#703 Butthole Adjacent

Katie has type 1 diabetes and a rather unique diagnosis story.

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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 703 of the Juicebox Podcast.

On today's show we're gonna be speaking with Katie. She's had type one diabetes for only about a year. But Katie is going to give a whole new meaning to the word open and honest on today's show. While you're listening, please do 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. Are you looking for the diabetes Pro Tip series? It begins at episode 210 In your podcast player, or can be found at diabetes pro tip.com, and juicebox podcast.com. If you would like a list of the episodes available on the Pro Tip series, or really lists of all the different series in the podcast, you really should consider joining the private Facebook group Juicebox Podcast type one diabetes and then going up to the featured tab where they are all listed in a very neat and orderly fashion. The T one D exchange is looking for US citizens who have type one diabetes, or are the caregivers of someone with type one to take a brief survey AT T one D exchange.org. Forward slash juicebox. This show is sponsored today by the glucagon that my daughter carries G voc hypo Penn Find out more at G voc glucagon.com forward slash juicebox. today's podcast is also sponsored by touched by type one, head over to touched by type one.org. To learn more about this great little organization, or to get tickets for their upcoming extravaganza, which yours truly will be speaking at. Lastly, but not leastly. The podcast is sponsored today by the Contour Next One blood glucose meter, you can get the Contour Next One at contour next one.com forward slash juicebox you will find links to all of the sponsors in the show notes of your podcast player and at juicebox podcast.com.

Katie 2:23
My name is Katie, I'm 28 years old and I was diagnosed with type one diabetes. Actually, I think it's going to be a year ago tomorrow.

Scott Benner 2:33
Really? Yeah. I just had the conversation with somebody recently where I said like so excited and like, like a child most like, you know, everybody comes on on their birthday or their diversity is or something like that. It's like it's such a coincidence that I realized that's not a coincidence. People look at the calendar and and pick when they come to their property one.

Katie 2:52
This one was semi coincidence. This was like the earliest, you know, date you had on and all that fun stuff. And then I just was like, Oh, well, that's the day before. That's kind of cool.

Scott Benner 3:02
Nice. Well, I'm happy you're here and, uh, years an interesting amount of time. So we'll say it again. You were how old? were you diagnosed?

Katie 3:09
I was 27.

Scott Benner 3:12
Do you have any expectation of this in the family or anything?

Katie 3:16
Oh, yeah. I think Oh, yeah. I think I mentioned in my email. I have my mom is a type one. Two of her sisters are type one. And then another one of her sisters daughters. So my first cousin is type one. So that's 1234 type ones kind of in my immediate family,

Scott Benner 3:37
your mom, two aunts. I say what am I from the south? A mom to ask. What do you prefer? Katie? Aunt or aunt?

Katie 3:48
I call aunts? I mean, I'm like semi from the south. But I say aunt.

Scott Benner 3:52
Okay. And then you makes five in the family. Yeah, yeah. I think there's gonna be more. Are there other people walking around looking real nervous?

Katie 4:02
I don't know. I besides myself, everybody else was diagnosed when they were like six or seven years old. And it's interesting. They've all been females. Like there's no Oh, okay. Oh, males. Yeah.

Scott Benner 4:14
What else I would this with a number like five? I feel like you're gonna tell me. Three of them have Hashimotos or hypothyroidism?

Katie 4:23
Actually, I don't 100% No, I know my mom doesn't have hypothyroid or Hashimotos. I know have a little cousin doesn't either. And I'm pretty sure the other two agents did not fit their celiac. No, not that I know. Okay, well, just I just diabetes. When

Scott Benner 4:46
you hit that number. I was like, oh, there's going to be a bevy of autoimmune diseases in that family and then nothing.

