everybody. Then I realized there were a couple other diabetes bots. Right. And there had been a number of them proceeded mine. I had no idea about them when I started mine.
Jennifer Smith, CDE 13:14
But I had, I think, I think Carrie sparlings was one of them. I think she started in 2005 or 2006.
Scott Benner 13:20
Definitely, definitely carry Scott Johnson probably.
Jennifer Smith, CDE 13:24
Yeah, maybe diabetes. Yeah,
Scott Benner 13:26
maybe George Simmons to like, if I'm thinking correctly, there were a handful of them. I was in the beginning. I just wasn't the beginning. But I had, I had this feeling that I was right. And similarly, I do this thing where I avoid other diabetes information. I know that sounds weird. Maybe when I say to people, but I don't listen to other people's podcasts. I don't read other people's blogs. I don't want to be impacted by other people. Because I want to come to these ideas on my own. Because when I come here, well, not only that, I can explain it if I know how I got to it. Right? When somebody just tells me set this there, that doesn't help
Jennifer Smith, CDE 14:03
me. It's like reading a definition out of a dictionary.
Scott Benner 14:07
Yeah. And then it doesn't help me to help somebody else. So I come up with this idea that we talked about in the podcast here, my house in my own head. What if I can't Pre-Bolus one day, how do I handle that? And then I came up with that kind of math that you've heard me talk about in other episodes, where I'm like, Oh, Bolus for the carbs. And then I'm gonna imagine the spike in Bolus for the spike. And then I'm gonna imagine the correction I'm gonna I'm gonna put it all in right now. And maybe I can get all this insolence so far ahead of that, that like a time travel movie, none of those things will ever happen because I killed the thing before it was supposed to happen, right? Mm hmm. Literally how I thought of it. And I started speaking about it and I called it over bolusing because I'm over bolusing. You can see how thoughtful so
Jennifer Smith, CDE 14:54
pretty fancy term there over bola. Thank you.
Scott Benner 14:57
And so our insulin board Over bolusing stop the arrows I am talking to myself like I'm for. And so. But anyway, it works. And then I was like, Ah, here I am again invent and stuff. And then one day you said to me, oh yeah, Gary calls that this and I was like, Wait, what? Yeah, but that completely makes sense that somebody else would have had the thought to. So what I call over bolusing is exactly what I just explained. It's the concept of getting in more insulin than you need for the current situation with the understanding that this current situation is going to get worse soon. And so you get ahead of the problem. But correct, but Gary calls it Super Bowl is saying, right?
Jennifer Smith, CDE 15:45
Actually, it's john Walsh, john. And we use that we use the term Gary uses the term too, but it originally came from my understanding came from john Walsh, who wrote pumping and pumping insulin. Okay, which from what I understand from people is a really great book. It doesn't it doesn't tell jokes resource. You don't get to hear Jenny while you're reading it. So Well, I mean, how?
Scott Benner 16:07
But but so
Jennifer Smith, CDE 16:08
it's, it's written in layman's terms. It's a good. I mean, it's not like a bedtime story or anything. But I like it from the standpoint of, you know, one of those books where you can go to a chapter that's like, how do I manage around exercise? Or how do I figure out bazel? Or how do I deal with these spikes post meal and over Bolus, right? Or Tino people? I think like you people think about, should I just take more insulin? I know that yesterday when I ate my cereal for breakfast. This is what happened? Well, what if I just took more insulin right now? Yeah, that's the same concept. It's, it's over bolusing, it's super bowl of thing, it's whatever you want to name it, it's just you head off the spike by just dosing more earlier,
Scott Benner 16:51
okay. And so to really to break it down, and we've done this and other episodes, but I want it to be here as well say that you've counted your carbs perfectly, but you have not Pre-Bolus. So you know, you're going to get a spike. And you decided that the meal is three, you know, three units, but the spike is going to happen because you didn't Pre-Bolus. And in your history, you found that that spike is going to go up to 225. Before it kind of before plateaus and levels off. And you know that it's going to take a unit to correct that to 25 back to 90. So then you put in 40 units instead of three, because you weren't able to pre Boss, I will I will absolutely tell you that. And I've said this one other time on the podcast. We don't Pre-Bolus as much as we used to, because I know how to overhaul us, right and it and I don't not do it. I always Pre-Bolus whenever I can. But when I can't, I guess I should have said I don't panic the way I used to write I just take care of it right then in there. Mm hmm. And, you know, that's a that's a definitely a another thing that you have to try over time, and there's going to be you know, there's gonna be
Jennifer Smith, CDE 17:59
some experimentation
Scott Benner 18:01
definitely gonna be experimentation for you to fail.
Jennifer Smith, CDE 18:03
And you know, you figure it out, you're super, you're like, I call it secret sauce to over bolusing. Right? You figured it out and you make it work. And, you know, I would say probably 98% of the time, you probably nail it because you've figured it out. And in terms of like, you know that that one unit you said before for the 225 blood sugar? Well, I know it's going to get here, you know, it's going to take a unit to correct and bring me down in a mathematical way, just for like definition of how could you figure that out, you can actually sort of back use your correction factor. You can say, you know, if I know that I'm going to start with a blood sugar of 100. I'm going to go all the way up to 225. And one unit brings me down 100 points, your correction factor is one to 100. Okay, one unit should drop you 100 you can say okay, 225, one unit will bring me down to 125. It's pretty close to 100. So let's just give a whole extra unit to the front of this food bolus, the pump suggested or I calculated three units for the food, I'm going to add on a unit without the time to Pre-Bolus or maybe it's just a really carby meal like cereal tends to be and so you head it off with that extra but that's a little bit of the math if you want a little bit more way to figure it out ahead of time. And then you know as we talked before, john Walsh's method with super bolus is really just to take, he does it by taking the bazel behind the meal. And he tacks that on to whatever the food beast Bolus is up front. So if you're, you know, if your Basal is running at one unit an hour behind the meal for two hours, that's two extra units of insulin. You take that two units, you pop it on to the Bolus up front, take it all at one time. And his recommendation is to then take the bazel down to zero. So your front loading with the insulin but you're also knocking off the back end effect so you end up not going low. Now again, there's some experimentation to that as well. Well, there's I've got some teens and young adults and even some kids who are taking the bazel down to zero, it doesn't work, they end up the Super Bowl is works, it prevents them from getting like that big spike, but they end up then staying too high later or going up again later because the bazel has been taken back to nothing. They still need it. So they need some of it. I've got a college student I work with and she does a 50% bezel reduction with a super Bolus. Okay, so there's some experimentation just like you found with your over Bolus.
Scott Benner 20:32
But yes, that's a good one. Listen, I made that word up in my house and I didn't know anything else existed. So in my mind, I'm again Magellan.
Jennifer Smith, CDE 20:40
You are you're over Bolus word you are. Yes.
Scott Benner 20:42
And if john Walsh had a podcast, he could tell us about his Super Bowls, but he doesn't. That's it all right now.
For all the people who don't actually get my sarcasm, I feel bad for how angry they must be at me while I'm talking. Like that guy. Every episode of the podcast and with Jenny giggling Thank you so much, Jenny Smith, for coming on the show today and sharing your wisdom with everybody. Don't forget to check Jenny at integrated diabetes.com link in the show notes at Juicebox podcast.com. And of course, our new sponsor the Contour Next One, you want to do yourself a favor, you want to do something, it's not going to cost you a lot of money but is going to add a ton of confidence and good feelings to you. To your life to your feels inside. Take away the stress and the anger. Take away everything. The worries go away. I'm feeling mountain away. Right? You never thought of it before. But a really solid, super easy to use small, like you know, completing your pocket putting the bag No problem, but it's still substantial in your hand. Right feels well made. You can hold on to it. You know, I mean, it doesn't feel delicate, like oh, I'm gonna lose it or it's gonna break. It's good. It's solid. It's not big, but it feels good in your hand. I like it. I'm just telling you right now. I don't want to do dirty the other meters that aren't used over the time but I'm thinking there's been a couple and ain't one of them been half couldn't hold a candle to the Contour Next One my friend understand Contour Next one.com such a simple thing. You've been walking around with his old dirty nasty meter that you don't trust for EVs. Why are you doing that? So simple to get yourself going with the right one? That easy? Right? Tell your doctor next time in the office. Yo, yo, how come? I want to get the Contour Next One meter. Make it happen. write the script script out. Or like I said, Contour Next One comm check that out to all kinds of ways to upgrade your diabetes. I'm all sorts of jacked up right now. Do you want to know why? You probably don't care. I gotta fly tomorrow. Oh, I hate flying. I'm trying to keep my energy up. I can't wait to get to the jdrf type one nation event in Oklahoma on Saturday, and go in there and do what I think is gonna be the magic. I am gonna really whip it out. I think I've given like four talks in the day. It's gonna be wonderful. I'm super excited about that. Here's the part. I'm not excited about driving to the airport early in the morning tomorrow. Oh, not good. getting on a plane with sick people. You know, they're sick. Right? And I'm not a germaphobe but it's January is cold out. You know, people like wipe their hands on their nose. Touch a part of the plane, and I'm gonna touch a part of the plane. Next thing you know, I'm not gonna feel good. I don't like that. Then I gotta fly somewhere. Now, I don't mind flying. But I hate layovers. And apparently, there is no way to get from where I am to Oklahoma without laying it over. So I'm gonna fly North tech go, like sad. I don't really know where Oklahoma is. But I'm like Southwest. I think I'm probably going right. Oklahoma, Oklahoma, where the wind? Yeah, it's probably like Southwest. I have to fly north to go Southwest. I don't want to do that makes me upset just thinking about so instead of being upset, I'm keeping up my good energy today. being excited, have a little bit of fun, trying to keep my focus off of it. I'm going to do my best to put up a couple pictures on the social medias while I'm there. So you if you're following me on Instagram or Facebook, that's where I would do that. What else? Yo Are you in the private Facebook group for bum in the bowl with its own Facebook page and there's like a private group of people talking about management stuff and other good things. Lots of good peeps in there. Go check it out if you want. Gotta be something on someone to tell you. has to be
I'm speechless. What is this gonna happen again? All right, I'm gonna go pack and get to Oklahoma. I hope I see you there. Or at one of my many events coming up, check them out. Go to Juicebox podcast.com scroll to the bottom, click on You'll see where I'm going to be in 2020 got a lot going on. Think I just added the Phoenix area in May. It's not locked down yet but have a good feeling about it. Um I might be having a good time recording. I don't want to stop but I have nothing left to say you're probably pissed now. I'm gonna let you go. Goodbye.
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About Jenny Smith
Jennifer holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a Registered (and Licensed) Dietitian, Certified Diabetes Educator, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. You can reach Jenny at jennifer@integrateddiabetes.com
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!
#294 Megan Makes Peace
Anxiety and Type 1 Diabetes
Megan has been living with anxiety and type 1 diabetes.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
This episode of The Juicebox Podcast is sponsored by Dexcom. On the pod and dancing for diabetes, you can go to my omnipod.com Ford slash juicebox dexcom.com Ford slash juicebox, or dancing the number four diabetes.com. To find out more about the sponsors. There are also links in your show notes right there in your podcast app, and at Juicebox podcast.com.
In this week's episode of the podcast, I will be speaking with Megan, an adult who has had Type One Diabetes for quite some time. Megan and I are going to speak today about her life with type one, the anxiety that she experiences, how she's handling it, and how she's brought her a one C from a double digit number to where it is today. At the very end of the podcast, I have a note from Megan that I'll share with you a postscript to the episode. But I'd like to get right to it. So let me just remind you that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And that you should always consult a physician before making any changes to your health care plan for becoming bold with insulin. Little programming note Megan and I talk about marijuana for like a couple of seconds towards the end of the episode. Nothing salacious. I just wanted to let you know.
Megan Carlson 1:53
My name is Megan Carlson. I live in Chicago, Illinois.
Scott Benner 1:58
I like it shortened to the point. Okay. So, I want to tell you that your email about wanting to be on the show was so sort of concise and well laid out that I think for the first time I might just follow the course of your email for this interview. Okay, so I need to know first and you don't have to tell me where you work. But what kind of work do you do? Because this is very well thought out and presented.
Megan Carlson 2:24
I do communications for a living. That makes sense then, doesn't it? Yeah, I work. I work in nonprofits. But I do communications in marketing.
Scott Benner 2:31
I work in working in the nonprofit doesn't mean you don't do you like I work in a nonprofit? What are you trying to tell me? You're poor? Is that the?
Megan Carlson 2:40
Yeah, well, I don't want them there. But I'm just more that I think like there's this like glossy marketing slick corporate image. And that's not my day to day know what you do?
Scott Benner 2:50
Well, I'm gonna listen, you made this one really easy. And I think it's incredibly interesting. So let me just sort of start with like, let's get the whole idea set up here for since you were diagnosed when you were four in 1992. How old are you now?
Megan Carlson 3:05
I'm 31. Okay,
Scott Benner 3:06
so 27 right. 27 years, you've had type one diabetes. That's a long, blank time. So okay, so I want you to tell me a little bit obviously, you don't remember being diagnosed at four or maybe you do.
Megan Carlson 3:22
Very little. I remember being in the hospital. I don't remember the lead up. I've heard the story. You know, it's kind of the traditional thing as very thick, very thirsty. And then being in the hospital and the rooms being yellow and not being able to eat when I wanted to.
Scott Benner 3:36
There's a strong possibility we start off calling this one very sick, very thirsty, yellow, yellow room, because I never heard anyone I like that. You can tell Hold on, let me start my thought over, you can tell that you've had diabetes for a long time because you're not that interested in telling the story of like the beginning. It's just like, Look, I was sick, and I was thirsty. And I went to the hospital. That's what happened. It happens to everybody. Bla bla bla. Great, very nice. I like that. But you described your family and their sort of aversion to doctors to me and I wonder if you couldn't put that into context. Don't forget check out dancing for diabetes.com that's dancing the number for diabetes.com
Megan Carlson 4:17
Yeah, sure. I think that um, so it's not if I just read Tara Westover is educated and I wouldn't say my family's anything like that. That's like a very like culture, a culture that doesn't appreciate the medical industry. I would say my family's issues with doctors and hospitals are really out of fear and a bit out of money. Like it's expensive to go and I think it's just it's passed down my grandma, we still can't get her to go to the doctor without a fight. So my dad I don't think has been to the doctor and like years and years and years, so it was just one of one of those things that it felt scary so nobody did it.
Scott Benner 4:54
Do they not go because they don't need a doctor or do they need a doctor and they don't go in spite of that.
Megan Carlson 4:59
Well I was I grew up with my grandparents and my dad, I would say, it varies by person, my grandma's just very like Well, my go if even if she needs to it's a constant battle among us all. My dad's been pretty healthy. I think that's kind of it. It's like, you know, that ain't broke, don't fix it, which is a bad way to look at your interactions with the healthcare system.
Scott Benner 5:19
So yeah, I for certain, let me ask, and you don't have to go too far and other people's details, but your grandmother, an older woman, I would imagine and she's alive, right. So she Yeah, so she just like in she like an old busted down car that every time you look at it, you think I can't believe that thing runs? Or is she doing okay?
Megan Carlson 5:36
She's, you know, when she had a couple, she has to go a little bit more. Now, we had some scares kind of five or six years ago, where she did have to go to the hospital. And so she's had to do you know, she has medication now. So it's, it's just a little bit of a back and forth with her all the time.
Scott Benner 5:52
Doesn't make it easy. But she's getting the care she needs. That's good. But for the but you know, but you grew up in a family who weren't going to doctors, not even just not running to them, but they weren't using them when they needed so much. And then all of a sudden you had a chronic illness. And you describe in your email that there, your visits were infrequent, and sort of just there for you to get yelled at and get your prescription. Yeah, can you remember? Do you have any thoughts or memories of that as you were growing up?
Megan Carlson 6:23
Oh, a lot. Um, it's going to the doctor was really, I don't think I'm overstating it by saying it was a traumatic experience, because we didn't go very much. And that was a child outside of my control. Like now I know. Like it wasn't, you know, I, there's nothing I could have done. But we didn't go and then we had one nurse practitioner at the Children's Hospital who just I can I can picture her face even now we'd go in and I'd get my a one C which I don't remember. So to present that question. And she would just it would just be so much judgment, and why aren't you doing this? And why are you doing this, and then we would just wait for it to be over. And then we could wait another whenever three months, one year, we hustled a lot to get prescriptions. But it was not a good experience. It was not helpful. I never felt like that was part of a team. And it's so funny. I think another thing with my family and the end, like the healthcare complex was just, they weren't able to advocate for themselves. And I think they didn't understand what was going on. I think a big component of this is ignorance. And so we didn't know we could see a different doctor, we don't have to go to the same judgy person all the time. Um, but yeah, that's kind of what the the whole interaction was, like, I always
Scott Benner 7:38
wonder if there's so you you described like a situation where your family wasn't it like, you weren't going in the door, like, Hey, we're here we want to learn tell us more. Plus, you've got type one, and it's, you know, largely invisible. And I wonder if it was largely invisible to your father. And and he just thought, like, Look, Megan gets up in the morning. She's going to school. She's you know, she's okay. I wonder how much of that I mean, 27 years ago is, you know, it's that it's what's it 1990 ish, like, Yeah, right. It's not exactly the Stone Age of you know, of diabetes. But if your dad didn't have any context for it, and you weren't, like falling on the floor, he probably was like, She's fine. Or do you think that he didn't think that? Do you have any idea what his perception was?
Megan Carlson 8:25
Yeah, so I think we've talked about it a lot now. So back then this is before carb counting really like carb exchanges. You still carb counted, but it was back when I've heard you have other guests who are a little older, we're, you have like a meal. And you have to have like your bread and your dairy and your you know, all these different things. And you eat very certain times. And so he was good about that. And we kept on it. I think the fear was him younger is always that you're going to go to bed and not wake up. So there were a lot of, I think fear with him around lows. And then, but what you're describing, I think was very much the case, as I got older and started to manage more on my own, especially my teenage years and definitely into my adulthood was that Oh, she's, she's obviously taking care of it. She's smart girl, I always did well on school, like so Oh, she must have it under control. Like, everything's fine. And I think there's some just not knowing and I definitely wasn't opening up at that time. Like the I know, the big theme of our talk right now is like the shame and anxiety. Like, I was not openly talking about my diabetes for a long, long time. So I'd be like, yeah, I'm okay. I'm okay. But I think another component of that is some willful ignorance. Like, Oh, she says she's fine. I'm not gonna probe further, even though, if you thought about it a little more, you might be able to tell I wasn't doing great.
Scott Benner 9:46
Megan. you've just described 96% of the marriages that I know. She I mean, she didn't say she was unhappy, but she's crying. Yeah, but she didn't say it.
