#620 Exclusive Omnipod 5 Interview

Omnipod 5 receives FDA clearance!

Shacey Petrovic, President/CEO and Dr. Trang Ly, SVP and Medical Director spend an hour talking about the FDA approval of Omnipod 5. Tune in to learn about the approval, how the automated system works and so much more. This is an exclusive conversation that will only be heard on the Juicebox Podcast.

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

Scott Benner 0:00
Hello friends, and welcome to episode 620 of the Juicebox Podcast.

It isn't often that I bring you a podcast episode that was recorded on the same day that you're hearing it. But today is a special special event. It is Friday, January 28. And this morning at 6am insolate, makers of the Omni pod dash announced that their automated insulin delivery system Omni pod five has received clearance from the FDA. If you're like me, you've been waiting for Omni pod five for quite some time. And this is a very, very happy day for you. I can't wait for my daughter to try it. And I know you might feel the same. So I thought you might want to hear directly from JC Petrovac, President and CEO of insolate. Joining JC and I today is Dr. Trang Lai, Senior Vice President and medical director at insolate. We're going to talk all about on the pod five get as many of the listener questions that I compiled in in this hour as we can I lose AAC after an hour, but trying hangs on for another 25 minutes to talk about insulin pumping with the Omnipod five. Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. I want you to be able to listen straight through so no ads today, but please do remember to support the advertisers of the Juicebox Podcast. If you're interested in getting a Dexcom use my link. If you want a great blood glucose meter, check out the Contour Next One at my link. If you want to get an omni pod, please use my link. If you're going to take the T one D exchange survey and please do it's super simple to do and it supports the podcast. Use my link Are you looking for glucagon try the G vo hype open at my link. And don't forget about touched by type one my favorite diabetes organization dexcom.com forward slash juice box on the pod.com forward slash juice box contour next one.com forward slash juice box Chivo glucagon.com forward slash juice box T one D exchange.org. Forward slash juice box and touched by type one.org. There are links in the show notes of your podcast player and links at juicebox podcast.com. To these and all of the sponsors. When you use the links you're supporting the show. Last thing before we get started with chasing and trying if you're looking for a great community online, my Facebook group Juicebox Podcast type one diabetes is a private group with over 20,000 members just like you it's a great place to chat, learn or just watch what people do Juicebox Podcast type one diabetes. At the end of the episode I'm going to give you a link special for Juicebox Podcast listeners where you can go learn more about the Omni pod five. This episode is the only place where you'll be able to get this link today. If this is your first episode of the Juicebox Podcast and you're enjoying it, there's so much more that you might love. Subscribe now in the audio app that you're listening in. And if you're listening online, get yourself an audio app and find the Juicebox Podcast Subscribe and follow today for more great content like this.

Shacey Petrovic 3:24
Scott, great to be with you. I'm JC Petrovac, the President and CEO of insolate.

Dr. Trang Ly 3:28
Hi, Scott. I'm trying Lai as senior vice president medical director at insolate.

Scott Benner 3:35
The person to me that wants to make the most of the hour wants to just jump in and start asking questions. But I think it would be wrong just not to ask you like what this feels like. Because I know the process has been long. And it was made more difficult by COVID. And I just wonder how you're feeling this morning.

Shacey Petrovic 3:51
I could not be more excited. And I know I can speak on behalf of trainers. She is also incredibly excited. You know, excited. This has been you know, the better part of a decade in the making and 1000s of people have been involved across the company across the diabetes community. And you know, many, many technical challenges hurdles it just was it was not a straight road. And so to tackle all of those challenges, be here really pushing the field forward with an incredibly novel technology that brings a lot of firsts to market and that we know has the potential to dramatically improve the lives of people living with type one diabetes. I mean it is for me, it's it is it is very much the proudest moment in my career. And so I'm really really thrilled.

Scott Benner 4:42
That's amazing. It really is trying do you have any feelings on the process?

Dr. Trang Ly 4:48
Yeah, I'm super excited and it's been a long time in the making, but I cannot wait to get this product out to patients.

Scott Benner 4:56
Excellent. Well, I can't either I'm gonna say from you know, the But I don't know if there are many people that speak to as many people with diabetes as I do. And I just think that what it's going to accomplish for just the general public of people who use insulin in general, it's going to be, it's going to be, I mean, life changing, seems trite to say, but I do think that's right, I watched an algorithm work in my house, I can't wait to try this one. And I know what it's going to do for people who struggle and who feel more of a, I mean, not just the health impact, I guess, but a psychological impact of having diabetes that sort of all over the place all the time and not having to think about that my daughter is getting ready to leave for college, you know, and so are a lot of other people's sons and daughters. So it's a really exciting time. All right, so I guess, I'll give you my understanding, you'll make sure I have it right. You know, there are, you know, algorithms you have won. And I want to know how it works. So I, I just I want to know, nuts and bolts how it goes. So I'm looking for just maybe a high level overview of what the system does, and then we can pick through it a little more.

Shacey Petrovic 6:08
Sure. Yeah. Well, I mean, I think, you know, we probably don't need to start at the high level, you and your, your listeners know better than anybody, just how hard diabetes is and how much work it takes to manage. So Omnipod five, and the smart adjust technology, which is the algorithm are really designed to be an incredibly easy to use system that reduces the amount of work that a person has to put in to manage their diabetes. The system itself is, consists of the same kind of small, wearable, waterproof pod, but there's been a lot of really exciting technology packed into that pod. And one of the big technical challenges of the program actually was getting the smart adjust technology onto the pod. You know, it's it's a very sophisticated algorithm, lots of processing power, and the team worked very hard to get that technology onto the pod. So that smarter just technology automatically, the pod connects automatically, with the Dexcom G SIX sensor, it takes a reading every five minutes, and it adjusts insulin every five minutes. The algorithm predicts where your blood glucose is going to be an hour from now, and then adjusts insulin in five minute increments to prevent against highs and lows both during the day and overnight. So you know, one of maybe try and can speak a bit to the uniqueness of the algorithm relative to others that you may have had experience with Scott. But what I can say as the clinical data was extraordinary, and demonstrates really improved glycemic control, improved time and range, lower agency and minimal hypoglycemia. So kind of the trifecta of the clinical results we're looking for for people with diabetes. Well,

Scott Benner 7:57
that must be true, because no fewer than three people in my Facebook group said I'm in this trial, they better not take it from me now that it came to market. So people seem excited and happy with it, for sure. You have a trend? What are your thoughts on on how it works?

Dr. Trang Ly 8:13
Yeah, I think she covered it. At a high level, I think, you know, very similar to what we expect from AIG systems. Now, the algorithm adjusts insulin dynamically every five minutes so that people don't have to make these decisions. And, you know, Scott, just how much better glucose control you get when you're adjusting and had that feedback loop from the CGM. So I think, you know, one of the unique features of our system is the customizable glucose targets that you can set at different times of day. And that really allows flexibility for people who might want to run a little higher at certain times, like maybe when you're going for a sleepover or night, or you know, you might be new to AD and be hyperglycemia unaware, and you might want to run out a higher setpoint. So that it does give that optionality. And yeah, it's a great algorithm, our clinical data proof site,

Scott Benner 9:12
well, I already pitched my marketing idea to you, I think you should give away a coupon for a new mattress and pillow because people are gonna finally get to sleep and they're gonna want to become they don't even know their beds are uncomfortable. They're gonna find out pretty soon.

Shacey Petrovic 9:25
Scott, by the way, we heard that time and time again, from clinical trial participants, you know, not just from people on the system, but from their families, their parents, and so I remember what six years ago when you and I first spoke, you said that that was the most important gift that we could give to you, you know, in terms of your health and your reduction of stress is just a night's sleep. So we're really excited to bring that to people with diabetes.

Scott Benner 9:53
I feel like I I have to tell you the I've sort of been on the inside of this for a little while. I don't know how you guys Take the stress of all this. I'm nervous right now, I have no stake in this whatsoever. And I'm feel like I can't believe this happen. Alright, so So okay, so somebody's going to get on the pod five, right? And they're going to get a selection of pods that will last them a certain amount of time, I'm assuming you're going to offer them a PDM as well. Right? Yes. Okay. Yes. Is that going to look like the dash PDM.

Shacey Petrovic 10:27
I'll let try and talk a little bit about the handheld controller. But every, every new user will receive a handheld controller, along with the system, we're really excited to offer Omni pod five through the pharmacy. And what that enables us to do similar to what we do with Omnipod dash today is allow people to use the system without a long term commitment. And without an upfront cost, like we see with other systems. And so we will provide this handheld controller free of charge. And, and you know, today actually, in the pharmacy Omnipod dash users can try the system for free for 30 days. And this promise that we have and offering the technology through the pharmacy means that people can upgrade without an upgrade fee, or without waiting out there, lock in periods. So that's the benefit of, of kind of getting on dash in the pharmacy. And that's our commitment, you know, in terms of the technology that we bring to the community is that we want to do that in the most cost effective way. Without and in the most consumer friendly way, you know, without making people wait out their contracts or pay large upfront costs.

Scott Benner 11:41
Let me kind of go a little farther on that then. So my two questions are, will they will it not be covered as a durable medical product?

Shacey Petrovic 11:50
It's right, it will be offered through the pharmacy. So not through DME the vast majority actually of our users today with Omni pod dash are going through the pharmacy. And the reason we like that channel is because it is a very predictable low out of pocket costs for our users. And it enables us to offer Omni pod dash today and Omni pod five shortly without that upfront cost and that long term lock in period that people experience in the Durable Medical Equipment channel.

Scott Benner 12:20
No, I'm hearing it. And I'm excited to say that you're also going to be able to run on the pod five from an Android phone. Is that right?

Shacey Petrovic 12:28
That's right. That's right. Yeah, we will launch with compatibility with a number of Android phones. And which means that they that you and your users will be able to download a secure app on their Android phone and can control the system without biocompatible phone without the need for the handheld device. But the experience with the handheld device is fantastic too. And I think maybe trying you can talk to some of that experience with the the handheld controller. Please,

Dr. Trang Ly 13:00
yeah, happy to. So Scott, you asked whether it was similar to dash, the user interface, and it it is it is built on the Omnipod dash platform. And so for our users who are familiar with Dash already, it's a very smooth and easy transition to Omnipod. Five. And in fact, if if you're already on Omnipod dash and A Dexcom G six, you can go through our onboarding, self service onboarding platform to be able to get yourself on to Omnipod. Five. So you know, we are really trying to innovate not just in the product, but the way we serve and train and assist our users in getting on to the technology. So the that was important to us that the user interface was not too different from Darshan. It's a very, very similar setup.

Scott Benner 13:53
Well, there. I have questions from from the audience. Well, I see the Dexcom information right. On the on the on the on the pipe screen.

Shacey Petrovic 14:03
Okay. Yes, you will. Front and center, actually. Excellent.

Scott Benner 14:08
Well, here's, here's a down deep question from somebody, will multiple profiles be available?

Dr. Trang Ly 14:15
And in terms of multiple Basal profiles, yeah. Is that what they mean? Are they

Scott Benner 14:20
Yes, yeah. Okay. So you'll be able to as by way of an example, my daughter can have a profile for different times of the month as an example. Yes, I just found myself being demure for reasons I don't understand. That's not usually how I am. Do different insulins yield different results? Because or does the algorithm adjust to it?

Dr. Trang Ly 14:47
Yeah, the Omnipod. Five was tested using humor log Novolog and admelog insolence and that's what they're cleared for. So we do not test them with other insolence. And so that's the indication. Gotcha.

Scott Benner 15:03
Okay. When I set the, I get the device and I'm super excited and I set it up, What settings do I have access to? Like, what do I have to tell it carb ratios, my Basal rate and, and then what happens from there.

Dr. Trang Ly 15:17
So the, when you set up dash, the exact same setups that you require settings that you would enter into dash, you would require those to be entered into Omnipod five. So that would include all the Basal settings, the insulin to carb ratio, as you mentioned, correction factor, the the key difference is the target glucose. So in Bolus calculators, you generally set up a target glucose so that the user can the Bolus calculator can help assist you in determining how much insulin your system is going to calculate for you for a Bolus. But what our system does is it also uses that information to drive the algorithm. So whatever customized target you choose, say you're choosing one 110, you know, all the time, 24 hours, then the algorithm is always going to be driving towards that target.

Scott Benner 16:15
Let me ask you this, if I tell it my Basal rates one unit an hour, and it realizes it's more like 110 or 1.1? Will it make that adjustment on its own in the way the algorithm works?

Dr. Trang Ly 16:26
That's right, that's what the system will do?

Scott Benner 16:29
Will it tell me that? Well, let's say, hey, chucklehead, I know you think your your Basal is one, but it's 1.1? Is there a little pop up? Or how do I know that that's happening?

Dr. Trang Ly 16:37
No. So it actually just takes care of it for you, you know, one of the philosophically what one of our really, you know, in Yeah, design principles and with Omni pod is really to simplify the experience for our users. And that means not telling you every single time we adjust insulin, if it's unnecessary, so we really want people to live their lives and, you know, not worry about their Basal rates. And we do ask them to Bolus for their meals. So it is a hybrid closed loop system where they are expected to interact with their device for boluses. But in between times, really, they just wearing their pod and their CGM. And the system takes care of them.

Scott Benner 17:29
How do I handle the transition that and if I put it on a prepubescent child, and suddenly they hit puberty, and their Basal rates go from point five to 1.2? Like I don't want the algorithm just keep doing do I want the algorithm to just keep doing it? Or do I have to go back in there and make a change ever?

Dr. Trang Ly 17:46
Yeah, it's a very important question for ARD systems. So we have an activity. And what that does is it adjust to the person's actual insulin use over time. And so if you do that, too quickly, you can, if you add activities too quick, you could deliver too much insulin, say you run into a couple of days where you have in, you know, infusion issues, or you know, your pod falls off, and you're actually delivering a lot of insulin, but, you know, it may it may not be your body may not be as sensitive, and then a couple of days later, you need less insulin, you don't want to a system that is adapting too quickly. And so we think our activity is just right, because, you know, it's worked really well in our clinical trials, and it will adapt over time for a growing child, you know, a teenager going through puberty, all of that. So, you know, that's why you test these systems over a long period of time, to see how well it works. And, and, you know, what, it's important to me when I look at all the different systems is not just how they work in the beginning, but how how they work over a period of time. And, you know, we've got Todman data now to show that the systems have really durable clinical benefit.

Scott Benner 19:03
Can I leave the algorithm and use the pod like a regular insulin pump? If i Yes,

Dr. Trang Ly 19:09
yes, yeah, it will, you can use it in in a very similar fashion to Omnipod dash. So if you didn't have a CGM, it will function just like dash and then with CGM, you will have the ability to switch into automated mode. Okay.

Shacey Petrovic 19:28
And train highlights a really important point, you know, we designed the system with sort of the rallying cry of simplicity. So, you know, toggling in and out of closed loop and open loop, it's just the touch of a button, you know, and we did try to provide just the information that people really want and not the information that most people really just don't need on a very regular basis. I think when we think about these systems and the ability to bring the the, you know, improved outcomes that Omnipod five can can really deliver for people with diabetes, you know, one of the hurdles to more people adopting Omni pod. And AAD has been the complexity and the cost. And so you know, when we set out on this mission, when he said, We've got to solve for the access issues, and we believe pharmacy offers a much better, much easier, much more kind of cost effective opportunity for the customer. And then we've got to make the system as simple to use as possible for multiple daily injection users, for kids for, you know, older people for the masses, essentially. And I think the team has done just a remarkable job taking what is incredibly sophisticated, you know, technology, elegant technology, but making it really, really simple for users.

Scott Benner 20:50
So I think it's important as well, one of the biggest issues that I've seen with other looping systems so far is that the, the, the things you need to know to use them sometimes are a barrier to using them. So it's not easy to just, you know, you start turning the wrong dial the wrong way. And and suddenly, things are upside down. So I think that's absolutely fantastic. I have a couple other questions. And then I'm gonna jump onto another. Another topic, minimum fill is 85 units. That's right,

Shacey Petrovic 21:19
same pod, just a lot more technology. And

Scott Benner 21:23
are there modes? Like, is there a deep sleep mode exercise mode? Or is it just how does that work?

Dr. Trang Ly 21:30
Yeah, so it has an activity feature. And during when you activate this feature, what happens is their target glucose goes to 150. And also our algorithm delivers less insulin as well. So that's our feature for reduced algorithm, insulin delivery,

Scott Benner 21:51
is there an increase? Setting, there isn't like a Thanksgiving setting or something like that.

Shacey Petrovic 21:59
You can target a higher setpoint for Thanksgiving, which is a great idea.

Scott Benner 22:04
So sort of bare bones like simple works, does it learn? Yes. Okay. It absolutely does. Yes. And but it learns over, like a short shelf life, like my like, point is that if I start wearing Omnipod, I keep saying I don't have diabetes, if someone starts if someone starts wearing Omnipod, five, let's say three months from now. And you know, they wear it for five years, is it like a supercomputer five years from now? Or is it just sort of like learning in the, in the now like, it learns from the past pod and applies what it knows from the past pod to the current pod? Yeah,

Dr. Trang Ly 22:39
it learns from the last several pods, in fact, Scott, and it updates accordingly, depending on how much the device is actually delivered insulin, rather than based off of Basal rate settings. So you know, what was important for us was, we don't want you or your daughter wouldn't be constantly having to tweak the algorithm in order to get optimal glucose control, it was important that we reduce the burden for people and families by growing with the user and augmenting that insulin delivery over time based on the information that we have. And so there is an activity. And probably the most dark example of that was actually, during one of our studies, which involved actually adults with type two, where we saw very quite large increase. So you know, these were people who had sub optimal glucose control when they came in, and the doctor put them on, you know, roughly 30 units a day, actually, it was 27 units, in fact, and then, over a couple of weeks, we actually, you know, the system because of persistent hyperglycemia, ramped that up to about 60 units over time. So it does have that ability to detect that persistent hyperglycemia react to that, and then kind of reset that baseline of required insulin delivery.

Scott Benner 24:11
It's interesting that you use that as an example because the other day in my group, a gentleman with type two, told me that he had found the podcast got himself an omni pod. Since then, his a one C is incredibly lower his time and range is crazy. He's lost, like 70 pounds, you know, and I didn't even make the podcast for people with type two diabetes when I wasn't till years later when I thought, I think this is as valuable for anyone using insulin. So I can't wait for it to help. Like there's such a such JC tell me for a second about seeing all the benefit in front of view. And, I mean, I know you're your next leap. I have the same leap to I have a completely different business than you but I have this thing. I know it's valuable. And how do I tell you about it? How do I get you to listen do an episode right? Like, is that nerve racking? Are you excited about that, because this is,

Shacey Petrovic 25:05
I am really, really excited, you know, there's there, we know that there is tremendous enthusiasm in the marketplace for this technology. We've already had, you know, 1000s of clinicians participate in webinars and sign up for education around it, I get outreach multiple times a day from people in the community that want access to the technology. So we're in a strong kind of strong foundation right now from which to really build awareness around the benefits of the technology. And our job now is to, you know, move into limited market release. And that will enable us to ensure that we test all of our systems, our processes, our trainings, to prepare for what we know is going to be tremendous demand for the technology. And once we've done that, we will really start to ramp up awareness and education in the community around Omnipod. Five and its benefits, you know, but you know, I stand here on the cusp of all of that, and I, I just am looking to the next several years, and we've got, we've probably got a decade in front of us, of improving outcomes for people with diabetes, first, for people living with type one diabetes, which is what this system will be indicated for ages six to 70, we will follow on that with what we call our preschool indication, down to age two. So we will be expanding our benefit for people living with type one down to really young, young people. And then we will, you know, we have work underway evaluating the algorithm in the type to user. So to your point, we're going to follow with multiple phone platforms, multiple centers, more and more patients who can benefit from this technology. So we're at the cusp of years of impact, but this this moment, we're we're about to bring this technology to, you know, the vast majority of people living with type one diabetes. You know, like I said, it's the better part of a decade in the making. And it's our job now to take the incredible technical and clinical work that training and our technology teams did, and, and help educate people on how this can change their lives. And, you know, forever, we've been changing lives really by, you know, improving the user experience, and to now take that and be able to add the incredible improved outcomes that we saw with Omnipod. Five, it's just, you know, it is very, very exciting. There's some anxiety because we know that demand, I'll tell you what the anxiety is there, because we know demand is there. And because we have moved to a business model where we don't have any constraints, you know, we're not making our customers wait four years for the next technology. And we're not charging upgrade fees. So technically, anybody who wants this technology can get it as soon as they have access to it. And that's the anxiety inducing thing. Are we prepared for that? But I know we're prepared for

Scott Benner 28:00
that. If you went one more word of that sentence, I would have launched into my Omni pod promise that that I know by heart. How long do you expect the LMR to be?

Shacey Petrovic 28:11
Well, we, we haven't really defined it because we do have to take the latitude to learn, you know, the whole purpose of a limited market release, which is not an FDA requirement. It's just a best practice in industry. But the whole purpose of this is to ensure that we are ready for larger demand. So for example, trying reference that the the easiest and fastest way to get on to Omnipod. Five is to be an Omnipod dash user with a Dexcom six user Dexcom six experience, because what that means is you will be able to essentially train via online tools and not have to meet with any sort of clinician or support. So that's one training pathway. But we know that plenty of people who today use multiple daily injections will be interested in the technology. We know that Omnipod users without Dexcom, GS six experience will be interested. And we know that people using traditional tube pump therapies will be interested. Each of those are different training pathways, and we have to test those and make sure that everything is in order.

Scott Benner 29:13
So I'm gonna ask an incredibly unfair and difficult question because you're literally this is the morning I don't know if people realize this or not. But you guys announced this like three and a half hours ago. And we're

Shacey Petrovic 29:23
Yes, you have impeccable timing set.

Scott Benner 29:26
I said, I said to somebody this morning, I was like, how did we randomly pick Friday and it worked out like oh my god for like a week, we kept saying like, are we gonna have to record this and it didn't happen, and we pretend it happened, and I'll put it out later. That'll seem weird. So this is an incredibly it's an unfair question, but it's a technology question that happens all the time. I'm not asking you what's next. But I'm hearing questions in my own head as you're talking. And I'm hoping that you're doing that stuff behind the scenes, for instance, integrating with G seven and like, my heart is like, I hope there are people in a room working on that. Lowering the target glucose, like, in my heart, I hope that you're like going to take a big deep breath, go on vacation and then be like, alright, FDA, we're doing it again. You know, like, I don't know, but but I think people will, you know, you're making a great point, like, I want to preface it by saying, if you're on MDI, right now, if you're using a pump that doesn't do this, no brainer, right? Like, it's an absolutely a no brainer. But I sit here in front of you, my daughter has a one, C has been between five, two and six, two for eight years. And we know how to do that, like so. But we do that with the do it yourself, algorithm. And before that, we did it manually. I can do it with an algorithm, I can do it without an algorithm, but my daughter's leaving for college and in my heart, here's what I think I look at the two of you. And here's what I see. I see the ladies that brought me algorithm on the pump, no link between a controller and a phone, and the pump. And my daughter doesn't have to be an app developer to use her, because I'm pretty sure if I sent my daughter to school with a laptop, and I was like, Okay, now listen, if something goes wrong with the loop, here's what we're gonna do. Because she'll be like, I'm not doing that then I was like, okay, so I love I love the system idea. Like, I cannot literally wait to get it like I would drive to Boston right now, if you told me I can have a box of it, you know what I mean? But and I think for the vast majority of people, that's exactly what it's going to be. But what do you do? If you're a five a one C, but you want the automation? Like, is there a way to live with that time?

Dr. Trang Ly 31:42
Yeah, I, you know, I think I hope that your family tries this, and really see the benefits of not having to worry about all the technical things of putting it together and, and give you the peace of mind that you've been after all this time. I, you know, in our clinical trial results for our adults and adolescents, down to age 14, a third of our patients had a time in range greater than 80%, which is really just quite remarkable. And for our kids, so the six to 14 group actually are two to six year olds as well. The mean, a one C was 6.9%. And but you know, what that means is that half the patients had an A one C with a six in front of it, which is just mind blowing, compared to, you know, where, where we are today in clinical practice? And so, yes, I definitely think that you know, that all the things that is driving good control with your daughter, it's likely, you know, to be attributed to things like diet, and exercise as well, not just the automated insulin delivery. And I think that she'll get really great results on our system.

Scott Benner 33:07
To be fair, and I want to be fair, part of the way we accomplish that is that we, with some frequency, leave the automated system and make adjustments to kind of stay ahead of things. So that's why I asked about that earlier. Look, seriously, I can't wait, I'm super excited.

Shacey Petrovic 33:23
And I think what we want for, you know, somebody like you and Arden is to be able to get that outcome with a lot less work. You know, I mean, that's, that is one of the major benefits of Omnipod. Five is just the reduction of burden all those hundreds of decisions and, you know, the constant interaction, that we can take some of that away from you so that you can get great outcomes without having to put in so much work.

Scott Benner 33:49
I can't wait, I'm genuinely. So G seven is probably going to, it's probably gonna pop fairly soon. And so I'm assuming you're working on that. Do you have thoughts about that, that you could share with people? Or no,

Shacey Petrovic 34:03
yes. So as I mentioned, you know, this is the start of what I think is going to be a really exciting several years of innovation. So we have shared publicly that we've got great partnerships, we have a wonderful partnership with Dexcom. They have an incredibly exciting pipeline. And we are hard at work integrating with their future technologies like g7. The same thing is true for Abbott, another great partner of ours, we're hard at work integrating with their sensor pipelines. And then of course, we've also mentioned publicly that we are hard at work integrating with future phone platforms like iOS. So all of that is underway. And the last thing I would say is we are hard at work also to bring this technology to people across the world. So we're starting with, you know, launch here in the United States. This clearance is a great milestone as we think about bringing the technology to other parts of the world, because it just is the final step in the clinical and regulatory hurdle and then we can start the work actually The work is already underway to really bring this technology to other markets outside the US.

Scott Benner 35:04
I've already gotten a message this morning from a person in Canada, a person in Sweden and a person in Australia. Please ask about us. So anyway, there it wasn't, you didn't have to ask also, you did me, I'm just gonna take my little whiteboard and erase where I wrote iPhone, question mark. Is there any kind of timeframe for iPhone that you have in mind, we have not

Shacey Petrovic 35:29
shared that publicly, what we have shared is the work has been underway for quite some time. So we our goal is to follow as quickly as we can. But you know, one thing we do is prioritize the user experience, which means we have to build a native app in both operating systems to ensure that we deliver the best possible user experience. So it is and the systems do work differently. You know, the operating systems work differently. So it is not a small technical undertaking. But that works been underway. We've got a very talented group of software developers and others working on that and and certainly understand that, you know, our customers want it and we're going to get it to them as quickly as we can.

Scott Benner 36:09
Excellent. A question about the sensors trying on day one, or with a failing sensor? How does the algorithm handle spotty information? Or how does the user handle it?

Dr. Trang Ly 36:21
Yeah, so I think the, the, the sensor issues that we used to see have definitely vastly improved. And I just really love the GC sensor every time I see the data coming in. And actually, you know, those sensor failures are definitely infrequent compared to what they used to be. So our algorithm has all the safety mitigations built in for loss of CGM signal. So it will actually use the prediction to deliver insulin for a certain period of time. But it actually depends on what the previous prediction is. So say, You were crushing low and you were predicted to be you know, 60 or less, and you were low, then the algorithm would actually suspend. And even if you didn't have the CGM come in, it would actually stay suspended for an hour. So there are a number of safety mitigations in place. And then when the CGM value comes back, it will actually just revert back and not like make you do stuff to put yourself back into automated mode. So you know that the whole user experience is really important to us. And, and you know, we're very lucky to be working with GSX, which is a really great sensor.

Scott Benner 37:36
That's well thought out. That's that's an excellent virtue of it for sure. Line of sight. So my, my satellite needs to see the Earth or my cell phone doesn't work, right. Does the CGM and the pod need to be in line of sight of each other? Or how does that

Dr. Trang Ly 37:51
work? Yeah, yeah, it does have to be within line of sight. And you know, I'm really proud of our engineering team. Scott, you know, when we first started the clinical study, I was a little bit nervous, I have to tell you about the connection between CGM and pod, because as you know, and can appreciate, it's all about how well those two devices talk to one another as to how good your glucose control is going to be. But you know, we have a fantastic antenna in our pod, the connection is remarkably good. Between the two in children and adults who were you know, CGM, obviously, for the 10 days, and then the pod button change every three days. So even with all of that, you know, every day use we have overall connectivity is

Scott Benner 38:42
excellent. Do you happen to see difference with people's body masses? Is there a change there?

Dr. Trang Ly 38:47
Yeah, there is. So it, so Bluetooth doesn't work well through body. But I have to say that because of the changes we've made to the antenna, the connectivity is excellent. It is one of the reasons why we have such good clinical trial results. Actually.

Scott Benner 39:08
Tracy, can I ask you what you've taken away from this process? I mean, about between making a product and the FDA like or do you have a notebook on the side of your desk that you're gonna that you were like, remember this next time? Or, I mean, honestly, Blizzard? Uh, I can't imagine it wasn't a learning experience. But like, was it valuable?

Shacey Petrovic 39:30
Yeah, it was incredibly valuable and incredibly valuable learning experience, I would say. I mean, I would never speak for the FDA, but I would guess it's a learning experience on both sides. Because this you know, we were designated as a breakthrough technology. This is brand new innovation that has never been delivered before. So phone control. This is the first time ever that somebody will be able to control their insulin delivery system, their Omni pod with a mobile a smartphone. You know, just the technology of getting the algorithm onto the pod, which, by the way, you know, when we started this venture seven years ago, the technology didn't exist yet, you know, the in train will tell you and the early clinical trials, people were walking around with backpacks of, you know, tablets, etc, it was a different system, but we knew the technology was in the pipeline of, you know, Chip companies, etc. And so we knew it was coming. And we had to take a bit of a leap of faith. And so, you know, it is really incredible to see the FDA lean in create pathways like breakthrough technology, like interoperability to help us bring new groundbreaking innovation to people living with diabetes. And for us, you know, incredibly learning experience, because nobody had done it before. We were taking advantage of new pathways, we were kind of working through what that needed to look like the FDA was extremely helpful in sharing their perspective on what needed to be in place, you know, clinically, and in terms of technical documentation and testing, to be able to feel confident that we could deliver this technology to the community. And so that's all, you know, that's plowing incredible amount of new ground. Yeah. And now, now we know what it takes. And so that's, that's a really exciting place to be in. You know, we've got certainly the battle scars to prove it in terms of the development process, the clinical process, but, you know, this has been building new muscles for our company. And frankly, you know, just bringing brand new technology that many people said, you know, even just a few years ago, couldn't be done to the community.

Scott Benner 41:43
Let me tell people listening, why that's more exciting than they think. So when you get a breakthrough designation, what that means is, the FDA does not see enough similarities between your product and any existing product. Because if they did, you could have piggybacked off of another company's filing look at me showing off what I know about the FDA. Hold on a second.

Shacey Petrovic 42:02
I think this is your wife, right? She's the regulatory affairs professional

Scott Benner 42:05
whispers in my ear. So I don't know anything. I just know how to make this podcast, honestly, and take out the garbage beyond that I'm kind of useless. So so. So here's why that seems exciting to me. It's because what you're telling me is you are bringing something to the world that does not exist yet. That's right. Yeah. If it did exist, and you were just putting it on the pod, we would have been using this thing. A year and a half ago, probably.

Shacey Petrovic 42:30
Right. Yeah, that's, that's right. This is brand new technology. And I think, you know, trying, obviously interacted with the FDA on a highly frequent basis. So she probably has additional insight to offer. But you know, what, what's exciting for me is that we are moving the field forward, you know, we we've known for years that people want to be able to control their Omni pod with their smartphone. And now we're finally here, having worked through all of the technical and regulatory hurdles to be able to bring that to people along with, you know, the algorithm and automated insulin delivery with Omni pod five. But this is no small feat. Nobody's done it before. We're the first and we're thrilled to be able to bring this to the community.

Scott Benner 43:12
I have more questions, but I'm going to ask trying a question in front of Chasey. Who's Chase, he's going to have to leave first. So I want Chang to be comfortable or trying to be comfortable whether or not she can answer this or not. Are we anywhere near the ceiling of what this algorithm is going to do?

Dr. Trang Ly 43:28
And there's no ceiling. Okay. I think, you know, I, I think you'll be pleased when you try it? Yeah,

Scott Benner 43:40
but am I going to wake up here, I'll tell you the fastest story. My daughter is 17. She'll be 18. This summer. We put her on an insulin pump when she was four, because we didn't want to send her to school using shots because I was like, What am I gonna let somebody I don't know, stick my kid with a pin every day. I was like, that doesn't sound right. So we went to our local children's hospital, they had an insulin pump there. And trying you'll love this story. There was a table in the middle of a conference room and it had all of the insulin pumps that were available. They were set out, like like I was buying jewelry, okay, there was everything but lights shining on them. Now, keeping in mind, this was 2007 or eight. And I'm walking around the room, I don't see anything that I particularly am excited about. In the far back corner of this conference from this like little cutout wedge, there's a little fold up table, and there's something on it. And I walk over to see what it is. And it looks like someone had an omni pod in their hand, got about 10 feet from the table decided they didn't want to walk any further pitched it into the wall and it landed on the table. Okay. So I pick it up and I take it over to the nurse practitioner and I go, Hey, what is this? And they're like, Oh, you don't want that. It doesn't have tubes. It won't work on your daughter. She's too thin. They said everything in the world to me about why I wouldn't want this thing. I took it over to my wife and I said this is a this is a contained device. And my wife's like, who cares? I'm like big cuz every time they change it, I started saying like, what are they going to do make 75 versions of this thing I was like, every time they upgraded, like, we're gonna move up with it. I was like, this looks mobile to me. I didn't know anything about you guys. I didn't know if even what I was saying was right or wrong. And that turned out to be true. Basically, I just like being right when I say something to my wife, but it's a long time payoff for me. But But overall, I think that's like, that's where my question comes from, like, in my mind, I'm like, three years from now? Like, am I going to be able to turn the targeted 85? Like, is it gonna get smaller when the technology keeps growing, like what can happen here, and I just, I want you all to stay. I want you all to say super excited about it. Like, I feel like I'm your cheerleader unnecessarily. But for everybody else, like don't stop, like seriously little vacation, I except maybe a week on a beach. Okay. And then we're right back in Boston to freeze our butts off and work on Omnipod. Six,

Shacey Petrovic 45:55
no one's taking a vacation, Scott, and we could not be more excited. And I think, you know, Trang Trang. And her team and many others in the company are already you know, they've already distilled the data from our pivotal distill the data from our type two feasibility studies, and they're already hard at work at our next generation algorithms. This is you know, our mission is to improve the lives of people with diabetes. So we don't stop that. And you know, bringing innovation to market is how we do that. And so we could not be more excited. This is a huge milestone for us. But you know, we expect many more milestones as we look forward.

Scott Benner 46:31
Okay. I'm going to ask a question, it's going to lead into another question JC for you. What's going to happen to the arrows pod? Are you going to keep making it? Or I mean, now we have dash we have on the pod five and we for people don't know we have the arrows, which isn't the original pod. It's the OG pod smaller.

Shacey Petrovic 46:49
Yeah, I like to call it the classic Omni pod.

Scott Benner 46:51
I think that's what we should go. So are you going to so here's my I interviewed chuck a few months ago, I don't know if you heard it. I did. I love Chuck. The minute I met chuck in person, I sent a text to somebody, I was like, I need to interview this guy is fantastic. But I tried to get out of Chuck, how much on the pod five product was piled up in Boston, and he wouldn't tell me. But I imagine you've only got so much space and so many resources, and you can't make an unlimited number of devices. Right. So you have a plan for that.

Shacey Petrovic 47:23
We don't have a plan to discontinue our other Omni pod systems on the market today. You know, we recognize that people want choice. I think that there, you know, I think there's going to be incredible demand for Omni pod five, and most people are going to want to move to that product. But we don't have plans to discontinue our classic Omni pod or Omni pod dash.

Scott Benner 47:44
That's very cool. So now that question leads me into this, which is I want to know your thoughts as much as you can share them with me about the do it yourself loop system and that people use Omni pod arrows to run an algorithm that has never seen the FDA and was written by people online? Have Oh, yeah, I've always wanted to ask you what you thought about that. So?

Shacey Petrovic 48:04
Well, you know, what I can say is that we wouldn't be here today with you know, now, multiple system, multiple automated insulin delivery systems on the market without the DIY community. You know, I think the DIY community helped push innovation forward, it probably helped inform some of the regulatory pathways that are leading to interoperability of systems. And so for that we are entirely grateful. And We involved members of the DIY community into the development of Omnipod. Five, because there was a lot to learn from the experience out there that existed. I think the challenge is that, you know, these systems are not they haven't been through the clinical and regulatory, rigorous pathways that Omnipod. Five has. And so we're so excited to be able to kind of provide, you know, provide a system that has the incredible clinical performance and the full muscle of insolate support, clinical technical product support behind it, and, but we're grateful for, you know, the paving of the way that the DIY community did, and it's a remarkable group of, you know, engaged, motivated, talented people, and we've benefited from their expertise,

Scott Benner 49:22
is that partly why you got involved with tide pool because they are taking that algorithm and trying to bring it to market through the FDA. So one day when tide pool gets the okay for their algorithm? Is it as simple as I'll be able to decide if I want to use the one on the board or the one in a tide pool out?

Shacey Petrovic 49:38
I'm not sure it's that simple. You know, we've had a development program for tide with tide pool for quite some time now supporting their regulatory and clinical development efforts. I think it's great that they're working to get this system, you know, through the regulatory process, which is, you know, quite rigorous. But we don't have a commercial agreement with them yet. And I think that's the interesting question. is a big benefit, you know, is the product support, technical support, warranty, all of that stuff that comes with it. So we've got to figure those things out. But, but certainly, you know, delighted to be helping support their clinical and regulatory work.

Scott Benner 50:16
You know, I'm sort of laughing to myself, because I'm thinking back to your previous answer, and I'm imagining, imagining about 10,000 people who use the DIY loop who have been prepping and saving the arrows, pods and clauses and fine. They're like, Wait, I didn't have to stock up on these things. I don't know. I got a couple of drivers. I don't know what to do with all this. It's very, it's a very enlightening conversation. Thank you. It really is. I mean, to your point about that, the DIY group I've seen over my years it push, I think that they're the reason why Dexcom got through so quickly, when they got in the beginning, like, you know, just to what you said, like people are doing this thing already, like, let them do it. i How many years ago? Did I say to you? Are we ever gonna be able to use this on a phone? And you were like, definitely, what is it like six years later? You know, it is. I mean, people are never going to understand the process, and how slow it moves. Right. And I mean, you talked already about you're redesigning a thing, you're packing technology into this little pod, it's not just one, but you don't give me one pod, you give me 10 of them in a bar, how many come in a box, now you changed it can or five? In a box, I need so many I need for a week for a month for a year, that technology lives inside of each one of them. And it just, it bounces online? Because I think most people do see it like, wow, why didn't they like, you know, for instance, like, Well, why is it available for Android? Now that iPhone? Don't they just have to copy and paste that into an iPhone app? Like yeah, I mean, like, it's hard to know, the whole thing. It just takes

Shacey Petrovic 51:57
no, you're right. And, you know, you think about it, we manufacture 10s of millions of pods every year. So you know, part of the FDA clearance processes, ensuring the quality systems, everything's in place to do that reliably high quality, you know, and consistently and with resilience. And so those are that's the you know, that's the not the burden. But that's the that that is why it's a lengthy, rigorous process with the FDA and why consumers that and can be very confident in the technology, like Omnipod phi that we're bringing to them.

Scott Benner 52:32
I, when I saw your your production floor in Massachusetts, I was so blown away with just how amazing it is, you know, the automation and all the technology that goes into building the technology is fascinating. It's why I asked Chuck to come on, because I thought if that guy thought of like this, like, I need an

Shacey Petrovic 52:51
incredible, incredible investment and incredible operation. I'm so glad you were able to see it. I wish I could show it to everybody. I think there's videos on our website, actually, if people are interested in the technology, but you know, just incredible automation, which brings a high level of quality, consistency reliability, to the manufacturing process. And you know, now we've grown so rapidly, you know, more than a quarter of a million people rely on us for their pods, you know, we've got to be able to and we're gonna see a lot more than that with Omnipod. Five, we got to make sure that we have a very high quality, scalable, reliable manufacturing process.

Scott Benner 53:27
Let me let me say something nice to you. For a second Tracy. I have my daughter's had diabetes since she was two. And she was diagnosed in 2004. I started writing a blog in 2007. And not long after that, I started writing little pieces for on the pods website. So that's my the time I go back with all this I've been involved somehow with on the pod before you were here before probably anybody that I deal with was here. There is this, I love the product. And I all I wanted was for my daughter to have it. And I lived with a tiny bit of fear every day before you got to Omni pod that a lot of business people owned it. And they were trying to build it up to sell it to somebody else. That was always a background fear in my heart. And then you got there and I thought oh, this lady wants to sell insulin pumps. And it just like, I mean, I was just so excited. You know, so I can't thank you enough for showing up and and doing that. I can't imagine the one ad you must have. It might have taken some real pulling to pull that those horses around into another direction I would imagine so. I mean, this thing is the it's the greatest thing that's ever happened to my daughter. Like it really has. She's worn one every day since she was four years old. It's almost 14 years.

Shacey Petrovic 54:43
Yeah, that is just I mean, you know, that makes my day that, you know, I'll share that with the team. I can say two things. You know, actually it's not just that I want to sell insulin pumps. I you know, my father lives with type one diabetes. What I want to do is improve the lives of people living with diabetes and you You know, we get to do that it's such a privilege, frankly, to lead this company and be able to see that our technology makes a real difference for people like you and Arden. And the last thing I'll say is, you know, what made the last, you know, several years possible, in terms of really strengthening the company, being able to deliver on the promise of the innovation roadmap, is just adding people like training to our team, you know, we have an extraordinarily talented, committed group of people that are working every day, you know, to deliver technologies like Omnipod, five to the community,

Scott Benner 55:37
you guys do little things that people don't know about, like, I've spoken to your employees a couple of times, just so this, you don't realize there are people that work there that don't have diabetes. And in their mind, they're making a little plastic thing, right, it's their job, and they just know what they're supposed to do. And you go to the trouble of making sure that they understand who it's impacting, and, and why it means so much. And I love coming and making people cry at your thing.

Shacey Petrovic 55:59
And you did, you did a great job of that almost every few months, we have somebody who comes and makes the company cry, as somebody who benefits from our technology. And we also encourage our new employees to wear the pod for, you know, we call it a 90 day challenge, but do what we can to really connect everybody in the organization, regardless of where they are, you know, finance, HR, or the manufacturing line to the daily life of somebody who relies on our technology so that we all understand that our job is to reduce burden. And everybody in the company has a responsibility to do that, and has the opportunity to do that. And so we take that really seriously. Thank

Scott Benner 56:39
you can you speak to. So I mean, there's no ads on this episode, but because I want people to be able to get through it and listen straight through. But, you know, for the last year, I've been telling people get a dash, get a dash get a dash. And you know, whenever you buy something, inevitably the new one comes out the next day. So for the for the group of people who are like I'm on my third dashpot. Are you kidding me? Can you explain to them if they want on the pod five, what's going to happen? Because it's not like and I know you said it earlier, but I just want to say it again, like in the past, they would have been stuck. So yeah,

Shacey Petrovic 57:14
that's right. And it's really important, because it's trying said earlier, we've thought about the customer experience, and simplifying the customer experience, not just through the technology, which we think we've done to great effect with Omnipod. Five, but also through the whole process of trying to access the technology, which we know is really burdensome for people. So that was the whole point in taking the technology through the pharmacy channel. And it enables us to do a few things, it enables us first of all, to let people just go to their local pharmacy and get pods. So some places they have to go to get their insulin and their other supplies anyways, it enables us to eliminate the upfront cost associated and large, you know, deductibles associated with the Durable Medical Equipment channel. And it enables us to get rid of that four year lock in period. So if you acquire dash tomorrow, and then your insurance covers Omnipod, five in a week, you can move right on to Omnipod five. So that is the benefit of the model. And you know, the great thing about Omnipod dash also is that Omni pod five was based on that platform, so it will make your pathway to Omni pod five, much easier from a training perspective. As training mentioned earlier, if you are in Omni pod dash user, and a Dexcom G six user, it's an online training module to then move from Omni pod dash to Omni pod five, once your insurance covers it, so no, no burden, some process to be able to access the technology, no upgrade fee, and no timing requirements, we're going to be able to let you do that as quickly as possible. So I always encourage everybody, you know, even if you think your insurance is gonna cover it next week, there's a benefit to getting on to Omnipod five and there's no cost I mean to getting on to Omnipod dash and there's no cost to move

Scott Benner 59:02
to five, five, the work you guys had to do getting on the pod dash covered by all the all the myriad of insurance companies. By the way, that's not a job anybody wants. But but getting all that worked out, is that going to translate right over to five? Or are you going to have? I mean, is there going to be a gap of time where you're out there? You know, talking to every insurance company trying to get coverage?

Shacey Petrovic 59:24
Yeah, our team has been hard at work establishing coverage for Omnipod five, and we're doing great. We now have more coverage established for Omni pod five than we did you know, months after we launched Omni pod dash, but there are payers who will not contemplate establishing a reimbursement policy until the product is FDA cleared. So, you know, today is a great day for us because it also will enable us to accelerate even faster on the covered lives or number of people that we can get covered for Omnipod five and all of that work is is underway. We do have a lot of leverage you It will launch in a really strong position. But now from here the teams are going to accelerate and get even more coverage established from the pot five.

Scott Benner 1:00:08
Oddly, I just got an image of you in a smoke filled room with a cigar calling insurance companies gone. Hey, we got the clearance. Let's do this. I don't smoke. I know. But that's what popped into my head. It was just completely ridiculous because looking at you, I don't think you smoked cigars. Well, she's the I'm gonna I know you have to go. But you're gonna let me hold on to trying for a little bit. She's happy to do that. Right. Gird your loins. I'm gonna beat you up pretty good. I got a lot of questions. Thanks so much, JC

Shacey Petrovic 1:00:35
thanks so much.

Unknown Speaker 1:00:36
It was great to talk to you.

Scott Benner 1:00:38
In just a moment, you're gonna hear my 25 minute conversation with Dr. Trang lie. But first, if you've heard about the diabetes, pro tip episodes from the podcast, or any of the other content, and you don't know how to get started, go to juicebox podcast.com. There, you'll find all of the series that are available inside of the Juicebox Podcast, not just the daily episodes, which by the way, the podcast comes out on Monday, Tuesday, Wednesday and Friday, every week. But there's also a protip series with me and a CDE named Jenny Smith, she and I break down all of the ideas that are spoken about in the podcast. And I think if you try those episodes, if you really dig into the Pro Tip series, you're gonna get an A one scene of variability where you want it. If you're just starting with diabetes, we have a defining diabetes series, which takes all the terms that you're going to use every day with type one, and explains them in very, very usable fashion. In layman's terms, it's not going to be all technical and medically and boring. It's going to be quick, easy episodes to get you in line with what it is you need to do. And what it is you need to know. You know how there's all those variables and diabetes, we have a diabetes variable series. There's also an after dark series where topics that don't get spoken about much get tackled. Past topics include heroin addiction, bulimia, other eating disorders, diabetes, complications, being from a family of divorce, sexual assault, PTSD, so much more. There are the things that happen to everyday people just like you that no one talks about, but we talk about it here on the Juicebox Podcast, there's a complete series about algorithm based pumping, which is only going to get longer now that only part five is here. And if you're interested in how we eat well, there's an entire series dedicated to how people eat. Because here are the Juicebox Podcast, I believe that it doesn't matter what eating style you employ. You deserve to know how to use insulin and use it well so you can be happy and healthy, and unencumbered day to day with type one diabetes. Check them out juicebox podcast.com. You can also find the pro tips at diabetes pro tip.com. And don't forget if this is your first episode, subscribe and follow in their audio app that you love using doesn't matter if it's Apple Music, Spotify, wherever you listen to audio, you can get the Juicebox Podcast. I appreciate you listening to all that. Now let's get you back to the show. All right, trying. Let's dig this thing apart. Okay, how's this thing work? What are we going to do? Let's go. Yeah, I'm ready. So let me let me I'll give you a little preamble first. And again, everyone should understand i, we didn't pre plan this, I may ask you something that you're not comfortable asking if that's the case, just say I can't answer that. And we'll keep going. So here's my perspective. I employ a very active insulin management system, like even when my daughter's just using Omnipod five, and I'm using a CGM, and we're making every decision manually. By that, I mean, we are very diligent about a good Basal rate, we Pre-Bolus meals, we understand the differences between the impacts of different glycemic load specific indexes of food, I don't abide high blood sugars. If I miss on a Bolus, I come back at it again, I live by the ethos that I'd rather stop a falling blood sugar than live with a high one. And and that is how we stay very flexible from there. A number of years ago now a listener contacted me and said, I want you to try this Do It Yourself algorithm. Because I you know later I learned that she didn't know how to use it. She thought if I learned I could tell people. So at the time, I did not want to do it. Every reason why a sane person would not want to download an algorithm off the internet and let it give their kid insulin. I had a problem with that. I watched everybody doing it. It was working for people. And overall what I thought was this is the future like algorithm based pumping is going to be the future. If I'm going to do a good job at this for my daughter and for this podcast. Honestly, I need to understand this so I begrudgingly did it. There's a great series of conversations about it in the podcast from me, you know on day one and being like, oh my god, I hate this thing. Why does it shut off the basil when I Bolus like you know, like all this stuff. But now I found a real happy place with with algorithms. And I gotta be honest with you, I'm not going back again, that doesn't make any sense to me, I also got to learn an immense amount more about how insulin works, just by having Nightscout on my phone, and watching the algorithm give and take away insulin, it's a fascinating way to learn how to manage insulin just to watch a computer do it instead,

I meant every word I said earlier, the minute I can have on the pod five for my daughter, I am taking the loop off of my daughter, and we are switching over and it is my wholehearted goal to keep her on it forever. But I feel like there's things I'm gonna have to learn about it. Like there were things I had to learn about the loop to make it as truly like successful endeavor. And so I just want to know what you learned with people wearing it, you know, and then if we can't dig into some of this a little bit.

Dr. Trang Ly 1:06:04
Yeah, I think the profile that you're describing someone who has well tuned Basal rates, who Pre-Bolus is their meals, who really understands the impact of low glycemic foods and high glycemic foods, I think all of that really bodes well for excellent glucose control on the Omnipod five system, you know, we if, if you're able to do all those things, and good glucose control is achievable with AD systems. The reality, Scott is that it's really hard to be very regimented about your diabetes every single day for the rest of your life. You know, I tell people, you know, it's like a exercise program, you know, a lot of us can do it for a day, three days a week, but it's really hard to do that for every single day for the rest of your life. And so, you know, we have built this algorithm for when people you know, underestimate their carbs, or or forget to Bolus, you know, for teenagers who do not Bolus. And that that comes from my clinical practice of taking care of a lot of teenagers, over the years. And so we really want it to work for the broad population of users out there who live with diabetes every day. And, and that means, you know, being able to be responsive enough to what we call an unannounced meal, otherwise known as a meal, where you haven't given a Bolus, you know, so that just happens really regularly in everyday life. And that's what we're trying to do. And, and as, you know, the whole art of this is giving just enough to get this person down, and not overshooting and causing, you know, prolonged, severe hypoglycemia. Because, you know, if that happens, then really, you know, you have not succeeded in this area, and you will cause you know, intense mistrust with with your patient. And so, getting that just right, and that formula just right, for our adults, as well as our little kids, was really important to me. And so I think will work really well for Adam.

Scott Benner 1:08:33
Okay, will will I see, when she's low and stable, like away from meal insulin and away from food? Am I going to see a 110 blood sugar? Are there worlds where she'll ride lower than that? Or?

Dr. Trang Ly 1:08:47
Yeah, in some cases, she could ride low, lower, for sure. But those are the sorts of numbers, you know, 110, between 101 10, you know, waking up in the morning was very, very common in the clinical data that we collected. Yeah, that is, I mean, as you know, that is really the impact of this technology is, is really that overnight glucose control and being able to wake up in range and, and not, you know, being agitated by hyperglycemia. And really, you know, really letting it ruin the rest of your day. That is the beauty of AIG technology is really enabling that. That dynamic glucose control in between those big meals,

Scott Benner 1:09:35
okay. Hey, just because it got past me earlier. Ai D, automated insulin delivery.

Dr. Trang Ly 1:09:40
Yes, that's right. Yeah. Very good with my abbreviating. So thank you.

Scott Benner 1:09:46
Make sure I was doing that. Right. So here's, here's a question for you. My daughter goes to Five Guys. She gets a burger and she gets a shake and she gets french fries. And are she

Dr. Trang Ly 1:09:55
gonna get peanuts? Two from five guys? We don't do that. Isn't that interesting to you? Peanut giant, I have the best peanuts. Alright, I'll

Scott Benner 1:10:02
try next time. Just now you're making I feel pressure, I'll eat the peanuts. So we go in. And here's what I know. I know it's a lot of carbs, right. And I make a huge Pre-Bolus. And for a lot of carbs, but what I also know is there is no amount that I can Pre-Bolus or Bolus, that's going to get ahead of the fat rise that comes about 45 minutes or an hour later. Now, right now, on the system we use, or even previously, before algorithms, I would have made a new Bolus about 45 minutes and I would Pre-Bolus the fat rise. You know what I mean? So yeah, I can still do that, right? Because the fats gonna hit like carbs. So they won't mess the algorithm up? Well, it?

Dr. Trang Ly 1:10:44
No. So you can Pre-Bolus For sure. Definitely. And, and you can wait till your daughter starts to kick up again, before you give more, that's totally fine. Or you could could Pre-Bolus and just let the algorithm run with it, as well. I think high fat meals are very hard to manage, it's likely, if your daughter runs at 5.2, she doesn't have that many of them.

Scott Benner 1:11:14
It's more likely that I'm really good at Bolus thing for them.

Dr. Trang Ly 1:11:20
And she's 17 Scott's gonna go to college soon. And you can't go with her.

Scott Benner 1:11:25
I got a text. Don't worry, we'll be good. But I've just, you know, My bigger question is about the algorithm like, can I put that in? If that works? Like, here's my other question does do fake this fake carving mess up the algorithm. So for people who don't know, some people adjust algorithms by lying about carbs that don't exist.

Dr. Trang Ly 1:11:45
So in our Bolus calculator, you can do everything that you do today. So you can set your insulin to carb ratio as aggressively as you want, or, you know, different times of day, you know, if you're more sensitive, or actually more resistant in the morning, which is much more common, then you need more insulin for those morning carbs, you can set those ratios through the day. And then same thing for insulin sensitivity, you can set that as aggressively as you want for different types of days, and none of that changes. So you don't have to kind of fake the system. I think what I've learned, looking, you know, taking care of people with diabetes is, it's really hard to get it right, even without, you know, training, fake things. So what the system knows is insulin on board. So if there is a lot of insulin on board, it notes to kinda like, take it easy. And if there isn't a lot of insulin on board it, it allows itself to be more aggressive in the presence of hyperglycemia.

Scott Benner 1:12:51
Okay. It's, I mean, listen, it sounds terrific. Here's what I mean. My goal is to take it and, and to get the settings in a place where I just fine tune it as best I can. I just, I genuinely meant what I said earlier. I don't I let me be clear, because I don't want to hurt anybody's feelings. I love the do it yourself loop. I think it's astonishing. As a matter of fact, I don't know who Ivan is, but you have to find him and hire the guy. And you know, but but but beyond that, this the ease of use the simplest that you guys have been saying it over and over again. It's what's in my heart. I just don't want I don't think that, that I care. Here's how I think about it, you don't have to answer. If my daughter is five, five right now and she can be six on on your product. My imagination tells me that in the future, you're going to work on getting the target down. So if the next number of years of my daughter's life are spent at a six a one C while she goes to college, and then one day, you and I are talking about this again, you have I look older, you of course look exactly the same. And you're like, Hey, Scott, good news, we got our target to 90 of bah, bah, bah, whatever. I don't think of those three wasted years. And I'll tell you why. Because I've interviewed so many people, adults with type one who had it when they were children who talked about going away to college, and ever it's just a dumpster fire while they're at college. And it gets so bad that they lose their way. And and a lot of them have to have some sort of like a personal awakening to even like try to bring it back again. It's it's an A lot of people don't come back from it. You know, and it's not the stuff we talk about so much. But it is the real like valid truth about diabetes is that you could burn out you could just be not good at it. Your diet might not jive. Well, your doctor might suck like there are so many things that could happen to you, where you're just calling to stay alive instead of a living well, and I as much as I'm happy to tell you that my daughter is a once he is five, five, I would gladly tell you that it's six, and that she doesn't think about diabetes very often that used to be the tagline of the company. Right, long time ago, make diabetes a smaller part of your life or something like that as a long time ago, but I still I shoot for that all the time. And the look on your face tells me I'm gonna find that with this. Yes. So,

Dr. Trang Ly 1:15:13
so sure, it's, it is really about reducing burden for our users. And, you know, all those things you say about. Just, I'm gonna, I mean, I've been crying a lot this week, God,

Scott Benner 1:15:32
just so you know.

Dr. Trang Ly 1:15:36
I'm gonna try really hard not to, but, you know, I have taken care of so many teenagers who have lost their way. And so a, it really is about reducing burden in ways to just allow them to live their life and not think about diabetes. So yes, all the things you're talking about, about lower targets and getting tighter control, we will get there with better insulins and better sensors, we've got to do it safely with the tools that we have today. And I'm really proud of the system we built that has excellent timing range, remarkable hyperglycemia reduction, and thriving children and adults on the system, who can live their lives and, and travel and not have to think about their diabetes. I mean, I have patients who we used to be my patients at Stanford, and I text them now they're on the system. And then Mom doesn't even talk about diabetes. And I'm like, Oh, my God, are you still she's still using the system. She was a year kid still using the system. But, you know, I get this long text about how she's doing really well at school. And she's top of her class. And, you know, that's what makes me so proud to be here today. So, yes, it is all about that. It's never been really about the numbers.

Scott Benner 1:17:03
Yeah. Okay. So a couple of harder questions based on that idea. I, I like to go happy to sad, happy to sad. I like the way it keeps it moving. So I mean, I don't think it's any surprise to anyone who uses an insulin pump that your site doesn't always last, as long as you hope it will. Sometimes it does there, there are times that my daughter rides in on the pod for 80 hours right into the emergency time at the end, and there's nothing wrong. And there are times where five, six hours before it's supposed to expire, I say to her, Hey, if I was you, I'd bail on this pod now. Right? So is the am I gonna see the algorithm like if the if the sight gets gets janky, and you're gonna see the algorithm pumping, pumping, pumping? Trying to get ahead of it? And does it have much luck with that, from what you saw, I

Dr. Trang Ly 1:17:52
think what you're describing, you know, the algorithm responds to that really well, without over responding to that. And, you know, what we've seen is that, yes, that that is a sort of something we see with all the types of pumps, in fact. And, in fact, it's actually more of an issue in tubes, plans, where people tend to, it's a bit like contact lenses, you kind of wear them, and you kind of forget what day you're on, right? So it can, you know, especially if you beyond that three, four day period of of an infusion set, you can generally see that hyperglycemia we don't tend to see, you know, that much of a problem and certainly, you know, the algorithm can really augment for that type of behavior, it really just sees that as sort of, again, just kind of that increased insulin resistance, so that you know, short term increased insulin resistance, so the algorithms able to respond appropriately, and deliver more can actually give up to you know, kind of 300% of kind of Basal settings so it has pretty well good range of being able to adjust to, to your insulin needs.

Scott Benner 1:19:19
So if my daughter's Basal is 1.1 an hour, if it sees her like randomly heading up, right, she's she's been 100 for a couple of hours, she starts heading up, it starts predicting more. It will as aggressive as it is, as it feels like it can do without causing a low later it's just going to keep it's going to quickly put up the basil to so there are you're you're you're basically doing micro Bolus is through basil, is that right?

Dr. Trang Ly 1:19:46
That's right. Okay. Yes. So micro Bolus is every five minutes. So yeah, so that's exactly you're exactly right. I will say, just to clarify. So when you first set up an AMI You plug five systems, so your daughter's on, you know, one unit a day just just for ease of math, the system will use that information initially, but later on, like, you know, by the second third pod, it will, in fact, not rely on the Basal rates to augment insulin delivery, it will rely more on her total daily insulin, because, again, we don't want people to spend their lives, you know, trying to figure out whether they need, you know, 1.1 or 1.05 units an hour. And so it is really the algorithms Basal rate that is being adjusted over time. But yes, it has kind of its own power to increase with in the presence of high glucose levels. And then within it has its own safety measures. So these are not related to the max Basal settings. And in fact, not related to max Bolus settings that you would set in a sort of traditional pump setting. It has its own safety mitigations. And based upon all the studies we've done over the last six years,

Scott Benner 1:21:16
so when a wearer puts the pump on on day one, it's collecting data on the on the first pot, then I take that I take that pot off after three days, actually, does it take the whole three days to figure out what it wants to know? Or how long does it take for to?

Dr. Trang Ly 1:21:32
Well, since you asked is 48 hours, so

Scott Benner 1:21:36
So yeah, so will I see a change on day three or not? Until pod two?

Dr. Trang Ly 1:21:41
Not until pod two. Okay.

Scott Benner 1:21:43
But now I wear pod two for three days, I'm getting the benefit of what it learned off of pod one. When I go to pod three, the 48 hours doesn't start over. Right? It just piggybacks on to what it knows from the

Dr. Trang Ly 1:21:54
Yes, you got it just right. Yeah.

Scott Benner 1:21:56
Okay, look at me paying attention. You don't know me. But anytime I'm focused, it's kind of amazing. This podcast is the only thing I'm an adult about the rest of my life, you just be like, why am I talking to this guy? But right here, you got the right guy? Is there anything that I didn't ask you about it that you were like, oh, we should have asked about this?

Dr. Trang Ly 1:22:22
Honestly, I think you've covered everything, I just want people to know, we're really proud of what we've built here. And it's going to change a lot of people's lives. You know, I get asked by patients all the time, you know, when they can get on edge. We we just have wonderful stories of you know, we have a child who is actually taken care of by his grandmother for various reasons. And Grandma said, you know, the system is so easy that she doesn't, she can actually send him off to daycare. So he's, you know, only a three year old boy. But because of the system and the simplicity, you know, other people can take care of him, he can go to school, daycare and be cared for by others. And, you know, I was just really proud of that. And I just, I mean, I have so many incredible stories. You know, I think you'll really appreciate this because your daughter was young. When she was diagnosed, you said to Right, yeah, yeah, so this child was six years of age, right? And wetting the bed because of hyperglycemia. So we'd have soit sheets and mattress because of his diabetes. And because of our system, this child doesn't have to wear diapers anymore. That's a

Scott Benner 1:23:55
big deal. Like, isn't that amazing? It just really is, I find that the ones I try very hard not to lose focus, because the podcast is, is pretty management centric. In some places, I realized that most of the people I interact with are, are, you know, on a higher level and are striving for that higher level. So I'm very careful to make sure to interview people who are not in that situation to so I don't forget that. No matter how many people this show reaches there are far many of them that have type one who never consider stuff like this and never find health or happiness. And it's debilitating. So I'm not I've listened you guys are advertisers. But if you weren't, you'd still be here today talking about I'm incredibly excited about this. So I really appreciate you doing all this with me. You did bring up one last thing before I let you go. You brought about you talked about kids go into preschool or their school for people who don't have an opportunity to Pre-Bolus Because of you know their caregivers won't tell helped them or they forget or something like that would the way I would handle it. And I'm not certainly saying you should have told me that you agree with this. But the way I would handle it is if I can't Pre-Bolus I over Bolus i Pre-Bolus. If I can't Pre-Bolus I Bolus for the food and I Pre-Bolus the rise, I know is going to happen by not Pre-Bolus thing I imagined with the algorithm, I could still do that. But my question is about little kids who can't Pre-Bolus At school? Is the algorithm going to see that rise? And try to stomp on it? And will that? Like, I guess what I see with my daughter when she doesn't Pre-Bolus on this current system is that it does a pretty good job of keeping her under one ad, if we don't Pre-Bolus Is that what do you see on your side?

Dr. Trang Ly 1:25:43
Yeah, for sure, when we did all of our testing, those were the exact scenarios that we look into, you know, every person is different, and you just can't control a toddler, you know, deciding, deciding what to eat, you know, I have a four year old at home who is impossible, he doesn't have diabetes, and I just shudder to think what it would be like. So it is very, very challenging. But it is, you know, it is the reason why we need better tools, like automated insulin delivery. And I think it'll hopefully make things easier for people and worry a little less, that they're going to be crazy out of range, you know, if they had no insulin versus with an algorithm that can augment and give more, when they're high. But you know, they may have just been running that school for, you know, an extra 20 minutes and suddenly be crashing low and actually not need that. Pre-Bolus right. You just don't know. And it's just so hard. And, you know, we can't always be with our children. And this, this system really gives people peace of mind.

Scott Benner 1:26:52
Well, I'm excited, I am going to here's my here's my promise to everybody listening, I am going to get on the pod five as soon as I can. For Arden I am going to become a super user of it. And then I'm going to come on here and ad nauseam beat into your head how it works. So because I think you're all gonna you're about to make a real leap with your lives. So I can't wait to try and thank you so much. I can't tell you how grateful I am for you and JC doing this. Thank

Dr. Trang Ly 1:27:15
you. Yeah, of course, anytime.

Scott Benner 1:27:18
Thank you have a great day.

A huge thanks to a huge thanks to Shashi And a huge thanks to JC and Trang for taking time out of their very busy day to come on the show and talk to me. I mean, this just became public three and a half hours prior to when we started this recording, and you're hearing it just a few hours later. This is hot off the presses kinds of stuff. I also want to thank all the sponsors of the Juicebox Podcast and remind you if you ever need them, they're there and using my links helps the show. All the sponsors are listed in the show notes of your podcast player and at juicebox podcast.com.

If you're a US resident who has type one diabetes, or a US resident who is the caregiver of someone with type one, go to T one D exchange.org. Forward slash juice box now and take a few minutes to fill out their survey. When you do you'll be helping people living with type one diabetes, and supporting the show. If you have any trouble learning how to subscribe to a podcast, go to the Facebook page for the podcast Juicebox Podcast type one diabetes, it's a private group, you'll answer a couple of questions and make sure you're a real person. And once you're in a bevy of information awaits you, and conversations with people all the way from newly diagnosed to people who have been living with type one forever. There's a equal mix of parents of kids with type one and adults living with type one in there. There's also a bunch of type twos, people who have Lada I'm very proud of that group. It is a wonderful place for people using insulin doesn't matter if you have type one, type two, if you're the caregiver, or have type one yourself, and just like the Juicebox Podcast, the Facebook group is absolutely free. Why don't you go check it out. Okay, if you're still here, you probably really want the link to go check out the on the pod five. I appreciate you listening this long and making it to the end. If you want to learn more about the on the pod five, go to my special link Omni pod.com forward slash juice box five, that's juice box and the number five Omni pod.com forward slash juice box five. You'll know you're there when you see the words on the pod five automated insulin delivery system first tubeless system with smartphone control and then that excited feeling goes up your spine. That's how you'll know you're at the link because you're gonna see a tubeless insulin pump running Automated insulin delivery system. Its algorithm pumping with an omni pod from Omni pod. Go check it out on the pod.com forward slash juice box. Oops, I did miss the Omni pod for will give me I'm so used to saying it the other way. Omni pod.com forward slash juicebox five. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast share this episode Everybody spread the word

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#619 Defining Thyroid: Defining Thyroid: Pituitary and Thyroid Glands

Scott and Jenny Smith, CDE share insights on thyroid disorder.

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

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends, welcome to episode 619 of the Juicebox Podcast.

Today's episode of the podcast is the second in the defining thyroid series. And today Jenny Smith and I are going to talk about the glands pituitary, and thyroid, the thyroid and pituitary glands. Now I know you're thinking, oh my god, Scott, so exciting. What are you doing to me? I know. But listen, it's important. If you have autoimmune, you very well may run into hyper or hypothyroidism at some point. Hashimotos disease, in fact, could be around the corner, you need to know what to look for. So, while you might not think this is exciting, it is very needed necessary. Listen and educate yourself. You'll be glad you did. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin.

This episode of The Juicebox Podcast is sponsored by touched by type one, learn more about my favorite diabetes organization at touched by type one.org. You can also find them on Facebook, and Instagram. And I heard recently a little birdie told me that I will be speaking at their next event. I think it's an August. That's a ways away. But anyway, go orient yourself with their webpage so that when I say to you, I'm speaking at the next touched by type one event, you'll go, Oh, I know right where to go touch by type one.org and you can go get yourself some tickets. If you're a US resident who has type one diabetes, or is the caregiver for someone who has type one, you could take the survey AT T one D exchange.org. Forward slash juicebox in fewer than 10 minutes. When you do this, it will be completely anonymous. They will be HIPAA compliant. You will be helping people with type one diabetes, and you will be supporting the podcast T one D exchange.org. Forward slash juicebox. If you're looking for the defining diabetes series, they're available in your podcast player or at Juicebox Podcast calm. At that website you'll also find the diabetes Pro Tip series. Ask Scott and Jenny. The diabetes variables episodes after dark episodes algorithm pumping based episodes, how we eat series. It's all right there. It's either in your podcast player or at juicebox podcast.com. At the end of this episode, and at the end of every defining thyroid episode, I will list the symptoms of hypothyroidism, hyperthyroidism, and Graves disease. Do you want to do the glands now thyroid and pituitary? Sure, okay. The weirdest part is the starting over because you have to remember it's another episode. I used to remember the defining diabetes idea. Hey, Jenny. Like like we like we just seen each other for the first time. Yeah. Well, hey, Jenny. Today I'd like to define what a thyroid gland and a pituitary gland are. Sure you want to start or should I read a definition and then we'll talk

Jennifer Smith, CDE 3:45
you can read the definition. I think it's the most specific thyroid gland

Scott Benner 3:49
is an endocrine gland located in the neck that produces hormones to regulate metabolism. The thyroid gland is controlled by the pituitary gland which secretes TSH in effort to trigger thyroid hormone production. But sometimes the thyroid simply won't release enough hormones. An underactive thyroid gland, one that doesn't produce enough hormones will result in hypothyroidism. That's not a bad reaction. I felt pretty good.

Jennifer Smith, CDE 4:16
Oh, that was a very good read.

Scott Benner 4:20
I didn't even like I'm very proud. Two years old, I read two sentences. And I'm like, wow, look at me. Yay.

Jennifer Smith, CDE 4:28
You get the gold star reading award today.

Scott Benner 4:31
So so let's go over it. First. Thyroid is where in your body. So it's

Jennifer Smith, CDE 4:35
located in your neck, kind of like this. Beside that bumpiness that you could feel going down in the middle of the front of your neck, right? But you would consider your throat and on either side. That's why it's called like a butterfly type gland because if you imagine the butterfly body being the middle, the wings sort of spread to the sides of your neck, right? So that's why If you've ever had an evaluation by a doctor, they will put two fingers typically on both sides of that middle of your neck and ask you

Scott Benner 5:08
to swallow. Okay, what happens when you swallow? They can find bumps then on it.

Jennifer Smith, CDE 5:13
Correct? Yeah. So if there are bumps present, indicating something is not going the right way with the gland, then they would essentially do more testing to reveal, you know, what might be the potential problem.

Scott Benner 5:25
Right. And will they feel but they won't feel bumps if I'm, if I'm hypothyroid. Without Hashimotos, though, is that correct?

Jennifer Smith, CDE 5:34
I don't correct. I believe that the bumps come specific to the autoimmune Hashimotos. Yes.

Scott Benner 5:40
Okay. All right. Well, it's a win. And sometimes when you see people who have that little like scar on their neck, that could be that they had thyroid cancer, right. Or, or that their or their Hashimotos was so a lot of work for graves, right.

Jennifer Smith, CDE 5:56
Graves disease. Mm hmm. Yep. Yep. Which is kind of the opposite in terms of hypo hyper, I mean, we all talk about hypose and hypers. Right. But this is a very different specific reason for that. But hyper would be, you know, the potential for having like a thyroidectomy or surgical removal of some parts, but most often it's, it's cancer.

Scott Benner 6:20
Yeah, we'll talk about that when we define Graves disease, I think. Yeah. Okay. So that's where the, that's where the actual

Jennifer Smith, CDE 6:29
the thyroid hormones come from and

Scott Benner 6:31
the gland is right there. Right? The gland is right, though we understand that. Okay, now the pituitary gland is a small gland, the size of a peanut that is located behind the eyes of the base of the brain. It secretes thyroid stimulating hormone, TSH, which helps control thyroid function. I didn't realize that so yes,

Jennifer Smith, CDE 6:52
so TSH does not. TSH is regulated by the way that the pituitary gland talks to the thyroid gland. Essentially,

Scott Benner 7:02
they're nowhere near each other. The body is amazing.

Jennifer Smith, CDE 7:06
No, isn't the body I know.

Scott Benner 7:07
Really? If they were talking, you think you'd make them neighbors? But I guess?

Jennifer Smith, CDE 7:13
I guess not. I know.

Scott Benner 7:17
I include a pituitary in here, because I don't think it gets talked about much when you actually have hypothyroidism. Nor do I think anybody's ever gonna bring it up to you while you're treating it or living with it. But

Jennifer Smith, CDE 7:29
because most people just think that there's an issue here, right? And so while the issue does lie in the thyroid, the way that the pituitary gland responds to the signals, it's getting, they work together. So they're, they're both important to understand. Definitely.

Scott Benner 7:47
Okay, is there anything else people need to know? I mean, that's pretty cut and dry and simple, but they should know their thyroid gland is in their neck, and that it can be looked at manually by their doctor visually, or they could have an MRI taken over as well. Those are the ways that would be looked at. Right. Okay. All right, I will put some more important stuff that people need to know after I let you go at the end of this. Alright, hold on a second. Now I need to keep track of what we've done. Because that is. While I'm moving to the next one, I'll tell people that one check them off. There was one time in 2021 where I had Jenny do a diabetes variable. And then like three weeks later, we saw each other and we did the same exact variable again. Neither of us knew that it happened. And that's all right. I was very amused by that. Why don't we now talk oh, what

Jennifer Smith, CDE 8:49
would be interesting would be to listen to both of those episodes and see where they similar

Scott Benner 8:54
it. And I did Jenny and I put them together in their variable. I forget which one it was. Because interestingly enough, we we sort of built on what we said previously without knowing it. Oh, okay. It was very interest, maybe

Jennifer Smith, CDE 9:10
with a subconscious realization that we've already talked about this, but these are the additional pieces to it, right? No one said

Scott Benner 9:18
it out loud. So I put them together. All okay. Okay, so let's put together here. Let's

Jennifer Smith, CDE 9:26
put well I think maybe the next thing would really be since we talked about like Hashimotos hypo, the glands that are specifically involved, maybe the types of tests like the hormone that would be being produced and how they work. Okay,

Scott Benner 9:43
so talk about,

Jennifer Smith, CDE 9:47
you think T sh t four T three. Yeah, that kind of stuff.

Scott Benner 10:00
A huge thanks to touched by type one for sponsoring this episode of The Juicebox Podcast. Don't forget to check them out on Facebook and Instagram touched by type ones mission is to elevate awareness of type one diabetes, raise funds to find a cure and inspire those with diabetes to thrive, touched by type one.org. And if you're a US resident who has type one, or is the caregiver of someone with type one, please go take the survey AT T one D exchange.org. Forward slash juicebox. Looking for community around type one diabetes, look no further than Juicebox Podcast, type one diabetes on Facebook. It's a private group with 20,000 people just like you.

Thanks so much for listening today. Please stop back frequently for more episodes of The Juicebox Podcast and to continue with a defining thyroid series. If you like Jenny, she's for hire. You can find her at integrated diabetes.com. She helps people with their type one diabetes, she really good at it. So if you're enjoying the Juicebox Podcast, and you're listening in an app, but you're not subscribed or following, please hit subscribe and follow on that app. And don't forget to tell a friend. Hey, if you find the podcast on YouTube, we started putting up animated versions of the defining diabetes series. They're really cute, great for kids. Very visual. Go find it. Alright, now let's go through the symptoms. We will start with hypothyroidism. Hypothyroidism signs and symptoms may include fatigue, increased sensitivity to cold, constipation, dry skin, weight gain, puffy face hoarseness, muscle weakness, elevated blood cholesterol level, muscle aches, tenderness and stiffness, pain stiffness or swelling and your joints heavier than normal or irregular menstrual periods. thinning hair slow heart rate depression impaired memory enlarged thyroid gland. In infants you're looking for a yellowing of the skin and whites of the eyes which is commonly called jaundice. In most cases this occurs when a baby's liver can't metabolize a substance called bilirubin, which normally forms when the body recycles old or damaged red blood cells. You also might see a larger protruding tongue, difficulty breathing, hoarse crying, or an umbilical hernia. As progression happens in infants, you may move on to constipation, poor muscle tone, or excessive sleepiness. Hypothyroidism in children and teens may indicate with poor growth resulting in a short stature, delayed development of permanent teeth, delayed puberty, poor mental development. That list is from the Mayo Clinic. Let's move on now to hyperthyroidism. This list is from the Cleveland Clinic. Hyperthyroidism may present with rapid heartbeat or palpitations, feeling shaky and or nervous weight loss, increased appetite, diarrhea and more frequent bowel movements, vision changes, thin warm and moist skin menstrual changes, intolerance to heat and excessive sweating, sleep issues, swelling and enlargement of the neck from an enlarged thyroid gland. Hair loss and change in hair texture. It would get brittle, bulging of the eyes as seen with Graves disease and muscle weakness. Okay, back to the Mayo Clinic for Graves disease, you're looking for anxiety and irritability. A fine tremor of the hands or fingers heat sensitivity and an increase in perspiration where warm or moist skin weight loss despite normal eating habits, enlarged thyroid gland changing menstrual cycle erectile dysfunction or reduced libido. frequent bowel movements, bulging eyes, fatigue, thick red skin usually on the shins or tops of the feed, rapid or irregular heartbeat palpitations, sleep disturbance. If you your child or someone you love has any of these symptoms, please seek medical attention. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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#618 After Dark: Sex Worker

Mila is a 30 year old stripper who was just diagnosed with type 1 diabetes.

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

Scott Benner 0:00
Hello friends, and welcome to episode 618 of the Juicebox Podcast.

On today's show I'll be speaking with Mila, and she's had type one diabetes for just a few months. Mila has a story and a job that fits very well into the after dark episodes. So here we are, again with another after dark. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. I'm just going to tell you up front case you usually listen with your children. Mila is a stripper, and she's going to talk about her job very candidly. So all the things you imagine. We're going to talk about those. If you don't want to hear about sexual encounters, alcohol, drugs, philanderers and other such things. Don't listen. Also, when Mila talks about her breasts, she calls them peace. I bleeped it out. But a lot of these in this. Having said all that, she's a lot of fun. And this is a good episode, I'd hang out

say hello to dexcom@dexcom.com forward slash juice box the Dexcom G six continuous glucose monitor is it's the bomb diggity. It's the bestest ever my opinion. And it's possible that you can get a free trial of it. So why don't you head over to dexcom.com forward slash juice box and say hello to Dexcom. The podcast is also sponsored by Omni pod makers of the Omni pod dash and the Omni pod promise. I'll tell you right now, in this moment that you may be eligible for a free 30 day supply of the Omni pod Dash. And the only way to find out is to go to Omni pod.com forward slash juice box. Later in the show. I'll give you more details tell you about the promise and other such things. I hope you're ready for Mila because she's ready for you. One more time. Tastes gonna happen a lot. Gird your loins.

Mila 2:28
Hi, my name is Mila. from Minnesota.

Scott Benner 2:32
Zach. Good, but I don't know. Are you happy with people thinking of us? Mila from Minnesota? Yeah, yeah, we're good. Yeah, yeah. How? How old are you? I'm 3030 How long have you had type one?

Mila 2:48
Um, I just I just got diagnosed on May 6 of 2021.

Scott Benner 2:53
No kidding. Yeah.

Mila 2:55
So crazy.

Scott Benner 2:57
In May of 2021. It's January of 2022. Right now, just for context. You've had it just for like seven months, and you're 30 years? Yeah. anyone in your family have type one diabetes?

Mila 3:10
I guess. Yeah. My mom said that. Like I a lot of people on her side of the family, I guess, like have it. But I don't know. She said like my uncles and I have that. And I guess like, yeah, my uncles and stuff. I don't know.

Scott Benner 3:24
Yeah. Okay. Well, yeah. But people you don't know. firsthand, right? Yeah, like

Mila 3:29
people. I don't know. But I guess I get I guess it's runs in my family. But I guess it like skipped my mom and dad though.

Scott Benner 3:35
Okay, just not something people have spoken about. How about how are other autoimmune stuff? Like do you have a thyroid condition?

Mila 3:44
No, no, I don't have like, anything else?

Scott Benner 3:50
Celiac? Anybody? Like your grandma had celiac or something like that? Nothing.

Mila 3:55
I have no idea. My grandma, my grandma definitely had diabetes. And I don't know what else. I don't know what else she had. She had a bunch of issues.

Scott Benner 4:05
It's kind of a weird question. Because people either are very aware of it. Or they, they're they're like, I don't know, my grandmother's medical history. You moron, you know So, but, but your grandmother type one or type two, or did you do not

Mila 4:17
know? Um, I feel I think she was type two. Type Two.

Scott Benner 4:21
Okay, so how were you diagnosed? What happened and what sent you to the to the doctor?

Mila 4:27
Oh my gosh. Well, for for the longest time. It's so crazy because like, oh, yeah, I got diagnosed in May. In January. I was like in Mexico, but I could not stop peeing. Like literally pee, like peed my pants. And I just thought I thought that I thought I had like a loose pee hole to be honest. So I just didn't I didn't like check into it or anything and I just was like, drinking a lot and I remember getting really sick. I got like strep throat really, really bad. And then I came home and I just like was just like drinking a lot peeing a lot. And I got strep throat again. And then I like couldn't breathe. Like, I was just like out of breath like even just like talking, having a conversation. And my friends came over to like help me put together some furniture because I just moved. And they're just like, are you okay? Because like you should call the doctor. So I called the I called the doctor. And the nurse was just like, she was just like really concerned because she was like, did you just like run a mile or like why? Like you like I need you to get an ambulance right now. But my friends just drove me because I live like I live downtown. So I'm like, around the corner anyways. Yeah, so they drove me there. And I don't know, they brought me to the ER. And then. Yeah, the doctor came in and just like asked me like, Have you been like eating and drinking? And I was like, Oh my God. Yeah, she's like, Yeah, we're pretty positive that you have diabetes. Wow.

Scott Benner 5:57
30 years old. Hey, listen. This is just a friendly reminder to people. I just tried something. I don't think you should ever Google the words loose P Hall.

Unknown Speaker 6:08
So Oh, no.

Scott Benner 6:10
I was like, maybe she had a medical condition. I was like, No, that's not what that was. Okay. Don't do that.

Mila 6:17
Oh, my gosh, just get a bunch of points.

Scott Benner 6:19
Yeah, it just didn't. It didn't go the way I was expecting. I like I was trying to be ahead of the conversation. I'm like, I wonder if there's like a medical condition like that. And I was like, Oops, no, that's my fault. I shouldn't. Yeah,

Mila 6:30
I literally thought it was like broken. I was just like, maybe needs to be tightened up. I don't know. Like, and I had Google too. I was like drinking a lot peeing a lot. And it definitely said diabetes, but I was like, oh, Google's just trying to scare me. Do you think Google is right this time?

Scott Benner 6:47
Let's just be clear. For a second Milla. You don't believe that? Google's after you write? What you don't think Google's trying to like, you don't literally think of Google as a thing that's trying to get you do you know, Oh, no. Okay. Great. I just want to make sure that, you know, you weren't paranoid. I mean, if you're, it's fine. I just want to know what I'm dealing with.

Mila 7:07
You know, like when, like, I guess I unless you like, if I'm sick or something I like, I'll Google it. And then it's just like, it'll be like, you have a brain tumor. Like something crazy. Yeah. I usually just don't listen to it.

Scott Benner 7:19
Right. There are a lot of symptoms that point to a million things. And if you can't find one of those things at fault, there do become more serious issues that those those, those specific symptoms actually point to as well. But people usually do jump right to the thing told me I had cancer, you know, like so. Yeah. You have a loose tendon. Yeah. Alright. So, um, you go into the hospital for this, or

Mila 7:45
Yeah, yeah. So they checked me and I was in ketoacidosis. They told me they're like, yeah, you definitely, like super like you didn't slip into a coma because I live by myself. So I guess I was like, got there and then make a time. And then I was there for six days.

Scott Benner 8:01
Now. What about the what happens next? Like when when they get you kind of balanced out? And they're gonna send you home? Did they send you home with an insulin pump or with needles or pen?

Mila 8:13
Yeah. So that well, they had to talk to an educator. And then they sent me home with two pens, and Mike, the computer and like strips and stuff. And then I had to, when I went when I had my appointment with my educator. That's when I got on the Dexcom. I don't have a pump yet. Because like I was, at first I was just like, No, I did not want that. But I just, I actually just met with my Endo. And I was just talking to him about the Omnipod. Because I feel like I'd probably be better at it if I had that.

Scott Benner 8:46
So what was your first? Like, you were okay with the Dexcom. But you were thinking no to Apollo, like, what was your thinking there? Well,

Mila 8:55
it's well, it's just like my job. Like, I'm a dancer. So I just like was like, I don't want like too many things. Like, like on my body. But now I'm just like, Okay, I don't really think it matters, actually.

Scott Benner 9:09
Well, and so you're going to be comfortable with it now.

Mila 9:13
Yeah, yeah. Well, yeah, because I'm just, it's just too much work like having like, these, these pens and just like having I eat out a lot. And just like having, like, I don't like I'll pull it out and stuff. I just think it's just like a lot of extra work kind of here. You know, it's actually a lot of extra work.

Scott Benner 9:31
Like, carrying things keeping insulin cool. I guess stuff like that.

Mila 9:35
The whole entire thing? Yeah, it's just like, it's just like, I have to think all the time. It's ridiculous.

Scott Benner 9:41
Gotcha. So you said a second ago that you're a dancer. That's actually why you're on the show, right? Yeah. Mille Mills Mills here to make an after dark episode. Is that correct?

Mila 9:53
Oh, yeah. Yeah, yeah, dancer, stripper. Yeah.

Scott Benner 9:57
So I don't know. I'm trying to like work. my way through this, but I think you sent me a note on Instagram saying like the podcast has been helpful. Was that about right?

Mila 10:08
Yeah, yeah. Well, yeah, cuz you have like this good episode with like, Well, I mean, they're all good, but like, Yeah, this one that like she was talking about like doing cocaine, and I was like, was it? Wait, am I allowed to swear?

Scott Benner 10:20
You've um, you've said don't worry. I'll just I have to. I'll edit it out later. You're fine. Okay.

Mila 10:25
Yeah, to be saying that right. Um, but yeah, so I was just like, Oh, like that, like, I don't know, just like resonated because just Yeah, I do it all the time. So.

Scott Benner 10:36
Okay, so you use cocaine? Well, yeah, right. And then you So you saw that you're like, huh, this is a representation of my life right here.

Mila 10:45
Yeah, yeah. Cuz like, I don't know, I just have like a very much party lifestyle. I suppose you would say,

Scott Benner 10:51
Okay. How long have you been dancing?

Mila 10:55
10 years. Wow.

Scott Benner 10:57
They give you like a, like a metal or something?

Mila 11:01
They should. Yeah. I'm like a veteran now though, sir.

Scott Benner 11:05
So my first question about this is gonna probably surprise you, but are you like a contractor? Like for your taxes? Do you like?

Mila 11:12
Yeah, okay. Yeah. 1099? Yeah. Not, not like not all clubs, do it. Like, you can be an employee if you want to be but they're just like, take your money. So,

Scott Benner 11:21
so are you like, uh, do you have one place that you dance? Or do you have a few places? Or how do you do that?

Mila 11:27
I just have one place because it's just like my home club. And I love it there. But I mean, a lot of a lot of people like traveling and stuff. Like I you could work wherever you wanted to. Okay.

Scott Benner 11:38
So now my, not my confusion, but my real interest when I kind of like, you know, when people messaged me, I click kind of through to see who they are. And I think you describe yourself as a sex worker. Is that right? Yeah. Yeah. What does that term encapsulate? It could be a lot of different things, right?

Mila 11:56
Sure. Well, yeah, I just think is like anybody, like anybody who like works in the sex industry, like ask for strippers, camera. People who work outside, basically, like, you know, porn stars, anybody who just like works in this, like, in the sex industry? Sounds like sex basically. And like, doesn't like necessarily mean like, have, you know, like, like, like having sex, but I mean, it can?

Scott Benner 12:24
Sure. It could include that. But it doesn't necessarily mean that right? Yeah. In your case, it doesn't necessarily mean that.

Mila 12:33
I mean, I could have somebody who's paying for now. No, just a stripper.

Scott Benner 12:39
So, so no one has has offered you that upgrade yet. But if they owe everybody options, Oh, really? Okay. Oh, yeah. Here we go. So

Mila 12:50
I've actually never met a more single man than a married man that's

Scott Benner 12:54
never met a more single man than a married man, like single in their head.

Mila 12:58
Oh, yeah. Yeah, sure. Yeah. When they're out on business. They're naughty boys.

Scott Benner 13:03
Should be a comforting episode for married ladies everywhere. So he's cheating. So where does the how does the floor work? Is there is there kind of like a main stage where people cycle through and then you kind of go down on the floor and look for lap dances, stuff like that. Private dances?

Mila 13:23
Yeah. Yeah. I mean, yeah, like you go on stage, just and then you just go on the floor and talk to people and see if they like, want to do VIP or do dances. And then yeah, I said, Well, have you been to a strip club?

Scott Benner 13:34
I mean, I'm old now. But I have been in the past. Yeah. I mean, but but the older guys? Yeah, I don't know. I'm, I'm pretty old. Like, I just My knee hurts. You know, they mean? Like, if if you came down and like sat on my lap, I'd be like, Oh, my God, my knee. Mila. Like, you'd be like, you want me to rub you? And I'm like, only if it's going to be my knee. So yeah, I mean, but so you're saying that when you get when when you head off into a private room? Give me Give me the breakdown out of every 10. Guys, how many of them? Want some sort of actual contact?

Mila 14:13
Oh, out of every 10 like way out of every 10 Who wants to go to VIP?

Scott Benner 14:17
Yeah, everything guys that you're in a private room with? How many of those 10 How many say to you, Hey, what is the next? Oh, how

Mila 14:24
many like asked me to go to their hotel room? Right? I would say like nine out of 10.

Scott Benner 14:30
And they want you just to do it. They don't want to they're not like, Hey, I have a business transaction for them. They just think that they're Oh no,

Mila 14:36
like they like they want they want to pay but it's just like, you know, like, I'm trying to lose my job. So it's just like, I'm just like, why don't you just you know, get another hour.

Scott Benner 14:46
Right? We'll see if that's sort of part of the I don't want to call it a game but is that sort of part of the business? Like just get them very excited, but then keep them they're spending money?

Mila 14:59
Oh, yeah, for sure. Sure, I mean, you know, I always tell them like, you know, there's no sex in the champagne room. But guys are very, I don't know, visual

Scott Benner 15:12
creatures, and they can get very single minded. Yeah, you put

Mila 15:17
a T in the dude's face and you really ain't thinking about my job. That's just empty their wallets pretty quick.

Scott Benner 15:26
And they do you think that they believe that there's going to be some sort of a more personal ending to this? Or do you think

Mila 15:33
I've seen dudes like, like, proposed to girls and VIP like guys? Some people get very delusional.

Scott Benner 15:40
Do they ever come back an hour later? And they're like, I didn't mean to do that.

Mila 15:44
No, these are like regular so like, they haven't seen a girl like forever. I used to have a guy who's like bring me in mac and cheese all the time and pizza because he knew I loved like cheese. And he liked that he was my boyfriend, but I never seen him outside the club but in his head. Like I was just girlfriend. Yeah, just

Scott Benner 16:04
interest. How does that how does that all manifest on your side? Like you don't think he's your boyfriend obviously. And and you're not asking him to bring you macaroni and cheese. But once he does it, I love that Macaroni Cheese example. And that once he brings you your mac and cheese, you're like, Huh, you ate it?

Mila 16:25
Yeah. It's like he would bring me the Babita boxes it so take it home like he is. When I lived in Guam, he was just

Scott Benner 16:35
throwing the shaky box at you. And he was like, Hey, honey, all you need to do is add water and you've got a meal.

Mila 16:40
Yeah, they bring in like a whole grocery bag for me. Yeah.

Scott Benner 16:43
And do you think that that alone, in his mind, he thought you were going to like, translate out of the setting into real life with him? Do you think he thought that was gonna happen? Or do you think he just likes the idea that he's got someone to talk to?

Mila 16:59
Oh, I mean, I think that he for sure thought that I was his girlfriend and that because by he because he would always be like, well, how come you don't see me to the club? What come to my dad tells like just weird things. Like, I mean, you know, it's he definitely thought so. But not all got like most guys like No, like they know what it is. But some of them get a little confused. Yeah, gotcha. Does it that's fine. Now, you know, I was just friend.

Scott Benner 17:25
Yeah, no, I understand. Yeah. And you don't see it as you don't see it as a one sided affair. Right. Like both both parties are getting something out of it. Oh, for sure. Yeah. Okay. Like you don't feel like you're taking advantage anybody?

Mila 17:40
Oh, no. I mean, he's got my old D in his mouth. He's having a good time.

Scott Benner 17:44
It's a fair trade.

Mila 17:47
I think so.

Scott Benner 17:49
So now you got me thinking? Like, what would I trade for a box of macaroni and cheese on my end? You're right.

Mila 17:56
Oh, wait, no, he also gave me money.

Scott Benner 18:00
You wouldn't just meal. It's like, Listen, if you ever figure out who I am pleased to not show up just with canned goods and try to get with me. That isn't gonna be enough. What's an hour cost?

Mila 18:15
an hour at my club costs 600 an hour. Wow, that's crazy. But it usually ends up being like, like I tell most guys, I get lease you're gonna at least spend like 800 Cuz that's just for me. And you got to tip the waitress too. And then if you get a bottle of champagne, it's gonna be much more because we usually get like, good champions. So it's usually like 800 to $1,200 for the bottle.

Scott Benner 18:41
How many people do you think in a shift? How long is the shift? First of all?

Mila 18:46
How long was the shift? I usually got the at nine and then I'll stay until like two or three.

Scott Benner 18:53
How many people can you see in those five hours?

Mila 18:57
Huh? I think it just depends. It just depends how busy it is. But if I'm really like, I'm just trying to find like one guy to bring upstairs.

Scott Benner 19:05
Okay. How much of the 600 How much do you keep?

Mila 19:12
I keep 500 and 100 for the table. Okay, um, yeah, and then usually asked for 100% Tip So do they do that? Oh, yeah, these guys because the guys that might like my club like these guys are like, like they wipe their ass with money. Like they're like rich so I don't have a problem being like, Give me all your money.

Scott Benner 19:33
I see that. So it's not like you're not taking like little Johnny's like inhaler money.

Mila 19:38
No, I'm I'm j&j His

Scott Benner 19:40
dad's money. That's funny. And Johnny is the CEO of

Mila 19:43
a company.

Scott Benner 19:44
I gotcha. Okay. Yeah. Interesting. You think it's, um, do you think it's about sex? Who do you think it's about power? Do you think it's about loneliness? Like, what do you I mean, how much time do you think spend thinking about the psychology of what's happening?

Mila 20:00
I think that it can be like, just, I guess, like, a bunch of different things. It really just depends, I guess like what the person wants when they come in. Because a lot of times we like to say like, we're basically like naked therapists, because guys will come in and just be like, complain about, like, the families and our wives. And they'll, like, pay us to do it. While just like a teaser out, so yeah, we're basically naked therapists most of the time, but a lot of times sometimes, too. I guess. It's just like, two parties. So then it'd be like, yeah, about sex. Like, they just want to see some buddies and have some drinks. You know, super fun time. Sometimes it's about business. A lot of business guys take like, their partners in to like, show them a good time. So like, sign the deal later, whatever.

Scott Benner 20:43
I have to tell you, as you're saying this, it occurs to me, I've never had a bad time with boobs. So I think yeah, I mean, I'm sitting here really hard pressed to think of a time where there were boobs available. And I was like, Oh, this is terrible.

Mila 20:56
Yeah, like, no, yeah, hot girls boobs and booze. Like, you really can't.

Scott Benner 21:01
It's a mix. Now, you said earlier that you use coke. So do you do it as a way to? Like, is it functional? Like you do it to work? Or do you do it? Personally?

Mila 21:14
No, it's just like a party thing. I actually I don't even buy it like, people just like I feel like like, not even just in like this, like the sex industry. But like, in like the like, in like the bar industry. And like the restaurant industry, like all these, like, all the way just isn't all the bartenders like there are they're all on cook. Most of them. And I don't know, it's just like, I just gets offered to me. And if I'm drunk, I'll do it. It's not something like I guess I don't if I'm sober. I'm Mike. Actually, by my cue, gross. I get that away from me. But if I'm drunk, I'm like. No, it's just it's my, I guess it's like, I would say it's like a social thing, like smoking a cigarette. Like I say, yeah, it's just there. It's always there.

Scott Benner 22:04
And now I'm going to do some use some words I don't have any context for but you're talking about, like, what I guess would colloquially be considered like a bump you're not or a line or like, yeah, not all night. Kind of thing.

Mila 22:18
No, no. Yeah. I mean, I mean, I knew years to get home at 8am. But, you know, besides No, yeah. I'm not like, doing an eight ball tonight or anything. I'd be dead.

Scott Benner 22:30
Yeah. I mean, I don't know what that means. But I agree with you. So oh, that's a lot. It's a lot. Okay. I mean, I'm, I'm in my mind, I'm imagining an eight ball on a pool table. Right about?

Mila 22:44
Yeah. Is that the vibe? Yeah. It's like an AP was like $250 worth of coke, which in a gram is like 80 bucks. So an AP was like three grams Basal.

Scott Benner 22:56
Or, like, 2.5. And you're not paying for it?

Mila 22:59
No, no, no. No, honestly, people just like, it's just crazy. How many people do it? Like? And like, I always think like, people who like don't do coke or like, never touched it or like, think it's like, like taboo or like scary. But like, in my like, to me, I'm like, i i every so many people do it. Like mind boggling.

Scott Benner 23:24
Yeah. In your world. You see it constantly. Yeah, like Yeah, yeah. Do you ever worry about like fentanyl?

Mila 23:31
Yes, yeah. There was well, especially after like, what happened? I can LA with those comedians, like they'll like died? Yeah. But yeah, I guess there was a bad batch going around Minneapolis, like a, like a month ago. And I definitely got a couple text messages like a like, don't don't do anything. But um, yeah, that's scary.

Scott Benner 23:53
Crazy question. Does your job offer a 401k plan?

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You can find links to these sponsors. And all of the sponsors of the podcast right there in the show notes of your podcast player. We're at juicebox podcast.com. Now we're going to find out if Mila has a 401k plan and a lot a lot more. I mean, this one's going to don't sleep on this episode. Keep listening. There's a lot there's like,

Mila 28:25
no, no. But we do have like this like this like spike sex worker. Like I know it's like this group of sex workers have like this whole thing. And they're like, talking to the mayor and stuff and they're trying to get like better. Better benefits and stuff like health insurance, like just basic for like dancers because we don't get any of that.

Scott Benner 28:49
Yeah, I mean, it's just so are you. This is a crazy and personal question. I can't believe it. This is the first time I've thought this is too personal to ask, but are you saving money? Yeah. Can you

Mila 29:04
know any other stripper out there like better showed saving their money because a lot of girls just like run through their money so fast because it's just fast money, but I'll save

Scott Benner 29:14
it. You know, oddly, I'm kind of comparing you to like an athlete in my head. Because yeah, it's or like a runway model, right? Because at some time, I mean, to be frank and to use your words at some point, a guy is gonna walk in there, see your TV, see somebody else's bees and yours are gonna look older and they're gonna be like, I'm gonna go with this girl. And then you're just gonna be like, Oh, geez, I get another great like, do you think I mean,

Mila 29:39
I guess if they start like, like, if they start looking ugly at some point, but

Scott Benner 29:44
I'm not saying they do. Let's be clear. And what I'm saying what I'm saying is that like your body is like it's your I mean, it's your product, right? Like so what happens when your body if your body becomes a product that people aren't as You know, desires of happening, you know, and then Oh, sure.

Mila 30:02
And then I guess I don't I I'm not gonna like stay in the business and time like 50. But there are girls that I know that are like in the upper 40s. And they usually make way more money than the younger girls because, like at, like, at the end of the day, like, yeah, like it's about like your body and your knees and stuff. But if you have like a mouthpiece on me, like if you know how to like, talk to a man and talk him out of his wallet and talk to him upstairs. That's really all you need, like a pig in a wig can make money, you know?

Scott Benner 30:34
Oh, well, we're so close to that being the name of your episode, except I don't think you're a pig in a wig. But that's okay, so. So what do you think you'll do after this?

Mila 30:46
I just want to save a bunch of money and like buy a house on the beach and like open a bar. But you know, I mean, and also, like, I do plan on having a rich husband. So that'll help.

Scott Benner 30:59
So this has been in the back of my head for about the last, you know, all but the first 35 seconds we were talking, you're going to make if you if you can find somebody you really like you're going to make, like, from the perspective of getting what you want, you're probably gonna have a fairly good time of being married is what I was thinking.

Mila 31:20
Oh, yeah, for sure. Yeah, yeah.

Scott Benner 31:24
So do you date while you're like, do you have like a somebody in your life?

Mila 31:30
Well, actually, I just got out of like, a five year relationship. I'm such a relationship girl, actually, I'm always in a relationship. But I've been single this past year. And so.

Scott Benner 31:38
Okay, so that's interesting. So you were five years with somebody while you were working? In dancing? Yeah. And

Mila 31:45
yeah, I would never, I wouldn't date somebody who like didn't click had a problem with my job?

Scott Benner 31:51
I don't imagine you could

Mila 31:52
know. Yeah, well, I mean, girls would do it, and then they'll their boyfriends will try to make them quit. Like, I'm just too much money to quit.

Scott Benner 32:01
I think that's a different psychological issue. Trying to save people like that feeling like you're gonna upgrade them or help them or get them out of something is.

Mila 32:08
That's yeah. Which is ridiculous. Because you just if you want them like work behind a desk for less money, that doesn't make any sense.

Scott Benner 32:15
So how did that go? Like, I mean, were trying to imagine like, you're like, Hey, I gotta go to work. And you're his boyfriend. Yeah, and your boyfriend's like, that's great. Get those boobs in somebody's face. Honey, we got to buy the we got to buy food. Like is that like, what? Yeah, no,

Mila 32:33
he used to drop me off every every night and give me just before I went in, and yeah, I would come home and be like, $2,000 and he'd be like, yay. Guys, a good time. It usually like that. Like, usually my boyfriend's be like jealous, like, Wow, thank you for making that much in one day,

Scott Benner 32:51
because it's so much money. It's more than they're making. Yeah, and he's really working his ass. So you think like, there's a, like, there's a lot of respect about the amount of money that you're bringing in.

Mila 33:02
thing, if you have respect for sex workers, then then you can respect the money that they bring in. But if you don't, I guess if you don't have respect for sex workers, then usually like the money doesn't matter, because they'll still be degrading, or some dumb shit. And then go watch porn. So it's just like, Okay,

Scott Benner 33:19
gotcha. So not okay for you. But it's okay for the girl in the video.

Mila 33:23
Right, exactly. So I just a lot of people. I think they're just kind of jaded by like, what society has taught them about like sex work. And it really like it can bring like women out of poverty, like, do a lot for you. It definitely brought me out of poverty.

Scott Benner 33:39
So I want to ask you a little bit about that. And then I have some diabetes questions. So yeah, at some point, we'll talk I mean, you know, for anyone listening, you don't come on here and say you're a dancer. And then like, I'm not gonna ask you about like your Temp Basal for pizza. You know what I mean? So not right away, at least. Do you ever feel degraded? And his his feeling that way? Is feeling that way in your control? Or is it in someone else's control?

Mila 34:09
Well, first of all, no, I never feel degraded. Because like, I'm not ashamed of my job or anything like that. And I feel like if anybody like anybody in the industry does feel that way. They should maybe think twice about being in it. Because I mean, you got to respect what you're doing. And if you do, then nobody can really make you feel like and anybody in any guy who has like, tried to be rude to me, like, I'm allowed to, I can hit you. I can pour champagne on your face. Like I don't you know, I'm not gonna I don't have to sit there and like, take you being rude to me. I can also get you kicked out. Right? And so it's like, I hold all the power.

Scott Benner 34:46
Have you? Have you ever felt bad about yourself?

Mila 34:50
No, no, no, not not. Not as far as like dancing or anything? No, no.

Scott Benner 34:55
And your job before this before you did this, what did you do before that

Mila 35:00
I worked at this bar in St. Paul, I guess nobody else. But um, yeah, I went to this copper actually, it was like a bears slash copper. And then before that I worked at a gas station. But yeah, the bar is what the bar is what brought like the bar is what got me into shipping because this girl came in one time and she was like my age, but she had like a Louis Vuitton bag and all this nation. I was like, okay, she affording this. And she told me she was a stripper and I was like, I'm literally going to my

Scott Benner 35:33
stripper to Let's go. Yeah, like, I swear, I'll get to the next thing. But you keep saying things. What's the interview process? Like?

Mila 35:45
Oh, there's no interview, you just audition. So basically, like you get on stage and they they they want you to do two songs. And then like if they like you, they like you and if they don't the dough

Scott Benner 35:56
and are their home? Or they're all different body types kind of represented in a club?

Mila 36:03
No, no most clubs or castles but some clubs. Yeah, well, like like, like, not just tiny skinny little girls be working. But a lot of places. I remember when I I was like 130 pounds. And this club told me to lose 30 pounds. And I'm five, seven. So it's like insane. So

Scott Benner 36:26
I lost 30 pounds when you weigh 130 pounds. If you're five seven? It sounds like you would Yeah, exactly. I would have been like a skeleton. So they want super skinny girls usually.

Mila 36:35
Some some places some places. Yeah. My place when we had our old manager he like wouldn't hire like anybody who was like, like, even like thick. Like if you had like too much acid it would be like good as a cooler. Oh, zuku Oh, by now now we got rid of him. So we have we have more diversity.

Scott Benner 36:55
Nice. Is there are there any girls that have like, I don't know, like a trick pitch. Like something? You know, I mean, like some guys throw fast balls and sliders. But every once in a while guys got a curveball. Like, you know, is there anything in the business that like, makes you like can separate you?

Mila 37:12
Oh, I don't know. I'm thinking like, I guess I mean, I don't know. I don't know what you mean. Like separate you how like by your looks

Scott Benner 37:23
like you've got like a special talent of some sort like, oh,

Mila 37:27
oh, yeah, I mean, yeah, some girls do like, cool on stage. Not me though. I just have nice boobs. And I'm fun. I'm a fun time.

Scott Benner 37:43
That sounds like a T shirt. Nice boobs. Fun time. I think that that pretty much encapsulates the entire thing. So yeah. Okay, well, that's all I wanted. Like, I was just wondering if there were like, genres of strippers. Do you mean like a stripper? A bad word, by the way?

Mila 38:02
No, no, no, no, I'm not in most I guess unless you're saying like in a derogatory, like way. But

Scott Benner 38:09
I think after half an hour, we can tell that I definitely am not saying in a

Mila 38:12
derogatory way. Right? Yeah, no, I mean, so we do we struggle.

Scott Benner 38:16
I'm trying to decide if I want to tell you the story. I have the brought this thought up in my head. Oh, my God, please do an exam. I was like I was I think we were really young. We were like, in our early 20s. And somebody, somebody one of us was getting married. And so there's a bachelor party and we showed up at this club. And I'm going to admit to you, I'm not very comfortable in that setting. Like, okay, so I'm and I don't drink. So it's, uh, oh,

Mila 38:44
yeah, you don't,

Scott Benner 38:45
it's a weird vibe for me. So now like, you're sort of just like stone cold, sober in the middle of a room with a lot of girls not wearing their tops and guys who are really drunk who are acting more like, you know, you're describing then I'm acting. So I'm just trying to like, stay busy. Like, if that makes sense. Yeah, keep moving, stay busy. So I'm just wandering around looking for people who I know to speak with. And I look up. And this girl is I don't know how to say this. I mean, I guess I just have to say it the way it happened. She's shooting breast milk into the crowd off of the stage.

Mila 39:27
Oh my gosh. And this has happened before guys.

Scott Benner 39:32
So I saw a man and I swear for anybody who listens to this who knows me it was not a person in our group that just saw it and stopped and acted like it was a water fountain and just turn to the stage. And my brain like said to me like, What are we doing here? What are we doing and I was frozen for a minute in this the ridiculousness of what was happening and then I moved on. Oh my god. Yeah, that's But made me wonder like this like can somebody do something weird or like special? Yes,

Mila 40:05
I Yeah, actually there's just one girl who definitely still has mocha. And she was last time we were in VIP. She was screaming and the students face guys just like weird it sometimes like and they love pregnant girls to

Scott Benner 40:18
pregnant girls are popular.

Mila 40:21
Yeah, like they like they will like rub your belly and your feet might give you money. I think that's like, you know, the captain save a ho type vibe, but

Scott Benner 40:28
they love it. Captain save a ho. You slip a lot of fun stuff in, like at the end of the year sentences. I'm just I'm trying very hard to pay attention. So. Okay, so you come back, though. So you're out of work for a while. And did you lose weight when you were diagnosed?

Mila 40:47
Oh my god, I was so skinny. And I just thought it was because I stopped drinking for two weeks. And I was like, wow, alcohol really puts a lot of pounds on you know, I lost. I went from I'm usually 145 I went from 145. Whatever, like 20 pounds. So whatever the math is,

Scott Benner 41:11
okay, once 131 4520 Yeah. Yeah, yeah, you're saving money. I mean, if you maybe you're,

Mila 41:21
if you're I mean, I was only out of work I was only out of work for I mean, those six days that I was in the hospital. Gotcha.

Scott Benner 41:27
Did any of the girls come to visit, you

Mila 41:31
know, because it was friggin cold. Like, I was only allowed to have like one visitor days. Just my sister and my, my ex came to see me. But oh, I was only allowed to have them

Scott Benner 41:41
in my head. It was an 80s comedy with starring Eddie Murphy. And like seven dancers showed up at the hospital. And then for the doctors anyway, none of that happened. You're saying?

Mila 41:51
strippers should definitely be allowed to just like go dance for people in the hospital? It

Scott Benner 41:56
would be an uplifting experience. And yeah,

Mila 41:58
and an old homes to

Scott Benner 42:02
think you're onto something. Why don't you start a business?

Mila 42:06
I don't think it's allowed. I have one customer who he he had one of his girls in his room after he had a heart attack and he got kicked out of the hospital.

Scott Benner 42:18
Do customers flame out? Like do you see them a lot for short periods of time? Then they're gone. And then there's somebody new or do you have people? Oh, yeah, yours?

Mila 42:28
Yeah, yeah. Yeah, people? Definitely. Well, for me, like most of my customers, like don't even live in Minnesota at all. Like they're from like New York or LA or something. And they come here like once a year. So I mean, they'll hit me up like once a year, but other than that, yeah, they all come and go.

Scott Benner 42:45
Well, okay, so you leave the hospital, you get a Dexcom? Like, is like where do you where the Dexcom? Usually?

Mila 42:54
I usually wear it on my arm. I've only worn on my stomach one time.

Scott Benner 42:57
Okay. Do people like the guys? I mean, I guess women come to clubs too, right to see women dance. But do do. You get your like, you can't get them confused and take their money.

Mila 43:10
Yeah. Yeah, I don't really talk to girls when

Scott Benner 43:15
I say so.

Mila 43:18
Guys. Yeah, guys upsets up to me like drunk guys. But like, what is that? Yes. And then like, a lot of them are like, because that birth control.

Scott Benner 43:28
Interesting. Now do you? Do you explain to them what it is? Or do you just ignore them?

Mila 43:34
I just I kill their vibe. And I'm like, it's for my diabetes. Every time we like, oh, but sometimes other people have diabetes to like this one guy who we were like, we were like, wow, objects calm and like we like like, put her arms together. And he got like some dances for me. And we were like diabetes buddies.

Scott Benner 43:52
That's crazy, though. That's kind of nice. Yeah, so people will comment on it, and they'll yell out stuff. You'll tell them what it is. So you're not afraid to tell somebody even in that. Do you know me like that? You don't think that makes you less attractive? You don't have that feeling at all?

Mila 44:07
No, yeah, no, no. No, because like, no, no, that's excellent. I guess. I feel like if you see me naked, you would not be paying attention to my Dexcom Yeah, look at

Scott Benner 44:19
you. Mila. Very confident. Okay.

Mila 44:24
Not that hard.

Scott Benner 44:26
Wait. Oh, difficult, man. aren't that difficult? Yeah. Yeah. I'm assuming these guys are all hard. They're just not difficult. Yes, yes. See, I can do work late, so I'm good at this. Okay, so now you're injecting so what's your goal? Like blood sugar? I guess let me ask you this first. I mean, you've only had diabetes for seven months. Really? How are you making out? Like, where's your agency? Like, what are you able to do? Have you been able to accomplish so far?

Mila 44:57
Um, well, when I went in, it was 16. And I just went in recently and it was 7.4. So my doctor was like, just like, yeah, we'll just like want to bring it like under seven. But um, I don't know, he's like, 16 7.4 That's pretty good. But

Scott Benner 45:17
for first jump, it's huge.

Mila 45:19
Yeah, yeah, that's Yeah, but yeah. And then he sent me an email. He's like, but yeah, like, it's like, get that under there. Right? Yeah, I was just like running high for these past two months. Because, like, sometimes I just really don't know what is going on. Like, you know, I feel like I do everything right. And it just is like, does what I want.

Scott Benner 45:38
Okay, so what kind of diet do you have? Like, do you eat like rarely

Mila 45:42
I just eat out a lot.

Unknown Speaker 45:44
I restaurant foods.

Mila 45:46
Before I had diabetes as like the type of girl to eat. I usually I would eat cake like once a day, like just sorry that I love cake and like ice, I guess sweet tooth girl like Cake, ice cream, chocolate, pasta, all cards. And, and now I'm just not that good at. I just feel like I get the doses wrong. Like are like, oh, like so I just don't need it that much anymore. Because I don't like to deal with it like so. I don't know if I don't feel like injecting or anything. I'll just see like, cheese and meat. But okay, or like stuff with no carbs. And then I if I feel like dealing with it, then I'll do it.

Scott Benner 46:25
So while you're while you're working Do you usually eat while you're working?

Mila 46:30
No, no, no, I usually I only I guess I eat like once a day. I just like I'll snap a snack and like meats and meat and cheese. I'm like a super cheat. Like I'm like a cheese where like, I just love cheese. Like I can have like seven shirring cheeses and like three hours. So good. But um that's where I live off of cheese and dinner.

Scott Benner 46:55
Okay, and and so like, do you ever find yourself having to inject at work? Like, is there a number you want to stay under while you're working? And does dancing? Yeah, I mean, how much of a fallacy is the word dancing? Like? I mean, you're not up there Flashdance. Right, like it's, is it? Uh,

Mila 47:09
no. I mean, I mean, I mean, I'm up there moving. I guess. I don't know. I'm like shaking my ass will do do it's definitely a workout. But um, and it's like, yeah, Tucsonans like, 10 minutes a dancing. But, ya know, I try to Well, obviously, I want to stay under. I guess I tried to be under under 180 I guess. And then above, like, I, I guess I don't want to be like, I guess like, I'd rather be like, above, like 100 At least I guess. Because I just get scared. I don't know. I've been like in like the 70s Before now, sir. And just like drink the juice and sit there and have anxiety.

Scott Benner 47:53
That's what I was wondering. Like, have you ever gotten low while you were dancing? Or have you ever been low when you're with a customer privately?

Mila 48:00
Yeah, well, no, the lowest I've ever been with like a customer dancing is like 70. And that's because I was like doing shots. Tequila. Okay. I mean, I guess it was easy to fix. I guess it's not that scary. When you're at the club. It's when it's scary. When I'm like by myself at home. That's, that's scary.

Scott Benner 48:17
What did your employer have to say? Like the I'm assuming you came back and said, Well, I have diabetes Did did you like Phil? Do people understand what that means? Like, would somebody there know how to help you if you had a problem?

Mila 48:29
I mean, hardly, but I mean, yeah, I just like, I guess if I pass out, like, give me some juice, or sugar or something. But most people have no idea for what is what it is. But in they knew though because like my like, my, my friends and stuff told them and he was just like, they were just checking on me. And I didn't do I didn't use stage for like, the first week that I was back and there just was like, kept asking me like, is you diabetes? Okay? I'm like, Yeah, I'm good. And that's like, but as far yeah. So as far as they know, and I'm just like, I never let myself I guess get to a point where I feel like I really need them to like, help me. I never. I don't know. I never I never really go under. Like, barely go. Well, I've been low like one time that wasn't even it was only like 70

Scott Benner 49:20
Gotcha. Do you carry glucagon with you?

Mila 49:23
No, I have those glucose tablets. And then but I have some I don't really even bring those to work because I just they just have like, you know, juice and pop and stuff.

Scott Benner 49:36
Yeah. Hey, so if you're a contractor, then you don't have health insurance through your job. Right?

Mila 49:41
Right. No, and I actually didn't have health insurance until I got diabetes and then they were like, oh, emergency life changing sometimes like that. So they gave me insurance.

Scott Benner 49:54
What what do you have like Medicaid?

Mila 49:57
I think it's called I mean, yeah, it's like, I don't know. It's like, take medical assistants like under the state. So I'm guessing as Medicaid.

Scott Benner 50:07
Okay. Wait, okay, I'm gonna carry it. I think it depends on I'm not sure.

Mila 50:12
I just have a $3 copay.

Scott Benner 50:15
That's pretty great. And you're gonna be able to get a pump.

Mila 50:18
Yes, yeah, sorry. I have to I'm supposed to make an appointment with my educator about so she can like explain to me that my different choices.

Scott Benner 50:27
Gotcha. And I only want one. Yeah. Oh, what is so you said that drinking can affect your affect your blood sugar? How does it affect it?

Mila 50:38
Well, drinking honestly, like usually. I feel like every time after I drink my blood sugar is just perfect for the entire day. What do you doesn't?

Scott Benner 50:48
Is it harder alcohol or beer? Or? Oh, no,

Mila 50:51
I just drink tequila, and Diet Coke. So it's like, I'm not like shooting up or anything because I don't like mix any sugar with it. So it just it really just brings me down really? But it doesn't bring me like low. I'll just basically, like right now because I'm definitely hungover right now.

Scott Benner 51:12
You're hungover right now. Yes. Do you are there ever nights that you go to work? And you're just like, I'm not drinking? I'm not doing any coke. Like, I'm just gonna I'm just here. I'm gonna, like, take some of this

Mila 51:25
money. Well, yeah, I mean, yeah, like, it's not every time it's just like, a lot of times I go to work and I'm like, No drinks for me. But it's just hard for me to say no. And like when a dude say do on a shot of tequila.

Scott Benner 51:39
Do you see that? Yeah, part of your job? Or do you just want the tequila?

Mila 51:42
No, yeah, I just wanted to kill it. Yeah. A little bit of an alcoholic over.

Scott Benner 51:49
I was gonna do you feel like you couldn't say no.

Mila 51:53
I guess I could if I wanted to. Okay. But I don't know.

Scott Benner 52:00
I don't know what that means either. I was just that's, that's all. This is all just based on your life and your answers. I have no idea about any of this. So far. All I've added to this is that I saw a lady lactating in a strip club 25 years. So I've really I've really added nothing else to the conversation so far. And there's an argument to be made. I haven't added anything at all. Although, I gotta tell you in memory, it was a funny memory. The layer and it wasn't the lady that was the funny part. It was the the person the gentle. Let's call him a gentleman even though let's be honest, I don't think he was but degenerate. It's my cousin. Yeah, it's because it caught him by surprise. Here's was The fascinating part about it. He was not looking at the stage. He was walking past this age he caught what I guess you would call shrapnel. You don't I mean, he got a little on the side of the head. It and in a split second. Even as drunk as I assumed he was he figured out what was happening and oriented his body towards the stage and then in an in a way which I think he was trying to be amusing just tilted his head back and open his mouth. And I'm fascinated to this moment how quickly he was because that's not me. Oh, let's say something. When liquid hits you in the head in public your first thought isn't Oh, that's probably something I can put in my mouth. Right? Like no, no. But he assessed the situation in a split second and went right now you could again make the argument that he should have assessed the situation and jumped on the floor, but instead he went away he went I'm never gonna forget that it could probably be one of the last things that I remember on my death get it? I mean, like, like your life memories are flooded from memory. Oh, yeah, really? I can't wait to share on it I have not made a word of that up by the way.

Mila 53:48
ship the ship cook customers are like super fun like if you ever just want to people watch go on a Saturday night. Have a great time.

Scott Benner 53:57
Can I ask you is there any Are you sort of like a doctor in that it doesn't matter what physical condition the person you're seeing is like or

Mila 54:10
Yeah, yeah, no. Yeah. I mean, obviously it's super nice when the customer is hot. But definitely have had like an old man with like, nasty breath like lick my neck before

Scott Benner 54:27
that's gonna be upset Oh my gosh.

Unknown Speaker 54:31
Now not worth $20

Scott Benner 54:33
I just I just got the craziest chill through my shoulders and up through my neck and then I started sweating immediately on my face. Hold on a second. Yeah. $20

Mila 54:43
Yeah, it was just like a regular dance to I was like no.

Scott Benner 54:48
Oh, I really am upset now. Okay. Oh yes, I

Mila 54:50
finished that dance and ran away so

Scott Benner 54:53
so you don't like you don't discriminate based on like body size style, but I mean, what's the most egregious thing somebody can be? I'm guessing it's smelly, right?

Mila 55:02
Yeah, yeah. If Yeah, if you smell bad, like

Scott Benner 55:08
different tell somebody like it's this isn't worth me You stink?

Mila 55:12
No cuz I might embarrass for them like I can't. I'm just like, I'm just like, I'm gonna finish my dance and walk away like you're not going to get another dance for me and I'm definitely not asking you to go to VIP.

Scott Benner 55:23
Is there anything that you do that you're that you're? It's not great for you like, like, What about like? So you we've discussed the very old guy, a smelly guy. What about a young person? Like, have you ever looked at a guy and thought he's too young to be here?

Mila 55:40
Oh my god. Yeah. Sometimes I'm like, Okay, let me see your ID because

you do not look of age. I gave a dancer guy last night and he was 21. He looked like he was like, 14.

Scott Benner 55:52
Yeah. Did he give you pause it all real? Like, he's gonna see my boobs and it's gonna kill him. You know, like,

Mila 56:00
Well, no, no, I'm just like, you're gonna spend all your money.

Scott Benner 56:05
I gotcha. All right. I listen. I think I mean, I'm not judging you. I hope I mean, you know that, obviously. Oh, no, no, I don't feel any judge. I'm just trying to get to the I'm just trying to get to the ideas here. Do you think that having a pump is going to cause you problems at work? Are you really don't think so?

Mila 56:25
No, I don't think it's gonna cause me problems. Because what I get first at first I thought that like, my darks calm would but like, even with that, like, I still make, you know, the same amount of money. So I guess I was just Yeah, I was worried that it would like, just look ugly. Or like, like, I don't know. But now I'm just like, I'd rather like have better control than not because I live like so in the moment. And I, I feel like I will regret it. Like later when I like have like, complication. Just something.

Scott Benner 56:58
You're worried about your health, isn't it? Yes. Yeah. I'll tell you right now. It's, it's stupid, because you just talked about using cocaine, and you drink a lot of tequila, but you're worried about your blood sugar. Yeah. So you think, Well, now that you did you feel worse? Like

Mila 57:19
it's just, I guess it's just crazy. Because to me like those things, I'm like, wow, everybody loves that.

Scott Benner 57:26
You're like, you're really, I'm enjoying talking to you a lot. Like you're you could possibly not be more opposite of me. But I've never I don't if you if you gave me three, like little cups with liquid in them and told me one of these is tequila, like, drink them and figure out which I would have no idea which one is to kill? I don't know. I've never had to kill in my entire life.

Mila 57:49
I mean, gosh, it's so crazy.

Scott Benner 57:52
I've never been high in my entire life. I mean, you could, that that's it's never even occurred to me.

Mila 57:58
I know. But I guess my question is why?

Scott Benner 58:01
It's never occurred to me. I don't know. I could ask. I think you should at least smoke weed or like taken out a bowl. I know. It's not that I couldn't. I just It doesn't if you put it here right now, if you said to me, Hey, look, here's an edible. You take it at your leisure. I just wouldn't take it.

Mila 58:22
You just keep it forever take it in your deathbed or something.

Scott Benner 58:24
We'd probably watch it and one day look at and go Oh, this looks dried up and I throw in the trash. Like I just I would never make it would never occur to me to do it.

Mila 58:32
I guess at this point, it's like for what for? I feel like an edible. Like you probably like call 911 or something

Scott Benner 58:37
I would call 911. I probably am a lightweight because I had like, oh for sure. Oh yeah. Like they give you this cocktail before you get like a medical procedure. And I the guy, like had this a good the nurse kind of brought it on one second. Sorry, my, my voice just broke. The nurse comes up. He's like, I'm gonna give you this. He explains what it is. And I said listen, before you give that to me, you should know like, I don't drink or smoke or do anything. And he goes, Oh, I'm on. Because I'm only gonna give you half of this then I was like, Okay. I always wondered where the other half of it went. Figured out windows pocket. He was like, Oh, alright, but I just found it. Yeah, like because I couldn't like I didn't need all that. Like I really it's just it's but again, not a judgment. Like I'm not looking at your life and saying why are you doing all this? I'm just saying it's like it's never occurred to me. I've had to access to the things that you're speaking of opportunity. It's never occurred to me.

Mila 59:40
It's yeah, and that's mind boggling to me. But But

Scott Benner 59:46
does it is it ever something you think like, one day I got to stop doing this?

Mila 59:53
Oh, for sure. Yeah. Yeah. Well like not like party and do coke anymore. You Yeah, I guess it's just hard that I guess the day that I like stop, like, going out. Like I they won't get offered to me because I mean, like I said, like I don't I won't buy it always like always smoke weed though. Yeah, Coke. No, that's just like it's just like a party drug. I'll phase out.

Scott Benner 1:00:22
So that's so when people say I know I'm gonna sound ridiculous for a second to you but when people say party, they mean in a building with a group of people who are mostly inebriated and they enjoy doing drugs and drinking and listening to music. That's party.

Mila 1:00:39
Yeah, basically. Yeah. Like I'm at the bar or something or at a party. Gotcha. That pretty much every single party somebody is going to somebody is breaking down some line somewhere, for sure.

Scott Benner 1:00:51
So let me ask you this question. Who this? I'm gonna give you a baby. We'll call him Billy. Billy. Billy's now your baby. And he's yours to raise. Right? Oh, god. Yeah, it's absolutely frightening. Trust me. So if you want to be like the guy look in your neck. That's nothing compared to having a kid. So yeah, so So Billy is on his way out the door one day. He's gonna go out have mom, I'm gonna go out with my friends. Do you say to him? Well, don't forget to drink and smoke and do coke and have a good time, sweetie.

Mila 1:01:25
No, no, honestly, what I would say is, I mean, if you're gonna do any of that, be safe. And like, I mean, call me if you need anything. Like, I'll help you. Because I think a lot of times parents can be very, like naive and thinking like that their kids aren't going to do drugs are going to try it. Versus like educating them and like making sure that they if they're going to do it, then be safe. Because, you know, just being like, don't go to the Billy like, okay, what are the chances really is gonna fucking listen to me. Yeah. Well, so it's like, give them the tools to be safe.

Scott Benner 1:01:59
I gotcha. Do you think your parents knew you were doing it? Oh, yeah.

Mila 1:02:03
I mean, well, yeah. My dad like, I remember the first time you try me smoking meat is like, grounded me. And then he gave me a bag of weed and was like, you can only smoke it in the house.

Scott Benner 1:02:13
Right? So your dad smokes, too. He caught you doing it? How old? Were you?

Mila 1:02:19
Oh, I was 14. When he first caught me. Yeah. And then the first time I did Coke, I was in 10th grade. And then I never did it again. And then in 11th grade, I did it like, every day,

Scott Benner 1:02:30
in what situation in 10th grade was cocaine available to you? In math class, where you

Mila 1:02:35
like hardens? I'm not gonna lie. I have done a line in math class before it in my book when the teacher wasn't looking. Like, I just paid pay more attention to the travel trip. Because we I mean, my friends are some badass kids. And now that I think about it, I'm like, I can't believe all the things that we were doing. That's insane to me. That's but that's why I'm like, not kids be lying. Like people think their kids are well, angels. No. Hmm.

Scott Benner 1:03:01
Interesting. And then in 11th grade, it was happening constantly.

Mila 1:03:05
Yeah, cuz yeah, I just, that's when I was buying it when I was in 11th grade. And like me, and my friends was doing it every day. We also we had this group of guys too, who like sold it who would like come and pick us up from school and like do with us? How people

Scott Benner 1:03:20
get money in 11th grade to buy Coke.

Mila 1:03:23
Where did I work? I think I read like Coldstone. So I was buying ice cream.

Scott Benner 1:03:30
That I just wait, you got to give me a half a second. I'm gonna take a drink Hold on. So I go into the Coldstone to get a cone. And then I'm like, I see a cup there. It's like, hey, leave us the tip. And I stuffed two bucks in it because like, you're like this 16 year old girl working their side job. And you're like, Oh, I'm so much closer to align rail. That's what's happening. I mean, maybe Are you trying to tipping because I think that's what's happening right now.

Mila 1:03:59
No, no, that's so funny, though. But yeah, I don't know. Yeah, no kids too crazy. I thought it was fun.

Scott Benner 1:04:07
I I left a fairly large tip with a waiter one time. It was bigger than it should have been. And he was young. And I looked him in the face and I was like, do not buy drugs with my money.

Mila 1:04:16
100%

Scott Benner 1:04:19
and I was screwing around, but it froze him in his tracks. And now you're making me think that happened? Not because he thought I can't believe somebody said that to me, but because he thought oh, I wasn't gonna buy drugs for that.

Mila 1:04:29
He's like, how did he know? You know, I

Scott Benner 1:04:31
was gonna do that. Now I'm gonna just assume that's what's happening.

Mila 1:04:39
For the most part,

Scott Benner 1:04:39
I mean, in social economic, like lines are blurred in the scenario right? Like it's not like it's not like, just like, Oh no, no prospects and no money. It's people. college educated people like it's, it's up and down the line, right?

Mila 1:04:56
Literally, like I would say every single one of my My aunt loves cocaine. And they're like, yeah, they are. I would call them what is it? Like, what are they called? White Collar? Mm hmm. Whatever the color is where they make a bunch of money, those collar people. Yeah. Yeah, one of my regulars here, actually, I don't know how these people aren't having heart attacks at this point. But I remember he was flying us out to Cayman Islands. And we had a layover in Atlanta. And we stopped that, like, we're in the airport, and he's like, you want to bump and I'm like, wait, you had this in your pocket? The entire flight? Like psychopaths. So yeah, they all do it. And like when I say like, everybody does it like, you would be like, shocked.

Scott Benner 1:05:44
Okay. I mean, I listen. Me, let's be clear. I'm shocked. Okay. You've you've I don't think you've said one thing that I have been shocked by. But it's why you're here to tell me about this thing that I don't know about. So I want to like I just keep imagining like that women are listening to this right now. And they're like, Oh, God, I think that might be my husband. You know, maybe like, yeah, that's a worrisome idea. But at the same time, there's got to be plenty of people who don't do anything like that to you just don't meet them. Because you're

Mila 1:06:18
right. I mean, when there's I mean, yeah. Right. There's good. There's good people out there. They're just not an

Scott Benner 1:06:25
interesting, that's an interesting statement. There's good people, do you see them as not good people?

Mila 1:06:31
No, know, I guess. I mean, you know, I'm just like, I guess like, as far as I mean, like, good people. I just mean, like, like, straight edge, like you. Don't drink Don't do drugs.

Scott Benner 1:06:43
I don't think of that as a thing. Isn't that like, I like if you said to me, you're an example of being straight edge. I'd be like, I don't I don't. I don't know what you mean? Like I just, I can do it. Like I just do what occurs to me. I guess that's what everyone's doing.

Mila 1:06:56
Just like, just rad dog in life.

Scott Benner 1:07:00
I mean, when I was younger, maybe. But now, I'd like to save it for a certain weekend, you know, so I hear what you're saying. Okay. This is okay. Wait a minute. I have to collect myself for a second. This happens frequently to me. Can we talk about diabetes management for a couple minutes? Yes. All right. So you have not had diabetes for very long. It's possible. You're honeymooning? Is that possible? Have you seen that? Have you seen days and times when you just don't need as much insulin? And it's kind of like, kind of shocking how much less you need? Well?

Mila 1:07:35
Well, yeah, well, he was telling me my MO was telling me about honeymooning. And I guess I don't, I don't really understand, like, does that mean like, I could, like eat something with carbs and like I wouldn't shoot out. Because if I fade some carbs like I shoot up. So I mean,

Scott Benner 1:07:51
what can happen sometimes meal and may not may not have ever happened to you, and it may not ever happen to you sometimes. There's almost like, I guess sputtering of like your pancreas working like it stops working, you get diagnosed, and then all of a sudden, it kind of picks up again, and starts making some insulin. So you're now adding manmade insulin, but all of a sudden, your body's like, no, no, I can do it. And now you have, you know, now you have too much insulin. But you would really know that if it was happening. It would present a number of different ways. But one of them might be like your feeding like You're like all day you have to snack or you'll get low whether you're whether you've like injected for a meal or not. Oh, Has that ever happened?

Mila 1:08:32
I mean, yeah, I mean, I've been like, I guess I've gotten low before when I thought I was injecting right but I don't know if it was like honeymooning or if it was just because you got the number wrong. I did something that I wasn't used to like when I went to the state fair in the summer. I had like my mix such a scary low experience. But I thought I'd be fine because I ate all these so many carbs and pasta. And I gave myself seven units because they make one to 10 So I thought like this pasta was like seven days and I had so much more than that to add like mini doughnuts and like all this that I didn't those four. So I thought I only needed the seven. And it like shot me down like to where it just says low and it was like double arrows. And I had to have like, I was like shaking and freaking out. I had to have like, like three had chocolates juices, a bunch of glucose tablets and then finally like went up and then after that was like terrified of insulin go after that. Oh, yeah, like I definitely overdid it because I was like freaking out. So I didn't want to wait because I didn't know like, I was just by myself. You know? Alright,

Scott Benner 1:09:44
I'm gonna say something. Vaguely parental to you. But I don't mean to come off that way. Okay. In between tequila, cocaine, and putting your head in somebody's mouth. I want you to listen to the pro tips of the podcast. Will you do that?

Mila 1:10:00
What? Yes, yeah, I've listened to a couple, I need to, like start from, from the beginning

Scott Benner 1:10:05
or at the beginning, just kind of listen through. Because in the end, what you need is to have your Basal somewhere near correct. And then you need to understand how to Bolus for your meals, meaning that you like some foods are going to need like Pre-Bolus thing that's greater than other times, you're gonna have to learn that the meal meal ratios for different foods are different. So where you might be one to 10 for I don't know, pasta, you might be one to 12 or one to eight for something else. And that pasta, you know it, trust me it I know. And like pasta is a good example. Right? You, you eat it, and it doesn't immediately spike your blood sugar up because it takes a longer time for your body to start digesting it. So if you so see what I'm saying you might need it for the pasta, but you might not need it when you're using it, if that makes sense. So the timings messed up a little bit.

Mila 1:10:59
So then like you just do wait to do the answer. And then like you eat to eat it first.

Scott Benner 1:11:05
There's all kinds of things that you can do in all different kinds of situations. Macaroni and cheese is a good example. Right? So the pasta and first of all, no judgment, but boxed macaroni and cheese is going to hit you harder than if you were to go out and buy some, like good pasta at the store and boil it yourself and put like real cheese in it like it like it's not going to be that much better. But it actually might be easier on your system. So the Oh, you were processed foods you eat, the more true you should find your carb ratio working. Example. But but with the macaroni and cheese as an example, you put it in, your body can't start digesting it right away. And it just takes longer to digest. So the impact from it might come later could come an hour, hour and 15 minutes after you eat it. Also, there's fat in the cheese. And the fat slows down digestion more, which pushes the rise up later. What else could happen protein, you could eat meat. And meat doesn't have any carbs in it, but later when it's broken, but later when it's broken down though your body turns into sugar. So you can see a protein rise. So even people who eat very low carb, if they were to go to if they were to go to McDonald's, and like buy cheeseburgers and throw the rolls away and just eat the burgers, they still might need some insulin 45 minutes later for the protein rice and that's all covered in the pro tips. Like it's all in there. So yeah,

Mila 1:12:35
okay. Yeah, definitely. Yeah, I remember asking my endo about protein in his like, no,

Scott Benner 1:12:40
they call those free. Right? He probably tells you that cheese sticks are free.

Mila 1:12:44
Yeah, yeah. Yeah, but does your blood sugar

Scott Benner 1:12:47
free after you eat that stuff later?

Mila 1:12:51
Hmm. I don't know. I mean, yeah, I guess Sorry. Yeah. Cuz that's like all I snack on and sometimes I wake up.

Scott Benner 1:13:00
Yeah, so you just have to pay attention

Mila 1:13:02
this morning. Yeah, this morning. I was like 240

Scott Benner 1:13:05
steps. Yeah, that time. We don't want that. So

Mila 1:13:08
then I went down to 198

Scott Benner 1:13:11
It's a you woke up at 246. And then it came back on its own to 198.

Mila 1:13:16
Yeah, so I'm guessing I was like, maybe the tequila hitting or something? I don't know. It could be. I don't know cuz I didn't do any insulin. I just, it went back down on its own.

Scott Benner 1:13:27
What time of day? Do you shoot your? Your Basal insulin?

Mila 1:13:31
That's the Lantus. Right? Yeah. At at 8am, if I remember, so I'm

Scott Benner 1:13:37
gonna guess I forgot to do it today. We got to do it. And I got what I would guess is that the Lantis probably is not really lasting a whole 24 hours, like the label says. So maybe you're drifting up in those last 810 hours of the 24 hours? Because the Lantis is not as powerful at that point. Then you put the Lantis back in and starts working again. That makes Yeah, yeah,

Mila 1:14:01
cuz yeah, it started going up at three, C went down at 8am.

Scott Benner 1:14:07
So it's easier to do this stuff, once you start understanding, kind of like what's what's expected to happen. So when you go on a pump, you won't have that problem with Lantis anymore.

Mila 1:14:20
Because yeah, because it just doesn't work for you. Yeah, you'll stop anthesis in the pump, too.

Scott Benner 1:14:25
There's no Lantis in the pump. What will happen is you'll stop, you'll stop taking the Lantis the pump will just have your meal insulin and what are you using? Novolog? Humalog? Yeah, yeah, no. Yeah. So you'll fill the pump with Novolog. And when you want to have a meal, you'll say hey, like I just had 12 carbs. And it'll it'll, you know, based on your meal Bolus give you insulin, but it will also give you tiny little spurts of insulin. All throughout Africa. Yeah, for Basal that'll also be covered in the Pro Tip series. Okay, all right. I want you to listen, I know

Mila 1:14:58
Yeah, I'm just saying To

Scott Benner 1:15:02
know, I know don't

Mila 1:15:03
have it listed on your website course.

Scott Benner 1:15:05
It's everywhere. Yeah.

Mila 1:15:10
Yeah. So um, so how to explore find which ones are the perfect?

Scott Benner 1:15:14
Yep, you could listen to them at juicebox podcast.com. You can listen to them at diabetes protip.com You can find them by scrolling through your podcast app. But seriously, it might take you 2025 hours, you know, over the course of a month. But if you listen through those, I promise you, you will have a better understanding of what you're doing. And oh, yeah, for sure. It sounds like it's important to you don't want to. I mean, you're not looking to have like serious complications 1015 years from now, so you're gonna need to understand all this, you know, plus, we want those boobs to hold up. Yeah. I'm saying so main issue. Can I ask? Are they more like small and perky are kind of big and wonders.

Mila 1:15:59
Question they're not small. No, they're I guess what the Double D is in perky. Oh, my

Scott Benner 1:16:06
goodness. Congratulations. are great. Just did you get them from your mom? Have you ever thanked her?

Mila 1:16:15
Yeah, shout out to my mama. She has like size up though. So Thank God my like stuffed. Wow. Those are humongous.

Scott Benner 1:16:22
stand for huge. You think?

Do your parents listen? This is silly question because I think the answer is yes. But Do your parents know what you do for a living?

Mila 1:16:37
Oh, yeah, for sure. Yeah.

Scott Benner 1:16:38
I ever tried to stop my grandma to wait, your grandma strips. Or your grandma knows.

Mila 1:16:44
No, no, my grandma knows my grandma. Just be like cool. Shakedown. Ask her. Yeah, my family's like, a bunch of like little hippies.

Scott Benner 1:16:51
Yeah. What other time? What background? Are you guys?

Mila 1:16:57
My mom's Right. and Mexican. And my dad was black by native. Okay, actually just passed away. November 12. That's sweet. Wait. Yeah,

Scott Benner 1:17:10
that's what I was saying to you. Okay, so what was your dad using? And he got caught with something he didn't know he had?

Mila 1:17:18
Um, I mean, yeah. So for the longest time he has had like painkillers because he kept his legs really bad in a car crash like 15 years ago, whatever. So then, you know, he got addicted to pain pills. And then he discovered fentanyl. But his girlfriend told me that he had been experimenting with it for six months. But that's all it took. Wow. To take him away from us. So sorry. How old was he? That's actually a good question. I don't know his burden. 63.

Scott Benner 1:17:51
Hold on, we can do the math together. Let's do that. I need a pen. This is embarrassing. And I know you don't

Mila 1:17:57
know I'm so bad at math. In math class. So

Scott Benner 1:18:00
hold on a second. So 1022. He said 6319 83. Now here, let me do some math. So the twos overtop of the three. So we have to move one over. So we take the one from that. Make that to one. Bring that one over. Now we have 12. So there's nine, I got a nine. Now I can't subtract six from one. So I have to borrow again. So now that 19 makes that 11 and 11 minus six is 789 10. And five. Your dad was 59. Yeah, yeah, yeah. Yeah, right. He was. I wasn't high in math. I at least know how to do simple subtraction. Better than me. I still had to write down. It's very

Mila 1:18:41
embarrassing. So I'm gonna just just do my calculator.

Scott Benner 1:18:45
Yeah, but listen, I knew you weren't going to be any help. When you told me you lost 20 pounds. You were 145. And you're like, so I don't know what that made me. I was like, yeah,

Mila 1:18:52
no. This let's thinking alright, so

Scott Benner 1:18:59
what have I not asked you that I should have asked you. Is there anything I missed? Or something that you think people should know?

Mila 1:19:08
I don't know. I don't think so.

Scott Benner 1:19:10
No. Do you have a podcast about this?

Mila 1:19:14
No, I podcast about sex work.

Scott Benner 1:19:16
I know. I miss what I'm saying. Like you. How long have you been doing that?

Mila 1:19:20
Oh, um, I don't know. Just a year. Yeah, just like a year.

Scott Benner 1:19:25
Do I tell people what the bias is called? You can? Oh,

Mila 1:19:28
it's called other words for horror with is an x where the OH is for horror. And yeah, it's an app on Spotify. And I just I interview sex workers from like, all over and we just take shots and touch.

Scott Benner 1:19:41
Wow, you get drunk and talk about this about your job? Yeah, what is the career

Mila 1:19:46
and like, you know, we just try to like, you know, also like, you know, a little bit education in there, like sex workers or people to

Scott Benner 1:19:53
Yeah, no, I understand. Do you? I think that's, honestly listen. I think it's important I'm like, I'm not joking around, like, I've tried to be fun and have a good time here. I try really hard to let all kinds of like, listen, I think it's fair to say I'll you know, this podcast is very well listened to. And I could easily ignore stuff like this and pretend it doesn't happen and make everybody comfortable and happy. But the truth is that there are a lot of people listening to this podcast, who drink who do code who strip who do all kinds of things who like us. And those people deserve stable blood sugars too. And they deserve I deserve to understand what their Basal insulin is doing. And and everything else that goes along with having diabetes, you don't get to not have healthy diabetes. Like, I know this sounds crazy, but you do coke doesn't stop me from believing that you should have good blood sugars. But I think some people would. But I think some people would think that I think some people would think well, she obviously doesn't care about her health. She's doing drugs and drinking. So who cares about the rest of us, but I care? Like the answer is if the question is, who cares? The answer is I do you know what I mean? Yeah. So I wanted to have you on like to learn about your life, because it's, it's uncommon. It's, you know, it's, it's interesting. And I think you should, you know, you should be applauded for finding a podcast about diabetes. I mean,

Mila 1:21:24
yeah, I'm so glad I found your podcast, it's been super helpful.

Scott Benner 1:21:28
I'm glad I really hope you dig into the prototypes, because I think they'll be really valuable for you, I think the pumps gonna be big deal for you. But understanding some of those things, like, you know that your blood sugar could go up in the morning when you wake up, or that you're, you know, some of those older injected Basal insulins don't work 24 hours sometimes, or you know how to figure out the difference between different foods and stuff like that. It's a big deal. Like, it'll, it'll go a long way to you getting your a one C lower, eliminating low blood sugars and eliminating big spikes, which is really what you're trying to do. You're trying to not have big spikes. You're trying not to have frequent lows. And you're trying to have stability, you know, honestly, is close to 8090 95 as you can, which will give you an A one C in the fives. Yes. And you can just go kill yourself with something else, but at least it won't be the diabetes. Damn it

Mila 1:22:25
long as it's such a killer.

Scott Benner 1:22:27
Yeah, listen, let it be the tequila. Not this. Also, do you seriously think you need help with alcohol? Like, should I be telling you to call a sponsor or something like that? Oh, I don't know. Know, where my responsibility ends and all this? You don't know. Alright. Alright, so last thing, you have a daughter one day, she comes to you. She's like, Mom, I'm gonna dance you stopper? Are you supporter?

Mila 1:22:52
Um, I would definitely support her but I you know, educator first. Okay. I would hope I would hope that, like men have my kids. Like, if I ever had kids, hopefully they would not like, have to. Because like most people, like do it to like, get out of like being poor. That's the one. You can make a ton of money though. So

Scott Benner 1:23:13
yeah, no, I mean, it's not just not being poor. Right? Like, I mean, $1,000 Nights a lot of money.

Mila 1:23:19
Right? No, yeah. Once you're in it you're in. So it's just like, but it's not something life's up everybody. I mean, you're my lifestyle is? Yeah, everybody can not even I can keep up with it. So

Scott Benner 1:23:30
Right. Are you? Do you think you're like particularly built for it? Or do you think that for economic reasons? You just didn't have a choice?

Mila 1:23:41
Um, no, I think I think I'm definitely built for it. I mean, I I really having like a boss and like working like a vanilla job. Like it was terrible to me. Yeah.

Scott Benner 1:23:54
Like, if you and I were dating, you'd leave me in like, what like three days? Probably. You'd be like, Oh my God. I gotta go. Right. Like it's why wait, why not looking for super normal, right.

Mila 1:24:10
I mean, I don't know. I feel like I feel like I feel like my, to me. My life is normal. I guess. I don't know.

Scott Benner 1:24:17
Yeah, I guess nor me. I guess it's more of what I meant. Like, just kind of boring. I probably like my life would feel boring to you.

Mila 1:24:25
Yeah, well, yeah, probably.

Scott Benner 1:24:27
No, trust me. It's almost boring to me. So I you know,

Mila 1:24:31
I mean, unless do you go in maybe if you go to Mexico vacation or something?

Scott Benner 1:24:34
I would if I could stop working long enough. But I just I work a lot. So I podcast right. Yeah. Are you kidding? This podcast comes okay.

Mila 1:24:44
Do you have like another job?

Scott Benner 1:24:46
I would not have time for another job. Oh, I was gonna say yeah. I mean, I have kids right there in college, like raising people is exhausting.

Mila 1:24:56
Yeah, I don't think I'll ever have kids. I have a dog and that's enough for me.

Scott Benner 1:25:00
Gotcha. That's good. I mean, I think we should do another one. Like, I don't think people should feel pressured into having children. Honestly. No, no. If it's not for you, it's not for you. And that there's nothing wrong with that. All right,

Mila 1:25:14
yeah. Nobody needs to be underneath my care. Even you hardly

Scott Benner 1:25:23
did the diabetes, things seem unfair because of the lifestyle you live. Do you think, Oh, this is like so unlike? Because it's very regimented. And there's nothing regimented about it.

Mila 1:25:32
It's kind of the most fix up thing that could have ever happened. Yeah, it's just a lot of thinking and a lot of math. And I'm so bad at math. And I hate like, the fact you have to like, think about it

constantly. Yeah, it's just annoying. A lot of work. Yeah. It's like a second job. For no reason.

Scott Benner 1:25:53
Well, it's good reason. It's gonna keep me alive. Yeah, yes. How's your hangover doing isn't getting any better?

Mila 1:26:01
Yeah, it's actually getting better. Good.

Scott Benner 1:26:04
Do you work tonight?

Mila 1:26:06
Yeah, well, I want to I'm just I didn't

Scott Benner 1:26:09
really Oh, is it that? Is it kind of that loose? Not?

Mila 1:26:13
Oh, yeah. We're not on schedule. Because we're contractors. We just come in?

Scott Benner 1:26:17
What if What if everybody rolls in on the same night?

Mila 1:26:21
That That wouldn't happen? Like,

Scott Benner 1:26:24
Oh, I see. You're

Mila 1:26:25
trying Are you trying to get us in?

Scott Benner 1:26:29
That's what I was about to get to. You're saying it's not like everybody's just running. So people kind of like, there's a lot of people who come in, take some money, use it up, then come back and get more again.

Mila 1:26:40
Yeah, yeah. Like, yeah, gotcha. Those girls were in every day. And then those girls who? I don't know, I worked like three days a week.

Scott Benner 1:26:46
Okay. All right. Well, Jesus, I would like to work through this way. That sounds good. Sadly, no one is going to give any money to see my so we're pretty much there. That's not gonna happen. How many times you never know. You don't you never know. Trust me. Let me just say it a different way. I don't want to meet the person who would pay money. Okay, how's that? That's specific. Let's get it over under right now. How many times do you think I'm gonna have to bleep out the word?

Mila 1:27:20
Oh, gosh, I didn't even know how to bleep that out so many times. Yeah.

Scott Benner 1:27:24
I mean, it's gonna be more or less than, okay, like, we might have

Mila 1:27:29
said it, like, 30 times.

Scott Benner 1:27:31
I see. I was gonna say like, 25. Okay. All right. Well, right. After I edit this, I will put the answer at the end of it, so people know. Okay. You're delightful. I really appreciate you doing this very much. Thank you. Yeah, absolutely. If you want to hold on for one second, I'm going to make sure you have access to the to the information you want from the podcast. I'll just make sure you know where it's at. And then I will let you get back to your life Hold on one second.

Well, first, I want to thank Mila for coming on the show and being so open and honest. And I'd also like to thank Dexcom, makers of the Dexcom G six continuous glucose monitor, head over to dexcom.com forward slash juice box and say hello, did X cow. If you're looking for that Omni pod dash trial, that free 30 day trial, go find out if you're eligible, and on the pod.com Ford slash juice box and don't forget about the Omni pod promise. If you got an omni pod dash right now today, and something huge came out tomorrow. Or the next day, you get upgrade as long as it's covered by your insurance. Go find out more on the pod.com forward slash juice box.

Let me tell you a little behind the scenes story. So the day after I record with Mila I record with Tony, Tony's got this young daughter you won't hear her episode for many months but and I could hear her daughter at one point in the background. She had the sweetest little voice. And after she and I recorded I said I'm gonna be forever editing Milos episode, because she said this so many times and she cursed and I'm gonna have to pull out all the cursing and I didn't you know, I love the episode. But as I go, it's gonna take forever. And she said, Maybe you should bleep it out with Arden's voice, same boobs. And I was like, oh, Arden wouldn't do that. But it would be funny. I said actually, what would be funnier is if your daughter did it with her little tiny little baby voice. And later that day I received an email with I think like four outtakes of her little daughter saying boobies and it was just adorable. It turned out to be too much editing for me to slide it in every time. Mila said these, but I wanted to put them here for you at the end so you could hear them. Just before I do that, I want to Say I didn't have any trouble with any of the words that mula used today. And if it was up to me, I would never take them out of the episode. But in order for me to have a clean rating for the podcast so that it can be heard in all different countries. I can't curse on an episode that says it's clean. And if I say an episode has curse words in it, then the podcast will be eliminated from some countries. bleeping and childish words are the answer to that. Movies. Thank you so much for listening. There are a ton of other after dark episodes, go find them in your podcast player, or at juicebox podcast.com. I'll be back very soon with another episode of The Juicebox Podcast. I hope you enjoyed today's episode. I enjoyed bringing it to you. There's much more coming. Make sure you subscribed or you're following in a podcast app or an audio player. Movie movie boom boogie. Do we boo boo

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