Katie 4:51
Yeah, you would think and then I mean, I have a really big family. So I guess I don't know everybody's intimate health history but that's Um, we talked about a whole lot, but even in the extended family, like, I don't think that there's any other real autoimmune stuff going on. Wow, that's

Scott Benner 5:06
fascinating. And all females, all females. Yeah, I think, um, I've said this before, I think it's my wife's side of the family seems to have some autoimmune. And it's all females. And then, and then suddenly my son got Hashimoto. So I guess that breaks that mold. But, but I don't know. Also, I'm adopted. So, you know, yeah. I could come from a week of people with autoimmune diseases have no idea. Okay, so this happened about a year ago, it wasn't a complete surprise. Was it one of those that you found out really, obviously early, because you're like, Oh, I recognize this, or?

Katie 5:45
I wish it was. Yeah. Okay. So I, I wanted to tell the story, it's hilarious, embarrassing, etc, etc. But I love it. And any of my friends who listen to the story are going to love it. So I actually, you know, I'm a nurse, and I work night shift. And this was last summer, I'd been like, I've been kind of dieting going back to the gym. I was losing weight. You know, I was like, Oh, great. Yeah, it's finally working. I feel like you hear that a lot. But uh, and I was like, really thirsty all the time. But I was like, it's summer I'm working night shift. I drink a lot of water on night shift, etc, etc. The the way that I found out actually, I started having some pain and an uncomfortable area. Vagina. No, no. Okay. Perry anal area.

Scott Benner 6:40
That's close to there though. Okay. Yes, yes. So for the layman. Katie, that's your tape.

Katie 6:47
It's right around the butthole. Gotcha.

Scott Benner 6:50
Boy, got Katie. In seven minutes. You might have named the episode right around the bottle.

Katie 6:57
I don't know how I would name my episode that fast. I was waiting for

Scott Benner 7:00
something. I'm not certain what you're gonna say next. But that's a strong contender. Go ahead. Third, so you're strong because you're drinking a lot of water go.

Katie 7:08
Yeah, yeah. So I'm at work and you know, it's getting painful to sit down. Like diabetes is not even on my radar. I haven't thought about diabetes since like, I was a kid when my mom would check my blood sugar all the time. So not even on my radar. I think that I have hemorrhoids like a hemorrhoid. Yeah, exactly. So I'm at work and I'm trying to just treat it at home because I'm a nurse and I hate to go to the doctor. So I like you know, bought all the creams, all that stuff trying to treat at home. Nothing's working. Finally, I'm like, You know what, I can't do this anymore. I get off work one morning and I go to an urgent care. And the doctor at urgent care. He looks at me and he's like, you know, have you had a hemorrhoid before? And I was like, No, I haven't. He was like, well, I could just prescribe you, you know, normal hemorrhoid stuff. But I'd kind of like to take a look at it. Sure. I don't think that was his cup of tea.

Scott Benner 8:07
I'm just imagining that you have to you think to yourself, I have to let somebody look at my butthole I'm not good at work where people can like where people I know I'm gonna go to an urgent care why don't know these people. But before you continue with your story, because I am enjoying it. If you wrestle that Khan's away from that dog and throw him out of the room. I'll give you $10 Okay,

Unknown Speaker 8:27
okay, hold on one second. Okay.

Scott Benner 8:36
I don't know if the rest of you could hear the licking and the, from the dog but it was trying to get into the story. And I was like, oh, dog. Can you hear me by the way while I'm talking? Okay, I'm back. Sorry,

Katie 8:46
guys. Are you talking about me when you're gone? Yeah, of

Scott Benner 8:48
course. Because Because your start I'm trying to get into the story and in the background while you're here like I'm gonna get I'm gonna lose my focus. I mean, you've already said taint. I said vagina. You've said butthole three times. You're about to show a stranger your ass and I'm like, I do not want that dog eating that Kong toy during this. So. Okay, go ahead. What kind of dog? Sorry.

Katie 9:10
He's like a 60 pound mine. Oh, lovely. From the streets. You know?

Scott Benner 9:14
It's nice that you took him up. Okay. Yeah.

Katie 9:17
Okay. Okay. So, um, go to urgent care. You know, the doctor wants to look at my butthole fine. He takes a look at it. He's like, I think you have cellulitis and I was like, Okay. Not what I was expecting. But he sent me home with an antibiotic. He was like, there may be an abscess there. If it opens you should go to the emergency room because we don't have good pain meds. And it's going to hurt.

Scott Benner 9:44
Yeah, so no, no. Yeah, he did happen. Oh, yeah. Oh, God. I know somebody that this happened to and just from their description of the pain. I'm already on the edge of my seat. Okay, go ahead. Katie. You went home. You must have been stunned first of all.

Katie 9:59
Yeah, I was like like, Well, I mean, I kind of was just like, Okay, I take these antibiotics for a few days, everything's good and well in the world and I'm back to my life

Scott Benner 10:07
probably thrilled you don't have a hemorrhoid. Yeah. Kind of.

Katie 10:12
I don't know much about hemorrhoids, to be honest. So that sounds like not a lot of fun. But I go home, you know, I'm like soaking in warm baths, trying to make myself comfortable. And at this point, just to set the story up also, my boyfriend and I had been together for February, March, April, May, June, four months at this point. Oh. Yeah. So he's, uh, at our apartment. I think we're living together then. I don't know. But anyways, he's at my apartment with me. And I'm in so much pain, like, just can't take it. And he's like, urging me this whole time. Just get an emergency room. And I'm like, no, no, like, you know, it's fine. Um, he was like, Well, what if it bursts open? And I was like, Oh, I've got some gauze and some cleaning solution. Like, I'll just keep it covered, and it'll be fine. And he's

Scott Benner 11:01
so funny. It's because you're a nurse. Right? That you had that? 100%? Yeah. Because if you told me what if my, I want to say at all so badly, but what if my butthole popped open? I'd be like, that's a valid concern. Let us go to the hospital right now. Okay. Yeah. But

Katie 11:18
meanwhile, me I'm like, you know, I can take care of that. Right. So it's hurting. It's getting worse, like throughout the day. So finally, he looks at me and he goes, Do you want me to look at

Scott Benner 11:30
it? Our month at the dog's back?

Katie 11:33
Yes, I he grabbed a squeaky toy. Oh my gosh, hold on. I'm gonna lock him in a room.

Scott Benner 11:38
There you go. The animal lovers alone like that? Are you guys like thrilled with this story? Like I am like she's about to make the decision. Am I going to show what might be a burst open? butthole to my four month boyfriend? I don't know. Would you do it? Think about it for a second. Would you just go to the hospital? i It's a big decision. Because this is probably I mean, you don't know if she's still with the guy or not right. This is probably a big moment. She's coming back. Okay. Katie, I did like a little build up while you were gone. Oh, gosh. Because the scene because Yeah. Because it's a big moment for you. Right? If you're with him for months, you clearly like him. It sounds like you're living together. And now you have to decide, am I going to look like a like a monster with like, a hole next to my other holes? Like cute. And by the way, do you bend over? Like a counter? Or do you go on your back? Right? It's a big question, don't you think? And you leave your underwear on and just kind of show him the one spot. All right, go ahead. Tell me what you got me.

Katie 12:49
Okay. I was like, Well, I don't really want you looking at it. But I kind of being you know, me. I was like, I kinda want to see a picture of it. So I can get it because I have no idea what this looks like at this point. I'm just taking that doctor's word for it. So I was like, yeah, if you don't mind, like, can you look at it? So I lay on the bed kind of on my side.

Unknown Speaker 13:13
Okay.

Katie 13:15
Yeah, you got to be comfortable. I'm gonna go through this intimate experience. You got to be really comfortable. So I have to

Scott Benner 13:21
ask you, Katie, when you laid down to do it, did you give any consideration to how you would look the least vile doing it?

Katie 13:29
I'm kind of I'm pretty sure like I kept the underwear like on you know, tried to cover myself up as much as possible by

Scott Benner 13:38
making take a picture. I did. No flash or flash. I don't remember because if you get a natural light, it looks a little nicer. And is this the first time you've ever taken a photo of your lady bits? Or was are you had you done this in the past? No, no, no. Oh, that was the first. I'm sorry. You're on your side. Go ahead. Do you? Do you expect him to do it?

Katie 14:02
Oh gosh, I'm trying to remember. I was so like, you know like traumatized at that moment. Yeah, it's hard to remember the details. I think that he did the cheeks.

Scott Benner 14:20
G voc hypo pan has no visible needle, and is a pre mixed auto injector of glucagon for treatment of very low blood sugar. In adults and kids with diabetes ages two and above. Find out more go to G vo glucagon.com forward slash juicebox G voc shouldn't be used in patients with insulinoma or pheochromocytoma. Visit G voc glucagon.com/risk. Are you in the Orlando area? Would you like to hear me speak live? Go to touched by type one.org. Click on the program's tab then annual conference. And you can register right Right now for touched by type ones Annual Conference, which aims to educate, encourage and empower people living with type one diabetes. Do you know what it costs register? That nothing. It's very pretty baby. Let's do it. Here, do it. Let's do it. Come on over on Saturday, August 27 and see me Scotty, where am I going to be the Loews Portofino Bay Hotel in Orlando, Florida. It seems like it's near universal studios. Registration again, is free and open to all with a connection to type one diabetes touched by type one.org. When you come over, bring your brand new meter with you, your Contour Next One blood glucose meter, the one you're going to get at contour next one.com forward slash juice box. I say it all the time. I'm not afraid to say it again. We just get the meter our doctor gives us most people don't get to choose if they did, they would choose accuracy, they would choose a bright light and easy to read screen something that is small enough that could be carried in a purse or a diabetes bag that has insanely accurate results. A bonus might be test strips that allow for Second Chance testing, and an optional app for your cell phone for your cell phone. What happened am I who also do we still call them cell phones, for your smartphone for your phone, let's just call your phone that keeps track of the data you get from your blood tests. That's the Contour Next One blood glucose meter. That's what you're looking for. Head to contour next one.com forward slash juice box right now you can learn more, or buy one today, you can actually get it online like through Amazon and places like that there's a link there for that. There's all this information about the accuracy the meter, the cost, you might that the costs that might be incurred with strips. And contour likes to remind me to remind you that it's possible that buying the Contour Next One blood glucose meter would be cheaper in cash than you're paying right now for your meter and supplies through your insurance, which would be bonkers. But as possible contour next.com forward slash juicebox. Get the blood glucose meter that I just use 20 minutes ago with Arden.

There are links in the show notes of your podcast player and links at juicebox podcast.com. To the sponsors. And all of the sponsors that Juicebox Podcast, when you click on the links, you're supporting the show. Very nice of them. Go ahead.

Katie 17:35
And as soon as he did that, it opened. Oh, oh. And he says, Oh, God bless him. He just looks up and he goes, I'm gonna go get some toilet paper. I was like, what? And he goes, we're going to the emergency room.

Scott Benner 17:53
Oh my god. Yeah. Did he? Did he redownload his Tinder app on the way to the hospital?

Katie 17:59
Sure he did. Man. It's a wonder we're still together. I don't know how that that's happened.

Scott Benner 18:04
Was there blood in pass? I'm so sorry. Oh, my God.

Katie 18:07
It's okay. Yeah. Like, like I said, I'm a nurse. Like,

Scott Benner 18:10
other people are listening to this.

Katie 18:12
They're gonna be mortified. I'm sorry, if you're you're you're listening your your views or whatever. I'm sorry if that drops.

Scott Benner 18:20
Oh, my gosh. Okay. All right. Blog and pass. We get it cleaned up a little bit. Yep.

Katie 18:27
Yeah. And he's like, we're going to emergency room and I'm like, no, no, it's fine. Like I can and he was like, No, we're, we're going. So we go to the emergency room. Mind you. I haven't eaten anything since like, midnight the night before? I was hadn't been feeling well.

Scott Benner 18:43
Yeah. Try not to go to the bathroom too. I'd imagine. Yes.

Katie 18:46
Yeah. That was excruciating. Go to the emergency room. I you know, we're out in the waiting room. I have to explain what happened to everybody again. And this is the waiting room. Also at the hospital I work at just

Unknown Speaker 18:59
FYI. Hey, Patti. What's up, Jim?

Katie 19:03
I definitely definitely saw people that I have worked with. And I don't work in the emergency room. But my nurse in the emergency room I went to nursing school with it was it was a fun time.

Scott Benner 19:14
I bet you they weren't thrilled either. Oh, I'm

Katie 19:17
sure. Were though,

Scott Benner 19:18
do you think later they run around? They're like I saw Katie's. But today

Katie 19:23
oh, gosh, probably that was probably a good dinner conversation,

Scott Benner 19:27
would it because if it happened in reverse, if the girl or guy that you went to nursing school with had to come show you they're asked for some reason, would you not? I mean, where's the line in medicine?

Katie 19:39
Well, I mean, I couldn't talk about who I could definitely say like, Hey, I had to look at a butthole today, but I definitely couldn't say whose butthole I don't know.

Scott Benner 19:50
I feel like in private moments, you guys just talk about each other incessantly. But whatever. Go ahead. Whatever you do on the podcast right now it's fine. Okay.

Katie 20:00
So we're in the waiting room. You know, when you go to the emergency room, they put in an IV and they just draw like basic lab work. They drew a BMP, which is just, you know, like a metabolic panel, and that has your blood glucose in it. And I get a notification on my phone, because I have like my chart system and all that fun stuff. And I get a notification on my phone that says, my glucose was high. So I pull it up, and I look at it, and my glucose was 312. And I was like, okay, um, well, surely somebody is going to talk to be about that. And maybe it's just the stress the infection, you know, that can raise blood sugar. So yeah, maybe that's it. So I go the entire emergency room visit, which was traumatizing in itself. And nobody says a word to me about the lab results. Yeah, like I have no other illnesses. I'm, you know, nothing wrong. And nobody says a word. So they end up lancing that abscess and send me home with more antibiotics. Which, for the record, the emergency room did not give me good pain medicine. I had they numbed it with lidocaine, which was terrible.

Scott Benner 21:16
Wait, somebody took a needle and put it in a butane shorted? Oh, my God. Yep. And at no point when this was happening, was it just so over was the rest of it so it was the fact that you're asked blew open? so overwhelming that you didn't go hey, my mom, my two aunts and my cousin have diabetes and my blood sugar's high.

Katie 21:38
I honestly, at Yeah, at that point, I was like, You know what, this is something I'll just deal with later. I just, I want my body to feel better.

Scott Benner 21:44
Okay. Oh, yeah. Well, I hear from like I said, I've had a person describe it to me, I think it's described as a horrible feeling. worse pain. Somebody told me once they had ever experienced in their life, but are we getting alright, I don't want to rush the story. This story could be about your this entire podcast could just be about your abscess. And then at the end, you'll be like, and I have diabetes. And I'll be like, No, we have to go. So. But go ahead. You're home now.

Katie 22:12
Yeah, yeah, I'm home. Long story short, I borrow my mom's old like meter and strips and all that stuff. Because I was like, I'll just test for a few days. See if it comes back down. You know, I test and I don't get a number below 300. I was like, alright, so I go to the My primary doctor. Does all the normal bloodwork. My agency, I think was 12.7. Was like had the antibodies and did the C peptide and all that fun stuff. And he was like, Yeah, you have type one diabetes.

Scott Benner 22:48
And do you think that that's where the abscess came from the extended high blood sugars?

Katie 22:53
Maybe that would be my guess, my endocrinologist I because I asked her. I was like, Do you think that I had this for like, a long time and just didn't know it? And she was like, No, I'm thinking it kind of started a couple weeks before you actually got diagnosed like it wasn't a whole whole long time. Okay.

Scott Benner 23:14
Wow. And this boy stayed with you.

Katie 23:18
Yep. We're still together.

Scott Benner 23:19
Wow. It's like one of those things where you went through a thing so horrifying. You're delayed fuse trauma bonding. Yeah. Is that what that's called? I think so. Oh, my God. When my wife and I were dating, something so horrendous happened. I would never tell you about it. And I do remember afterwards. Like thinking like, oh, I called her back.

Katie 23:45
I guess we still continued on,

Scott Benner 23:48
I guess we were like, Oh my gosh.

Katie 23:53
Well, everybody, I've told that story too, is like, you know, you have to marry him. Right?

Scott Benner 23:57
Well, that's at least buy him like a car or something. You know, like something significant that later? Yeah, he deserves something feel paid for like, like, in a significant way. Oh my gosh, okay. How long did it take for that to heal?

Katie 24:12
Um, once I started the antibiotics, it really wasn't bad. I mean, it was probably healed up in like a week or two.

Scott Benner 24:17
Okay. And how many days into your testing? Did you really like when did you start to think like, Oh, my God, I have diabetes. Like, was it the second day? Or did you hope

Katie 24:27
it was like, the morning after I tested like, first thing in the morning when I know, like, I hadn't had anything to eat like, and it was still, you know, like, 350. I was like, okay, yeah, that's, that's probably real. And I called my mom, you know, my mom. My boyfriend was with me the whole time in the emergency room. But I called my mom and asked for the testing supplies and kind of told her what was going on. And then I called her after I was diagnosed and she was like, Are they sure it's type one. Maybe it's type two. I think she just you know, was kind of in denial of it. Yeah.

Scott Benner 25:03
Well, and she tested you a lot as a kid. Yeah. Yeah. She was worried about her whole life probably.

Katie 25:08
Yeah. And then, you know, I know for her She probably thought like, after we grew up, like, Oh, my kids made it, you know, they don't have it. We're, we're good.

Scott Benner 25:16
Because the rest of the family was at a young age.

Katie 25:19
Yeah, yeah. And she in I mean, a lot of, you know, older diabetics, and even people in general, just, they didn't really know that you could be diagnosed older, you know, ya know, juvenile diabetes for so long for reason.

Scott Benner 25:32
Right? Oh, you got out of juvenile. You're all good now. Yeah, yeah, I understand. Okay. Do you? Do you think that you and baboy will ever make a baby together? Or is this a concern for you?

Katie 25:45
No, I mean, I think that's still on the horizon. I think that's it's kind of a concern for me. But I don't, I don't know. Gosh, I hadn't really thought about that.

Scott Benner 25:58
I'm sorry. No, like,

Katie 26:01
you know, we we just, we want kids so bad that, you know, I don't know, I think and, and like, diabetes, it's not like a death sentence. You know, so wouldn't be the worst thing in the world, I guess. And

Scott Benner 26:15
you have a different perspective. I mean, you obviously have a family with it. And you have it now yourself. Um,

Katie 26:22
yeah, I know, for a lot of people like it's, it's a really, a lot of people grieve and stuff, you know, when they get diagnosed, or their kid gets diagnosed, because it sounds like this horrifying thing that you're gonna have to deal with. And a lot of people have a hard time with that. But uh, I mean, for me, it was just like, oh, well, this is what I do now.

Scott Benner 26:41
Yeah. Do you ever talk to your mom about it like, or does she kind of held the way she feels privately?

Katie 26:47
No, I'm, we've we've talked about it a little bit. We're not very good about talking about our feelings. But I mean, we've talked about it a little bit.

Scott Benner 26:53
Yeah. Talking about your feelings. Now Catholic?

Katie 26:57
Did you just ask about Catholic? