#698 Defining Bold Beginnings

Jenny and Scott lay out the newest series on the podcast. Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.

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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 698 of the Juicebox Podcast.

Today's show is going to be slightly different. Jenny and I are discussing the next series that's coming up on the podcast the series is going to be called Bold beginnings. And it's based on listener feedback. In this episode, you're going to hear me tell Jenny the idea that I had explained to her about the feedback that I got from the audience. And then we take the big ideas from the feedback, almost like bullet points, we go over them, put them in an order we want to record in and talk about them as we go. So basically, you're going to listen to a meeting that Jenny and I had about the next series of the podcasts, but think of it more like a trailer, and extended trailer for a new series. 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 Ian pen from Medtronic diabetes, find out more and get started today with the M pen at in pen today.com. The podcast is also sponsored by us med us med is a place where you can get your diabetes supplies, and US med wants you to have better service and better care than you're accustomed to get yourself a free benefits check right now at us med.com forward slash juice box or by calling 888-721-1514. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juicebox. Join the registry, take the survey, it will take you fewer than 10 minutes. When you do this. When you complete the survey, you'll be helping people with type one diabetes and supporting the Juicebox Podcast. The survey is fast. It's easy. There's nothing on there. You don't know the answer to it's HIPAA compliant. And absolutely anonymous, T one D exchange.org. Ford slash juicebox. I have an idea for today. So, in you'll so we're recording already. So if you say no, it's fine. We'll just not do it. But okay, I don't think you're gonna say no,

Unknown Speaker 2:58
I usually don't. Well, you're

Scott Benner 2:59
Yes, you don't usually. So far, you haven't said no. I've said some weird things. But once or twice, you've been okay with it. So I had this idea a couple of months ago. And I kept thinking, again, the private Facebook group is just a font of information, because you can see what people are thinking. Right? Sure. And then eventually, if you see people think the same thing over and over and over again, you think to yourself, Well, this must be a question a lot of people have. So I, I put this question out. And I said, What do you wish you would have known at diagnosis. And what I got back, turned out to be an 80 page Word document full of information. Now, Isabel has gone through and she's taken out, like duplicate questions and things. I was gonna ask how much was duplicate? Not as much as you would think when you hear AVP. But but a fair amount was was duplicate stuff. And she broke and she broke it down into into sections, like put people's questions into, you know, under headers. And I was thinking that we should do individual episodes based on those headers. Sure, and then combine the episodes together in a series. You know, I don't know what I'll call it yet. But it'll be something about questions that newly diagnosed people have, like frequently asked questions of newly diagnosed type ones or something like that.

Jennifer Smith, CDE 4:27
Yeah, I'm curious how did since you've read through all 80 pages, or you're like, Oh, this is 80 pages. That's a lot.

Scott Benner 4:37
I've been making my way through section by section.

Jennifer Smith, CDE 4:41
And because I'm curious if some of the questions are. Gosh, I really would have liked to know this because definitely right up front. This would have been super, super duper beneficial. Whereas some questions may be, well, gosh, this would have been Nice to know upfront, but it's a little bit more. I know you say like ninja level, right? It's a little bit more down the road, definitely you would use this, but you're not going to use this two days from diagnosis

Scott Benner 5:13
and see the way you're thinking about it is the way I was thinking about it. And so what I what I thought was, if we take each header and almost handle it, like it's an ask Scott and Jenny episode. Sure, right. And then and then go through them have conversations, why does my voice break only with you? You don't might be because we're on Mondays.

Jennifer Smith, CDE 5:35
That could be I was actually gonna say if my voice today is very scratchy. I actually canceled clients like two days last week, because I had laryngitis

Scott Benner 5:44
No kidding. Oh, why don't want to talk?

Jennifer Smith, CDE 5:49
No, no, no, no, I think I'm definitely better. My voice is not like, weird, not there for five minutes. So yeah,

Scott Benner 5:56
so what I thought was, and this is good for your situation, is I just want to talk through the document with you. But we're gonna, we're gonna record it. So I sent you an email, which will open up into your apple notes.

Unknown Speaker 6:12
Okay. Let's see, we'll go to my email and see where your email is.

Scott Benner 6:21
I just think that conversationally is the only way to work through all this. Because otherwise, you know, what most people would do, who are creating content for diabetes, they read these, they choose a handful of questions. And they turn it into some bulleted point less than they put a, you know, two sentences after each one. But I think that, when we're talking about it, the length of time that we decide to talk about a question, usually is pretty accurate to answering the question. So some of the most part, I mean, I think we do a good, I think we do a good job of seeing the big picture when we hear people's questions, I guess, is what I'm saying. So do you have my email? I don't really know. Second,

Jennifer Smith, CDE 7:10
do you not talk a lot on weekends? Is that why you are saying that? Maybe it's because it's Mondays that your voice cracks a

Scott Benner 7:16
lot? I don't talk as much over the weekend. My wife would disagree with that, I imagine. But I don't think I do not nearly as much as I mean, I record this show. I mean, the last couple of months have been crazy. I've been recording like five times a week. So I talk a lot a lot. Yeah. And then I put ads on things. I probably I probably sit and talk directly for 10 hours a week. Just like constantly talking. There are times when my throat feels sore. It's not It's unpleasant. Okay, did the tag

Jennifer Smith, CDE 7:47
I'm right there with you. I talk all week as well. Sometimes at the end of my like, really long days, which are Mondays and Fridays. I get done. I have to like, take a couple breaths before I like walk out of my office space because two children like they just they want you know, they want like, Oh, now can I talk to you and you know, kids my age have no inner monologue whatsoever. And it just all comes out. And I'm like, Oh my gosh, Mommy needs quiet tie with a bubble bath.

Scott Benner 8:19
I'm in a mood right now. If you want to know how to Pre-Bolus a bagel, that's all I can tell you at this moment. Does your head does your head gets swimming. afterwards. Mine does. Yeah, the if I sit down and do a talk, like for hours, or even when I'm the one of the reasons I don't like people to look at me when I'm recording with them is because I stare at a spot on the desk bond accessing what I understand about diabetes like and I just I talk like

Jennifer Smith, CDE 8:43
plugging yourself into a file, right? Yeah, here's my file. I'm gonna connect to it. I download everything I needed for this circumstance. And then you unplug. Yeah, I do

Scott Benner 8:53
wonder if people don't understand, like people who don't do this would understand that. It's just, there's a there's a, uh, I don't know, a lake, a damned off lake full of information in my head. And if you get me to open it up, I can just let it out. But if you but if you ask me right off the cuff, I'd be like, Oh, hold on a second. So you're saying this happened. But once I started talking about it, it just if it just comes out smoothly, so know why that is?

Jennifer Smith, CDE 9:21
And that's kind of sometimes the reason that I get a little bit thrown off when people who are not in my diabetes world, whether it's friends with diabetes, or people I'm working with or colleagues like you or whatever, the general public without diabetes, when they ask you these very random questions. I have to be very careful about how I start talking about something because like you said, I will go off and then you get the glassy I look like deer in the headlights like this really, I didn't want and all this information. shin and I feel like you're speaking like alien language to me.

Scott Benner 10:05
I find in that scenario, my explanations are are so childish and simple, that if the next thing I said to them was, I have a very popular podcast about diabetes, they think I wonder why? Because I just I'm like, oh, yeah, she's fine. Right. Hasn't outgrown it yet. Right. Yeah. You know, that's not, hey, you know, what, forget it. Like, you know, so it's just, I don't know, I don't get too deep in it. Otherwise, and just like you're saying, I'll just start to talk. Right? And then

Jennifer Smith, CDE 10:40
I don't when I get going, yeah. It's, it's, it's hard to like find the end point, right?

Scott Benner 10:46
No, because there's because the explanation. And I think I mean, to bring it back around to this is the explanation is always conversational, I'm starting to believe that that's sort of why it's harder for doctors, because, because they're in that they fall in that same category as a person writing a blog about it, which is, I have about 350 words here. Before I lose people, and I run out of time, and or whatever the reason, I gotta get it out, I gotta get out succinctly. And this stuff's not generally speaking, not cut and dry. You know? No, you need the big conversation.

Jennifer Smith, CDE 11:24
So well. And I think that's why the conversational learning, as you do is very helpful to many people, because they're already in the realm of something that they are trying to understand, or they understand because they're living it, when you're trying to have a conversation with somebody who doesn't live in the diabetes world, and or has no connection from family or a friend or whatever. The conversation becomes very one sided, you become whether you wanted to or not, you become the educator, right? And then it's less of a conversation and more of a tutorial. And it's not a fun conversation.

Scott Benner 12:04
Right? No, no. and the Self Editing that happens, whether it's by the doctor, or someone writing a blog, is you know that you get to a point you Oh, I don't want to tell them that because they might misunderstand. Or, you know, I wouldn't want anybody's blood sugar to get to like, you know, to think I don't want anybody's blood sugar to get too low. The way I think of that specific thing is people's blood sugar's get too low, all over the world using insulin, but most of them don't know who I am, and will never hear this podcast, right. But if we give them enough information, they maybe could stop it from happening. And I would prefer for them to have a chance than then to not have a chance it it almost feels like a I don't know, it feels like an action movie to me. Like, you know, we've got to jump over this lava. If right, if we don't, the monsters gonna eat us, right? Well, we might as well jump and see what happens, right? Maybe we'll make it over the lava. And that's sort of how I think about this, like you should have the opportunity to succeed. It's not going to work out right for everyone. Or it might take longer or shorter for some people, but not telling everybody so that some people don't fall into the lava. Does that make sense to me because everyone's gonna get eaten by the monster. Correct. That's just

Jennifer Smith, CDE 13:23
and at some point, somebody's going to be ready enough to jump. Maybe they weren't when you first gave them the information. But if you gave it to them, at some point, they're likely going to try to use some tidbit that you provide it right. They'll

Scott Benner 13:38
have this recollection, they'll think oh, you know, I listened to that. Like, again, I I swear I didn't bring this up on purpose. But this idea of talking about these people's questions after being diagnosed, you can listen to these, and maybe maybe three months from now, you'll say to yourself, Oh, I remember someone said that in this thing. I could go back and look again, I could maybe just go with my recollection. But isn't that better than them being blindsided by it? Another great example, I think, is that this morning, in the Facebook page, someone someone's kid had a seizure, their their Dexcom was I don't know if it was in. If it was starting up, they didn't have access to their Dexcom data for a little while. kid had a seizure. She grabbed the G voc hypo pen, she stopped the seizure. She took the kid to the hospital. He's recuperating. Now, my point is, is that she did it like, like you should see her recollection of it. She had the information about what to do. It's not it's not this harried like, oh, it's not the Scarlett O'Hara post where she's like it. The world's happening to me again, you know, come pray. She's not asking for prayers. She's like saying, Look, this thing happened. It sucked. And we took care of it. And here he is. He's fine. And right and i thought i I was proud of that, like, I wish it wouldn't happen to the kid. But I mean, as a person whose child's had a seizure, it can happen, you know what can

Jennifer Smith, CDE 15:08
happen, right? And I think another another thing that you bring in there without really saying it is that, in this circumstance, the parent didn't get emotional, the parent was rational. They said, This is what's happening. This is what I have to do about it. And this is the next step. And that's what you have to do. I mean, if I had a t shirt that says, said, anything, it would be be calm and think like Spock, it would like seriously, if you just all of these things that you learn along the way, many of them are very just rational, do it decision, right? Don't emotion, don't put emotion into it. Because despite there being feelings about diabetes, and how cruddy it can be to manage things at times, and whatever. A lot of its decision that is, right now, this is what I have to do.

Scott Benner 16:02
And someone brought it up to me recently, and I'm gonna have to look into it more because it keeps popping back into my head. They talked about thinking like an astronaut, because everything that an astronaut comes up through is trying to kill them. Right? So when everything that you say you put it in order, like this one's gonna get me first we'll take care of this, then that one, then that one is the seventh thing, the 70 a thing on that list gonna kill me. It might.

Jennifer Smith, CDE 16:29
But but if I clear up one through 69, it might not it

Scott Benner 16:33
might not. And maybe it will something will change or whatever. And I just, I don't know. I think about life that way. Honestly, not just diabetes. So you know, whatever's our most emergent problem. It took me years to explain to my wife that my to do list was fluid. Like she would write it for she'd write it to do list she'd like you didn't do number one yet. I'd be like, well, number six is on fire. So I can't get one through five doc before six burns the house down. I'm gonna have to move the list around a little bit. It's, it's one of the reasons I enjoy making the podcast by myself. And not because people are like you, you could get an assistant or you should do this or what about an editor? And I was like, huh, I don't know. I like, I like the way I think about it. You know? So anyway, did you get my text? 20?

Jennifer Smith, CDE 17:21
Yes, that's right here. I thought I said yes, it came through perfectly fine, and was enjoying our conversation. It's, it's probably the longest text message that I have in. But I should say it's the longest texted note. As I have. No,

Scott Benner 17:38
did it open in your notes? Yes. Okay.

Unknown Speaker 17:40
It opened in my notes now.

Scott Benner 17:41
Yes. It's all good. Well, trust me, it's the longest one I've ever seen either. So scrolling through it, she's got it broken down to carb guidelines and impact of food. This is Isabel who took care of this she's, which is a pretty long list. It is then there's stalking, range, food choices Pre-Bolus Sing the 1515 rule. Fear of insulin highs and lows. Isabel, you did such a nice job of this honeymoon, terminology, flexibility, guilt, fears and hope expectations. And I'm still scrolling. Wow, that's that's a long one. About the podcast and the community around the podcast, medical team. Holy Hannah, technology and diabetes supplies Jenny, I'm gonna need you to quit your job. So we can do this. And insurance and insurance, long acting insulin exercise, journaling. That's interesting school being diagnosed as an adult, family, extra topics and then stuff that she's

Unknown Speaker 18:57
wasn't relevant to that that

Scott Benner 18:58
she didn't find would be relevant to this idea.

Jennifer Smith, CDE 19:02
Or maybe they didn't fit into a category. So I mean, they might be things that we can look through and see if there

Scott Benner 19:07
Yeah, and the rest will call that at some point if we get to it.

Jennifer Smith, CDE 19:12
So now my brain like I did when we first did the pro tips, like we need to rearrange this listing, right? I would probably go through this and list them out according to what I think would be really important first newly diagnosed really go here first and then next year and next year kinds of thing.

Scott Benner 19:36
I was hoping you would think about it. Honestly.

Jennifer Smith, CDE 19:39
I mean things like a medical team, and

Scott Benner 19:52
you ordered diabetes supplies. And if you're like me, you may have been using a place that made you want to reach up with your hands and Grab your hair and urine couldn't read out of your head because it was very frustrating. Or they say things like, well contact your doctor, you don't have to worry about it, then you had to worry about it because they never contacted your doctor. If this sounds familiar, and you're tired of that, I was almost like crap. But now I said it anyway. So if you're tired of that, I suggest you check out us med. US med accepts Medicare nationwide in over 800 private insurers. They carry everything from your insulin pumps to diabetes testing supplies, and the latest CGM. They always provide you with 90 days worth of supplies, and they have fast and free shipping. US med likes to say that they want you to have better service and better care than you're accustomed to today. Why not give us metta shot, they have an A plus rating with the Better Business Bureau. And they've served over 1 million diabetes customers since 1996. Us mad.com forward slash juicebox. That's the place you get your free benefits check. You could also do it at 888-721-1514. Get yourself some white glove treatment. Instead of that treatment that you're accustomed to. Oh, we'll call your doctor for you take care of the whole thing. There's nothing for you to think about bowls. You know what I mean? Us med.com forward slash Juicebox. Podcast is also sponsored today by Ian Penn from Medtronic diabetes, you might want to know more about it. And if you do want to know more, you're in luck, because Google's God is here to tell you about it. The in pen is a is a pen. It's a it's an insulin pen. I thought that was you know, it's an insulin pen. It's an insulin pen, but it's so much more because it connects to an app on your phone. This app gives you access to a dosing calculator, dosing reminders, card counting support a digital logbook, many of the features that people with insulin pumps get. So if you're looking for some of the features that you can get with an insulin pump, like you know how much insulin is active in your system. If that's something you want, you should look into the NPN. There's also an offer on the internet. Now you have to have, let me just say you have to here's I'll read it to you, instead of me just fumbling through the words, this offer is available to people with commercial insurance and Terms and Conditions apply, right? But you may be able to pay as little as $35 for an in pen, which is crazy. Medtronic diabetes does not want costs to be a roadblock to you getting access to the therapy you need. So go check out in pen today.com a great device, I think you're gonna really enjoy it. There's not much to lose here. So go ahead and check it out. There are links in the show notes of your podcast player, and links at juicebox podcast.com. To end Penn, US Med and all of the sponsors, including a link to where you can take the survey for the T 1d Exchange. Check it out, please support the sponsors. When you do you're supporting the show. I really appreciate it. I'm gonna get you back now to my conversation with Jenny, as we talked about bold beginnings. In Penn requires a prescription and settings from your health care provider, you must use proper settings and follow the instructions as directed. But you could experience high or low glucose levels for more safety information visit in Penn today.com.

Jennifer Smith, CDE 23:49
Maybe even food choices before like the carbs and the carb effect kind of thing. I think that the 1515 rule could definitely go along with the lows and the highs, I think can be kind of included together. Gosh, there's so much in here honeymoon definitely up at the top. I think that honeymoon is really poorly explained from the get go. And it's almost like a skirted over sort of comment. That's not explained very well. And so people get lost in whether it's going to happen or it's happening or how to know what's happening or what to do about it. You know what I mean?

Scott Benner 24:34
Yeah, okay, well, let's, let's do this together now. Okay. Okay. So I'm, you tell me and I'll put them up at the top.

Jennifer Smith, CDE 24:44
Well, I would definitely say honeymooning would be a good first, because that's going to mean for the most part. Within a very quick time post diagnosis. If honeymoon is going to happen, that's where it's going to end. happen. So that would be probably first. And then I'm kind of curious, you know, terminology is almost like the defining, yeah, diabetes. Right. So terminology, these are really good. Maybe just the ones pacifically post diagnosis that would be very important to have information about. So I would say, right along with honeymooning the terminology,

Scott Benner 25:30
okay. I have it there. I am putting him in your order.

Jennifer Smith, CDE 25:35
And then I don't know, I'm kind of like the medical team, I think could maybe be laughed before we move into like a little bit deeper. But I'm wondering like the highs and lows, especially, because there's a fair amount in the fears around highs and lows. And then specifically the 1515 rule. I don't know how many people post diagnosis I get to talk to who specifically asked about that. So clearly, this rule is still being taught. Yeah,

Scott Benner 26:09
exactly. And it's, and it's, and it becomes obvious to people pretty quickly that it doesn't make sense. And then they get stuck. Frustrated. Yeah.

Jennifer Smith, CDE 26:19
Yes. So I would definitely say that. Mmm hmm. I think right along with is there's one about insulin in here. And I think it might even be able to be included around fear of insulin is the Pre-Bolus thing. And I the reason I put it in there is I, I think because from the get go if people aren't taught about timing, you do start to fear insulin. Yeah. Because it seems because it's erratic. Exactly. So I would say, you know, within that 1515 rule, the fear of insulin lows and highs explanation of insulin, and then moving into Pre-Bolus Singh. And I think Pre-Bolus Singh could then move more so into wondering like curb impact, because they kind of go hand in hand.

Unknown Speaker 27:23
There are so many categories here.

Unknown Speaker 27:28
What about what about stalking?

Scott Benner 27:32
Well, stalking is going to be

Jennifer Smith, CDE 27:38
I mean, that kind of goes along with fear of insulin. It goes

Scott Benner 27:41
along with everything. It goes along with, right 1515 It goes along with fear of insulin Pre-Bolus thing you ever have somebody ever have somebody asked you. I had dinner, and I Pre-Bolus. And then I had seconds, what should I do? And it's fascinating. They don't, they're stuck. They're like, I've never had a meal inside of a meal before. What goes on? I can't just Bolus again. And it's funny, because in my mind, I'm like, well, you're taking in more carbs. Why not? You know, and then the I think that what they think is, well, that's so much insulin. And I just put in someone they might be thinking about stalking without ever having been told the word because because it seems like too much to them.