Unknown Speaker 10:00
So
Scott Benner 10:02
I'm not characterizing my marriage that way. I was just saying that I there, it's very common for people to just look the other way. You know, I'll worry about it tomorrow. I'm too busy to think about it today, this isn't a pressing issue. And or I wouldn't know what to do if it was a pressing issue. So let's just not everybody be grateful that nobody's asking me for the quite the answer. And, and you know, what to? Do you have siblings?
Megan Carlson 10:30
I have. I'm an only child for, for all intensive, intensive purposes. I have three half siblings, but I didn't grow up with my mom.
Scott Benner 10:39
That's why we're in the house. Okay. Yeah. Because sometimes too, in a multiple, like, child situation, the one who appears to be getting the good grades and getting their homework done. You never asked them, hey, do you need to handle that? And you know, and then when they're adults, they're like, Hey, you never helped me, you helped everyone else. And I could have used help. And you know, it could but you're not in that situation. Exactly. Okay. So but you also weren't going to him and saying that I'm not doing well with this. Would you have gone to him about other things that weren't diabetes related?
Megan Carlson 11:11
Growing up, it's, you know, it's hard to remember, we've been pretty close, I'd say we've gotten even closer as an adult. So now I talk a lot about this. All the diabetes stuff with him back then I'm trying to think. I don't know if like as a teenage girl, you go to your dad for every single thing.
Scott Benner 11:29
In here is so much different than that. That's why I asked I don't like you in the box. At the very end of your note, you're like Don't forget, you know, around ardens period. And Bob like talking about that. We talked about that here constantly.
Megan Carlson 11:38
Oh, good. Yeah. Cuz it's no one doctor ever told me that and like, and if I can segue briefly, that's another thing that's come up a lot is that I didn't have any tools to help me like thank God for the internet now and the diabetes community on the internet, because, like, I would just get a lot of judgment and like, bring your a one c one out, bring your a one c down. But no one ever says how do you do that? So things like knowing that your your blood sugars are going to shift based on your menstrual cycle. No one told me. Like, I just figured that out, like
Scott Benner 12:12
what's going on? Even if someone told you like, Do you wonder if you would have just been like, That's weird. I'm like, I don't care about that. I just got a note from a person this morning, who's you know, talking about how great the Pre-Bolus episode was that we did? And then she's like, how could it be possible? That something someone's been saying to me my whole life I've been ignoring, and then some random guy says it on a podcast, and I'm like, Oh, yeah, that makes sense. Like, like, how did I ignore all that time? And but, hey, here's an aside. Why period? Like At what point? Did someone say menstrual cycle? Let's call it a period? Like, why not an ellipses? Or an asterick? Or I don't like why did they pick period? Do not? I mean, why isn't it called a comma? Or are you listening to me? Do you?
Megan Carlson 12:56
I love it. It's so vague and mysterious, because it's like that we don't want to talk about this thing. So it's very good that you talk about this with your daughter, because there's something shameful about like, your period, menstrual cycle, whatever, like you kill nature, that whole weird
Scott Benner 13:08
thing that happens to you ladies, it's making the whole world roll around. So no, it's very important. And but I still don't know who's I would love to know the first person who is like, I don't want to say menstrual cycle. I'm gonna say, period.
Megan Carlson 13:22
And my Grandma, I'm sorry to interrupt, but my grandma called it your sick time. So when I was growing up, like that's your sick time,
Scott Benner 13:31
time. Oh, I know someone who says Menzies and I don't know why. But I adore that word. I don't know what it means and makes you feel weird and unhappy and, and want to laugh all at the same time. Anyway, if it was named after punctuation, I mean, maybe maybe somebody said one time You know what, this sucks, period.
Megan Carlson 13:53
Oh, yeah, that I could get behind.
Scott Benner 13:56
Okay, so so you're coming up? This is your experience over and over again? What's your first recollection of a of an A one see that, that you remember having?
Unknown Speaker 14:07
Um,
Megan Carlson 14:11
I could give a range. Probably when I was young. I was definitely thinking double digits. And then I know my worst, which I don't really want to say but double digits. But that was that first one I remember is from when I was an adult. I would also do Oh, I also faint when I get my blood drawn. So I've done lots of sneaky things to get out of getting an A one seat taken.
Scott Benner 14:33
Do you think every time someone draws your blood?
Megan Carlson 14:36
It's getting better? It's getting better? 27 it's getting
Scott Benner 14:39
better. Hey, listen, by the time you're 65 I think you're gonna have it under control. Right?
Megan Carlson 14:43
All right. Yeah. Well, now they can tough day one see what the finger prick which like, I've been going to kind of like, a little like less professional hospitals, I guess. And so when I went in, and they did it on a finger prick, I was like, What is this magic? It's done immediately. That was cool.
Scott Benner 15:00
I would love to know what a less Professional Hospital looks like. But that's a that's another story. So okay, so you had double digits 10 we're above a one season even here, we're still hearing you have in your mind right now there is a high number a ones that you have a watermark that you've hit. And you really you still don't want to say it because you you feel ashamed of it. Is that right?
Megan Carlson 15:23
Yeah, yeah, actually, no, it's the way you phrase that I'm trying very hard not to be ashamed. I remember anyone see, I was like, 13, I think in my 20s. But there were lots of times where I just avoided taking the test all together, like I would do anything I could, because you thought it was higher than that even, um, or around there. And the number was very meaningless. To me, this is another thing I actually kind of wanted to talk about, too, is when so when I was starting to think about getting kind of my life in order and getting my health in order, so maybe like mid late 20s. I people would actually know this goes from earlier, this target of like, you know, you need a six or 6.581 c seems so impossible, especially like so thinking about the numbers, like being at 100 made me feel like it because I was Oh, crap. I knew I knew I was gonna swear.
Scott Benner 16:15
I'll be put out and I've said this before, and I'll say it again. If you all knew how amazing it was that I don't curse while I'm doing this podcast, it's really one of the great accomplishments of my life, because I love to curse and do it almost all day long. So don't worry about it. We'll bleep it out. Keep going. Okay.
Megan Carlson 16:33
Yeah, so I felt like crap. I felt like garbage all the time, because I was so used to being at higher numbers and the idea of being at 100 or 110 all the time. Like, I was, first of all, I had no idea how to do it. And then secondly, it just seems so out of range. The why even try?
Scott Benner 16:50
I understand I so everything you said makes sense, honestly. First of all, the not feeling well, part of it is so countered or counter intuitive to what you're being told someone's telling you like, yo, your blood sugar should be 100. Then one day gets to 100. And you're dizzy. Yeah, you think well, that's not right. I feel much better here. No one gives you the rest. Like it's always the rest of the sentence that doesn't get spoken. You want to have your blood sugar around 100. Because and by the way, because you've been so high recently, this is what it's going to feel like sir, for a while. So let's not just shoot for 100 right away, why don't we just get you to 200. And then we'll get you to 150. And then we'll keep moving you down. And you know, and that's going to be the process that we follow. And by the way, here's how we're going to do that. But you were with in a situation that I think most people find themselves in, they go into an endocrinologist office. And someone tells them this is your goal, but gives you no roadmap or tools to get to that goal. Just you have to accomplish this. Or you're going to you know what, whatever the scary stuff is that these people, you know, the ones who aren't good at it blurt it people trying to scare them. Like, how do you scare someone into doing something they don't know how to do it. I like, here's my example. Right? If someone burst into this room right now pointed a gun at me and told me to jump out the window and fly away, I'd be really scared. But I'd still fall and hit the ground when I jumped out the window because I don't know how to fly. And and they didn't say get wings or get into a plane or here's what you're going to do to fly. They just said, Do it right now. I'm going to scare you into doing it. And that just is is an incredibly stupid idea. And I think that, you know, sorry, no, it just doesn't work. It would never work.
Megan Carlson 18:32
I think it's so important because I have had a lot of doctors do the scare tactic thing with me, like many. And it is it has the opposite effect. I know some people that works and they get scared straight. Okay, but I doubt it works with most people. Because what happens, or what happened with me is that I get a doctor saying you're gonna lose your feet, you're gonna have this problem, you're gonna have this problem, like, you know, the consequences. And that would make me really not want to see the doctor again. Yeah, that's all made me avoid the doctor
Scott Benner 19:02
because you didn't know how to you didn't know how to stop, quote, unquote, from losing your feet. And you didn't want to be told it was gonna happen again. Now you're just trying to live in a blissful ignorance and get as far as you can before your feet fall off. Right? Right. You're not yet I don't know who does that and thinks this will work. Like, like, it just, it's got to be a tired person at their job, a person who just is either lacking in the real desire to get you to another place, or in the way to talk to you about it. And I you know, I just got done saying this to somebody recently, but because I record these so far away, it'll be six months ago, the last time you heard me say it, so there's no shame in me saying it again. But how is it possible that a podcast helps a person that I a person who has no training, I have no medical training, I don't know anything specific that you know anyone else can't figure out on their own. And yet I found a way to talk to people Where they don't feel like that? How is it a doctor can't feel find that? Like, how can you not figure out how to speak to someone to help them? And, and don't tell me everyone's different. Because I have almost a million downloads on this podcast, everyone's different. And most people can figure it out if you just give it to them in a digestible way and, and let them find their way to it. It's not difficult to communicate with people, if you have a skill to do it like and if you don't then get out of the business. You know what I mean? Like you're in a business where you're supposed to be communicating something confusing to people. You're making me upset, man, I'm getting upset?
Megan Carlson 20:35
No, well, I'm with you. I'm about as well. And that's kind of the thing that I wish, some more doctors knew. And I think that it's it's complicated, too, because it's not just how we trained doctors and like lack of empathy training, but it's also a doctor is not the bad guy. But it's like time like so when you mentioned before, the forget, you said something about like, the second part of the sentence is that, oh, you're going to feel like, you're not going to feel great for a while it's going to get better. Like all this time, you need time to explain the things and what happens when you're in the doctor's office is you're with a specialist, they have 20 minutes, and they just tell you the directions and I found out for my myself, just the way I learn. And I bet this is true for a lot of other people is that if you just tell me the thing, and don't tell me the mechanism by which it works, I'm not going to understand. So if you just say like, shoot for 100 that's, that's meaningless to me. If you say like, shoot for 100, you're going to take these steps, then it might feel bad for a while, but just understand that it's going to get better. And that's because your body's been used to this sugar. And now as you come down, it has to adjust to new normal, like little stuff. But that takes time and doctors don't have it. And so they just give the direction. And like there's so many things like think about like a non diabetic person going getting some medical direction they're gonna hear drink eight glasses of water. But if you don't understand why then it's like, well, yeah, sure. That sounds like a good thing to do. But why like,
Scott Benner 21:59
yeah, cuz it's not fun drinking eight glasses of water. So you have to give me a really good reason to do it.
Megan Carlson 22:03
I have to understand. Yeah,
Scott Benner 22:05
right. No, yeah. And, and that also keeps you from being surprised, as changes come, so that you're not like, everything that becomes different your life, you don't stop and go, I wonder if this is okay, or not just let somebody know, um, you might feel dizzy at 150 for a while. Yeah, you know, go somewhere safe and try to write it out, don't push your blood sugar back up again, to make it feel better. And just any number of I don't know, I just even as you say that, that makes sense to me. And I don't think that's an unfair defense of the situation that doctors find themselves in with the short visits, but still, in 15 minutes, I could explain to you the necessity for you to Pre-Bolus. And that alone would keep your blood sugar lower. So that the next time I saw you 15 minutes later, I can add another piece to it. Sure, it might take two years, but I still think I could build that house 15 minutes at a time. I don't think it's I don't think it's the best way. But I think that if that's the only way i had i do think I could drag somebody along slowly through that time. And you know, you're right, there's nothing ideal about it. To be perfectly honest. You know, a group Skype between all of your patients every day would probably be a more valuable use of 15 minutes. Oh, totally, you know, right. Like, you could just have like a little seminar every day. And people could pop in and out and get something out of it and move along. And I'm just I'm a huge fan of that. Like, you know, like when you're filling your toolbox, you don't always get to fill it right up the first time. Sometimes you're walking along, and you know, you're Dora the Explorer, and you're like, Look, I need that stick that my backpack. And you know, maybe I don't have a use for it now. But when I find the next thing, these two things are going to work great together. I think that you can, I do think that's why the podcast works. Because sometimes you and I have a conversation and somebody's gonna hear something in it. And then they'll listen to the next conversation, hear something different, and eventually their backpack will be full. And there'll be on their way. I know I started toolbox and with the backpack, but Dora popped into my head and I don't know why. So,
Megan Carlson 24:12
no, it's great. I'm with it. Um, no, I think that's totally useful. Because I would say all this stuff that I've learned about managing diabetes, and now I'm in pretty tight control, like it started listening to this podcast. And then and the thing is, you can take what applies to you and you can leave there's been some things that you've suggested that I've tried, they're not for me based on like my body and the things that I've gone through. So I don't do them, of course. And then the the online community is really great. I remember so in the early days of the internet going on the there was like the forums, right? So I go on diabetes forums occasionally. And I remember is again, these people who had these like beautiful anyone sees and they were just like, you know, if you are just a perfect Angel of humans behavior, you will have a great agency, and just feeling frustrated about that. But now it's so different because I think people are very honest. And the Instagram community specifically has been fantastic because they talk about their ups and downs. And a lot of people do include their downs. So you know, hey, I'm not alone in this. Oh, I'm not the only one experiencing this weird blood sugar that happens with this thing. Yeah, and it's just, it's more approachable. And then you can share kind of tips and tricks about what works. And that's the thing you never get in a doctor's office is like, here's little things you can do to manage better. Like, I wouldn't even when I tried to get my diabetes in order a cup, like probably in my, when I was starting to try to get it in order in my mid 20s. Like, the only thing endocrinologist would talk about was my insulin dose, and like, Hey, I can do basic math, like I don't really need that much help with insulin dosing. Like I need help with, like understanding digestion and hormones and all that stuff. And that's just not I'm not getting that from a traditional doctors.
Scott Benner 26:00
Yeah, I think. So I obviously have a lot of like, thoughts about how people share online, everything and but to go back to what you said about being there's things I say that you're like, yeah, that didn't work for me. And I leave that aside, but this piece did. If I could, or anybody could give you every Imagine if I was able to give every single one of you your entire perfect picture. I couldn't do that. Like, that's insane. You know what I mean? Like, I don't know all the little ins and outs about your life. But what I found is that there are sort of these basic tenants, and that they all hold basically true for most people. And so you can take the ones that work for you and help you and leave the ones that don't behind. And it's perfect, but I don't and I do agree to that people showing they're sort of like ebbs and flows is incredibly important, because you could follow somebody and say, Oh, my gosh, look how great they're doing. But then if they're not doing great, you know, quote, unquote, the next day or the next week, that's comforting to you know, Arden's blood sugar's higher right now, you don't hear me say that on the podcast a lot, because it honestly doesn't happen a lot. But it happens sometimes. And it happened today, she, you know, got something, and it really crushed her. So you know what I mean? Like, you're you just, it's a different situation. And we stopped it. And we Excuse me, I'm actually going to talk to her right now. And I'll tell you what, what's happening, we stopped it, and we fixed it, and we're gonna get it back again. But she says, she's at school, and she's like, I'm gonna go get something to eat. And I got really late notice on, I'm gonna get something to eat, right. And so there's no Pre-Bolus. And I thought I was aggressive enough, and I wasn't, and so then we had to come back around and be aggressive again. And now she's, you know, it's back. But it's not level, I didn't come in for the smooth landing. So we're gonna have to grab it with some juice right now. And, you know, I'm gonna get her level right around 90. And she's never having gone to been low, and wasn't over 170. But still, if, if we had a little more time and a little more notice, I wouldn't have, we wouldn't have hit the 170. But we did, because life and all that, you know, and so when people are willing to share that online, that's incredibly valuable, because you get to see everything doesn't have to be perfect. I try to remind myself every few weeks to put something up, that doesn't look good. so that people can see that work. That is, you know, my daughter has an eight, one c between five two and 64. Five years, but look, her blood sugar goes up and down, like your stuff. You know, like, like, but but there are also people who share and they're in a bad place, or they only show share the bad stuff, or they won't click Yeah, so they do the clicky stuff, which is like, isn't this hard? This is so hard. Isn't this hard? It's so hard, isn't it? And like yeah, it's hard. So I get a like or a click and they get to sell ads on their blog or whatever it is they're doing because they have a lot of clicks. That stuff I don't like like that. Yeah, that makes me upset.
Megan Carlson 28:59
Well, there's definitely the there's the influencers. I think there's a little bit of both. I think it's kind of fascinating and I do you know, marketing for a living I think about this, but um, the there's definitely the what is it fitspiration there's the people who are like on the tee Wendy community on Instagram, who are also kind of like the fitness instagramers and that's so like not, I'm you know, I'm in my 30s I don't care about that, like so it's like I have to kind of pick and choose among the people I follow. But it has been like kind of back to your point about like seeing the bad stuff and and the good stuff. It's helpful, especially if you're experiencing shame. Like the thing that destroys shame is talking about stuff. That's part of the reason I wanted to do this podcast because I'm trying to get over that stuff. And this was like a tool to help like, hey, if I go on as and can talk about my experiences to a lot of people I don't know, like I'm gonna do a lot to reduce the shame that I felt for years of not taking care of my But seeing someone else go through and and being able to reach out and just being like, I know there was someone posted the other day about having a bad week of blood sugars and nothing she could do to bring them down. And I was like, oh, I've been there. I know what that's like. And just that little bit of I don't know if it's like human connection or bringing the secret out of the shadow, but it's so helpful.
Scott Benner 30:20
Yeah, no, I, I'm excited to have you on because of that, because you are. So let's, let's kind of bring people back into your story a little bit. So you, you know, become an adult get into your 20s, you have the same sort of like Doctor avoidance stuff that that you grew up with, you're not going as much as you want to. And you say in your late 20s, you got a better job. And that how did that help you with your health? Was it insurance or money? or What what? Where did that move?
Megan Carlson 30:48
You? Yeah, me. I was definitely living. Like I said, I worked in nonprofits last of my life, so I was not making bank. And doctor appointments are expensive. And I'm already going to preempt the not your comeback to that. But like what someone might say is that like, Well, yeah, but you need to prioritize your health. Yes. And if you're 24, and only have a couple hundred in your bank, like, do I spend $40 on the copay? Or do I buy you know this thing? Or do I go to dinner? Like, you know, you just you make choices. And so I wouldn't say like, I probably could have managed money in a way that would have made diabetes, my number one priority, and it's still would have been hard. I'm not sure if I could have afforded Dexcom and Omni, I actually couldn't have afforded all these things that I'm using now. Because the upfront cost would have been too much. So not having money being such a stressor, when I got this better job was a huge, huge child, because I couldn't, I didn't feel like going to the doctor was another thing that was hurting me.
Scott Benner 31:56
Good. Yeah, that's, that's and so in that interesting, right. So you have some money now. And now it's not, oh, I have to go do this thing that's going to be unpleasant. Probably not end well, but I know I should be doing it and doing better. Not only that, but now I'm going to be broken, it's going to mess something else up. If I do that. Yeah. So you're taken out of that situation. Healthcare is not what we're talking about. But obviously very important, especially for chronic illnesses like this, where you have to go a lot to kind of manage and understand where you're at, you know, with the trends and your blood tests and all that stuff. It's really, it's it's imperative. And you're showing that because you went, and you started getting things back on track, and you're and you were moving in a better direction. You were moving in a better direction. How when did that start? Like when did your move in a better direction begin, like, in year around,
Megan Carlson 32:47
I think about three years ago, but it's been very slow. So like, I think three years ago, I started this job a little more money. So I was 28. I think I also started being in a more serious relationship around that time. So less social pressure to like, go out and do probably unhealthy things. Yeah, but it was still kind of slow going. I was working with one doctor. And the same thing. I wasn't really getting the tools, or the help to bring anything down. I was just kind of going more often and paying a little more attention. But all the things I couldn't have. There's only so much I could do. So I was getting it down slowly at a time, but almost like with zero guidance.
Scott Benner 33:34
Okay. And so what were your first steps to? Is that when you found the pockets back then?
Megan Carlson 33:40
No. So I'd say I started kind of getting things in order about three years ago, but not really, really getting them in order. I started like paying a little more attention. I remember when I finally had like an 881 See, probably two years ago I was thrilled and I know that's like insane high for some people but that was so exciting to me to feel like I could do it.
Scott Benner 34:00
That's amazing. I mean, you came from double digits to eight by just like paying more attention to what was going on not necessarily even making grand changes just what what did that mean? Yeah, like correcting a high or what what did what did starting to pay attention look like? And new year and a new decade has arrived. Why not add to the list of new things, a new way for you to think about managing your type one diabetes. That's right you or a loved one should be using, in my opinion, the Omni pod tubeless insulin pump and you'll be able to decide if that statement works for you by getting yourself an absolutely free zero obligation demo of the Omni pod sent directly to your home. That's right, if you go to my omnipod.com forward slash juice box on the pod we'll send you out an on the potty and insulin pump. It may be non working meaning it can't give you insulin it's not going to inject canula into you but You can wear it to feel the size and weight, how it looks, how it feels and how it adapts into your life. You can bathed with it, swim with it, do a jumping jack, I don't care, whatever you're doing cook dinner, tumble around on the floor with a friend. Whatever you got to do, and if it's on your kid, send them outside to play. I know it's cold, but they'll be alright. Anyway, check out the Omni pod, see how it fits into your life. And then if you want to continue just contact on the pod back and let them know, I want to do this. It's that simple. Miami pod.com forward slash juicebox. start something new for yourself today. Alright, so do you understand your day so far, you're gonna go to my omnipod.com Ford slash juice box, check out the Omni pod demo, then you'll probably bop over to dancing for diabetes.com just to see what's going on. And while you're full of the goodness in the life, you might as well go to dexcom.com Ford slash juice box and get started today with the dexcom continuous glucose monitor. Feel the comfort that comes with knowing the direction and speed that your blood sugar is moving? I need you to try to picture this. Your blood sugar is moving down? How quickly is it moving down? That's a big question right? It tests with a meter and you go Okay, my blood sugar's 90. test again, 20 minutes later, it's 85. I don't know what that tells you release it about the state 85, you're not going to know without the Dexcom. With the Dexcom. You can see my blood sugar is dropping at one point every couple of minutes, two points every couple of minutes. Or that's how fast it's rising. See when you've missed on a bolus, see when your adrenaline spiked up, and you're going to need in some of the time when you didn't realize it. Those are the things that the Dexcom does for you. My daughter has been using the Omni pod and the Dexcom for years and I'm a huge supporter of dancing for diabetes, I can think of no better way to spend a couple of moments and to look into these three things today. I very much appreciate that you listen to Juicebox Podcast and that you consider supporting the sponsors. Now let's get back to Megan and go straight through to the end. What did starting to pay attention look like?
Megan Carlson 37:07
I think actually a big thing was making sure that I insulin for like every little thing that I ate. So like I'm like a bit of a snack or grazer. And I always and I've had some eating issues in the past. So knowing that even if you eat a little bit, you need to like you need the insulin for it, even if it's a couple of grams of carbs. And then the flip side of that is, which I didn't know back then is that you're going to like stack your insulin a lot if you do that. So I think that was a big thing that changed. I started slowly. So I used to keep my numbers really high when I went to bed because I would be scared of going low overnight. I often did. And I think without any guidance, what I'd been doing was keeping my basal rate really, really high, just for the day. And that kind of kept me steady enough. But I would often go low at night. So I kind of like would go to bed pretty high. So that high number that I go to bed at I started kind of slowly bringing down but I don't think I really
Unknown Speaker 38:04
kind of
Megan Carlson 38:07
I guess I'll just kind of continue my story a little bit because then I can explain how I've gotten in control now you're doing great. I'm not stopping you. Good. Okay. Um, so I was slowly getting things in order and slowly bringing things down. And then last year in May, I had an eye hemorrhage. I have proliferative retinopathy. I had had retinopathy and the doctors were monitoring it. And I'd actually had an ophthalmologist appointment, I think only a month before, but it can happen that fast. So that kind of, I'd say a few months before, I'd also started having some really tricky blood sugar's where I was doing better in terms of managing, I think my agency was in the sevens. But things were just really unpredictable. And they're so unpredictable. And I think it's a combination of stress and hormones and some diet changes. And I'm kind of figuring it out. But at the time, I was just very stressed out and my blood sugar felt like it was all over. And then a couple months later, I had this eye hemorrhage. And that's when I kind of got really, really scared straight, almost too scared straight and straight to like, just absorb every piece of diabetes knowledge that I could get my hands on. So I think around that is when I started the podcast. So it's only been less than a year. And I learned really fast to the point where sometimes when I'm talking about there, you see Wendy's because I go to like a meetup or I go to a support group now. I realized like, I might know actually a little bit more because I've made this such a high priority. But that's when I really started learning all the ins and outs of like Pre-Bolus and what insulin can do and action times and digestion and like all them you know myriad factors that go into your daily blood sugar management.
Scott Benner 39:50
Do you find when you're in support groups that that a lot of people's like sticking point is that they just don't have that kind of basic information.
Megan Carlson 40:00
So I've only started the support group this year. So it's a newer one in Chicago. So I've only, we've only had a couple meetings, I don't know. And I think sometimes it's more support in terms of like, I'm not the only one going through this, like, it doesn't feel as much like therapy as much like a group dinner with people and being like, Oh, yeah, I have to do this too. And then we kind of can ask some questions about like, what do you do when this happens? What do you do when this happens? It's nice.
Scott Benner 40:29
It's a great, it's a really important piece of this that, again, doesn't get told you by anybody that you have to go find other people in some fashion and, and see connection? Yes, that's really important. Okay, yeah. So your, your eye your eye is, let's like, make sure people understand before we go forward. Where's the ayat right now.
Megan Carlson 40:52
Um, so I have the condition in both eyes, the right eyes a little worse, and I've had a hemorrhage in that eye, I'm getting treatments so you can do combinations of getting I'm on something called Avastin. So you get like Avastin shots in your eyes. That was formerly a drug for cancer. And they found that it has this unintended side effect of helping with diabetic retinopathy. But it basically stops the there's kind of miscreant blood vessel growth when you have this condition. And then those blood vessels are very weak because they're new, and they can break and bleed. And that's what happened with me. So Avastin kind of stops your brain from signaling to make those new blood vessels. So that's one part of it. And there's different drugs that do the same thing. And then laser is the other thing. So I've had I kind of get ongoing Avastin shots. And then, and they're on different cadences, because one is a little worse than the other. And then I've had laser in both eyes, and we'll probably need laser again in the future. But ophthalmologists, I think, differ a little bit on what your treatment approaches. And I think now the thought is to make it more individualized, which is good. So that might not be anyone who's listening like that might not be your experience with your ophthalmologists. They might have a different treatment plan for you.
Scott Benner 42:20
Well, that's I, I'm imagining the scariest thing that's ever happened to pretty close.
Unknown Speaker 42:26
Yeah, yeah, I would think so.
Scott Benner 42:29
Now, I don't want to make you feel bad. But I do want to ask, does that having something like that that's now tangible? Does every time your blood sugar start creeping up? Do you think oh my god, I have to get it back down my eyes? Or are you able to live a little more free than that?
Megan Carlson 42:46
Uh, it's definitely like that. And I'm working on it. Because this is the second part is that I definitely have out of control anxiety now because this thing happened. And it's, it's getting better day by day, because this is all in the last year. So it's getting better. And I'm getting to the point where I don't freak out every time like an aberrant blood sugar happens, but I'm saying that I'm realizing that's not even true. That happens. It happens all the time. I'm starting to rise, I kind of get a little worried. And then, like, if it's low, I'm worried because I'm pretty symptomatic with lows. So yeah, the anxiety is really tough. And it's it's tough, because anxiety causes your body to release all these hormones that cause your blood sugar to go up. So it's like this awful feedback loop where like high blood sugar, anxiety, higher blood sugar, insulin resistance, higher blood sugar, and then it's just this like, really hellish cycle. And then you feel like you're doing something wrong like, like, Oh, my stupid and anxious brain is the one causing all these issues. So it can it can be really tough to manage, but I think that the AI stuff can exasperate exacerbates that feeling of anxiety for sure.
Scott Benner 44:00
I can imagine I only have one thing to share with you about this. And this is something that I heard recently, another person said to me, so the conversation was around alarm anxiety on their CTO. And the idea that, you know, she said, Every time the alarm rang, she's like, Oh, great, I mess something up. And you know, or what's wrong now? Or you'd like that kind of feeling that always felt like that. But she said that she listened to the podcast, and she pushed her alarm way down. So her high alarm was now like 120 or 130. So now when the alarm goes off, instead of thinking, oh, gosh, I messed up what bad thing happened? She gets the think, Oh, I'm about to do something positive. That's going to keep my blood sugar from ever getting high.
Unknown Speaker 44:41
Yeah, and
Scott Benner 44:42
she said that tiny little change took that. That feeling away that her CGM was an alarm to tell her that things weren't going well. Instead, it was an alarm to tell her how she could do something really simple, really easy, very quick. That was good. It all was good based and At a bad based,
Megan Carlson 45:01
totally. And that makes that makes sense to me. And I'm trying lots of little like tips and tricks. And that's actually a big one is that I just got on Dexcom in the summer and it is a life changer. I think that's the other unspoken thing in this, like how I've gotten my blood sugar's in control is definitely Dexcom. But there's a flip side to that is that it, it makes my anxiety goes through the roof. And a big thing is the alarms, I turned off all the alarms, so they couldn't deal with it. I have them on at night, but not during the day. Because it would just give me like a panic attack, basically. And the weird trigger for me, like oh, my God, such a trigger, is seeing the little up and down arrows. And then I will without thinking do start correcting it in whichever direction but not taking the time to think like, Hey, is this the right thing to do. So I'll just like jump into action. And so if it's like going low, maybe eating too much, or like I do this frequently, if I'm going high, like the kids call it rage bolusing like, and so just things that aren't like the smart, wise decision to do in that moment, where if you just took a breath, but those arrows man they get me but I think that's my goal in terms of anxiety is that I want to get to a point where I'm calm enough where I can see the arrows and not feel so many feelings and just kind of take it in, it's a number treat if you need to, and then kind of move on. But I'm a little far from there right now. But I'm hoping that someday that happens. And we pick
Scott Benner 46:24
into that for a second because it's interesting to me because I experienced what you're talking about in the beginning. But I'm not an anxious person by nature. So I was quite literally able to stop myself, like you've heard me on the podcast, say like, you can't be dramatic around diabetes, right? stops you from making good decisions. And you spend so much time just, you know, being dramatic that you can't like and I don't mean that dramatic to be insensitive. I just mean to be, you know, communicative of the idea of like, Oh my god, like or Pac or whatever. So, I was actually able to say to myself, at some point, you can't do that anymore. Scott, like you can't look at this and be upset, you can't see the arrows and be upset, you can't see the number and be upset. It's all about to be just data to make better decisions with and I made that leap past that. Because I used to be like my wife. I know I've said to her before, but I my wife said the you know, sh it would come out of my mouth a lot. Like I would like see something on the CGM and say that, and just be like, oh, and she's like, you know, you say that like 1000 times a day. And I'm like, I don't mean it. Like, I'm not upset. I'm just like, well, I can't believe it got to that. I didn't think that was gonna happen. But just stopping myself from reacting that way. was a big step in me not thinking about it like that. Yeah, so but but I also don't have the problem you have. And so I was wondering if you if you can if you can't, that's fine. I just think it would be interesting for people to hear. Can you talk about when the mechanism hits? What this like what it feels like in your brain? When you see when you see an arrow up? Like what happens? Is it do you do hear voices telling you things? Do you have thought like? I don't know what I'd love to know if you can put it into words.
Megan Carlson 48:07
Oh, sure. I sure can.
Also, it's funny that you mentioned the like saying curses when you look at the CGM, because that's the thing that my boyfriend has definitely told me that's happens a lot. Like where he's like, you don't even hear yourself doing it so much. But I relate to that. Yeah. So if I'm having a high blood sugar, and I think knowing your triggers, I think is important for any kind of anxiety thing. So like, like, the up arrow for me is like a trigger. The I would say also, like a blood sugar I didn't expect is very triggering to me. So, you know, all of a sudden, I both I had the same meal, I did the same steps and like and all of a sudden I'm 180 which usually don't even get that high, but I'm
Unknown Speaker 48:51
looking at you right now.
Megan Carlson 48:52
So I was like, oh, roll it back. But it's because I'm like so glued to my Dexcom that I'm like watching so it's like see it before 180. But the Yeah, so I'll like start I am very physically symptomatic with stress. So like, I will start feeling like my chest get really tight. And then I know, so there's this whole, like, I'm anxious about the blood sugar. And I think if you kind of unpack the thinking around it, it's like oh, man, high blood sugar means like, my, my eyes are gonna get messed up. I'm gonna go blind. I'm gonna die. I'm gonna get kidney stuff. That's kind of a like train of thought that goes, but I don't even think I I don't consciously think those things that's like, that's several steps beyond I'm at the point where I'm just reacting. And if I want a ton packet, I could get to all those things, but I don't even it's not as logical as just being like, well, you're gonna be fine. It's okay. Yeah, it's really this like body reaction. So I have so I see the number. My chest gets tight. And then there's this whole anxiety on top of the anxiety which is like it's very common with people with panic attacks. They start getting afraid of having a panic attack and not the initial stressor that was causing the panic attack. So it's so I'm anxious, I know I'm anxious, my chest is tight, my brain started to go 3000 miles an hour. And then I'm like, Well don't get anxious, your blood sugar's are gonna be bad, like, don't get anxious don't get anxious and funny thing, that kind of thought is not very relaxing.
Kind of how it goes.
So some days are better than others and I can just chill on the like I treated, it's going to come down. And then some days, you know, you're it had the physical reaction happens so fast, you just can't do much to stop it. You got to kind of write it out.
Scott Benner 50:41
It is absolutely fascinating to hear you explain that because it's not my reality. And it's as you're talking, the first thing that pops into my head is the wrong answer for everything you said. Like, look, you don't I mean, like you said, you know, having a clear thought like, This isn't how I should be thinking doesn't stop it. There's no, there's no common sense that common sense is you out of anxiety. Yeah, right. And and so you're learning coping mechanisms and therapy and things like that. Do they help? Or? Or do you just need to become a weed person? Like, what what what exactly is, and I'm not a drug advocate. But I'm as you're talking, I'm like, Megan needs to relax. And
Megan Carlson 51:27
so funny because I was thinking about that in bed last night, I was like, I probably just need to wait. And I was like, Don't bring that up on the podcast.
Scott Benner 51:34
I've never said that out loud before. I will tell you something now that people find completely, most people find difficult to believe. But I don't believe I'm 47. In my lifetime, I don't believe that I have had the equivalent of a case of beer. And I've never been high. And it just it just doesn't occur to me to do it's it's not a moral judgment. It just it really just doesn't work. Like it just it never occurs to me. It doesn't occur to me to drink. It doesn't occur to me to get out of my head. Like none of that happens. But I know people that helps. And my goodness, you seem like maybe you're one of them. Yeah. Because the other thought is you need like some sort of medication. And that's not a great way to live either. Right? All right. Have you tried that?
Megan Carlson 52:16
It's tricky. I've been considering it too. I worry about like blood sugar management with all that. And I would say another thing too, like, I self medicate with alcohol quite a bit. And that's hard for me to talk about, but it is what I did. So now that I don't do that very much. I don't really have I had a great tool for managing anxiety. Really, really good one. Yeah, yeah. And it worked. Because I could see numbers. And I'd be like, Okay, well, that's happening, and treat if I needed to, but I didn't feel this like terror. But now that I don't do that I'm kind of trying, I'm in this process right now, or I need to find something to replace it to manage anxiety. So I had, I've used that coping mechanism for a long time. And now I need to, you can't just like not have a coping mechanism, you need to find something I do. But I'm gonna
Scott Benner 53:07
cut you off for a second because I think that it is most people's inclination to address alcohol use or drug use there for people who are definitely in situations like you, which by the way, most people who are doing that are trying to mask something. And for those of you who don't feel that way, or don't have those triggers, or that anxiety to judge that is It's horrible. You don't I mean, like you You don't know what it is to have the experience that Megan just described, that cycle that doesn't just, it's not just an A and B cycle, a C jumps in, and like makes it spin faster, and then everything she can think of to stop it makes it worse. And you can't live like that, you know, and then you add the diabetes to it. You know, my God, like I would have been drinking with both hands, probably. And and you know, I mean, like, so anyone who would hear that and judge that. I would say that's a situation where you just don't you don't know. And yeah, it really brave of Megan to come on and talk about it. And so keep that in mind as we keep going, please because she's really trying to share here and she's doing a great job. So okay, so you tried the drinking path, which was never. Right. And you're beyond that, which is good for you. That's amazing. I, you know, I've indicated maybe a medication would help you but then we're talking about like, you know, like the Zoloft, Paxil, you know, Wellbutrin road which has its own speed bumps that you might not be interested in. And and at the same time, you can't keep flipping into this cycle over and over again, because now you have real concerns about your health. And it's your right Something has to you have to do something somewhere. And so what is it that's occurring to you to do like, what direction do you think you're going in?
Megan Carlson 55:02
I'm trying everything, which like might be counterintuitive. Also, I had to take a step back. But um, so therapy is a big thing. But therapy's kind of a slower process. A lot of people recommend meditation and I'm giving that the college try. And I think it's really important, but it's a it's a habit that's a little hard to cultivate, I think for a lot of people.
Scott Benner 55:25
Meditation is that the way you're going
Megan Carlson 55:28
mindfulness that I kind of try everything, and I'm open to everything. And that's definitely when it when it's going well, that is very helpful. Because the few times I've been able to, like see an arrow on the CGM and kind of be relaxed about it, it's been usually because I've been like meditating a little bit more and can kind of take a step back from my feelings, like, not identify so strongly with my feelings and kind of have a good detachment. So that's, that's helpful. I can't see right now, but I have my Essential Oil Diffuser going. So got a little bit of that stuff to help your body relax. Have you tried this? oil? I actually should give that another college try. Because so finally, you mentioned weed, I actually don't get high, most of the time that I tried it, it happens down again. So that's another tricky, it might not be my thing. But
Unknown Speaker 56:20
I'm screwed, even we won't work for you.
Megan Carlson 56:24
And people have suggestions. Let me know. I think the some of it too, is just coming becoming comfortable with my new normal with taking care of my eyes. And knowing that not every, there's so much out of your control. And I think that's what it comes down to. So like anxiety is because you think that you can do something that's going to make it better. And that's true for a lot of stuff with diabetes. But there's some stuff that's just going to be random. And a lot of this stuff with my health is it's random. So just kind of being comfortable that Yeah, there's going to be ups and downs, and much easier said
Scott Benner 56:57
than done
Megan Carlson 56:58
to be like relaxed about it. And I'm like feeling really good right now sitting in my in my living room. But yeah, when you're actually in a crisis is when you want to know, yes, ah, it hits the fan. No, I know, listen.
Scott Benner 57:10
So I have one thought for you after talking to you for 55 minutes. And maybe you'll find this useful. And maybe you'll be like, Scott, that's stupid. That's not gonna work. But you mentioned earlier in the podcast that when you were diagnosed, and when you were younger, how helpful it would have been, if you heard the the drawn out disc description, like you're going to do this thing. And then this is going to happen, and it's going to make you feel like this. And that if you had that information, that forward looking information, that you would have found it really valuable and comic. And so the leap we make when you say that is that it's going to go somewhere good. And because it's going to go somewhere good. You're okay with it when you hear it. And I'm wondering if you can't just break up the my blood sugar is going to go up? I'm going to feel like this. It's not valuable for me to feel like that. Because this is going to happen. Can you think it through before you get to it so that when it happens, it's expected? And would it being expected stop it from being reactive?
Megan Carlson 58:17
Yeah, and I think that's a big component is kind of knowing ahead, like, and this is like, I think common with people with control issues, which is very closely related to anxiety is kind of being prepared for for those kinds of things. And I think that's been helpful to me, because actually, even though I'm still very anxious, and I have a lot of trouble with it, but if you'd see me in last May like when like I had my eye hemorrhage, that was like panic attack a day. So I'm like, I'm
doing much better
than a lot of that is kind of being able to know, hey, you're just going to treat it and it's going to come up or sometimes it doesn't come down. Sometimes you have insulin resistance, and that's okay, you'll do more insulin, you'll watch it kind of knowing that ahead is is helpful.
Unknown Speaker 59:04
It's like I think the
Megan Carlson 59:06
what I'm working on now is there's sometimes there's surprises like and that's kind of what I referred to before is like triggers, like you got to kind of know your triggers. So maybe the next thing I work on is like being a little more prepared for these triggering episodes that are a little more of surprises.
Scott Benner 59:21
I want you to know that in my mind, and I'm not being productive. I imagine you like curly from The Three Stooges, just like hitting yourself and wiping your face and running in circles. And to me is what it must have been like a year ago. Just you're just like, whoo. And
Unknown Speaker 59:37
yeah,
Scott Benner 59:38
because that's what, that's what, in my mind, that's the that's the sound effect that pops into my mind when too many things happen at once. I'm just like, wow, everything just got really wonky out of nowhere and and there's no and you have to reorder everything. But I have the ability to just stop and step back and then assess and move forward. And you, your brain works in a way where those things start happening and you just pick the worst one and run at it on fire.
Megan Carlson 1:00:07
I happen so fast, right? That's the thing is like, rationally I know all these things, but it can just happen so fast that it Yeah,
Scott Benner 1:00:14
well, I first I want to tell you that you have my I don't know what you know what the right thing but my empathy for sure because it cannot be easy. And, and it sounds like a tortured way to live some days. And no one deserves that for certain. I don't know if anything you and I spoke about today would help help you. But I hope it did. I definitely think it helped other people which may be in that would help you that knowledge might make you feel better, because you're going to reach you know, honestly, countless thousands and thousands of people who are now going to hear your story and maybe avoid that being their story someday. And and that's really a great kindness that you did by coming on and sharing all this. Is there anything we didn't talk about that you wanted to get to?
Megan Carlson 1:01:06
I think I would just make a final thank you for saying all those things. I think I'd make a final plug for being an advocate for yourself in the doctor's office that if you need to slow things down. And you need to ask more questions do that, like, I wish I'd gotten help a lot earlier. I wish I hadn't just tried to do this alone. So I guess it's it's two pronged, like, make sure that you're with a doctor you like try to find someone as hard and ask questions as you need to. And don't let anyone shame you. And then also reach out for emotional support. Because I think that would that would have helped me earlier on to so we could do the things reach out.
Scott Benner 1:01:48
Yeah, well, you said something that I hope people heard which is there was a point where somebody important came into your life. And you said it was a boyfriend and then you've started trying to do better if I've heard over and over again on this podcast when loving someone else can lead people to taking better hair themselves. And so being loved and being in a relationship like that it doesn't have to be romantic. It could be it could be a friend or a family member or somebody who just clearly cares for you. And doesn't it doesn't have to be set. Right? Like that person doesn't need to walk up to you every day and go Megan, I love you. And I want you to be healthier, and I'm here for you. It doesn't have to be like that. Sometimes it's just the knowledge that you're there. And you know, like, I'll tell you the silliest little like parable about that. So my son is away at college. And he liked this video on Twitter. And it was a video about a major league pitcher who had been working really hard, and really just honing his craft but wasn't having the success that he felt like his skill and work should have led him to. And so he just kept doing the things he was supposed to do the work, you know. But one day he realized that he had to step back. So he he just went and found something else that wasn't baseball to busy his time with and to give him some balance and perspective. Excuse me. And my son retweeted that or liked it. And I thought, well, that must be important to him. Right? But just calling him up and being like, Hey, I saw you like that video. Are you looking for balance in your life, buddy? Like you don't mean like that would be stilted and weird and not the right way to go and would chase him away. So as crazy as it sounds, now I have to find the guy's name before I let you go the pitcher. But so a week or two later, this guy's pitching. He's a Cleveland Indians pitcher. I want to say his name is Kay Hill. And I'm going to figure it out right now. Hold on so I can tell you the rest of the story. This is exciting on a podcast when people do nothing better.
Megan Carlson 1:04:06
Well, you have the sound effect though the typing. Oh, yeah,
Scott Benner 1:04:08
it really it really grabs your attention. Is this not popping right up? Oh, come on internet. Don't let me down now. I just the internet loves me. It loves other people. I see. It'd be nice to other people all that does not love other people who doesn't? You don't think so homeless? Was it not? Now I'm getting angry. Now mad at the Internet. Hold on a second, because I googled the wrong thing. I'm Trevor Bauer. Where did I come up with K? All right, let's not go there. Okay, so Trevor Bauer is the pitcher. And if anybody wants to, I'll have to put the video into it. So people can see it because it's just this mindful little video of a guy who just has been working his butt off his whole life at something and put himself in the right physical, you know, mindset. You know, his mechanics were right, but it's just his mind wasn't really there. So that this goes up. And you know, my son likes it. And a couple of weeks later, this Trevor Bauer guy at the beginning of the baseball season is throwing a no hitter going into like the sixth inning. This is pretty amazing. And so I'm at while this is happening, I'm at Home Depot, because I needed a larger desk for my podcast, which by the way I have now and I did not get it and I did not get it home depot I found somewhere else. But I was at Home Depot. And this pops up on my phone, Trevor Bowers taking his no hitter into the sixth inning. And I was like, Oh, that's cool. So what did I do? I texted my son. Hey, Trevor Bauer's got a no hitter going if you want to watch, I didn't say I saw the video. And I saw your retweet. And I know this, I just set it. Like, you know, here it is. And a few minutes later, he's facetiming. Me and I'm walking around Home Depot facetiming with my son. And he starts telling me about the video. I don't know if you saw it, he says but you know, this guy, just you know, it's bah, bah, bah, and all that stuff. I never said yeah, that's why I told you about it. I just let it go. I didn't need I didn't need credit graded any credit for it. Like that wasn't the point of it. The point of it was to let him know, like, I've got his back. Do you don't mean even even in a way that he's not 100%? Sure. That's what I'm saying to him. We just had sameness all of a sudden, and he didn't know why. So a month later, I'm at his school. And we are having he just got done playing and I took him out to dinner afterwards. And we were sitting there. And he said something about balance. And I said, Yeah, I saw that you liked that, that tweet that tweet about the Trevor Bauer video. And then he launched into talking about it. And when we were all done, and I thought that we had gotten pretty much everything out of you know, that, that that I was going to get out of that, you know, parentally I said, actually, you know, if you remember, I when I told you that he was pitching a no hitter. I did that because I knew you like that tweet. And I just, you know, I wanted you to know that I was thinking about you. You know, and, and that's what he got out of it. So you don't need to be right up someone's butt to tell you that they love that you love them right? Or that you've got their back or that they can feel comfortable around you. So as a really long way of saying there's a lot of ways to support people that aren't the ways you see on sitcoms, I guess.
Megan Carlson 1:07:37
Yeah, and actually, I think that's a really good way that you put it because I think at a certain time in my life, if people come up to me and said they wanted to help, I would have pushed them away. But I think like I think if it was my boyfriend now, so I'd agonized for a long time over getting a pump because it felt like I was constantly pressured and getting a pump. And I didn't want one. And now I have one. But something happened like two maybe a year. Yeah, I'm probably about a year ago, where he's like, Oh, you should just get the or he said something that was very accepting about getting the pump. It wasn't like, here's what you should do. He's not very involved in my diabetes like that. But he was like, Oh, yeah, it's like no big deal. And something about just the acceptance of that was like, Oh, it's no big deal. like wearing something on me all the time. My partner doesn't care. Like just little stuff. Like being there. Like that is so important.
Scott Benner 1:08:27
Yeah. No, it's just it. It's difficult to quantify, right? The idea that someone's there for you, or, you know, wouldn't care if they walked in and saw you in the shower with an insulin pump on it. Because I mean, we've heard from adults in the past who say there was somebody on recently who said, I didn't get an insulin pump for a long time, because I just didn't think it was sexy. So I didn't want to do it. And that was that she's like, I knew it was, you know, I knew it could have helped me and I was like, Well, I don't want I don't want men to see me that way. And that's, you know, what your girls don't know is you could be wearing 75 insulin pumps, we wouldn't care. Like, I mean, honestly, it wouldn't make any difference to us. I really mean that you could fall in a mud hole and stand up and I'd be like, yeah, I'm still good with it. It just really is. You don't understand how boys brains work, I guess. If you're worried about that, you're worried about the wrong thing.
Megan Carlson 1:09:22
But it is a worried like, cuz I think when I was younger, too, that was the thing like, Oh, this is gonna be it's gonna make me different. I'm not gonna be as cute. Yeah, that's silly stuff.
Scott Benner 1:09:31
Now I know. And it's, I mean, who would know? That's why I tell people all the time. I know that you don't want people to see your pump or your CGM. But honestly, for your long term health, and I don't mean your physical health, but for your long term mental health, just put it somewhere where people can see it and be done with it. Yeah, you know, and if somebody gives you, you know, a problem about it. I don't know what to say move. You know what I mean? Like, go to a more accepting part of the world, but don't let someone tell you That this is wrong. And then you take it off like it just you just got to keep going. I mean, listen, don't get me wrong if you're in a bullying situation or something like that, that's different. I'm talking about in general, you know, in general, you got to go be you. And whatever people think about it, they think about, I'll leave you with this thought wrapped around that. If you have a moment, I know you're Yeah. But they don't pay you. So what do you care? By the way, who would have thought that when you were going to work for a nonprofit, they meant you?
Unknown Speaker 1:10:28
Oh, yeah,
Scott Benner 1:10:29
you're not gonna make a profit is what they meant. But I was just on the phone with a person that I do business with yesterday. And they said that they said that they had heard from somebody that didn't like my podcast. And and they asked them why. And the person said, Well, you know, he just comes off, like, he knows everything. And everything he says is going to work for me. And, you know, in the end, what it turned out to be is that that person didn't really have a problem with what I was saying as much as a problem with how it made them feel. And it made them feel like they were failing. And I said, Well, I try really hard to present a possibility. And if you misread it in the beginning as me being like, boastful, I mean, there's not a ton I can do about that. I guess I i've scaled back personality enough, this thing still has to be interesting, or you're not going to listen to it. So I still, this still needs to be entertaining, right? And so that conversation led into the person saying, it was weird, because that person, like, got through it. And they do like the podcast now. It's like, interesting. But what's it like to hear that someone doesn't like you? And I was like, Oh, that's no problem. I've never had an issue with that. Even growing up. You know, when I was much younger, I met my wife. She said to me one day, that guy really doesn't like you. How does like does that bother you? And I was like, No, not at all. I said, to be perfectly honest, I don't think he's a great person. And I would wonder what it says about me if he did like me. And so my point is the three people who would bully you about wearing an insulin pump don't like you. It's good. They don't like you. Those are the people you don't want to agree with you. Yeah, right. You know, there's nothing about them. That should correlate to you, you're decent person. You don't want that guy. Like I mean, just I don't want to I don't know who to use as an example, right? But you don't want like the bad guy in the movie to be your best friend. Because why does he like you? What does that say about you? And and I and I just said to my wife, way back then when we were just dating. I was I told her that. I said, Look, everyone's not gonna like me, the best I can do is be myself. Some people like me, and that's got to be enough. Like, what am I trying to do? I can't make everyone happy. And I just think that that's important when you're when you're living with diabetes, like you just need to be you. And if some people don't like that, then too bad, then those are people you don't talk to.
Megan Carlson 1:12:58
Always now you know, and you can avoid them. You're not gonna waste your time with them. Yeah. Actually, I can leave us on a really positive note about this too, is that's
Scott Benner 1:13:05
gonna ask that because it got sad there in the middle.
Megan Carlson 1:13:11
Yeah, and it's, you know, that's the reality. And I don't think it's bad to talk about things. I'm on a positive note, I really kind of owned my diabetes. Now. Like, like I said, I'm going to the support group, and I'm going to these meetups, I'm talking to people on Instagram. And I'm like, I'm excited about my pump. Like, I've got an omni pod. And it's makes life so much easier. And I like kind of like showing it off. I feel like I showed off too much. I'm getting to be weird, but
it's a good thing.
Scott Benner 1:13:40
I don't think you're weird. And I think you need I think you should do whatever, whatever makes you happy. Let your let your diabetes flag fly. Seriously, just get out there. And Alright, so Megan luck. I want to wish you all the best. I would like it if you kept in touch. I would love to know how things are going for you. You know, especially with not just with your eyes, but with I think with the anxiety and everything because your agency is rocking. You're down. Would you say that when you sent this email? It was six, six.
Megan Carlson 1:14:08
Yeah, and I'm six, five now. That's really great. And I got through a sixth one, but it was actually probably not
Scott Benner 1:14:14
great for me. So six five is pretty good. That's not just pretty good. Really. Let's be honest. It's, it's amazing. And and you're talking about coming from Did you say a 13? At one point? Yep. Yeah. Okay. So let's just say you're doing great. And, and you really should just, I hope, I hope you can hear that. And, and just accept it as a well meaning well intended, honest compliment and not, not let your brain take you any further than that. When you hear it. You're doing great. I think that you just keep doing that and you're gonna be you're going to be great moving forward, you're not going to need you're not going to need all that. That other stuff that that that you know, kind of like I was holding it down before. I'd love to know how Don't i think i think it's possible that six months from now you tell me that you've really kind of broken free of a lot of this. And I think that'd be great.
Unknown Speaker 1:15:08
Thank you. I hope so. Oh, listen,
Scott Benner 1:15:11
I don't have anxiety. So it's easy for me to say, I can't even I can't even begin to imagine like, the number of times, let's just say goodbye. We'll stop recording but so goodbye, everybody. That's it, but I'm gonna keep talking to Megan for a second. The sixth season of the Juicebox Podcast has started off strong, powerful, even with two great guests, Jenny and now Megan, so much more to come in 2020. I really appreciate you listening. Don't forget to share the show with someone else. And thank you so much for supporting the sponsors. In this episode, they were Dexcom on the pod and dancing for diabetes. There are links at Juicebox podcast.com in the show notes of your podcast player. And of course, you can always type them out Miami pod.com forward slash juicebox dexcom.com forward slash juicebox dancing the number four diabetes.com. And starting later this month, I want to welcome Contour Next One Arden's blood glucose meter to the family of sponsors of the podcast. I look forward to telling you more about the Contour Next One in the coming days, weeks and months. But for now, let's just say this. It's little. It's pretty, it's easy. Works terrific. I've never had a meter matchup so closely with ardens g six, rd has been using the Contour Next One for it's gotta be a year now. And it's honestly been the absolutely best blood glucose meter experience that she's ever had. And now, I would like to give you a little something about Megan. So after I edited this episode, I found myself thinking maybe Megan should come back on one day. But I wish I knew how she was doing now because what you of course don't realize is that Megan's episode was recorded a long time ago. And so I reached out to Megan, I said, Is there anything I could put at the end of the episode to let people know how you're doing? She sent back a note. She said, Hi, Scott. That's awesome. Where am I now? Huh? Well, there haven't been any major changes. The anxiety for sure has gotten easier as time goes on. But it's still there. And something I work on daily on managing with my therapy, journaling and mindfulness. The biggest change and the best treatment for my anxiety has been getting a dog. We adopted our boy Nikita, in July, and I swear nothing chills you out like petting a giant fluffy wolf dog. And she gave me a picture. So I'm gonna put the picture of Juicebox podcast.com for you. Actually, I'll put it up on Instagram. So beautiful dog. Although weed is legal in Illinois, as of three days ago, so who knows what the future holds like it Megan thrown a little humor in there at the end. Oh, in my last day one C was 5.8. And I'm still loving my Omni pod. Anyway, use as much of this note or as little as you'd like. I can't wait to hear the episode, Megan. So that's it for today's show. Hey, if you're in Oklahoma, come see me this weekend. I will be speaking at the jdrf type one nation event on the 11th of January. Come one Come on. We're gonna be talking about being bold with insulin and a lot more at the jdrf in Oklahoma. If you come you may catch me try to sing from the musical Oklahoma. It's a strong possibility. I'm going to make that mistake.
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