Jennifer Smith, CDE 28:27
And I think the real definition of stalking too in there, or a better definition of stalking, because what you're talking about, in a way it's stacking, but it's not stacking without purpose, right. You know, everything that you eat is going to require insulin, right. And it goes back to the timing of the insulin. And also now that we have wonderful technology, like a CGM. What's your CGM telling you? Yeah. Are you stable? Are you already rising? Are you falling? Are you low falling? Right.

Scott Benner 29:03
So this this lady posted a graph the other day, and it was a 12 hour graph was beautiful. And there was like, I don't know, she took the kid out for waffles and ice cream or something like that in there. And she said something like that her her child had like 250 carbs in this giant like, you know, food. Right?

Unknown Speaker 29:27
That's a lot of food. Holy cow, right?

Scott Benner 29:29
I was like, Wow, no kidding. But she you should have saw the line. And and it was it was so it was so flat. And then everybody comes in and their first thought is that's so many carbs. That's so much insulin. How much insulin was was a smaller kid right. And and she says it was like it was over time I think 17 units she used over out the kid didn't like horsepower. Yeah, this this happen, like stages over a couple of hours. hours. And I kind of chuckled to myself when I read it. Because if Arden has a carb heavy meal, she could use 17 units for a meal. And sure, it's a lot like, you know, I'm not saying it's not, but it's not a lot for that food. It's just it was interesting that people's, that their first thing isn't, Wow, you did that? How can I do that? It was, it was back to their preconceived notions about things. That seems like a lot of carbs, that seems like a lot of insulin. It seems like you know, and, and that's all relative to begin with 17 units. I mean, listen, if you if you had, you know, if you had type one, and you weighed 350 pounds, you might be used in 17 units to move a number, you know, like, like, there's all different reasons why the numbers should be. The numbers are what they are. You know, if Arden goes out has nachos with cheese steak on it, and french fries, you know, we're somewhere near 17 to 20 units. It's you know, because for the fat and everything, there's a lot you know,

Jennifer Smith, CDE 31:04
I don't think I've ever taken a 17 unit bowl. Oh, my

Scott Benner 31:08
like, yeah, well. You eat like a healthy bird.

Jennifer Smith, CDE 31:16
I don't know. I you know, even growing up though, I had definite high insulin needs as a teen. I all teens do. But yeah, I don't know, maybe it was more just from the standpoint that I also started in a very different school of thought and education than we have today. Yeah. I mean, I actually I went to my mom's on Saturday with my boys just for an early Mother's Day. And she's been trying to like do some cleaning and whatnot. And so you know, for my brother and I, she kept really organized files, like every report card we ever had. All of these things. Well, I found in there a scrapbook that I had, at some point put together after my diagnosis with all of my cards, all of my mylar balloons taped into this scrapbook and everything. And I found three of my hospital menus with my choices during that week. You kept all of

Unknown Speaker 32:14
that. I didn't my mother. This is my mom. Yes, this is what she does. But it was snowing.

Jennifer Smith, CDE 32:23
Yes. But it was amazing to me. And in terms of this, that I had a very structured plan that was based on portions and the insulin that went along with it. There wasn't as much variety or variability. And that's just not how my mom did it either. I'm sure other people probably at that time may have. It's just everything was very structured.

Scott Benner 32:50
It makes clear what the technology wasn't there to track anything you did. I mean, if you started if you try to eat 250 carbs back then you would have I mean, you would have been high. I don't see another way. Oh, yeah, your blood sugar would have been high forever. I think that's why some of the the old time he type ones in those group, see, see that? And it fries their mind? Yeah, you know, like you can't do that is always there. I wish the internet was audio. So that because I think you can't do that. In typing, you know, typed out doesn't mean the same thing is how it would sound like, you know, it sounds. It sounds like a direction typed out. You can't do that you're not allowed to do that. What I think they really mean is holy hell, you can't do that. Right. Yes, that's not gonna work. But, but I mean, it does it just, I mean, it does, you know, and again,

Jennifer Smith, CDE 33:44
it goes along with timing of insulin and when to put it in and what you're seeing again, our technology today allows you to do some of these types of things. As long as you're paying attention.

Scott Benner 33:57
Yeah, right. Right. So all right. So we got some stacking fits in there. So right now have honeymooning terminology highs lows 1515 Rule fear of insulin lows and highs Pre-Bolus thing carbon pack stacking

Unknown Speaker 34:14
and then I think I would put do we put food choices somewhere in there? Not yet.

Unknown Speaker 34:24
Um,

Scott Benner 34:26
sort of has to go before Pre-Bolus and doesn't Pre-Bolus

Jennifer Smith, CDE 34:29
thing? Yeah, I would put it in definitely before Pre-Bolus. And then I'm wondering if I was just reading range. I'm assuming we're talking about glucose ranges here.

Scott Benner 34:48
Let me look. Next, make sure I see it the way you said. What range to be out or shoot for. How being 200 for weeks is okay as the body adjusts. But to taper down to More realistic unhealthy range, that it may take a while to normalize blood sugars that have been happening. So it's kind of a broad it is. Yeah,

Jennifer Smith, CDE 35:10
I would probably break it down to range based on what's considered healthy range, what's considered a normal range outside of having diabetes, what is the human body typically aim for. And then I would move into range that might even include things like safe ranges for activity and safe ranges for illness and range that you might hear from your medical providers versus what you're really trying to aim for. Along with, where should your glucose be? What should your target be? Fasting first thing in the morning? What should it be? Or what should you expect after meals? All those things, I think, fit within range.

Scott Benner 36:01
Well, we could do it as as one episode, and just break it up within the episode, right?

Jennifer Smith, CDE 36:10
Yes. And I think I'd I'd move into then definitely, maybe even terminology. And there's one in here that's about I think, the medical care team, right? Because I think they they all in a way go together and medical care team in terms of ranges alone, or they're going to have a very similar range for everybody. They're just going to give you your their blanket statement. You should be here. That your alarms here. Yeah,

Scott Benner 36:44
they're gonna say whatever the ADA said last right. For the most part, 70 to 180 right now is that the numbers,

Jennifer Smith, CDE 36:51
that's the numbers right now, I mean, even even most of the CGM does have that set as their default in terms of data collection 70 to 180, unless you go into your own settings, and actually physically adjust them to see your cumulative information that's scaled to your target range. And again, a lot of people don't even realize that they can do that within their, you know, software, data analysis, like clarity or whatnot. But then even discussing within the medical kind of piece, how to pick a medical team how to ask questions within the medical team, I mean, I'm assuming some of these are the questions within that medical.

Scott Benner 37:32
So what if we didn't worry? What if we put these in order, which we're doing now? Then after we have it in order, then I will apply a topic to every one of our recording dates coming up? Perfect. And then we can be read ahead? And then just sit down when it's time to record and, and have the conversation? Were actually well planned? Jenny, what do you think of that?

Unknown Speaker 38:01
That's a great idea.

Scott Benner 38:04
Listen, I'm gonna tell you, we don't

Jennifer Smith, CDE 38:06
usually ever in fact, we never do. I never know what we're talking about until we click in together and I like gardening. And you're like, let's talk about this today.

Scott Benner 38:14
I'm gonna tell you right now that one of the things about the Pro Tip series that I'm most proud of is just that, that it really is. I mean, we made a bullet pointed list. And then we said the topic out loud and then did what we did. And it's been so valuable for people. I think this is going to do something similar. Now, here's a question for you. This is more of a pocket podcast question. But I'm interested in your opinion. Do we just make this part of the Pro Tip series? Like remember, I said, I wanted to go back and revisit the pro tip episodes. Right? Maybe this is going to do that?

Jennifer Smith, CDE 38:52
It may, it may do enough of that. I think the pro tips are I don't know what the longest pro tip episode was maybe an hour.

Scott Benner 39:01
Yeah, there might be one that's more like our 15 or something like that. But pretty, pretty close to that.

Jennifer Smith, CDE 39:06
Because I think those were very, very specific. And while we talk and veer off and whatever within our conversations, I think if I were to do it, I might actually put this as a pro tip, category, pro tips for newly diagnosed and then put these all up definitely as pro tips, but these are the things within here. If you are newly diagnosed, go here and if there are additional questions based on one specific topic, maybe go to the regular pro tips and look up that you know what I mean?

Scott Benner 39:51
Yeah, no, I do. That's a good idea. All right. So I'm still I'm still pulling topics and bringing I'm up top so that I can see them. So you know, there a lot of Yeah, hold on a second so Okay, so we have still flexibility, medical care team guilt, fears, and hope X and hope expectations, podcast community family journey school journaling, exercise, long acting insulin. I know that when, after the after the topics came back, so I eventually close the thread and I was like, Okay, this is enough. I'm good thanks. And it was very generous of people to come in and spend time but giving real clear explanations of the things that were confusing to them or that they found helpful, etc, right. And then I put it all into this Word document. And I was like, I don't know what to do with this, you know, so I didn't have time. And I thought this is such an asset. I don't want to lose it. But I was like, I don't know what to do with this. And Isabelle said, I'll go through it. And I said, thank you very much. And weeks, took her weeks to like, you know,

Unknown Speaker 41:15
I'm sure. A lot of information 80 pages is no joke.

Scott Benner 41:19
No. And so she went all through it. And I thought, it's a lot. And most people wouldn't put this effort into their content. And I think that's why it's gonna be good. You know? Yeah. So it's even why I'm not scared to discuss it here with you. I mean, honestly, this episode is going to serve as sort of like a primer to let people know what's coming. They probably, they probably won't hear this, too. We have a number of these recorded already, I'll probably put out first get them ready to that it's coming. But there was a there's a voice in my head that says, Don't let people hear you and Jenny talk about this, because they're gonna rip you off. Because that does happen. Jenny, I put up content. And then a week later, everybody's, somebody else has to talk about the same thing like, oh, wow, what a surprise. And but I don't care. Because I think, I think first of all, I think the effort we'll put into, it won't be matched by anyone else. And the information, you know, I would hold up against what anybody else could come up with. And, and the other thing is, I just don't think that this is how, I don't think people put this kind of effort into stuff. I just don't, you know, even going all the way back to the Pro Tip series, like the amount of hours that we spent recording that stuff. You know, a lot. Yeah, and you you know, we say this all the time, but you don't work for me, like you're not getting paid to do that, like, you know, where are you gonna get somebody with your knowledge, and your understanding of how to explain things, and an ability to talk to me because you and I, like, we get along really well. And we vibe off of each other, but we're not similar. Like, you know, it just it just works, you know? And you're not gonna get that so I think we can do this. I think this will be terrific. No, this is really great. Yeah. Okay. So does it repopulate when I move words, do you see it happen right away?

Unknown Speaker 43:08
I see it happen on my screen. Okay. Okay,

Scott Benner 43:11
so you saw me misspell a word. That's embarrassing. Nevermind.

Jennifer Smith, CDE 43:15
Actually, I was gonna ask you what? You had the word long after exercise. And I was like, what else goes along with that? I don't know what long means long time without insulin long time

Scott Benner 43:27
to scroll to make sure we have them all. So I mean, there it is. Right? It's, it's, I think that's everything. I'm gonna go back down and go through it when we're actually you stay up there where the list is. And I'll scroll through and tell you what's here. You can tell me if we have it up top or not. Extra topics. I'm not worried about that right now. Family is family up there. Family is up there. Yep. Being diagnosed as an adult. I don't remember typing

Unknown Speaker 43:57
that is not up there. No,

Scott Benner 43:59
can you add it and we can rename these topics because you know, Isabel's first language isn't English. Oh really? She's French.

Unknown Speaker 44:13
Oh, that's you did tell me Yeah.

Scott Benner 44:14
And I only said that so when she hears this she'll she'll be mad at me for saying that. school.

Unknown Speaker 44:23
School is in there

Scott Benner 44:24
journaling yep exercise. Yes long acting insulin. Yes. Technology and diabetes supplies that's out there. I can add that okay. And then insurance which I know I didn't put up there either. Insurance and the medical team Yes. Yes. Did someone add did I add podcast and community? Yes. While this topic so long I can't get the The header what is it going to be? I'm still scrolling.

Unknown Speaker 45:05
I think the long one.

Scott Benner 45:06
It's guilt fears, hope and expectations is incredibly long. That's here. Okay, there's probably the reason for that is likely going to be that there are a lot of personal anecdotes in here, which took people log in to type out. I'm gonna,

Jennifer Smith, CDE 45:19
I wouldn't expect so to and some of that, you know, we'll go through these obviously ahead of time, but I would expect some of the things within that, especially the fears may be addressed within the other topics,

Scott Benner 45:33
right? Yeah. Yeah, I don't think we're gonna I don't believe that we're gonna have to go through these, these and read everyone's thoughts and answer them. I think I think the way I see this happening is that we prepare by reading them make our own couple of notes, and then we can have a bigger conversation around that and interject people's thoughts when they when they build on everything. Flexibility is up there terminology is up there honeymoon is fear events on lows and highs 1515 Pre-Bolus. thing I'm getting close to the top. Food Choices, range stalking. Carb guidelines and impact of food. Carbon pack gifts,

Jennifer Smith, CDE 46:23
is current guidelines and actual

Scott Benner 46:27
I think that's a topic Yeah. All carbs isn't a topic, better education on how insulin works with specific food groups would have been beneficial.

Unknown Speaker 46:35
The hospitals there's there's curb impact is that the headaches?

Scott Benner 46:41
But hold on a second, you typed it in

Unknown Speaker 46:42
here already?

Scott Benner 46:45
I see what you're saying. You're saying it's possible that I, I shortened it. And I should have wrote that. So I'm gonna put that in there. And I'll change that. Yeah, because this is really interesting. The hospital made it seem very black and white. You eat X carbs, you take this much insulin and go on with your life. Another person said the impact of food nutrition component on blood sugars. Why isn't her blood sugar tracking the same for breakfast day after day, even with meticulous carb counting? You're right, a lot of these are going to be able to like we're going to be able to give an explanation and then point somebody to a different episode to wait where they'll be able to be helped counting carbs as a huge stressor for us easy ways to count carbs and how different things hit you differently would have been great. Yeah, so basically, these last three statements sort of say the same sort of say the same thing. So okay, great. But my point is, is that the luck of having such a large group of people, one of the things that's great about it, is that this is, um, this isn't just a random person saying something now, like we have consensus,

Jennifer Smith, CDE 47:56
this is a pool. This is a pool of you know, I mean, if you were doing like a research project, you would have a lot of participants. Yeah, right. Our research wouldn't be n of 10, which then the general information about like a study like that is like 10 people great, but the world has how many billion people in it right? And now many of them have diabetes. So how relevant is this, but this is a very good yeah, amount of people comments

Scott Benner 48:22
right now, I think this is so be good. And then some people go into more detail, my biggest frustration is that at first they send you home and tell you that your child can only eat carbs during the three main meals. They talk about free snacks outside of it. So you spend hours researching free snacks and loads of money buying them. And then two weeks later in class, they say oh, by the way, she can have carbs whenever she wants just those for it. Here's your new chart, even if they just said we want you to wait a couple of weeks, but at this point will teach tricks and I say okay, yeah, this is this is gonna be good. All right. I'm excited. This is cool. This is what I was hoping would happen. You're up for it. So yay. Do we want to try this last couple of minutes we have do you want to try to put the rest of them in order or?

Jennifer Smith, CDE 49:10
Sure let's see so we have order already for Honeywell and terminology highs lows kind of all the insolence sort of together. I think maybe within the insulin we should also put probably

Unknown Speaker 49:32
let's see highs and lows

Jennifer Smith, CDE 49:33
I think should also maybe be Where's range because the highs and lows kind of go along with range. Okay, so right. So maybe highs and lows and then range. Alright, that's all together.

Scott Benner 49:51
Got it. I feel like guilt fear, hope expectations, podcasts and community Isn't last, like, towards the end may be correct those things so I'm gonna chop those out and put them down lower. Make some space here. I think flexibility is a huge part of it. To be honest. I honestly think your medical team is towards the end newly diagnosed people are not going to break away from a from a new medical team. If it's a bad one, they're not going to even know. Right away. Right? So Correct. Maybe put that more towards the end as well. Oh, great. All right. And long acting insulin could just

Jennifer Smith, CDE 50:40
think long acting needs to be around the well EV around that fears of insulin lows and highs. Because you can also define rapid acting insulin within that even though it wasn't a question asked. I think it's going to be a piece of that fear of insulin.

Scott Benner 50:58
I put it before because I can see myself talking a lot about basil in there. And correct. I just think that basil gets ignored by everybody does. Yeah.

Jennifer Smith, CDE 51:08
It gets ignored by everybody. Except it's the first place that most clinical people adjust first. Yeah, they just don't. Some are Basal here. Yeah. Hi, here. Let's just put some more Basal insulin here. Yeah, probably not. But

Scott Benner 51:23
I put I'm starting to work backwards. I put journaling and family towards the end. Correct? Sure. And so I'm going to put towards the end, we can rejigger these as we need to technology and supplies. That one,

Unknown Speaker 51:38
I might put that with maybe before after insurance before or after insurance. Okay.

Scott Benner 51:43
Being diagnosed as an adult.

Jennifer Smith, CDE 51:50
Um, that might actually, I'm wondering if that wouldn't be too bad to put after honeymoon.

Scott Benner 51:56
Yeah, so that everybody can feel like they're a part of the of the series as it comes out. Right.

Jennifer Smith, CDE 52:02
Right. And because being diagnosed as an adult, you may actually have a more pronounced honeymoon, you may have more of a real honeymoon, depending on how you learn to manage things from the get go. So I think that's good there.

Scott Benner 52:19
And then we left flexibility school and exercising. So I, I would think, I'd like to put flexibility, at least in front of I think flexibility and stalking, right? Yeah, right before guilt and fears might be valuable. Correct. School and exercise. So now schools interesting, because I haven't read them yet. But I'm gonna guess that a lot of these questions were about, hey, how do I just send my kid to school five minutes after they have diabetes. So I don't know about that. And exercise is kind of the same thing. You see people get sedentary after they're diagnosed, because they don't know what to do.

Jennifer Smith, CDE 53:06
Well, I think school and exercise there's something some of these are as well, but they're more visible variables. School is a variable exercising is a variable. So

Unknown Speaker 53:25
choices, maybe,

Jennifer Smith, CDE 53:27
maybe right after school and exercise, or right after flexibility, put school and exercising. Because those both really do require some flexibility in what your typical management style would look like. So

Scott Benner 53:48
you see what I'm doing now? Um, yes, I'm gonna put them in an easier to look at. format. All right, well, this should keep us busy.

Jennifer Smith, CDE 54:03
Along with all the other things that you had us, like scheduled out for the rest of the year, right?

Scott Benner 54:09
I'm gonna, I'm going to, I'm going to put an end to ask Scott and Jenny because the thing about those are, that are great as they can just go somewhere. They're really valuable. They don't need to be attached to anything else. They're great standalone episodes. Right? So I'm going to so basically, at the moment I have I have about three ask Scott and Jenny episodes, a couple more defining episodes, so I'll put up the defining things till they're done. Then I'll put up I'll put up the ask Scott and Jenny's while we're recording these, and then when they ask Scott and Jenny's run out, we should have enough of these to get going. Okay, that makes sense. Fabulous. Right? Neither of us can get sick or get a life.

Jennifer Smith, CDE 54:56
I will promise to try not to get laryngitis again. Yes.

Scott Benner 55:00
Sometimes I look at I was, I was getting ready to go under for my, for my surgery. And I said to my wife, if something should happen, hire an editor. I have like 70 episodes of the podcast that need to go up. I was actually, like, concerned or worried no one would ever hear them, you know. So. Anyway, all right. Well, thank you. This was true. Yeah. I enjoyed listening to this kind of talk through the idea. We'll find I'll find out if I get notes like, could you guys not not record your meetings, please?

Jennifer Smith, CDE 55:37
Well, you know, but I think it's even if you put it up as a as the preliminary pro tip for honeymooning. This is what's coming. If you are newly diagnosed, we promise we are we are getting to some of these big questions that you really want to know sooner than later.

Scott Benner 55:59
910 I'm counting 1112 1314 2020. Okay, so yeah, even the way the podcast runs, usually your episodes go up like once a week on Friday. Okay, you're you're like you're the Friday girl. And but maybe I don't put episodes up on Thursdays maybe so that I can get them out more timely. Maybe I'll put them up Thursday, Friday for 10 weeks, and then we can get them up more quickly. Okay. Thank you so much.

Unknown Speaker 56:27
Yeah, absolutely.

Scott Benner 56:35
A huge thanks to Ian pen from Medtronic diabetes for sponsoring this episode of the podcast learn more about the impended in pen today.com forward slash juice box. Also like to thank us Med and remind you to go to us med.com forward slash juicebox. Or call 888-721-1514. To get your free benefits check. Take the T one D exchange survey AT T one D exchange.org. Forward slash juicebox. The very first episode of bold beginnings will begin in just one week on Friday. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

If you'd like to be part of the Facebook group, where we got all the information for the bulb beginnings series, it's Juicebox Podcast type one diabetes on Facebook. It's a private group. So you'll need to fill out a little bit of information, just answer some questions to prove to the algorithm you're a real person. And just like that, you'll be in and talking with 25,000 people who use insulin Juicebox Podcast, type one diabetes on Facebook. And if you're enjoying the show, please leave a rating and review in the podcast app that you're listening in now. And if you're not listening in a podcast app, please think about doing that. Following the show in a podcast app or subscribing to a show and a podcast that really does help. It helps very much you have no idea it raises the ranking of the show and makes it more visible to other people. So you can tell somebody about it. subscribe or follow on a podcast app. And don't forget to follow the Facebook page. And that's pretty much it. I'll see you soon

Test your knowledge of episode 698

1. What is the main topic discussed in Episode 698?

  • Introducing the Bold Beginnings series based on listener feedback
  • Insulin management tips
  • Carb counting techniques
  • Diabetes complications

2. What method did Scott use to gather information for the Bold Beginnings series?

  • Conducting a survey
  • Asking questions in the private Facebook group
  • Interviewing medical professionals
  • Reading scientific articles

3. How many pages of feedback did Scott receive from the community?

  • 60 pages
  • 50 pages
  • 100 pages
  • 80 pages

4. Who helped Scott organize the feedback document?

  • Cole
  • Jenny
  • Kelly
  • Isabel

5. What format will the Bold Beginnings series take?

  • A single long episode
  • Short daily updates
  • Monthly webinars
  • Individual episodes based on specific topics

6. What is the goal of the Bold Beginnings series?

  • To promote new diabetes technology
  • To share recipes
  • To address questions and concerns of newly diagnosed type 1 diabetics
  • To interview celebrities

7. What did Jenny suggest about the structure of the series?

  • To have guest speakers in each episode
  • To make each episode very short
  • To organize the episodes by the importance of the topics for newly diagnosed
  • To focus on advanced topics only

8. What did Scott compare the information provided in the feedback to?

  • A small pool of knowledge
  • A dry well
  • A thin stream of data
  • A dammed-off lake full of information



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Read More

#697 After Dark: Emily

Emily has type 1 diabetes and she is here to talk about her life.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon MusicGoogle Play/Android - iHeart Radio -  Radio PublicAmazon Alexa or wherever they get audio.

+ Click for EPISODE TRANSCRIPT


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

Scott Benner 0:00
Hello friends, and welcome to episode 697 of the Juicebox Podcast.

On today's episode we're going to speak with Emily, she's an adult who has been living with type one diabetes for a large portion of her life. Today is the 26th installment of the afterdark series. And Emily is here today to share her very, very specific rememberings of her upbringing, and to talk about how they've colored her life with diabetes. Please remember, while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. We're becoming bold with insulin. If you have type one diabetes, and are a US resident, or are the caregiver of a US resident who has type one diabetes, please go to T one D exchange.org. Forward slash juicebox. Join their registry. Take the survey taking the survey takes fewer than 10 minutes. Your answers to simple questions help people living with type one diabetes T one D exchange.org. Forward slash juicebox. I swear it takes no time at all you can do it from your phone. After you get done listening to me head over, I guess maybe you could multitask and do it at the same time. Today's episode of The Juicebox Podcast is sponsored by Dexcom, makers of the Dexcom G six continuous glucose monitor, learn more and get started today@dexcom.com forward slash juice box it is that that very same link where you might find out that you're eligible for a free 10 day trial of the Dexcom G six. The show's also sponsored today by Omni pod makers of the Omni pod dash and the Omni pod five. Find out if you're eligible for a free 30 day trial beyond the pod dash, learn more about the Omni pod Vive or get started with some Omni pod product at Omni pod.com forward slash juice box. If you're in the market for an insulin pump, I highly recommend it.

Emily 2:19
Hi, my name is Emily and I was diagnosed a type one diabetic when I was 10 years old. How old are you now? I'm 41. I mean, sorry, I was 41 years ago. So I'm 52 You're

Scott Benner 2:32
52? Do you know Emily? And by the way, you'd have no way of knowing this, that I interviewed someone yesterday. And today was there 52nd birthday. Oh, that's interesting. And at the same time only interesting to me, really. So now that I've shared it with everybody else. I was amused by it. And it I realized and quickly it has nothing to do with the podcast. So let's just keep moving.

Emily 2:53
Well, all the best people are born in the first quarter of 1970. I have three of my closest friends. were all born in the first quarter. So we get together each year for fun and games, usually in Oakland.

Scott Benner 3:11
What happens in Oakland is it isn't Oh, that's

Emily 3:13
just sort of the meeting point. I have a friend who lives in Oakland proper. And then another who lives in Danville and another who lives in Turlock, which is sort of central California.

Scott Benner 3:26
If anybody listening wants to kidnap your friends, they're a third of the way to it. So

Emily 3:32
I don't think these women will let themselves be taken.

Scott Benner 3:36
Well, oh, you're saying come get us. It isn't gonna work out for you. I gotcha. Exactly. Exactly. That's excellent. So okay, so diagnosed. 10 years old. Is that right? Yes. In the 80s. The early 80s. Yes. And anybody else in your family have diabetes?

Emily 3:54
Nope. I was the first one. Although my sister who was five years older than me, four years older than me, was diagnosed. That 10 years later, when she was in college.

Scott Benner 4:09
Interesting. So you in the early 80s, your sister in the early 90s? Yes, you as a 10 year old her is more like an 1819 20 year old. Yep. Okay, are you guys closer, you're pretty far apart in age. It sounds like, um, well,

Emily 4:24
we were always fighting. There's third oldest sister. And so she and I were more close because she sort of took me under her wing and would recommend, Oh, I like reading this book when I was your age, that kind of thing. Whereas my middle sister and I were too close. Where we actually would end up at that same school like we are at the same high school for two years and that he hated having to give me a ride around town and stuff like that.

Scott Benner 4:59
That sucks. If I would have just said, Look, if you want a car, you drive Emily. And that's that anybody makes a face no more car. That's the end of it.

Emily 5:07
Right? Yes. You met my mother apparently.

Scott Benner 5:11
That's maybe why she didn't enjoy driving you around. So okay, so you're diagnosed me, you're gonna have diabetes for a decade before your sister dies. There's no other diabetes in the family. What was it like having type one as a 10 year old back in the early 80s?

Emily 5:27
Well, it was all a big mystery. And I beginning to suspect it was a mystery to every doctor I ever had. Because we got we took a couple classes and stuff like that. But my parents were never, they never understood sort of what first of all, I was testing my urine with a test tube and, you know, I droppers and little pills that turns certain colors. And so you had a very wide range of what your color might mean, if it was dark blue, then you were really low or had been, you know, five hours ago. It was never explained to me the timeframe between when I tested my urine. And when that low had actually happened. Does that make sense?

Scott Benner 6:20
Yeah, you don't know. There's no context for you between the test and the event.

Emily 6:25
Right. And they never bothered to explain it to us. And my parents never realized. They don't know how they could have realized that they would be punishing me for something that I had done five hours ago and had no idea I was doing. So I was running high all the time. Simply because, you know, I had never learned any portion management because that was not in the cards in the early 80s for 10 year old. And so I just feel like every single piece of knowledge that we got that then was wrong and just set me up for failure. Yeah.

Scott Benner 7:07
Were you using early 80s? We're using animal insulin or we're using regular mph.

Emily 7:14
Yes, like for the first couple months, it was beef and then we got brand new pork insulin for a while and then I went to Cuba log insulin and mph or human. Insulin, probably starting in college, maybe?

Scott Benner 7:35
Okay. Oh, a lot a decade. Yeah, yeah. All right.

Emily 7:40
Well, I went to college when I was 17. So seven years. Look at

Scott Benner 7:43
you, smarty. So, so basically, you're shooting insulin in the morning, and at dinnertime. And, and you're, I mean, you know, I've never asked anybody this, but you get the pee in the test tube the way I assume right? You just hold it under yourself.

Emily 8:01
You get this hat. I don't know if well, you're if if you're a woman, and you go into the hospital, and they need to collect your pee, they give you this what looks like a plastic hat that you put underneath the seat in the toilet, and then you pee into that. And then you take out

a sample eyedropper and you take out the sample. So then you have this plastic head that's always in your

Scott Benner 8:28
bathroom. I was gonna say it's the plastic cats were usable, right?

Emily 8:32
Yes, but it still got gross. Even when you clean them.

Scott Benner 8:36
Anything up on Emily? I don't know. Yeah, it's a gross factor at some point. So you're basically using this thing, taking out the sample, dumping out the rest of it, rinsing it off putting it I imagine it starts not even getting put away. Right? It's just leaning on the wall in the bathroom or something like that.

Emily 8:51
Oh, yeah. It never had a place to be put away. It was always just stuck in a corner. Yeah. Have you ever

Scott Benner 8:55
noticed when they build houses? They don't think where would we put a plastic cat if somebody needed the bathroom?

Emily 9:01
Yeah. It's they're still not building them in there. i It's not fair.

Scott Benner 9:06
So it's still not out? Yeah, gosh, I mean, even that alone has got to be arduous as a young child, right? Just, yes, I drudgery.

Emily 9:17
Yeah. And the only time I was doing it was in the morning or at night. You know, I was only testing myself. At times when my blood sugar's or, you know, my blood urine. My urine sugars would be high, you know, like after I've eaten dinner.

Scott Benner 9:36
So you have a real chance for this test to come out looking positive anyway, because you're probably not using enough insulin. You don't have any idea about food or nutrition. So you're just basically testing at the highest points of the day. And then exactly right. Your parents see a color and get mad at you. Yes.

Emily 9:53
And so it took me 25 years to start. Seeing a blood test as being just information that I'm being given and not a judgment on what kind of person I am. Yeah. And it's still, I'll still fall back into that. Sometimes I just recently got a Dexcom. And I mean, I just got it. I'm on my second transverse.

Scott Benner 10:26
Second sensor, you're less than 20 days with it. Exactly. Wow. Okay.

Emily 10:31
And so and it's, it's driving me crazy, because I will see, you know, it tells you you're going up, you're at 190. And you're going up, and I'll be like, no, okay, I have to wait. I've taken my insulin I've eaten not do I have to wait for it to calm down and then I can't, then I'll be like, I'll take two, two units of insulin straight to get it down. But of course, that doesn't show up for another hour. And by then, I haven't gotten the hang of it yet. It gets very saddening.

Scott Benner 11:02
Well, so first of all, I know exactly what you're talking about. Because when you're presented with the data in a new way, it feels like starting over. Because even if you weren't doing it, you know, doing it doing diabetes, the way you were hoping to prior to that you were at least probably in a rhythm. Like you did it the way you did it. And it's, you know, what, what's expected happens, etc. And then you get a whole new set of data. And you're like, Oh, like this is I'm really bad at this is how it feels. I mean, they felt like that way to me, at least when I saw Dexcom for the first time. Yeah, you're making me think that Dexcom should make an ad where they're like, Dexcom better than a plastic hat to PN?

Emily 11:44
Yeah, they should

Scott Benner 11:45
capture the 60 year old market. No problem. People would be like, Oh, they know about the plastic cat. Yeah. So so. Are you? Well, it sounds like you're not. But I would say that. The first hump you have to get over is to not see the data as like a report card, but just see it, like big picture, step back from it. Don't look at it minute to minute hour, look at it over 24 hours. So you can kind of get a feeling for like, Is my Basal right. You know, like, that's where I would start. Because, yeah, you know,

Emily 12:20
I don't even have enough. I have to my endocrinologist appointment is hopefully coming up soon. They haven't actually called me back to make the appointment yet, but hopefully, they'll be able to give me more information because I don't really know what I kind of know what Basil is, but I don't know. How to cook with that. I mean, no,

Scott Benner 12:48
no, I do. I was just gonna say you are from a time period of diabetes where no one let you adjust your your insulin, right? Yep. Yeah, you just go to the doctor and they tell you like, Oh, we're gonna make it. We're gonna make it eight now. Like, that's pretty much it. You go. Okay, that number is eight now. And you just go with it. What is your agency's been like over your life?

Emily 13:10
Oh, I'll tell you a story. I was seeing this diabetic nurse practitioner. And she said, You know, I think my last test had been at like 9.2 or something. So she says, Would you like to try this? drug? It's not. It's for type two diabetics. It's a shot. You take it when you take your insulin. And it's supposed to really help with control. And I'm like, sure. Okay. And so I took it for three months. And what it did was it made me so nauseous. I never ate. I was constantly throwing up. I why I stuck with it for so long. I don't know. But my blood sugar numbers were pretty great. And so then I went in, and I told her that I wanted to get off of it because I was literally throwing up every day. And she's like, Oh, okay, well, your numbers are really good. You're down to 6.5, which is ideal. And so she tried to talk me into staying on it because I wasn't eating and so I had lost all this weight. And my numbers were down.

Scott Benner 14:30
That's not a perfect I can't believe I can't believe that ideal was the word that was used because it's not ideal if you vomit constantly and that's why you lose weight and why you can't write why your agency is lower because you're not eating and there's no food your system. Exactly.

Emily 14:44
How can I even got a little certificate in the mail saying your agency is perfect well done, and they spelled my name wrong. I don't like your My name is right there like it's in the list.

Scott Benner 14:58
So Emily asked her Hearing that you were vomiting your way to a six a one C on some medication that clearly did not jive with your body. Well, they sent you a certificate of achievement in the mail and spelled your name wrong. Yes. Well, that's that's a copay well spent for you. Did you keep taking it? Or did you stop?

Emily 15:19
I stopped? Yeah.

Scott Benner 15:21
I have to tell you I would not. It's an interesting thing, that generational thing with diabetes because if somebody gave my daughter something, and it made her throw up, I'd stop giving it to her immediately. Like, I wouldn't care what they said. You know what I mean? But it's interesting that you persevered with it, how long did you do it for?

So I just checked out my link dexcom.com forward slash juice box, and somebody at Dexcom has spruced it all up. Thank you. Dexcom. It looks fresh and new. I was immediately greeted by a handsome photo of Nick Jonas, who, as you may know, has type one diabetes. After I swooned for a moment, I scrolled down, who do I see Miss Patti LaBelle, Patti LaBelle, seeing her gave me a new attitude, if you know what I mean. Here's the point. If you're using insulin, type one or type two, the Dexcom G sex is going to be a friend for you, you're going to be able to see your diabetes as it's happening. That's the speed, direction and number of your blood sugar. Is it 89? Is it 120? Is it 150? Is it 240? Is that rising? Is it falling? Is it rising quickly? Is it rising slowly, etc, etc. So on and so forth, so forth, so forth. Speed direction number, you see that on the Dexcom receiver if you like or you can see it on your supported iPhone or Android device, this is a big deal. To see your blood sugar without a finger stick to see it in real time to be able to set alarms and alerts. I want to know when my blood sugar goes under 80. No problem, you can get that you want to know when it goes under 60 you can get that you want to you want to know when it rises above 121 4150 to 100. Wherever you set those alerts. The Dexcom is gonna give you the little beep beep and let you know when it's happening. On top on top, on top of all these alerts and alarms, the Dexcom also allows you to share your data with up to 10 people if you'd like that means your kid could be at school and 10 family members. I mean, you probably don't know 10 People but I mean, you know I'm saying it could be up to 10 Could be your school nurse. It could be your husband or wife, a sibling, a friend an adult could have their friends looking up to 10 people can take a look at your Dexcom right on their phone if they like. Head over there today. dexcom.com forward slash juice box see Nick Jonas's smiling face. Learn more about the Dexcom G six, find out if you're eligible for that free 10 day trial of the Dexcom g six@dexcom.com. Forward slash juice box. On the pod is a tubeless insulin pump. It's a tubeless insulin pump that my daughter has been wearing for like 14 years now. been wonderful. She's had it on every day. You can check it out and try it for yourself. And on the pod.com forward slash juice box. Here's what you may be eligible, you'd be good. But I can't talk. Here's what you may be eligible for a free 30 day trial of the Omni pod dash. That's crazy enough. You can also head over and learn more about the new Omni pod five. That's an algorithm based system that makes dosing decisions for you in conjunction with your Dexcom G six. Are you kidding me? The future is now baby and it's here. Omni pod.com forward slash juicebox Get started today, learn more contact Omni pod and say hey, you know I'd like to try Okay, get to trial. He even think they'll send you out a like a little we haven't talked about this in a while. But I think they still do this. You can get a single pod like a dummy pod doesn't actually work. Just if you want to try it on aware to get a vibe for how it feels. All of this is at your fingertips. The internet is at your fingertips, you use your fingertips that's at your keyboard, and then you type on it. The va.com forward slash juicebox if you're looking for an insulin pump, in my opinion, you should look at the Dexcom. If you don't like it, it's cool. But I mean a free 30 day trial gives you plenty of time to figure it out. omnipod.com forward slash juicebox dexcom.com forward slash juice box links in the show notes of the audio player you're listening in right now. And links at juicebox podcast.com. Let's get back to Emily. And trust me. There's a lot more to talk about with Emily. Three months. No kidding.

Emily 19:48
And well. I would call her and tell her that I'm throwing up she's like well try staying with a little longer. It may just be taking you a while to get used to it. So I kept thinking it's not like I called her every week. She kept telling me to take it. Yeah. But you know, after the first week, she said, well take it a little longer see if you still have it. And I just kept thinking, well, maybe next week, it'll get better. What was the drug? I wish I could remember the name as long ago, right? It's i It's one of the ones that's has a commercial on it now. But every time I tried to look for that, like, they didn't give me the they gave me the off brand.

Scott Benner 20:25
Oh, you were using a generic of it? Yeah. And they didn't try. They didn't even try moving into the drug. Just generic only.

Emily 20:36
Oh, that well, that was Walgreens fault.

Scott Benner 20:39
You have it the doctor can say no generic substitutes. I'm saying like the doctor never stepped up. Did the doctor know you were taking the generic? Do you think

Emily 20:49
the Nurse Practice Nurse Practitioner was the only one I was seeing. And I honestly didn't, it didn't occur to me that it would matter.

Scott Benner 20:57
Gotcha. Might not have I'm just saying I was wondering if that was the that would have been the first thing I said if I was the doctor. So I was wondering if it got said to you. Alright, so. So this is pretty much your setup, like this is how it's going. You're Are you your Dexcom and MDI are Dexcom in a pump.

Emily 21:16
MDI MDI,

Scott Benner 21:18
would you ever use a pump,

Emily 21:20
my doctor keeps trying to get me to take a pump. But my I had a Dexcom, about 10 years ago. And I had a very bad experience with it, which I'm not having this time around. But it was with the the insert, I don't remember the name of the three pieces. But the the piece that you carry around with you, as opposed to the recipient,

Scott Benner 21:49
I'm sorry, the central know the receiver, the part that you carry to look at your numbers on the receiver, right? The receiver

Emily 21:56
was set so that it would be but certain times you couldn't change the beeps. And it was just constantly beeping. And I got so frustrated, because it would wake me up for no reason, if you like your blood sugar is on its way up, like I know. And I couldn't turn it off. And so I just said, No, I'm not going to do that anymore.

Scott Benner 22:18
Emily, you have gotten no help. Because those alarms are custom are customizable. You can change them.

Emily 22:24
Well, the one I'm on now I'm on the GS six, you can customize it except for what it deems is your lowest low

Scott Benner 22:31
5050 BMC. Yeah,

Emily 22:35
I consistently wake up at night, well, before I was on it, I consistently would wake up with my blood sugar being in the 30s. And I'd be pretty much coherent. And I would just get up and I'd eat something and I'd go back to bed.

Scott Benner 22:52
So, so Emily, there's a lot going on here, you are about to learn a lot with this Dexcom I tell you, first of all, please stick with it. Like unlike the drug that made you vomit, I think you're gonna have a good outcome with this. I stick with it because it sounds to me like you are using insulin in a way that is making you low at times. You don't need to be that I mean, 30 is just, I mean, 30 is a pretty big mistake somewhere. You know what I mean? Like, I don't know if it's with your meal or with your Basal insulin like I couldn't possibly tell you from here. But have you listened to the Pro Tip series of the podcast?

Emily 23:31
A couple. A lot of them. A lot of the the podcasts I've listened to just happen to be about things that don't really apply to me. At least I haven't I haven't heard ones that apply to me yet. But I, I listen to a lot of different kinds of podcasts. So I have to admit that I don't listen to yours on a regular

Scott Benner 23:58
route. So I'm gonna send you a specific list of management ones that might help you get your Basal insulin dialed in, and then give you ways to think about giving yourself insulin at mealtime. Because Because you shouldn't be at 30 like and I don't think you have to be you know, so I think somebody needs to help you a little bit and get you get you going in the right direction.

Emily 24:22
Well, I can tell you that. Now I'm I'm on a human log and Lantis at least four shots today. Because the Lantis is I use a pen so the Lantis is separate. And what I will tend to do is I'll be hungry, so I'll try to figure out how many cards I'm going to take. And I was given at one point, the ratio that I'm supposed to use. And so I'll figure out the carbs. And then I'll take my insulin and then I'll end up about halfway through getting or, like I have a really small stomach. And so I never finish a meal. And so the hardest part for me is figuring out how much I think I'm going to eat versus how much I do eat. And when I should be taking my insulin, so they said, Well tried take your insulin afterwards. And so then I do that

Scott Benner 25:23
not okay. So, again, the input, the information that people come back at you at is interesting, where they skip over the common sense and go right to the dumb idea. I've seen that this has now happened twice in your stories. It happened throughout my life, right? So yeah, so here's, here's a thought, if you don't know how much you're going to eat, why don't you Bolus half of it as a Pre-Bolus? And then if you finish it, put the rest of it in. Like you're not afraid of the needle. I mean, you've had years you don't get about, oh, I just cursed. You don't care about injecting? I imagine, right? Yeah, no, right. So do half upfront, give yourself a reasonable do you Pre-Bolus your meals at all?

Emily 26:03
You mean, take my insulin before I

Scott Benner 26:05
yeah, like but yeah, you do. But like 15 minutes, five minutes? How long do you do?

Emily 26:12
It's usually about five minutes. Okay?

Scott Benner 26:15
There's a whole world out there you don't know about I'm excited. I'm excited to send you these episodes. I'm gonna list them at the end of your episodes so people can hear them. But when we get off, I'm going to just send you an email with a list. Okay. Okay. All right. And I think that you'll be able to get your IP. So, Emily, this is interesting. For me, I didn't realize we were going to talk about this before we talked about the other thing. So in my mind, everything about type one diabetes is how you use insulin. And everything about the insulin is the timing and the amount, meaning you need to use the right amount at the right time. That can mean your Basal insulin Volantis for you. And that can mean your mealtime insulin. Both things need to be measured and used properly. So the first thing you're going to kind of work on is getting your Lantis, right. And your Lantis should be holding your blood sugar stable at a number, whatever your number is that you want. Like if you want to be 90 all the time, if that's your goal, if you want to be 120 all the time, if that's your goal, like whatever your goal is, there's an amount of Lantis that you can take that away from meals away from meal insulin, and away from exercise. Your Atlanta should hold you with that number. You should have enough of it in there to hold you steady. You should think of the Lantis as sort of like a giant unseen force standing over your top of your blood sugar pushing down with its palms, holding your blood sugar stable at a number not letting it rise up past that. That's its job. Now once you have that, right, you need to move on to understanding how to polish your meals right.

Emily 27:54
Did you say pushing down with its paws?

Scott Benner 27:57
With its palms? I'm sorry? Oh, yeah. Just like try to imagine Lantus being a giant. I don't know, like a god. Okay, well, I'd

Emily 28:05
like to think of it as a giant bear now.

Scott Benner 28:07
Okay, fine. I'm with you. All right, I thought I heard pause. And we I'm going with you. And this is a bear. Okay, it's a bear 10 times the size of you. And your blood sugar is this. I don't know, unforeseen ocean that's trying to float up too high. And the bear is just pushing it down, pushing it down, pushing it down, but not too far, just keeping it where it wants to be. That's what your Basal job is. It's to hold you stable at a number. Okay. And then once you do that, that's sort of not a variable anymore for you. Because you know, your Lantis is set up well and doing its job. And then you come along and look at your meal and say, Alright, this meals, 30 carbs, and you look at your insulin to carb ratio, you put your insulin in, in enough time. I call this a Pre-Bolus. I think it's a pretty common phrase write in enough time so that when the action of the insulin starts to work on your blood sugar at the same time, or very similar timing, the food starts to work as well. So think of the meal as a tug of war. So on one side of the rope, put the insulin and on the other side of the rope, put your your food. Now, if you inject your insulin and begin to eat right away, the insulin is not going to start working for probably 1520 minutes, maybe if you're lucky. And then it's not going to be at full power probably for 30 minutes, like when do you usually see a peak like 45 minutes maybe? Right and then, but the food hits you much quicker than that. So now you've put the insulin in, you've started the timer on the insulin and you've told the food go ahead and pull on the rope. While the food is now has a huge head start it's pulling on that tug of war rope and that flag is going more and more on the on the food side and your blood sugar is getting higher and higher. And you're seeing that now for the first time in your life. because you're really wearing a Dexcom. So even if you start eating at a 90 blood sugar, you put in the food you put in the insulin 10 minutes later, the your 90 is 100, then all of a sudden it's 105, then the arrow flips up diagonal, now it's 110 115 121 25. And then the arrow flip straight up, this sounds familiar, right, and then your blood, your blood sugar starts flying up. And now it's, you know, 30 minutes later, your blood sugar is 190. And the insulin is really kind of feeling itself now and it's at full, it's at, it's more full power, and it starts to pull down. So now the insulin is finally pulling on that rope. And then that arrow goes from straight up to diagonal up to level, because that are, if you can think of the insolence got a hold of that rope, and it's finally pulling back, and it's pulling that arrow back around. But at this point, you only gave yourself insulin for the food, with a 90 blood sugar as your math. But now your blood sugar is 190. There's momentum on the side of the of the blood sugar on the side of the food. This insulin you've used is not nearly enough. And that's one thing that happens to you. The other thing that happens to you, I bet is that that whole process happens, but you don't finish your meal, and then the food, then the insulin comes online overwhelms the number and crashes you back down again, Does that all make like sound like stuff that's happened to you?

Emily 31:22
It's like, you're reading my pancreas,

Scott Benner 31:26
I have to tell you, those other podcasts you listen to, are gonna have to go on the back burner for a while I'm late because we are going to get you straightened out. Okay. So

Emily 31:35
let's see. That's the whole reason I wanted to talk here because my therapist said, you know, the whole way you're dealing with everything as far as diabetes in chronic pain and stuff has to go back to the grief that you've dealt with. Since you were 10. And on, tell me about it. And, you know, my grief. Does a grief when you're diagnosed as a diabetic, because even if you don't understand it, you do understand that you no longer get to eat as many double stuff Oreos as you want. There's a loss there. There's a, you know, a loss about, well, now I have to start thinking about everything I'm gonna do for the next hour, day, week, month, year, I have to sort of plan everything out, like my friends make fun of me, because I'm one of those people who has a purse that has something for every possible thing that could happen. Because that's what diabetics have to do.

Scott Benner 32:45
Well, Emily, not that people with diabetes don't need to be prepared. But I'm going to assert that it's more of what you have to do than what some people have to do. So my daughter is 17. She's had diabetes, and she was to yesterday afternoon, she came home from school at one o'clock. She's a senior and she's got an early release. They apparently are not teaching them anything in her last year. And she comes home and hurt her day begins basically her personal day and we knew my daughter had plans to go out with her friends that like they were going to go to dinner. So my daughter comes home. She had eaten something at school, we had not spoken to her about it. She had given herself a little too much insulin. So while she was getting ready, she took care of that with a little bit of juice, got herself at about a 90 blood sugar, took a shower, put her makeup on and got dressed. Her friend came and picked her up, they drove to a friend's house. Three, four hours later, they were having dinner. They ate at a restaurant from like six to 730 they went back to the friend's house, they hung out all night did a sleepover and she walked back in the door today at 10am. I did not speak to my daughter since she left the house yesterday at three or three I think maybe two and I'm going to pull up her her Dexcom in front of me right now. Okay. And over the last 24 hours after my daughter fixed the little low that happened when she came home from school, which was about 65 her blood sugar is for a number of hours from three o'clock until 630. Her blood sugar was 88 to 91. And then it looks like she missed a little bit on her dinner. And she had a spike but she spiked to 140 and that only lasted for about a half an hour. And then over the next 738 3930 She came back down. She looks like she caught it with a little snack. The drop around nine o'clock, and then she leveled out. And by 10 o'clock she was 75 and for the next 12 hours she was basically between 85 Have and at one point she got to 110. And that's a pump and an algorithm and a CGM working together along with her knowing how to Bolus for her meals, and how to fix her low blood sugars without causing a high one. That's all she knows how to do. She fixed her low without causing a high, she Bolus for her meal. And other than that she's wearing an algorithm. She's wearing it on the pod that's running an algorithm. And it is giving her insulin and taking it away and keeping her basil exactly where she needs it to be. That is a world you could easily live in. It is not that hard to get involved. If you have insurance, it'll cover a deck sound, you can get a pump, you know? Or you can or you can learn. I'm sorry, I'm sorry. I'm sorry. I didn't mean to step on you. But where you could learn to do it with MDR? There are plenty of people who do.

Emily 35:49
Yeah, I think I mean, I was really burned at the beginning with the the lack of information I got, and then I just I have a complete mistrust of doctors. I stay away from them as much as I can. Because I've never had a doctor really tell me anything particularly useful. When I was 13, I passed my first kidney stone, although that's not what I thought it was. I stayed home because I thought I had cramps. And then I was passing the kidney stone which have you ever passed a kidney stone? My wife has? I have not? Yeah, they're really horrible. Especially without pain medication. And sorry, I'm Flemmi.

Scott Benner 36:40
You're fine. I have an edit thing later, I'll listen back to this, no one will ever even know you cough. Don't worry about

Emily 36:45
okay. You can change this to say I'm Flemish, if you want. And so I called my mom at work. And I said, Mom, you have to take me to the doctor, I'm in so much pain. I'm pretty sure this is because I'm a bad diabetic, I'll do whatever you want. Just get this pain to stop. So she didn't it didn't occur to her that it was a kidney stone. It didn't occur to anybody that it was a kidney stone. They got me to the doctor, the doctor said, Well, have you been testing your blood because by now, blood testing had come out where you did these big strips, and you had to put like, half a gallon of blood on it. And then it would show you a color scheme. And I didn't do those because I didn't. I just didn't want to. I had sort of no one ever explained to me how that would be any more helpful than the urinalysis test. So I get to the doctor, and I'm still in a lot of pain. And he says, Well, what are your last blood sugar has been? I'm like, I don't know, I haven't tested on and he's like, why haven't you tested them? And I said, because I can I feel I can feel if my blood sugar is gonna go low. And he's he slams his fist down on his desk, and screams at me. Sorry, you're fine. And to a 13 year old, right? Like he went all he got credit for dinero in my face. And so I left that never getting help for my kidney stone, which I then eventually just passed.

Scott Benner 38:26
They didn't they just let you leave the hospital. They had me leave the hospital? Because you didn't test your blood sugar. They didn't check on the pain. Yeah. Emily, where did you grow up?

Emily 38:38
Northern California.

Scott Benner 38:40
Wow. Um, listen, let me say something to you. I didn't think this was gonna go this way. But I am sorry for all of the bad information that you have gotten over the decades. But I wanted to tell you that, that doesn't exist anymore. If you don't want it to the information is easy to come by now. It's literally in that I'm gonna give you basically, I don't know, 15 episodes of this podcast, if you listen through them, and marginally understand what you're listening to your agency will be in the sexes. It's it's the technology is so much different. But I think for you, if faced with that information, I think the 40 years of somebody or everybody may be letting you down. You just feel like maybe it's not possible, or is it? Or do you feel like it's too late because it's not too late. And it's incredibly possible? Like you should go into my private Facebook group and see that there are 20,000 people in there who are all either learning or doing and their blood sugars are not the way you describe. They are not living lives the way you think it has to be. Because you have diabetes. You just grew up in a bad time with type one, but you're still here and you're young, and it doesn't need to be like that anymore.

Emily 39:59
Well, I Appreciate that, and I will listen to the podcasts. Here's the kind of thing that I grew up with. I was diagnosed in December of 1980. And I turned 11, the next month in January, and we got a diabetes forecast magazine. Does anybody still get that?

Scott Benner 40:23
I don't know. But I was in at once. Oh, congratulations. I don't I didn't feel that exciting.

Emily 40:30
I had my doubts about this whole diabetes thing. When I saw there was a cover article that had the headline, I'm a diabetic, or maybe it was my daughter was just diagnosed diabetic. Can I still get a Christmas tree? Wyatt. That's what I said. And I, I it confused me. I'm like, why wouldn't we? Why wouldn't you get in? I knew enough about diabetes to know that Christmas trees have nothing to do with diabetes. And so anything I ever saw was either super, super scary. make no sense at all, or was super tweet like that? Just the sort of not

Scott Benner 41:18
helpful? Yeah. Exactly. The diabetes space is full. Yeah, yeah, I don't I don't do. So I'm just telling you there's a it's timing and amount, use the right amount of insulin at the right time. Your Basal right, you'll learn to Pre-Bolus for foods, you'll learn the difference between different foods glycemic index and, and load just meaning that, you know, 10 carbs of watermelons not going to impact your blood sugar the same way 10 carbs of white rice will. And then you stay flexible after that. And bunch of other stuff. It's a 681 say just good basil. Get your Pre-Bolus together understand how much insulin things need. That's pretty much it. Like there's not much more. I mean, listen, that's an unfair statement. There's a lot more to it. But that's the base of the that's the base of the building right there. You got to get that right. And then after you get that, right, the rest is a learning experience that you'll actually have time to learn because your experiences won't be so horrible. Like, you know what I mean? Like there's a difference between something going wrong and your blood sugar spiking to 140 which is what I described with my daughter's dinner last night, and something going wrong and you waking up in the middle of the night your blood sugar's 30. Like one of those things is an emergent disaster. And one of those is like, Oh, I got my Bolus a little wrong here. You know, so like, when you're constantly in the disaster, you can't see the lessons. You only mean like when you're running from the from the bear through the woods, in the woods or on fire? That's not the time to think the forest is a deforestation probably caused this, you know, like, this is the time to think I gotta run from the bear and the end The woods are on fire. I don't want to burn down. You're always constantly flight or fight, I would imagine. Yeah. And you need, you need to get you into a more calm place where you can actually watch something happen and say to yourself, oh, Emily, hmm, I Pre-Bolus 10 minutes here, and I spiked a little bit and then didn't get low later. I bet if I changed that Pre-Bolus to 15 minutes for this meal, the spike wouldn't happen. And I wouldn't get low like you can be a little more thoughtful about it when you're not running for your life.

Emily 43:27
Does that make sense? Yeah. Well, I think part of the reason I react the way I do to pretty much any sort of problem is, you know, my basically, I was diagnosed diabetic when I was 10. My dad died when I was 12. And so my fight or flight reaction is stuck at that age. So I feel like I don't quite under you know that. It's still a 10 year old me who was trying to fight with this diabetic stuff. Yeah. And is just so shocked. You know, I thought I was gonna die. My whole family joke that I would be the first one to die because of the diabetes.

Scott Benner 44:12
bunch of comedians who grew up with their Emily. Oh, yeah. Oh, yeah.

Emily 44:15
And so the fact that I've made it to 52 is so shocking to 10 year old me.

Scott Benner 44:23
Well, I'd start taking that as a sign if I was who am I? Am I dumb? I forget what those people said. And I'd get busy living. You know what I mean? There's a lot here.

Emily 44:37
The diabetes hasn't stopped me from doing anything except my mom sat me down. When I was in high school and said, you realize that you're going to have to have a job. The minute you get out of college because you need to have health insurance for the rest of your life. And she explained to me what insurance will do you know, once you get off insurance now this is a preexisting condition and you can't get on insurance again. Unless you have a job that recognizes you know that we'll give you health insurance. And then for six months, you're paying, you know, millions of dollars for your insulin, even though back then it wasn't as expensive as it is now.

Scott Benner 45:23
Yeah, device, get a job have insurance. I think that's valuable advice for a person that was type on.

Emily 45:27
Yeah, no, I'm really glad I know it. But having to do that kept me from doing what I really wanted to do. Like I ended up. It took me five years to graduate from college because I had to have a full time job as well. Because my mom stopped supporting me, and which was fine. I was an adult. But then, I had to start temping so I could get insurance. And I wasn't able to do I wanted to move to New York and become a comedy writer.

Scott Benner 46:04
And you got a job to make sure you had health insurance.

Emily 46:08
Yeah. Instead, I started temping at a just marketing company. In San Fran, well, I had a whole bunch of temp jobs. And I started working for this marketing company. And that got me into databases. And now I do it stuff, which I mean, I'm okay at and I guess it's okay. But I sure would rather be

Scott Benner 46:31
doing something different, or at least at least trying the thing you were hoping to do. Yeah. Well, you talked in your note to me about grief. And you said that obviously being diagnosed was hard. And then your father passing soon after was hard. Did it keep coming after there? Or were there two were these two things just very present with you constantly growing up?

Emily 46:54
Well, my family didn't know the rest of my family. My mom and my two other sisters didn't know how to grieve. My dad's loss it so it got buried under about, you know, 15 miles of crap. And my mom ended up like, right when I felt I needed her most let alone my other sisters. My I was 12, my middle sister was 16. And my eldest sister was 90, and hang on a second. Okay. Because my mom wasn't expecting this, I think she sort of reevaluated her life, and realize that she was going to start spending her life for herself and not for her children. And she found this friend who was 12 years younger than her and they just started, you know, running off on trips and doing things like that. And I don't actually have a problem with her having done that. But she didn't allow us to grieve. She just said, Okay, move on with your life. I'm moving on with my life. And, you know, I barely saw my mother. Well, I wouldn't say barely. But she, she wasn't around as much as say, my friend's moms. And the last conversation that I remember having with my father was one that he was accusing me of, because my blood sugars when I did test them were high. He, he had the memory of my urinalysis being high, he had decided that I somehow had found a way to go to 711 and buy candy and I had it hidden somewhere in the house, which was not true. And that was the last interaction. I remember having with him before he died. How did he pass? He had a heart attack. He was a US only 49. And he was a five pack a day smoker, meat and potatoes guy, so it's not a shock.

Scott Benner 49:08
Certainly drinking or drugs going on in the house with your parents? No, no. Interesting. Okay, so your dad dies, your mom flips out. Do you remember your mom being a panic before your dad died or to just really get to her?

Emily 49:21
I think she didn't know how to deal with it. My entire extended family I've talked to like, I'm really close with my cousin. And she talks about how her family you know, our whole extended family doesn't know how to grieve. You just kind of you're supposed to push things down. The only the only thing you're allowed to do at family functions pretty much is laugh. We're all very happy, goofy and not recognizing the problems that everybody has. Which has caused several divorces and just weird

Scott Benner 49:58
things not going well. Right. And for you, the for you. I mean, let's be honest. Right? You feel abandoned?

Emily 50:06
Right? Yeah. Even though I mean, I wasn't really abandoned. It just felt like that.

Scott Benner 50:10
Yeah. And well, you don't have to stick up for anybody I understand what we're talking about. Don't worry. I know they didn't leave you on purpose. But I'm saying you the end result is you feel abandoned. Your dad left, he died, your mom left, she kind of went and took care of herself. And you may she might have physically been there, but she wasn't helping you. And you were only 12 years old at that point. Right. Right. Yeah. And so you grew up 1213 1415 1617? Probably with your older sister helping you more than anything else, then you go off to college. In the middle of being at college, your mom lets you know she's not paying for you anymore. Right? Right. Yeah. So that's an abandoned feels. That'll make you feel abandoned as well. And then you abandoned your dreams to take care of your diabetes. Right? So you hate diabetes. And you're probably not thrilled with your mom. But she didn't leave you leave you so I'm assuming you write that off in your head. Are you mad at your dad?

Emily 51:12
I'm getting there. Now. I romanticized him for a long time. But I took it all out on my mom, because she was the one that was there. And she talked about being abandoned by your mom. She drove me I went to UC Santa Barbara. And so she drove from the Bay Area down to UC Santa Barbara. And for some reason, she had decided that she was just going to turn it's like six hours, six and a half hours, right. And she decided she was going to do the drive all in one day. So we got up super early. Everything was already packed, drove down there. unloaded my stuff. And then I turned as I put the last box down, I turned around, she was already in the car, starting it up and driving away. And she yelled out the window. Right when you get work.

Scott Benner 52:03
Were you guys broke?

Emily 52:05
No. Well, okay. i We there were more money problems. And she led on she just didn't tell me. Right. So you know, if she had told me if she had told us we could have

Scott Benner 52:17
you know, understood maybe? Yeah. Was your mom a nice person?

Emily 52:24
Absolutely. Yeah, she was a nurse. That's why they caught my diabetes super early, because I started showing symptoms over Thanksgiving, and then was in the hospital by the second week of December. So I still don't have knock on wood. Very many. You know, I've never been gone into ketoacidosis. As far as I know. Okay. Certainly never been hospitalized for it. I by optic nerve is still perfect. My kidney values are fine, except for the stones. I don't have you know, I don't have all the things that are supposed to happen. You haven't

Scott Benner 53:17
had any you haven't any, like ill effects from diabetes yet.

Emily 53:21
Yeah, that I would have expect to happen by now, given the fact that I haven't even bothered to really pay attention.

Scott Benner 53:29
When did you start to pay attention? When did you actually start testing your blood sugar?

Emily 53:35
In 1999, I moved up into the Pacific Northwest and saw a doctor and they said you know there's much better insulins that you could be on there's there's much better things that you could start doing. And so they gave me a book blood testing monitor, whose name I'm forgetting off the top of my head. It's the freestyle freedom like where you can have alternative blood testing sites. So I started using my forearm rather than my fingers because I could never handle the fingers. Okay. And so once I could do that, I started testing my blood more.

Scott Benner 54:24
So Mm hmm. Basically, when 18 years without testing your blood sugar, and then I getting that timing right about 18 years. 81 Yeah, I

Emily 54:34
was 3020 years.

Scott Benner 54:36
20 years. Okay, that's 20 years you didn't test. And then for the last, you know, the last chunk here, you've been paying more attention. So in the last 20 years, have your agency still been in the nines?

Emily 54:49
Um, the mid 80s. Low 90s.

Scott Benner 54:54
How much effort do you put into diabetes every day? Not a lot. Not a lot. Okay. So it's, it's not. I see. Do you know other people with type one? No, no, you don't know anybody else with it? Well, my sister

Emily 55:11
I did. I didn't know her. She was also not a good diabetic. But she hadn't been diagnosed she had it way before she was diagnosed with it. Because she was on her. She was in college, and she was on her summer bikini diet and eating like 500 calories a day. So it wasn't as obvious. You know, she was losing weight, which she thought well that this diet is working right. And she thought she was paying a lot because she was drinking so much water. She thought she was drinking so much water because she had. Yeah, she was supposed to drink eight glasses of water a day or whatever. Yeah, it all

Scott Benner 55:51
covered each other. Do you guys ever talk about your diabetes? The two of you?

Emily 55:56
We would complain about it. She died in 2014. I'm sorry. Okay, well, so let me get the overall grief thing out of the way. So you can understand. Okay, so I got to college in 1987. Pass a couple of kidney stones moved back up to the Bay Area in 93. And my middle sister starts to be antagonistic towards me, because we each got an inheritance from our grandmother. And I used mine and took a trip and backpacked around Europe, whereas she was married. And so she bought a house. And so she was mad that she didn't get to go to Europe. And so she, we never talked about this, but that's how I sort of felt about it. She was just always kind of, she had I was staying in her house. For about three weeks or maybe a month, I was working three different temp jobs until I could get enough money to move out. And then I caught walking pneumonia. So while I was out with walking pneumonia, my sister thought I was making that up. So she, if this sounds so much more Maury Povich than it really was, but she had my mom kick me out of her house. She my sister had my mother kick me out of my sister's house.

Scott Benner 57:32
Okay, I understand.

Emily 57:34
Which I didn't know you can do that. By letter. I didn't get to talk or basically what am i Mom writes, you know, you've always been the funniest, but also the most selfish, like this really harsh letter. And so I we, we kind of had a falling out after that, although it would kind of go up and down in 2012, so I moved to the Pacific Northwest Northwest and my eldest sister was in Pacific Northwest already. And in 2012 My mother dies, surprisingly, like no one expected it at all. So that threw us all for a loop. And then two years after that, my middle sister dies. They're not sure of what we would have had to pay like 1100 bucks for an autopsy. And we didn't

Scott Benner 58:43
know I was married with the house one, right?

Emily 58:46
Yes. Okay. And she's the one who also had diabetes. So when you have diabetes, and you die, they assign you we always used to joke that oh, you know, we get in a car crash they're gonna blame it on the diabetes right? And well, she was also on several different pain meds because she had terrible complications. She had a tracheostomy because of all the throwing up. She did, because she had What's that stomach disease when your stomach doesn't gastroparesis? Yes, she had gastroparesis. Her kidneys were basically shot. And so she died at the age of 47. It sounds

Scott Benner 59:37
like she was doing less day to day work on her type one than you were for sure. Well,

Emily 59:43
actually, she actually. I don't I don't know whether she was doing more or not. We never discussed it. But she had just always had because her diabetes had been noticed. Her diabetes had taken hold much earlier before she was diagnosed, that it just came with more crap. Like, I think even if she had a pump and the best everything in the world she still would have gotten gastroparesis, she still would have gotten the neuropathy. Um, yeah, I

Scott Benner 1:00:20
mean, I don't know how to say for sure what people what what things people would develop or not develop based on their care. I can tell you that I think if you get good care immediately, and you keep a onesies lower that that lowers your chances of these things happening but certainly it's not a not a foolproof system. But it sounds like a lot went wrong like it to me. I mean, a layman from the outside. It sounds like your sister's a onesies were really high. And it was just ravaging her in a number of different ways.

Emily 1:00:52
Yeah, she she would go into ketoacidosis. Like, every three weeks. Yeah. And well, the problem was that her doctors would fight with each other through her, like her diabetic doctor would say you need to do A, B and C and her her kidney doctor would say no, no, you need to do XYZ. In the meantime, she's in so much pain, and neither of them are giving her any pain medication. So finally she gets an okay, she's changes hospital and she moves up to, to Pacific Northwest. So all three sisters are together after mom died. And she lived near my other sister. And she was on disability. And so my eldest sister found her apartment and my niece was going to go over and just sort of help her out. You know, clean the cat box for her and stuff like that and hanging around and make sure she was okay. And within a month, my niece went over there and found her dead on the floor. And we don't know what killed her. But because she had a bottle of you know, legally prescribed methadone. They decided that oh, she she Odede.

Scott Benner 1:02:23
Was she a recovering heroin addict? Nope.

Emily 1:02:28
Methadone is a common pain

Scott Benner 1:02:30
is common for pain. Yeah. Oh, I didn't realize that. Yep. Okay. And it's really

Emily 1:02:35
good. I'm on it, too. And it's really good. It gives you it helps with just standard. Just the lowering of a pain

Scott Benner 1:02:46
changes your threshold.

Emily 1:02:47
Yes, exactly.

Scott Benner 1:02:49
What, what are you on it for?

Emily 1:02:51
I have chronic pain in my hips and legs and shoulders. My shoulders basically are like, stuck in Frozen Shoulder syndrome and have been for four years now.

Scott Benner 1:03:04
Well, that's a complication of type one frozen shoulder? Yeah, yeah, that's what they've told me. Are they? Did you get it looked at like by somebody who thinks they can treat it? Or are they just treating the pain?

Emily 1:03:17
Um, well, I have a pain management doctor that I also am seeing a physical therapist, I have a PHP, I'll be going to see an endocrinologist. Um, my pain is pretty well managed now.

Scott Benner 1:03:33
Okay. Do you have any considerations about like, maybe if you brought your agency down and got your variability a little stable, like your stability better than maybe some of your problems might alleviate? That would be great. Yeah. Because there have been people your age that have come on that I've talked about that. People with, with significant type one, complications, who were on their way to others, and then they found the podcast and got their agency down in some of those complications. I'm thinking of one person now whose vision was going and then he got his blood sugar down and stable and his vision stabilized.

Emily 1:04:13
Oh, well, yeah, that, that totally makes sense.

Scott Benner 1:04:15
Yeah. Do you understand? Like, why high blood sugars cause problems like this?

Emily 1:04:23
I'm in a very vague way I sort of pictured in my head as if Hi. I always picture my body's being sort of a cartoon. And so you know, like my optic nerve. High blood sugars. High blood sugar to me is like a cotton ball surrounded by steel spikes. So as it rubs up against the optic nerve, it shreds it. It's a sort of a weird No, no,

Scott Benner 1:04:57
it's not weird at all. It's how I think about it too. I I think of it as there's a certain amount of sugar that belongs in your blood. And that at the molecular level, sugar is jagged, just like you would see table sugar, but smaller. When you pack too much of it in your blood, you're basically being scraped or sandblasted from the inside out. Right? And, and all you need to do for that to stop happening and to give your body a chance to heal is to get a adequate, but not too low or too high level of sugar in your blood and find some stability, you don't want to be rocketing up and down, up and down. That's really bad for you as well. Right? Yeah, I. So Emily, in the last years, last couple of years, well, just the other day, actually, a company named Omni pod came out with a algorithm pump that will make your, you know, insulin dosing. Well, it adjusts your insulin as you go along during the day, you still have the Bolus for your meals. There's also a company named tandem that has a pump that does the same thing. Control IQ. Medtronic has a pump that does the same thing. There are three pumps on the market that do this, two of them work with your Dexcom control, like you on the pod five, like these things, if you got them on with even like reasonably good settings, I think your blood sugar would would level out, I think your agency would go into the sixes and stay there. And you know, then you'd really just have to worry about you know, your bolusing for your meals properly. counting your carbs, right understanding the different impacts of different foods and Pre-Bolus say a little bit. I really think there's a lot of success very available to you and everybody else, not just you. But you got to go get it like you have to. I mean, you got to go to a doctor and make them do it. Don't wait for them to suggest it to you. If that's what you want to do. But you're also at the same time you're battling all this grief. Right? You're in counseling. I guess how long have you been doing that? Um,

Emily 1:06:59
well, I saw one therapist for about 15 years, and then she retired. And so I've seen I've been seeing the one I'm have now for a couple years. Is it helping you? Um I'm having a slightly harder time adjusting to my new person. She's great. She's a little more in your face than I'm used to.

Scott Benner 1:07:31
What's the goal for you and you go to therapy?

Emily 1:07:33
Yeah, see, that's the problem. My goal when I was seeing my first person was to basically just express my grief and my rage and everything else in a safe space. And then prescribe antidepressants because I've been diagnosed with severe depression, surprise, surprise.

Scott Benner 1:08:01
How is your Shiva for your thyroid levels checked?

Emily 1:08:04
Oh, yeah, I'm on thyroid meds too. I'm on Synthroid Synthroid. Yeah,

Scott Benner 1:08:10
what's your TSH when it gets checked? Do you know it?

Emily 1:08:14
I don't know it off the top of my head. I get really bad about taking. I was only told recently that you're supposed to take your thyroid meds before you eat and right first thing in the morning like

Scott Benner 1:08:30
not not with any other medications or food. Right? Yeah. So you've been taking it? It's not been helping you? Right? Yeah. So one of the things that you might find with an unregulated hyper, you have hypothyroidism or Hashimotos. Have they told you? Oh, hypo. Okay. So with hypothyroidism, depression is one of the things that you that you get from having an unregulated thyroid very possible that could be from that. So taking your thyroid medication every day, at the same time, letting it stay in your stomach for an hour or, you know, at the you know, without putting anything else in with it. You might see an improvement just doing that for two weeks. And then continuing on but I mean, I'm saying in the first two weeks, you might see a real benefit that you have. Are you cold all the time? Does your hair fall out? Do you have dry skin?

Emily 1:09:24
I have dry skin, but no, my hair is okay. I'm not always cold.

Scott Benner 1:09:32
regulating your thyroids a really big deal. It also makes your blood sugar management easier. There's a whole series in the podcast about thyroid so you might like this podcast, you'd be surprised.

Emily 1:09:45
There's only so much self improvement I can do before I start to rebel because remember, I'm between 10 and 12 years old.

Scott Benner 1:09:54
Yeah, well, and we I don't know a lot about the psychology of people. Um, I'm certainly no expert, but I will tell you this, if you don't do something different, it ain't gonna end well. So, you know, you might as well like, I mean, if you're gonna find something to take serious, I would think that your that your physical health would give you the best chance. I would think that having solid physical health is attainable for you. I don't hear anything about you that says that you couldn't accomplish that. And then you would give you more time to work on your on your mental health. And you might, you might have an easier time with that when your physical health is is there. I mean, high blood sugars make people you know, it's altering in your mind. And low blood sugars are as well vacillating up and down blood sugars are hard on you. I think you I think you take your Synthroid every day, I think you listened to a few episodes of this podcast to figure out how to get your your insulin like regulated a little bit. And you might see a really different person 30 days from now, looking back at you. Are you up for that? Do you think? Or are you just gonna like like this thing on fire and ride it out to the end?

Emily 1:11:13
I don't know. I haven't decided yet.

Scott Benner 1:11:17
Well, that's up to you. But I'm like, No, but I mean, everybody in your life has gone, right?

Emily 1:11:22
Yes. After my middle sister died, and my niece found her. Two years after that my eldest sister died of a very rare cancer called gastrointestinal stromal tumor.

Scott Benner 1:11:41
Emily, I would take the fact that you're still alive as a sign that you're supposed to be here. I mean, because everything around you is a show due respect. Yeah. I mean, it's a it's a dumpster fire. And, and you're, for some reason, standing up in the middle of it, and you're okay. And you're at the very least alive. And I don't know, like, I mean, it's a really weird thing, because I'm not judging you at all. Like, if you just want to sit back and be like, I got a crappy hand dealt to me, and I'm just gonna ride it out. I wouldn't know. I mean, I couldn't blame you. You know what I mean? I don't know what you've been through with it. Maybe it's more than you can overcome. But, I mean, I think it's obvious that, that this path is going to end poorly. I mean, you've seen that with everybody in your life, basically. You might as well try a different path. I mean, what do you got to lose? Really?

Emily 1:12:35
Well, that's true. It's just a, I don't have a keep to itiveness that, you know, I get on these kicks where I'm like, Alright, I have found the solution. I'm gonna do this. And then like, after a week, I lose interest. And I don't know if that means. I don't know what that means. Or where I got that from. You know, my dad always thought it was because I was lazy. My mom always thought it was because I was lazy.

Scott Benner 1:13:01
I think my play pop psychologist with you. I would think it's because that somebody has sent that expectation out for yourself. So you're just trying to you're just trying to prove them right? I think you're just i All that sounds like nonsense to me. Like you're a reasonable person. You were here when you said you were gonna be today, right? You get your insulin, you buy your your CGM, as you go to your doctor's appointments, you get up in the morning you eat every day, you're, you do plenty of things you don't I mean, I feel I should get a cookie for that. Well, good, then have one I don't give it. Like definitely have a cookie like, like, feel good. Pat yourself on the back all day long. If you want to, I'd wear a shirt that says Emily rocks. That's fine with me. You know what I mean? But what I'm saying is, is that if you grew up with a father telling you for too, you know, for two years, every time that that test came back, hi, it's because you're lazy. First of all, no offense to your father. He didn't know what he was talking about. Either. It either did the medical community at that point? You were a child. So you're being told every day you're doing something wrong. In fairness, you didn't know what you were doing. So it's not like you were actually doing something wrong. It wasn't even willful, you're just doing what you were told to do. It was ending the way it was always going to end. Because you were set up for failure to begin with. And then along comes this person to tell you it's your fault. So they don't have to feel bad about it. Because what he really is thinking is, oh, I'm failing this little girl. But I'll put it on her. So he puts it on you. Then your dad dies, and your mom puts it on you. Right? And then life puts it on you. And you're just you're just living a self fulfilling prophecy of of you're trying to make them right. I'm lazy things don't go right for me. My sister died. My other sister died. My mom died. This is my lot in life. I'm gonna die. Here I go. I don't think any of that has to be true. Well, I will die. Well, it doesn't need to be today. You're 52 Well, no,

Emily 1:14:56
I don't think it's going to be today. Yeah, like let's

Scott Benner 1:14:59
like let's Let's get into this. Like, I'd like to see you back on this podcast 10 years from now be and look at me still here, baby. You know, seriously like, and I'm telling you, the only thing you need to do is understand a little better how your insulin works. Take your Synthroid on time. Do it every day. Don't don't I mean, look, if you're going to tell me that I'm going to get bored, then there's nothing I can tell you in return. I don't think there's anything your therapist is going to tell you in your return. You got to you got to prioritize you, and you got to stop listening to ghost voices tell you you're bad at this. That's how it seems to me, but I've only known you for an hour, 10 minutes, 17 seconds. So

Emily 1:15:36
it's still it's up? 17 seconds there.

Scott Benner 1:15:39
That's where I really started understanding.

Emily 1:15:41
Yes. I was gonna say something, and now I've just forgotten. Okay, well take your time.

Oh, my mom told me something really weird when I was, like, 30. She died when I was 32. So we were at a family function. And she she said, oh, did I ever tell you the plans that your dad had for you? And I said, plans. And she said, Well, he had decided that after graduation, you are going to go to school at UC Berkeley, which was laughable because my grades would never let me get into UC Berkeley. But they had both gone to UC Berkeley. And you would live at home until you met your husband. And then he would hand you over to your husband. Not that my dad was one of those religious people who thought you know, the man is the head of the house kind of crap. But he thought that I would need to be watched over my entire life. And so he would do the watching over until my husband did. And that floored me.

Scott Benner 1:17:09
Emily, would it hurt you to know that I think it would have been better if you were born and then left in the woods to your own devices? Well, I think if you would have grown up feral you might be in a better situation.

Emily 1:17:26
See, but my parents were both great. I don't want Oh, they were doing the 70s that they weren't

Scott Benner 1:17:32
Yeah, looking. I was born in the 70s to trust me, I know what you're talking about. Like, nobody was thinking about anything very deeply. You know, it's people were not, you know, if your kid wasn't dead, you're taking care of them. You know, the, the idea of you go to go into college was like a great thing. You know what I mean? Get out of here, we're not paying for you anymore, you know, be gone with you. You'd probably the only thing I think that you could hear today that would make you cry is that I'm considering after talking to you getting in a car and driving two hours to take my son something he needs a college. And I would think that, like that seems like something that no one would ever do for you. And, and it's just that I've made a decision to like, I've made a decision to be the kind of parent I think you wanted to have. And you got the kind that that you know, either got sick and died or was like, Oh, I'm gonna get sick and die one day, I better have some time for me and they stopped making time for you. You know, but you could do it for yourself. Do you have kids?

Emily 1:18:36
No, no, I have never really wanted children. And then

Scott Benner 1:18:42
that's cool. Like, I mean, are you married? Are you with anybody? You by yourself? I

Emily 1:18:45
am. I am married. I'm actually married to someone I went to high school with although we weren't dating at the time. But yeah, we just weren't interested in kids. I like cats better. And then I just thought my genes are not the genes that should get passed on. Respectable the future

Scott Benner 1:19:04
respectable decision. I wouldn't. I wouldn't say anything bad about that. Can we put this guy in charge of the Synthroid. I like him having a job in this.

Emily 1:19:12
Oh, he can tell when my blood sugar's low way before I can.

Scott Benner 1:19:16
I want him to charge to the Synthroid. I want him in charge of the Synthroid, I want you taking that Synthroid every day for 90 days. And then I want you back at your doctor to get a blood test to see where your TSH level is. And if you're, if your TSH is over two, I want you to tell the doctor I want my TSH to be two or below. And then let's get my medication. Right so that happens. And in those 90 days, too, you start taking a little better care your blood sugar's I'm telling you you're a different person after this is over.

Emily 1:19:43
Okay, well, I will tell him he gets up. We both work from home, but he gets up about an hour before I do. So I'll just tell him to wake me up and make me take my

Scott Benner 1:19:53
pill, stick that thing in your mouth, drink a little water. Make sure you have enough and then whatever. And that yeah, that hour over be perfect. I seriously, nothing wrong with needing help getting this going. You know what I mean? Nothing wrong with that. Let him help with that. And, you know, we'll tasked you with listening to a couple specific episodes of the podcast and see if you can't figure out how to use your insulin a little more effectively. This all makes sense to you. Are we gonna get off this? And you're gonna be like, Yeah, screw that guy.

Emily 1:20:22
No, I mean, I feel very motivated at the moment.

Scott Benner 1:20:26
Good. Well, great, then that's it. Let's leave you right here, then. Let me not let me I've done my job. There's no more talking to do. Excellent. I do want me to tell you the episodes I think you should listen to.

Emily 1:20:39
Um, weren't you going to email them? I don't have anything to write.

Scott Benner 1:20:44
We're just making the podcast. You don't have to write it down. Don't worry. Okay. Okay. Yeah, we just want the pelota here. You know what I mean? Yes.

Emily 1:20:50
Oh, sorry. Yes, please. i Please tell me them right now.

Scott Benner 1:20:53
See, look at you're getting a no. All right. So I think there are a number of different places and ways to begin. Do you? Are you comfortable with terminology? Do you think you know, the terms that you need to know for diabetes? Because if not, I have one? Yes, you do?

Emily 1:21:15
I think I think so. I mean, I was on one of the Facebook groups for a while until I realized that it wasn't the face group for me because it was mostly people talking about taking care of their diabetic children. And I didn't feel like I really had fun. I can't tell anybody how to take care of their diabetic child.

Scott Benner 1:21:36
May I, Emily, you're thinking about that backwards. So it doesn't matter if their kids are adults. By the way, there are a ton of adults in there. They're just quieter. They don't They lurk more than they talk. But the point is that taking care of a five year old diabetes, taking care of your diabetes, at its core is pretty much the same thing. So I let the let the other stuff go just look at the focus. But if I said to you, Bolus, you know what a Bolus is, right? Yes. Okay. Basal.

Emily 1:22:06
Bolus is the current that you you are based on that give you getting the most Okay. Basil is the kind you take would be taking your short acting insulin Bolus is belonging acting.

Scott Benner 1:22:19
You have those backwards. Okay. Okay, so Basil is your Lantis. Bolus is your humor log. So just having said that to you, I'm going to tell you that there's a series of very short episodes called defining diabetes, I'm going to send you that list. Okay, okay, there's three, five minutes long, they're going to pick terms and they're going to define them for you, it's not going to be boring. And then you'll you'll kind of have this idea of like these, these things that are going to come up in these other episodes. Once you have those, you move on to the Pro Tip series. And the Pro Tip series is just going to walk you through basically how I think about taking care of my daughter's blood sugar, it's going to be me, and the CDE named Jenny. Jenny's had diabetes for like 33 years. She's delightful. She's from the Midwest, right? So you can't help but love her. And I don't think they're boring. They're going to it's going to be one of the episodes is going to be how to start over one's going to be about MDI about Pre-Bolus thing about insulin pumping. And then some other ideas, some variables that might impact you how illness exercise, how those things might help, you might might impact your decisions. That's it. There's, there's not many there. I think if you listen probably to the first like 10 or 10 or so you should be in a better situation. So I would have you listened to the defining diabetes first than the Pro Tip series. And then if you like them, or you see them helping you, that's when I say just jump in. Because even if you think about your episode right now, like, if I asked you when this is over, what's this about? You're gonna say, I got diabetes, when I was younger, I've had a lot of grief in my life, and I'm struggling, right, except there's a ton of management conversation in this too. And that exists in every one of those conversations. So sometimes just hearing people talking about it, normalizes it. And that makes it feel you know, like it's not work it just I don't think of diabetes as work like you don't put much effort into diabetes you said but you don't get a return. I probably put about as much effort into it as you do. And my kids a once he's in the fives. And she doesn't have any diet restrictions. She had like some pasta and bolognese sauce last night when she went to that restaurant.

Emily 1:24:35
Yeah, but did she have a Christmas tree?

Scott Benner 1:24:38
Every year? Every year Emily, I swear to you, that's a wonderful, I wish I could find out what the hell that was about. Like you can have a Christmas tree with diabetes. Shame on anybody who wrote that episode. That article by the way.

Emily 1:24:51
That was not that was a joke in my family for years.

Scott Benner 1:24:57
Well, it should have been that's ridiculous. Alright, so hold on, I am actually creating. I am going to create an email to you right now. So that I said I literally don't forget, because I'm so hungry. When I get done here I am 100% gonna go eat something. Okay, do you feel okay about all this? Is there anything you want to talk about that we haven't talked about?

Emily 1:25:21
I just want to end on a funny story, if I may, please. Okay, so we took a trip to San Francisco, once my, everybody in my family it because I was like a, I think 11. And so we all went to Fisherman's Wharf, there was a favorite restaurant, my family would go to, and I was sitting, my mom would usually give me my insulin. When I was 11, just because it was easier. I mean, I could do it myself if I want to do but she just wanted to. So I was sitting sort of next to the wall, and my three, two sisters were sitting next to me. So it wouldn't really easy for me to get out and go to the bathroom and shoot myself. So mom, we had ordered our meal, and mom's like, Okay, I'm gonna shoot, you shoot, you now. Just get under the table. And I'm like, Get under the table. She's like, Yeah. And I'm like, okay, so I get under the table, and I stick my arm out. And she shoots myself, she shoots me, and I pop up. And the weight person is there ready to put my food down. And so she had a way person had shown up while I was under the table, saw that I wasn't there, turned around, picked up my plate and went to put it down, down. And then I was there. And she nearly jumped out of her skin. And we thought it was hilarious.

Scott Benner 1:26:50
Well, I'm, I'm sad that they made you get under the table to get your get your insulin, but at the same time, I think the story is hilarious. Yeah,

Emily 1:26:59
that is the kind of person my mother was she just caused very funny things to happen.

Scott Benner 1:27:04
So Well, it sounds like she was lovely. It sounds like in general, you guys were overwhelmed with diabetes. And we're not getting any help. And I hope that somehow this has been helpful to you. Yes, I really.

Emily 1:27:16
And I would like to add to anybody listening. I did and do love everyone in my family. So well, the little things that I'm talking about.

Scott Benner 1:27:26
Yeah, for context. Look, look, I have to thank you for your honesty, because you really were able to come on and tell stories that, you know, didn't shine people in the brightest light all the time. But you there's no need to say. I mean, to me, there's no need to say what you said. Because I don't think that what you said is an indication that you didn't love and respect and care for your family. I'm just saying that. You know, sometimes people are outmatched by the things they're asked to do in life. And sometimes those things impact children. And you were around some people who got outmatched a couple of times, unfairly points even to them. And then it just had the impact on you that it had. And it's not fair to you either. So you don't need to. It's not just because that's how their life went doesn't mean that that's how your life needs to go. I guess. If there's one.

Emily 1:28:15
Do you still think this is an an after dark episode? Oh, yeah. This

Scott Benner 1:28:19
is very sad. I'm incredibly sad. You're a little girl who? Listen, let's not go over it again. But no, I think it fits well. In the after darks. Have you heard any of the after darks?

Emily 1:28:33
Yeah. The one that caused me to write my email was the one with the woman who was a recovering heroin addict.

Scott Benner 1:28:43
Yeah, that one's tough. They're all tough. Have you there's a ton of them. There actually, are, I think of some of the best podcasts that we have. Because like yours, people come on, and they, they've gotten to a point where they recognize that they're going to be incredibly honest, because that's what people need to hear. So I appreciate that you did that very much.

Well, I'm gonna thank you for listening first, and I'm gonna thank Emily for telling her story. And then I'm gonna thank Dexcom and Omni pod for sponsoring this episode of the podcast. So here, I guess I don't have to do it. I pretty much did it. dexcom.com forward slash juice box, go check out the Dexcom G six. See if you're eligible for the 10 Day Trial Get started today. Omni pod.com forward slash juice box may be eligible for a 30 day trial of the dash. You can check out the Omni pod five, two. And what else you can get started with my link Omni pod.com forward slash juice box when you support the sponsors. You're supporting the podcast so thank you for using those links. Speaking of the sponsors, I almost forgot that I am contractually obligated to say this For full safety, risk information and free trial terms and conditions, also visit omnipod.com forward slash juicebox. All right, now we'll get to the other stuff. All the episodes that I spoke about with Molly are available at juicebox podcast.com, diabetes pro tip.com. Or you can join the private Facebook group, and then scroll to the top and click on the feature tab where they're listed for you. These are going to be the diabetes pro tips. This will be the diabetes Pro Tip series, The defining diabetes series and there's a lot else there's a lot else that's not English, there's a lot more, check out those lists in the Facebook page or on the website. If you're enjoying the podcast, please tell someone else about it. Please, please, please share the show. It's how it grows. And it is really growing. And it's because of you. And I can't thank you enough. Oh, what else? Seems like there should be more but this about an hour and a half in you probably get a little tired of me by now. So maybe I'll just let you go. Does that seem fair? I'll bring up a bringing another podcast very soon. You can check that one out too. Before I go, let me thank somebody in the Canada for leaving a really wonderful review of the podcast says I do not listen to podcasts. That's actually not what it says. It says I did not listen to podcasts before my daughter was diagnosed type one in February 2022. Now I listen to the podcast religiously and find that I have learned so much about good diabetes magic management, from the pro tip episodes, the pumping episodes and the ongoing exploration of how others with type one manage their disease. I am less than six months out with my kids diagnosis and feel like a mini expert on how to manage her disease and how to teach others about how to manage it. Isn't that lovely? That's all the way from the Canada that's a foreign country. Did you know The Internet even worked like that? I want to thank whoever JoJo jammer is by the way JoJo jammer cool name for leaving this wonderful review takes a few minutes to leave a well thought out five star review that helps other people see the podcast and think maybe I'll give this a try. So if you're looking for ways to promote the podcast, leaving a great review is one of them. telling a friend is one. Tell your doctor. You can go out the window if you want. I don't think it's going to reach anybody but do that. And while I'm thanking people here at the end. Do you know the there'd be no way for you to know I've never said this on the podcast I don't believe I think we're up to like six states in the United States where somebody has a Juicebox Podcast license plate, a vanity plate, like someone they say like juice box or juice box. Like stuff like that. I tried to show my children because I thought it was really cool. And they were like what what are people doing? I was like, I don't know, isn't this really great? They love the park so much. They did a plate for their car with it. Anyway. It'd be cool if you guys all did that. So couldn't you free time or whatever. Go get a different license plate. I'd like to have like a collage of all 50 states and not for nothing. There are license plates on cars and other countries too. So you know what I mean? Anyway, if you do that, thank you. It's very cool. It's heartwarming, but if you definitely do it, send me a picture, please. All right. Now I'm really leaving. I'm out of here. What do I have to say at the end? Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.


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#696 Double Transplant

Michele had a kidney and pancreas transplant.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon MusicGoogle Play/Android - iHeart Radio -  Radio PublicAmazon Alexa or wherever they get audio.

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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 696 of the Juicebox Podcast.

On today's show we'll be speaking with Michelle who's had diabetes for well over 40 years, but most recently has had a kidney and pancreas transplant. She's here today to tell us all about it. 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. If you're looking for the diabetes Pro Tip series that begins at episode 210 In your podcast app, you can also find it at juicebox podcast.com diabetes pro tip.com, or a complete list of the Pro Tip series and other series on the private Facebook group Juicebox Podcast type one diabetes up at the top in the featured section. If you're enjoying the show, please subscribe in a podcast app and tell a friend

this episode of The Juicebox Podcast is sponsored by Ian pen from Medtronic diabetes, vn pen is a reusable smart insulin pen that uses Bluetooth technology to send dose information to a mobile app. And I'll be telling you more about it later in the program. You can also go to in Penn today.com. To find out more. If you have type one diabetes, and are a US resident or are the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juicebox. Join the registry, complete the survey. And just like that you've helped people with type one diabetes and supported the Juicebox Podcast, they're going to ask you incredibly simple questions about type one, you'll know the answers, they're not going to be difficult. The entire thing will take less than 10 minutes. It is completely HIPAA compliant and absolutely anonymous. T one D exchange.org. Forward slash juicebox.

Michele 2:32
I am Michelle. I have been a type one diabetic for 45 years. And in May of this year, I had a kidney pancreas transplant. So that's why I'm on to talk

Scott Benner 2:47
I Michelle 45 years. All right. This is oddly going to be easy. Because it's 2021. So I just take 20 away, right? And now I'm down to 25 years, then I take the one away down to no way then I'll take 20 More away I get down to 1980. And what am I left with five? Did you were you diagnosed in 1975 76? Close? I was feeling pretty good about that. All right. That's, you know, I was born in 1971. Wow, how old are you?

Michele 3:22
I am 59 years old.

Scott Benner 3:26
You weren't born that much before me. 1962. So I'm just gonna say that a little bit.

Michele 3:33
I'm proud to be this old. I'm lucky to lift as long as I have.

Scott Benner 3:38
I'll tell you right now that I know you're saying that because you have diabetes. Right? Right. And when you're diagnosed, I don't have diabetes, I feel the exact same way. I got up this morning and I was like, I had my pants right. And my back is stiff as it always is. And I think to myself, Do I like Go for it? And just like pick my leg up like a person and stick them through? Or do I lean on something just to make sure I don't stumble?

Michele 4:07
That's pretty sad, but understandable.

Scott Benner 4:13
People want to understand they get older, right, Michelle? Exactly. Okay, gives them something to look forward to. I look forward to having to consider putting your pants on.

Michele 4:26
Struggle some days.

Scott Benner 4:28
I am determined to to fix this somehow. I don't know what I'm gonna do. I'm thinking about different exercises to strengthen. I'm trying different stretches but I just My back is hurt since I was like 20 years old. So I would like that to stop one day. I would just like to get up one day and not think about that. But I'm complaining to a person who had a couple of their organs pulled out and replaced with organs. So why don't I stop that and ask you a little bit about what it was like to have diabetes for 45 years.

Michele 5:00
Well, I was diagnosed at 14. So that was interesting. Because if you're, you know, getting right into those teenage years, and now something's wrong with me, which was very shocking, because I had been held healthy, pretty healthy up to that point. So, you know, I diagnosed spent a week in the hospital went home, I only saw a primary care physician. And I would see him once a year. So he would do a fasting blood sugar. And send me on my way for with my one shot a day of beef, pork insulin. So it went on like that. Boy for probably 10 years or so. Up, a friend of mine was diagnosed. A couple years later, she was she was a semi close friend, but not real close. And she came back from being diagnosed and was like, you know, you have a lot to do. And I'm like, not really take a shot today. That's pretty much it. All I have to do. So I went on for many years really, kind of living a normal life. With this one shot a day that I had to

Scott Benner 6:25
do, yeah. But what was testing like, then, like, how were you measuring success? Or where were you not?

Michele 6:35
I basically was not. So they showed us how to do the urine test. But to me, it made no sense at all to do that, because I couldn't do anything about it. So if it came back, hi, what do I do? There's there was really nothing I could do. They didn't really talk about increasing insulin or decrease in insulin. You know, they had me on the one shot today. So it was very interesting.

Scott Benner 7:02
So you could see you take this injection, and then their advice was to do the urine test strip, and then, but then no matter how the test came back, there was no next step.

Michele 7:15
Exactly. Exactly. So I had to eat at certain times during the day because you'd have those peaks and valleys for the insulin. But I'm a pretty relaxed person. So I wasn't on a strict schedule. It was more if I felt like I was need to do something. I would eat something my mother would make me breakfast every morning. So I would have breakfast right away. But beyond that, I pretty much lived a normal life.

Scott Benner 7:43
Okay. All right, and how long with high blood

Michele 7:46
sugars? Yeah, of course.

Scott Benner 7:48
You were were those urine tests usually high?

Michele 7:53
When I did them, but I quit doing them pretty quickly after diagnosis. I didn't really pay attention.

Scott Benner 8:04
I hear you. So I get that. How many years do you think that you did that just didn't just did that contest and did your doctor ever up your insulin like based on like weight gain or age or anything?

Michele 8:18
I just saw him once a year. And I don't remember him adjusting it. It was always like you're doing fine. Keep doing what you're doing. And like I said he was a primary physician. I didn't even know about endocrinologist at the time. So he diagnosed everything from diabetes to cancer to everything in between. Okay, and

Scott Benner 8:46
let's say Say that again, for me, you saw him

Michele 8:50
from 1976 to probably through college. Okay. So ad one, ad two,

Scott Benner 8:59
so he's not an endocrinologist. He's just a row. Okay.

Michele 9:03
And just a primary care. What general practitioner,

Scott Benner 9:07
what other issues did you have during that time?

Michele 9:10
Um, really? None?

Scott Benner 9:11
None. Okay. All right. So he just didn't do anything. You just kept injecting staying high and Japanese thing. winded. I'm like, I'm guessing that the technology changed somewhere and you changed with it or No,

Michele 9:23
I changed influence. I went to the you know, the synthetic insulin versus a beef pork. When that was available. I saw my first endocrinologist in the 80s because I went to was going to grad school. And I lived with my brother and sister in law and my sister in law was a nurse. So she recommended seeing an endocrinologist, which I went to his reaction was pretty much if you don't fix this, you're gonna die. Okay, and I, because he had me start doing finger tests, like at that point, the finger testing was available. So I would do it. And he had me doing it three times a day. And it was always in the two hundreds. But again, he didn't tell me what to do. And it was a little bit longer till they had that sliding scale, where if your sugar's this, take a shot, if it's this take a shot. So he didn't really give me a whole lot of information. So go ahead. Did you?

Scott Benner 10:33
Do you remember having any feelings about the information that you had gotten prior from the other doctor at that moment?

Michele 10:41
It was kind of shocking. It was like, Oh, I'm supposed to be doing something differently. I didn't know I had, I really didn't know. And but I thought I was doing what I was supposed to be doing. I, you know, do my show today and go on with life. I was went all through college that way. Did my shot a day if I like, spent the night at my friend's house or something, I just go back in the morning and take my shot. So it was just kind of a, you know, crazy time, or you especially now with all the technology that's available

Scott Benner 11:14
and what you can see now. Yeah, were you in your mid 20s. At that point, when you switch the insolence.

Michele 11:20
I was mid 20s. And then shortly after that, I was diagnosed with retinopathy. Wow. So that really scared me.

Scott Benner 11:29
Yeah. When you first get the hay, you're gonna die. If you don't do something talk. Do you even believe it?

Michele 11:37
I was kind of like, yeah, yeah, yeah, whatever. Like, I've been living this way. All this time. No one's ever told me anything differently. But I did what he told me to do, like, I'm a rule follower. So he told me to do this testing. So I did change the insulin I did. So that was my life. But, you know, once the right not that the came out. And I was dating somebody. And at that point, it was like, oh, I need to do something about this, because I don't want to go blind. So, you know, had laser surgery in both eyes. And that was probably 87. And, but I haven't had any eye issue sets. So they have been stable since then. I've got a lot of laser burns in the eyes, but the eyes have been very stable.

Scott Benner 12:34
Okay. Okay. Wow. That's crazy. Okay, so you're, you're so you're still doing it now. So now you're testing and you see your blood sugar's higher. But it takes more time to even get to the point where doctors are talking about making adjustments once you see your blood sugar.

Michele 12:53
Well, right. I mean, we they had the sliding scale, so then I would use that. Okay,

Scott Benner 12:59
about that point, what point in your life? Do you think the sliding scale popped up?

Michele 13:03
That was probably 8586 8586.

Scott Benner 13:05
Okay. That's okay. But it all makes a lot of sense. I'm just thinking back to when my friend was diagnosed in like 88. And I'm just putting the pieces together kind of backwards from what you're saying to this at all, that all lines up for me really well. But so when the retinopathy laser surgery in the 80s? Yes. What was that like?

Michele 13:32
It was a bright light flashing in your eyes. I probably had three times on my right eye, two times on my left eye, they would give a shot to numb the eye, kind of underneath that in their eye. And you would see bright flashes of light. I didn't like it. But I didn't want to go blind. So, you know, I kept going back for those.

Scott Benner 13:57
Yeah. And that and that. Plus, I'm imagining your control started getting better as well.

Michele 14:04
Right. You know, just because now I'm seeing of endocrinologist, I'm seeing a regular doctor. Then I met my husband in 87. We got married in 88. So he was there through the timeframe of the laser surgery. And, you know, shortly after that, I started talking about having a baby. Now my endocrinologist was like, I don't have time for you. So he ended up sending me I'm in Cincinnati, he ended up sending me to University of Cincinnati hospital that had a clinic for diabetics. And they were it was a study kind of measuring the effects of high blood sugar and low blood sugar on children that were born. So I entered that study and the doctors there saw me all you know quite often, even before I got pregnant to get the blood sugar's more in line, but they were proud played a Wednesday was probably still in the eights and nines at that point.

Scott Benner 15:05
I am fascinated that you there was a time where you could say to a doctor, hey, I'm gonna have a baby. And I'm like, yeah, get out. I don't want to be involved in this. But also that he sent you to a study, do you think he sent you to the study? Because they're like, well, this lady is going to provide good data if she gets pregnant, or do you think this study was meant to help you?

Michele 15:27
I really think that he, I think he didn't have time to deal with me and my blood sugar's so he sent me the study so they could deal with me instead.

Scott Benner 15:41
Alright, Michelle, are you telling me that that that standard care wasn't very adjusted, and you were trying to figure out something greater?

Michele 15:51
I believe once I knew better, I believe I stayed on top of technology and things like that. When I was pregnant with my first son, the nurse there had started wearing an insulin pump. And she suggested I get on it. But at that point, I didn't know how those worked. So I had my first child in 91. So I didn't know how the pumps worked. And my belly was so big, like, how is that going to fit on my belly? Because it was Medtronic back then. So I didn't start that till probably 9394, maybe 90, maybe 95 on the Medtronic pump.

Scott Benner 16:36
Okay. Wow. That's a that's really a tale. And now and you're still just, I mean, did you did you end up having a baby?

Michele 16:45
I had two sons. They were both healthy, healthy. They were big babies, but, but I was a big baby. So I'm, I'm sure part of it with the diabetes, but part of it was just having the genetics to have big babies. My first son was 10 pounds, or nine pounds, six ounces. And the second one was 1013. But I was 11 and a half when I was born, and my mother was not diabetic.

Scott Benner 17:15
Any other diabetes or endocrine issues in your family?

Michele 17:20
Yes. So my brother, I'm the youngest of eight. My brother, who is eight years older than me, was diagnosed at 14 as well. But he kept it really private. And he saw the same doctor as I did. So he had to boil his insulin needles and, you know, reuse the needle every day. So it wasn't a big shock. When I was diagnosed. We were all tested, when he was diagnosed. And none of us had it at that point. But I kind of had a feeling in the back of my mind that I was going to get it someday. I don't know why. But so when I was diagnosed, I was unhappy, but it wasn't a big shock. But again, I didn't see him living a very different lifestyle other than, you know, taking his shot every morning. Well, yeah,

Scott Benner 18:11
there was a lot of like, just masked ignorance right about what was Exactly, yeah. How.

Michele 18:17
And the funny thing is, we're a very smart family. We're not dumb. So it just the information wasn't available. You didn't have Google, you didn't have your doctor wasn't telling you. You didn't know it just

Scott Benner 18:30
didn't exist yet. It just you were doing the best that that was available to you. Exactly. How is his health generally?

Michele 18:39
His is not as good. He lost a leg. And he has trouble getting around now. He's still alive. So he's eight years older than me. 67. But not very healthy.

Scott Benner 18:59
Okay. Did he ever make the switch like you did.

Michele 19:04
He finally he got on an insulin pump. Gosh, I don't even know 1015 years ago, but it was much later than I did. And then he did try. He stayed with Medtronic. And he did try their CGM. But really didn't use it very often. And I talked him into the Dexcom. And I'm not quite sure how often he is. He doesn't like to talk about itself. Yeah, so we don't spend too much time talking.

Scott Benner 19:39
I understand. Okay, well, I appreciate you sharing that with me though. That's it's valuable information for the for the big pick. So

Michele 19:45
that's one. Pretty much everyone. All my siblings have thyroid problems one way or another either low or high thyroid. I have a nephew with type one diabetes. And there's talk about an uncle that had diabetes, but there was it was never very clear about whether he was type one type two or what, how that was related?

Scott Benner 20:13
Sure. What about genealogy? Where are your people from?

Michele 20:17
We are from Slovakia and Poland to half of each interesting. Thank you. My grandparents actually came from those countries.

Scott Benner 20:27
My wife's mother grandmother, my wife's mother's mother is Polish, and she had celiac. And they call it the sprue.

Michele 20:40
That's a new one.

Scott Benner 20:42
I guess at some point, it was referred to let me check celiac sprue I think it's been kind of like rebranded as celiac disease. Yeah, but at some point, it was called celiac sprue pets. That was kind of the, the general term for it. And my, my, my wife's grandmother, who was a generally unpleasant person, just she, she'd be like, I have this sprue I can't eat that. And it kind of went like that. That's great. It really, it really hurt her at the end of her life, because she finally I think she finally gave over to the dieting but way late. And, and it just then she was so old that the dieting for celiac, I don't think she was doing it. Well, she just lost so much weight towards the end of her life. Right. But anyhow, okay, so that's a lot. But I understand I appreciate you filling me all in on it. Now let's get to the fun stuff. Michelle winters really get upside down. Because I'm assuming it happened at some point if you ended up with a transplant right.

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Michele 25:16
Okay, so I mean other complications along the way. I have had probably almost all my fingers operated for trigger finger. I had frozen shoulders and both shoulders over time. But see again, you know once once I got pregnant once I was past that I would stay up on technology. You know, I got the insulin pump as soon as I could I got the CGM as soon as I could switch to Omni pod is I think I got the CGM in 2011. Yeah. Got the Omni pod in 2013.

Scott Benner 25:51
So you selling you know, I tried to stay on top? Yeah, ya know, you did exactly what you hear me talking about, right? Like, I'm always saying, you know, pay attention to technology, you don't want to be using the last generation of stuff, you know, keep up with what people are doing, you know, don't switch just the switch. But when it makes sense, you got to keep up because, you know, as we move forward, better technology is going to equal better results and better results are going to equal better health. Right? Yeah. You saw that and you got to it, your your brother either didn't see it, or didn't care to see it one or the other.

Michele 26:29
And he was eight years earlier. So you know, a lot of damage had been done by the time the technology came around.

Scott Benner 26:36
Okay, so you still felt hopeful? You think when when this stuff was available to you, like I can still do something about this for myself.

Michele 26:44
I never thought I never thought I had a shortened life or anything like that. I really just thought, Okay, it's just another piece of me and something I have to deal with. As I move forward. Yeah. So so the eyes checked me. And then over time, it's been a slow progression with the kidneys. So you know, you get a test at the endocrinologist, oh, you're you're creating levels that are higher than they should be. And that went on for years. And then, at one point, I finally said to my doctor, I'm like, should I be seeing a kidney specialist? And he's like, Yeah, you could do that if you want, you know, as the numbers were creeping higher and higher and the creatinine levels.

Scott Benner 27:30
Michelle, test me. Oh, nephrologist,

Michele 27:33
nephrologist. Yes,

Scott Benner 27:35
thank you, Grey's Anatomy, go ahead, keep going.

Michele 27:39
So I saw him and I'm not quite sure how many years I saw him, but I'm still feeling good through all this time. And I didn't really, I really never felt bad. You know, I still exercise I still do all the things that I'm supposed to be doing. I eat right. So then, at the end, January of this year, the GFR, which is what they look at to determine if you need to go on dialysis or have a transplant, it went to 20 or 18, beneath 20. So once it's 20, then you're eligible to get a transplant. So I'm still feeling pretty good. But I knew dialysis is can really be damaging to people. Yeah, so I went to four different hospitals and started just applying for transplants. So I contacted you when I was still in stage four kidney disease. And everything went pretty quickly. So I had to have a majority of tests. You know, you had to make sure your teeth are good. You have to make sure your heart is good. You have to make sure you get a stress test. A colonoscopy like every test in the world. MRIs, CAT scans, they've done every test on me in between January and May. May the end of May, I was finally listed at a hospital for a kidney pancreas transplant. Actually, two of the hospitals would list me one didn't want to because they thought I was too old. But the one I finally went with was really happy with the condition that I was in. They see they said they feel a lot of people younger than me that are in lot worse condition than I was. Okay, so I was listed. And three days later I got a call to get a pancreas kidney transplant.

Scott Benner 29:53
Huh? No, it was so quick. Show. Let me tell you something. So have you heard me talking about my friend Mike? whose past? Yes. Okay. So when he realized he needed kidneys when he started doing dialysis, I would say to him, like, you know, are you on the list, you know, get on the list. And he would always say I can, it's hard. There's money, it's insurance. It's this. And he always felt like, like too big for him to conquer the process. And then you just described how important it was like you went

Michele 30:28
after this, right? Yeah, I didn't wait. But you

Scott Benner 30:32
just were like, I am going to go find out how to make this happen for myself. Exactly. Good for you. Wow. Okay. So

Michele 30:41
right, because the first couple of hospitals I called, they said, No, we don't do any kidney pancreas under over 50. If you're over 50, we don't do it. So then I started doing more research calling around asking, and one of the hospitals I actually went with, told me that they do, do pay increases over the age of 50. But they wouldn't listen to me for that. They would only listen to me for kidney.

Scott Benner 31:08
So Wow. So this is exactly what he used to talk about. Like they always sounded like some people say they'll do both. Some people say they won't, blah, blah, blah, like and so you just had to keep looking to find somebody to do both. Exactly. Michelle, do you not have diabetes anymore?

Michele 31:26
You know, I asked that question yesterday. I'm like, am I type one diabetics? So the answer is, yes, I am still diabetic, controlled with a pancreas transplant. But I have not taken insulin since the transplant.

Scott Benner 31:44
Yeah, that almost made me cry. Michelle, actually, hold on, it might still give it. Hold on, I gotta do that wavy thing that you see ladies doing? Why does that work? By the way, we need to hear up if you just put some cool air on your face. It slows it down. I don't know. I don't either. But trust me, I do it a lot while I'm making this buck. Wow, that's incredible. Good for you. Do the downside of all this is.

Michele 32:12
All right, so there's lots of pills. So over time, I'll reduce the number of pills, because I'm only five months out at this point. So I have to take pills for digestion. I'm told those will go away. Eventually, I take anti rejection pills. So I have three different anti rejection pills, they need to take twice a day. I was recently told I have a low white blood count, which could be related to some of the medicines that I'm on. So you have to be very careful. I am constantly washing my hands. I'm constantly using hand sanitizer, wearing a mask, in crowds, and so on and so forth. So it's not just a breeze. There's still other things you need to do. But I'm feeling better every day. I've got a scar from my chest bones down all the way down. That's healed well. And I think because I was in good health forehand, at least I'm considered myself in good health. I think everything's feeling well. And doing well. Wow, congratulations.

Scott Benner 33:26
All right. So I want to walk through it. You get you get it all set up, and you find a place that's going to do both. Is it fair to say that without the kidney transplant, like what would your life have been like?

Michele 33:43
I had already been tested for doing peritoneal dialysis. So they were already talking about putting the tubes in, which would have been doing dialysis at home every night for eight to 10 hours every night and then another session during the day. So that's taking fluid into your belly, letting it sit there and draining it out every night and every day.

Scott Benner 34:13
And that's not necessary. Even if you did that every night and every day for your whole life. It doesn't mean that things wouldn't continue to go backwards, right? Correct. Yeah. So it's not like you're not stopping it in that even though that sounds like a unpleasant way to have to live. It's not like it would never get worse than there you would continue on. On exactly,

Michele 34:33
which is why I wanted the pancreas because I'm hoping to slow down some of the damage caused by the diabetes.

Scott Benner 34:39
Right. And surgeons must have felt comfortable about it because they gave you the organ Right? Exactly. Yeah. Okay. All right. So when let's start with the day you find out you're gonna get the surgery. What happened? Alright, you when Michelle we've got you know, you're on the list, right? So right Once you're on the list, is it's a matter of matching from donors, I guess,

Michele 35:04
yes, it's a matter of matching the blood type, as well as any antibodies that you currently have in your system. And I don't quite understand all of that. There's a lot of and I've asked, ask people, and they said, it's just it's very, very complicated how they match people with a donor, and you want to be as close as possible to the match, so that you're not rejected. I was lucky to have a B blood type, which means I'm a universal receiver. I can't give to any other blood type than my own, but I can receive from all blood types. So that helped.

Scott Benner 35:45
Okay. And then what was the, the amount of time between? Yes, you can be on the list and hey, we have your stuff.

Michele 35:52
So that was a Wednesday? Yes, you're, you're formally listed. On Friday morning, I got a phone call at 8am. And I didn't answer it because I didn't know the phone number. But then my husband's phone rang. And he answered it, and they're like, Okay, we have a possible donor. You need to hold on and look for this phone number and answer the phone. And if it is going to be your donor, you'll have to come to the hospital to tomorrow morning. So Saturday morning, so you have one day to get your things in order. And in February, I had a new puppy born, so most of that day. So the puppy was born in February, I brought it home in April, thinking I'd have all this time to train her. And so most of the day on Friday, I was trying to figure out what I was going to do with her because my husband works. He can't take care of her. I was working from home, which was helpful because I you know, I could do training in between the times and take her for walks at lunch. So my kids ended up like taking her the day I went into the hospital and drove her up to my sister's house four hours a day so that she could hold on to her while I was recovering.

Scott Benner 37:19
Let's be honest, though. Did your sister do a good job training the dog?

Michele 37:23
She She did a great job. Are you worried she ever lessons? Yeah, no, she did. She's she's an animal lover. She's had animals all her life. And I knew she would do a great job with her.

Scott Benner 37:35
So it must have made your boys feel good to do something. Like kind of like wholesome for you as you were heading into surgery too. I would imagine Exactly. Yeah. How about them? Do they have any autoimmune stuff? The kids?

Michele 37:47
They do not I had them in testing. I don't think it was called trial net then. But because I was in that program. I followed up at the Children's Hospital with testing from for them early on. They hadn't had any antibodies, or whatever the things are called for markers.

Scott Benner 38:06
Michelle, do you think it would be absolutely ghoulish if me if I said trialnet.org forward slash juice box right here.

Michele 38:13
Go ahead, go right. Are you telling? I keep telling my son to have his son tested? And so yeah, I'm all for trial on it. But that was probably the beginnings trial net wasn't really an existence, I think when they started because it was 9193.

Scott Benner 38:31
Okay. Oh, yeah, probably not. You were just getting that testing through a different way. You probably knew a lot of things because of the stuff you did earlier in your life. Right with research.

Michele 38:41
Right? Right. I kind of stayed on top of that. So yeah, they did that we I took them to Children's Hospital for years after that, you know, having them get different kinds of blood tests along the way. And then my younger son recently went back and had more testing done. And he still did not have the markers.

Scott Benner 39:02
So I'm good for him. I'd be nervous too. If you are my mom you understand? Yeah, no kidding. Let's look one more time. Okay, I'm sorry. So now we've got the dog squared away and we're sitting around Are you sitting in your house thinking this isn't gonna happen or it like is it hard to feel hope? Is it I

Michele 39:24
thought, no way is this going to happen? Because I've read you know, my kidney groups on Facebook, I'm on kidney pancreas groups on Facebook and you know the time it takes to get tested and the number of times people have to go and wait at the hospital and then it doesn't match for some reason. So I went on Saturday we went got there at 7am sat and waited and waited and waited they had to go get the organs. They had once they brought the organs back they had to so as I understand it, when they To acquire the organs, they have to wait for the heart to be taken out first, and then the liver. And then so the other organs get taken first, and then the pancreas and kidney come out. So each doctor team, oh, okay does their own organs, so they fluid back. And then another doctor had to take a final look at the organs to make sure that they were still viable when they were back in our location. And I don't know who my donor was, I don't know where it came from. I don't have any of that information unless the donor family wants to tell me Can we?

Scott Benner 40:37
Can we ask you about guilt? Like two things? So did you feel like you were jumping the line? Because it was happening so quickly? And is it a weird thing to be happy about somebody passing away?

Michele 40:52
It is. It is it's, it's odd. But the way I kind of look at it is they were probably already on life support when I got the call. So if it wasn't going to be me, it was going to be somebody else. So that kind of helps me with the guilt of taking it from someone named Michelle, I'm happy it's me. Yeah,

Scott Benner 41:17
I don't think you should feel guilty. I'm just imagining that it has to be a natural reaction.

Michele 41:23
Right? I think if I knew more about my donor, I probably have even more feelings about it. But at this point, I'm just happy. I'm blessed to be able to been on that list at the time I was and been available. I asked them when I was called, is there a backup? And they said, a backup person. Like if I don't give it they will get it. And I was the only person I guess in the country that was a match for this organ.

Scott Benner 41:51
Good for you. I mean, yeah, it's amazing. I would, I would have been like this is nuts. Just because you were probably just resolved right? Like this may happen. It may not happen. It's going to take years.

Michele 42:04
Right? I thought I thought six months, I really thought okay, it'll be a while. Because if it's kidney only the weight per kidney only is like five years plus. Or you can do a live kidney donor, which you can get quicker. And I did have people that said that they would get tested. No one actually had gotten through the testing yet because they don't test them until you're formally listed.

Scott Benner 42:30
I want to know what to ask you so badly. If you believe the people who offered or not, or do you think they do you do? Yeah, okay. I do. I do you know what I mean? Right? Like, I'm not being a I'm not being a jerk. I'm just like, I wonder how many people just out of like, you know, like, are like, Oh, Michelle, I'll get I'll do it. Yeah, I'll do it. Like, you know, do you mean yeah, that's what I was wondering. Oh, this is this is all kinds of

Michele 42:57
friends contacted me because I put something on Facebook just I wasn't asking. I just kind of did my situation update. And two of my friends from grade school that I haven't really stayed in too much contact with over the years. Both offered to get tested. How did

Scott Benner 43:18
that make you feel? Like I imagined it's a it's a wonderful feeling. But do you question it like, Have you ever considered like, I don't know if I'd give my kidney to somebody.

Michele 43:28
I was so grateful. So grateful. It just amazed me how generous people can be.

Scott Benner 43:36
No, it's really fascinating to me. i That's those people. I'd like to talk to one of those people. Somebody somebody that just said yeah, you can have one of my kidneys. That's you don't I mean, like that's a special statement. Right? Exactly. Okay, so you're it's five years of the five years for just the kidney what was what was the expected length for both again?

Michele 43:59
They didn't really tell me but they told me probably within a year, I would find a match. Wow. Because because it's two kidneys or two organs versus one. And pancreas is aren't in as high demand as kidneys are. Oh, I

Scott Benner 44:14
see by asking for the pancreas as well. It moves. So most people are just looking for kidneys. Right? Oh, so by by matching to you we don't waste the pancreas. Exactly. I'm getting it now. Michelle, I'm really coming online here with this. Okay. So, okay, so you're in the hospital. They're like, wow, this is gonna happen. Do you freak out? Are you nervous? Do you have any second thoughts?

Michele 44:42
We waited all day long and I didn't think it was I I tend to think of the worst outcome so that I'm not disappointed. I'm more happy so we didn't really know you know, we're waiting waiting. There's really no word or problem. really their Gosh, at their at 7am, it was probably 12 to 14 hours before they finally came in and said, Hey, listen, we need to do an enema because you're about to go into surgery. I'm like, okay, so all day long, they did not have me eating, but they just wanted to make sure your system is totally clear. And then it happened so quick, like they put me on a stretcher, wheeled me back, my husband saying goodbye to me, as we're wailing back. And I was knocked out.

Scott Benner 45:38
Is there any, any concern about just not making it through the surgery beyond the general concern about being put under?

Michele 45:48
I think my husband was worried about that. I really didn't think that that was a chance. So I just naively, but I just thought, hey, I'm getting this done, and I'll be fine.

Scott Benner 46:01
Did you have that moment on the gurney? When you looked at him? You thought he thinks I'm gonna die?

Michele 46:07
afterwards? Not at the time, but after a couple three comments, and I'm like, Ah, he didn't think I was gonna make it.

Scott Benner 46:16
I gotta be honest with you. I had my appendix out in an emergency situation. And I was like, on the phone to people. Like, I gotta say, oh, no, it doesn't seem crazy to me, they're gonna put you to sleep and cut your body open. I mean, I know people do it all the time. But it's some some people don't react well to anesthesia. So you know, I was doing my diligence column, my call my peeps, you know, let everybody know. But this sounds like it happened super fast for you. How long was the surgery?

Michele 46:51
The original surgery was seven or eight hours. And then the doctor came back and something was too tight. So then I was in surgery for another two to three hours. So in he had to bring the whole team back in, because they had gone home went to bed. So he had to bring the whole team back in and had more surgery. Meanwhile, my husband is there in the waiting room, wondering what in the world is going on going on? And only getting, you know, bits of information back? Oh, we have to take her back in. didn't really explain why they had to take me back in.

Scott Benner 47:30
Let me understand the process seven or eight hours for the surgery come out. You're in recovery. And pretty quickly. They realize you have to go back.

Michele 47:37
Yeah. And I was not awake. I don't remember being awake during that time. So I didn't know anything about it.

Scott Benner 47:44
Okay, something was too tight. And then they can you you know, it's funny as you're talking about this. I'm like, how do they do that? How do they perform surgery for seven hours?

Michele 47:57
I know they had two different surgeons, one for the kidney one for the pancreas.

Scott Benner 48:03
I'm just telling you, I can't stand that long.

Michele 48:05
Yeah, exactly. If you like, some special people. Yeah, they can be called at anytime, day or night, and they have to come in and do the surgery. So they're very special people are go collect, you know, click the organs for more, they need to be collected.

Scott Benner 48:22
My mom has to have surgery next week. And my brother had already made plans to come in to be here a number of days prior to the surgery and after the surgery. And then they up and called us yesterday and said we need to move the surgery to the following week. And I said please don't do that. You know, like I my brothers. My brother's not a wealthy person. I don't imagine he bought refundable airline tickets. And you know, like, right, you know, stuff like that. And so she calls me back an hour later. And she goes, we're just going to do it the next day. And I said, Oh, that's wonderful. Thank you, the doctors just gonna tack it on to the end of his schedule. And I was like, Wow, what an amazing thing. You know, I'll just do one more surgery on Thursday so Bev son can fly in and see her before her surgery. And I was like, wow, yeah, some doctors are amazing. And some you don't get anything out of

Michele 49:12
and I think you know, they have a whole team of people. So I think you know, you've got the original the people coming in that are prepping you and the anesthesiologist and the you've got a whole team of people that do the the closing up afterwards. So I think everyone has their specialty that they stay in for some I'm sure they have breaks during those that 1011 hours

Scott Benner 49:34
still amazing. So you come out how long does it take you to come to and then what do they expect from you? They want you like nowadays they get you moving pretty quickly after surgery. But what was your process like?

Michele 49:46
I I was in the hospital for two weeks.

Scott Benner 49:51
About your I

Michele 49:53
had, like I had some problems. So I think most people are six to eight days. That's what they tell them. But I had some problems like at one point, I couldn't keep any food down. I got Botox in my stomach. Which was, you know, I joke that I got Botox, but it didn't make me look any better. I imagine what that was supposed to do is make your stomach more active to move the food through because I was having trouble keeping anything down. Then electrolytes were kind of out of balance. So I had to have fluid and magnesium and potassium and phosphorus and all those kinds of things added.

Scott Benner 50:34
Were you in danger? Or is this just things they had to do? It?

Michele 50:40
This was ask your question again.

Scott Benner 50:42
Were you in danger? Or were these just steps that needed to be taken? Because

Michele 50:46
no, I think this is it was pretty common. Okay. For the surgeries. Just did people have different kinds of imbalances after that type of surgery?

Scott Benner 50:58
Okay, two weeks, and, and when did the medications begin, right away, antirejection, all that stuff, right away, right away,

Michele 51:08
right away. And then for the first three months, they're really, really careful with you because you have so many anti rejection pills at the beginning. And they say really, within the first year, it's really important to stay healthy through that first year.

Scott Benner 51:24
Did you ever hear Nicole's episodes about her surgery?

Michele 51:28
I did. Yeah, I did. I've listened to you quite a bit. And I'm actually still listening. And I don't know why. It's kind of crazy. But I contacted you back in 2016. When I had my agency had gotten to 6.3. So I messaged you on Facebook. And you said congratulations. Then after that. I was volunteering with JDRF and trying to get people set up for booth at our JDRF tonns event. And I contacted you and you said you couldn't come out to get a booth. But you could maybe do flyers or something and you never sent them. And

Scott Benner 52:21
so I'm very busy. I'm a one man show here. I'm so sorry.

Michele 52:23
I know. Well, then then you came I think the next year or the following year and spoke at Cincinnati. JDRF. tell

Scott Benner 52:31
people how good I was.

Michele 52:33
You were excellent. Did you talk during the luncheon?

Scott Benner 52:38
I did I asked for that actually. Because while everybody's busy wanting their own little space. I'm like, I always think everyone there has to eat and they eat at the same time. So I get to talk to everybody if I eat if I speak during lunch. There you go. Yeah, it's a I remember that there's a big room. It was a really well run event as well. Exactly. Yeah. No, i i It's uh, as far as those things go, I think of that one is almost a gold standard. The person who runs that chapter is type A and the best way and that that event goes off very, very well. I you know, I met Chris Rutan there for the first time. I met him in person.

Michele 53:23
Yeah, I saw him speak when he was there.

Scott Benner 53:25
Did you Okay, yeah. Okay.

Michele 53:27
And then. So, so yeah, I was actually on a panel that day of adults with type one. So the night before they had that reception, and I met you briefly while you were there as well.

Scott Benner 53:44
Oh, at the home was someone's home. Yeah. What is? What is art asking me Hold on a second. I'm sorry. You're fine. She's like, can I call? Can I call who? Me? I'm sorry, this is out of nowhere. I'm trying to figure out what this is. She's had trouble with her loop app earlier. And I helped her through it. Okay, she's gonna call me let's find. Let's find out why together Michelle. I'm just gonna keep Okay. Well, I'm gonna take off one of my earphones. Hey, alright, what's up

Oh, are you home still

so, honey, the problem is there's a little bit of a there's a glitch in the loop app and I need to reset it. So we have to have your the Bluetooth has to be off for like 20 minutes before we do it. That's why I had you do it when you came home when you told me it was working okay, so it's not gonna work till we make this little adjustment in the timezone. It's a glitch in the app. So when are you coming home again? were you headed to a restaurant? Oh, okay, well shut your Bluetooth off. Bring the food home when you get here. Come right to me and we'll do the fix. Okay, and watch your blood sugar on your deck. Stop yourself. Alright, bye. Sorry, Michelle technology let us down there. There's a small glitch apparently in the version of the loop app that Arden is using. And if you try to change the insulin sensitivity, and the timezone in the app is wrong. It crashes the app. So anyway, I don't know if that sounds like gobbledygook to you or not. We should I lose you. Michelle. Michelle, the show my Hello Michelle. Hello. Hello. Hello. Michelle. What the heck? Alright, I'm gonna stop recording. Michelle. Michelle, Michelle. Michelle. Michelle. Hello. Hello, Michelle. Michelle. All right. I'm gonna send her a chat. And you hear me? Hello. This is the end. Aquarius? Why would that song pop into my head? On Aquarius. Michelle Deanna, I can hear her typing. And she's not answering me. See if I have a phone number for do. This is boring. There's no way I'm leaving this in. And yet every time I say I'm not going to leave something in. I totally leave it in

Alright, I've texted her. I said, Hey, it's Scott. I can hear you typing but you can't hear me. And then I said it out loud. In case you maybe would hear people do not want to make a podcast. It's a lot of work. And sometimes it's irritating. And annoying and weird. Why is she unable to hear me? Michelle? Michelle. Michelle. Michelle. Michelle. Michelle. Hello, Michelle. She is not here

all right. I'm gonna call her will she answer this while she thinks she's making a podcast? No, right.

Michele 58:47
I can't hear you at all.

Scott Benner 58:49
Oh, okay. Michelle. Huh? She can't hear me at all. Why would she not be able to hear me?

Michele 59:06
I don't hear you. Hey, Michelle. I

Scott Benner 59:08
know we're on the phone now. But I hear you fine. And you're not hearing me. So let me I hear you through the phone. Yeah, let me figure out why that is. I don't know why that would be on

Michele 59:19
mute somewhere.

Scott Benner 59:22
I'm looking that looks right. Nothing here changed.

Michele 59:29
The lower left hand mute my audios that

Scott Benner 59:33
No, I didn't mute anything. I actually was like, keeping you on. I was recording with you. I wanted you to hear the phone call. Like just because I thought I didn't know if it would be interesting for the podcast. Not like I'm not muted. I'm gonna mute myself now. And then unmute myself again.

Michele 59:50
I heard the first part of the phone call but then it went away.

Scott Benner 59:54
Wait, can you hear me now? Through your computer? No. That's insane. There's nothing different here. All right, well, that's no,

Unknown Speaker 1:00:06
I hear you now.

Scott Benner 1:00:07
Oh, okay, I'm hanging up the phone. Now you can hear me. Yes, that doesn't make any sense. But who cares? I'm sorry. So you, you didn't hear all that Arden's having problems. Her loop app has a glitch in it, and it crashed the app. So she's gonna have to come back here in a couple of minutes. You're gonna hear me fix the app again. But she'll be in person when that happens. So I don't think anything should change on the audio. Okay. Okay, I am sorry, that was so long. I forget where we were. But I hope you

Michele 1:00:40
I don't remember either. We talked about post surgery.

Scott Benner 1:00:44
You were going through your medications and and everything you were taking after post surgery, told me that you had some trouble digesting. And then

Michele 1:00:54
yeah, that was in the hospital.

Scott Benner 1:00:57
Sorry, we were in in Ohio. You were telling me about being there. And I was getting ready to ask you. Because you were talking about having seen the been listened to the podcast for such a long time. So why why are you still listening to the show?

Michele 1:01:12
Don't know? The stories are interesting,

Scott Benner 1:01:16
I guess. Yeah. Do you feel bad for not having diabetes anymore?

Michele 1:01:20
No, I don't feel bad. I do know that my body can attack my pancreas again, because I'm still have those more markers that I had before. Those don't go away. Yeah.

Scott Benner 1:01:34
Right. And so it is possible that you could just get type one again with your new pancreas. Right, exactly. Is that based on other transplants?

Michele 1:01:46
I haven't found them. People, like the hospitals will track transplants, like after one year after five years. And they don't do a great job of tracking things after that. Okay. Which is kind of interesting.

Scott Benner 1:02:03
Gotcha. Well, let's just say that would suck. And I hope that doesn't happen.

Michele 1:02:09
Me too. Me too. But I think the technology will be so much further by then. That it won't be such a pain.

Scott Benner 1:02:17
Yeah, well, I mean, you you really are pretty caught up where you are until all of this until you put your pump in a drawer, I guess. Right? So like retiring? Did you like fold it up and put it under your underwear or something like that? Or?

Michele 1:02:27
I wore the Dexcom for about two months afterwards? Because I was afraid it was gonna get the sugars were gonna go high. And then it ran out one time. And I'm like, I'm not putting that back on. Why should I wear it? Okay, so I quit worrying. It

Scott Benner 1:02:44
was pretty cool. It really is. How scary is it to have all this going on during COVID.

Michele 1:02:52
It's worse during COVID. Just I feel more isolated. I can't really it my problems are kind of like COVID, where you can't see COVID. And you can't see all the germs in the system. So you don't really know where it's safe to go and what's not safe to do. So if I'm in public, if I'm in a group of people, I'll wear the mask. If I'm just around a few people I won't. It's much more easy to find a mask than it was probably prior to COVID. Yeah.

Scott Benner 1:03:28
You go all the way using it again. And 95 mask? I do. Yeah, I would. Yeah, I put one over my eyes. If I was you, just in case.

Michele 1:03:37
I know. I work I work glasses most of the time. So I'm a little protected.

Scott Benner 1:03:42
I would wrap my whole head in one, just bubble wrap people would be like what's wrong with her and I'd be like, I just had a transplant. Get away from everyone get away from me. But the feeling of isolation is real. It's terrible. You know, so I feel free there. And you said the first

Michele 1:04:01
I just had a baby granddaughter. I have a three year old grandson and a newly born baby granddaughter, and I've gone over there and saw them. I wore my neck the whole time because I'm worried for her too.

Scott Benner 1:04:15
Yeah. But congratulations. That's lovely. Thank you. Good for you. How's your husband handle all this? Has he been helpful? Did he do like is he like, standard guy thing? Does he stand in the corner and wait for you to need something? Or has he kind of jumped into action?

Michele 1:04:31
He he tries to be helpful. I mean when I was in the hospital. So the hospital was two hours away from Cincinnati. And I had to go two times a week after I was released from the hospital. So I actually had my top four brothers and sisters are all retired and they spent a week to 10 days with me and driving me back and forth because I couldn't drive for a while and But he would when I was in the hospital, he would come home from work, drive the two hours, sit with me for two to three hours, drive home. And then you know, wake up the next day do the whole thing again. So he runs his own business. So he doesn't have the luxury of just calling in sick, you know, he's off to do the work.

Scott Benner 1:05:20
Somebody got paid for those pills.

Michele 1:05:22
Exactly. Do you and I'm still working. So I carried the family insurance, which is good.

Scott Benner 1:05:30
At this point. Yeah, good for you that you're able to work through the they gave you would you take like FMLA little medical leave, and then come back start

Michele 1:05:39
short term disability for the first three months. And then I came back and they're allowing me to work for from home for six months, because the hospital requested that I do that. Excellent. How do you like working from home? I love working from home. So I've been working from home for a year and a half now. And it's awesome.

Scott Benner 1:05:58
I have to admit, I enjoyed myself. I don't know like the best probably is just very, you know, I don't know how interesting this is to people. But I love that I can get up in the morning, do a bunch of my work, record an episode, go, you know, grocery shopping, if I have to then come back and start working again. Like it's so it's so nice not to have to do stuff like that. At the end of the day when you're exhausted. It's so much easier to work until you're tired and then stop at the end. I do find that I work too long. Because I because my job's at home. Yes, but But I do like the knot. I do like that part of it like getting to break up the day. I do wish I had to move around more though. And that that. Well, that's right.

Michele 1:06:43
I did get my puppy back. And she has way more energy than I ever expected. So I get out at lunchtime and take her for walks. I'm up to like, I don't know, a mile and a half a day taking her for walks. So that's good.

Scott Benner 1:06:57
How long did your sister have the puppy?

Michele 1:07:01
About three months? Wow.

Scott Benner 1:07:02
Did she have trouble giving it back to you?

Michele 1:07:05
I think she was ready for me to get her get her back.

Scott Benner 1:07:09
So not attached. She's like, Please somebody come kick this

Michele 1:07:12
off. She was shocked at the puck he still remembered me. But she did. We met about halfway and picked her up. And she still remembered me and came home and is very attached.

Scott Benner 1:07:25
That's excellent. Good for you. Is there anything? We haven't gone over that I've missed? Because I don't understand the whole process?

Michele 1:07:33
I think we hit a lot of things. I don't I don't have anything that I can think of off the bat.

Scott Benner 1:07:41
Yeah, what is your moving forward look like? Oh, you thought it's something go ahead.

Michele 1:07:46
I was just gonna say the reason I wanted to why I didn't really want to be on the podcast. But the reason I contacted you was because you can't find anybody going through the kidney issues. Like there are a lot of people online but no podcast, no type one diabetes, talking about complications and things like that. And I wish I you know, I listened to Nikki, listen to her calls, but having people with real life experience is so difficult to find. So I broke down and said, Okay, I'll be on the podcast and contacted you and you're like, Okay, set it up.

Scott Benner 1:08:30
Let's go. I'm very grateful for this. And I agree with you there aren't I mean, listen, if you have a four year old that just got diabetes, I don't know how fun this is to listen to. But, you know, I think there's some solace that comes from the fact that you were diagnosed, you know, in the 70s, your care is nothing like care is now. But in fact, there are still people who don't, who don't pay attention and or don't have the tools or don't have the knowledge or whatever you want to say, to create, that you still can create this problem for yourself in modern times. You know, and so it's, it's good for people to know what could happen, you know, people who are like, Oh, my blood sugar is just 200 all the time. Well, that's what yours was. Right? You know, and,

Michele 1:09:16
and I was just naive. I'm sure there was more things I could be doing. You know, the more I talked to people or volunteer with JDRF there are people that have been diagnosed as long and knew more than I did at that time, right? Yeah, yeah, I just didn't have the the contact

Scott Benner 1:09:33
information just did not have access to the information. That's why I like to have people on to talk about all kinds of different things. Because I know there are some people are going to be like, don't you know, why are you telling me about complications, but it's so that you understand the big picture, and so that you can then apply it back to your life and think maybe I am missing out on something the way Michelle was missing out on something. Great. Did you enjoy Mike's episode about complications? Which one was that? Very recently it was an after dark about complications. Oh, yeah, yeah. I listen to that one. Yeah, that's the kind of stuff that has to be said once in a while, like you said, because nobody talks about like, I mean, I'm, I'm nearly 600 episodes into this, as I'm recording this right now, no one's ever no one has ever once contacted me and said, I want to tell you what it's like to be on dialysis. You don't think there are people listening to this show who have been on dialysis who are on it now. And no one's ever reached out and said they want to talk about it. And I understand that, but I'm saying there are plenty of people out there that might benefit from hearing from those people as well. Exactly. Yeah. I'm glad you did this. Thank you.

Michele 1:10:42
You're welcome.

Scott Benner 1:10:43
Let me just ask you a couple more questions, and I'll let you get back to your life. So moving your your new lease on life, moving forward, is your it's about staying healthy, staying away from being ill taking your pills, but what other milestones are you looking forward to or having to reach?

Michele 1:11:03
I want to start traveling again. So we're possibly doing something in February, we'll see. I still have to make reservation. So we'll do that. I'm spending more time with my grandkids that's on the top of my list.

Scott Benner 1:11:20
You want to travel somewhere warm?

Michele 1:11:21
I want to retire soon. But it's kind of out of the picture right now. It's I carry the insurance. And I'm too young for Medicare set. Well, I actually I'm on Medicare for three years, but my insurance is primary and Medicare secondary for 30 months. So how did you get on this early because of the end stage renal disease. So as soon as the transplant hit, I'm eligible for Medicare for three years. Gotcha. Okay, that only takes me to age 62. So it's still another three years in between till you can go on or I can get insurance.

Scott Benner 1:11:55
Right, right. I understand. Wow, that's a little scary to me. Yeah. But you'll you'll, it sounds like it. Listen, I gotta be honest with you, Michelle, you kick an ass. So I don't imagine you can't get any of this done. You took the bull by the horns about 16 times in this story. And ended up getting everything you needed. So I'm really impressed with you. Seriously, thank you. Yeah, thank you. Good for you. All right, I'm gonna, I'm gonna say thank you and let you go. I really appreciate this.

Michele 1:12:27
Okay, thank you. I appreciate all that you do. Oh,

Scott Benner 1:12:30
it's my pleasure. It really is. Hold on one second. I'm gonna say goodbye to you like privately. Okay.

A huge thanks to Ian pen from Medtronic diabetes for sponsoring this episode of The Juicebox Podcast, head over to Ian pen today.com. To find out more, you can also find those links in the show notes of your podcast player, the one you're listening in right now probably at juicebox podcast.com. Don't forget if you're a US resident, please go take the T one D exchange. Survey. Take it from me t one D exchange.org. Forward slash juicebox. Thank you very much for thinking about doing that. Alright, so we thank them pen. We thank you. Who do I thank you. I will thank you in a second. We asked you about the T one D exchange. What else should I say to you before I let you go? I don't have anything. Oh, my goodness, my mother, where are my manners? I want to thank Michelle for coming on the show and sharing her story. How crazy is that? That she got that transplant so quickly. Absolutely stunning story. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Oh, I'm sorry. You know what I Michelle sent me a note later she said when we were talking about other autoimmune stuff in her family. She neglected to talk about her sister who had Ms. She said it progressed very quickly. And she passed from it at age 48. Her sister was six years older than Michelle. She asked me add that and I wanted to wanted to do that for Okay, so again, thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. If you're enjoying the show, please subscribe or follow in a podcast app like Apple podcast, Spotify, Amazon music, wherever you listen in an app. If you're enjoying the show, tell a friend about it. Or an acquaintance or anybody you think might enjoy it. Tell your doctor about it. Tell somebody Thank you. This show grows when you share it with people and that's why I asked you to do that. Alright, that really is that now I'm gonna go I hope you have a good day.


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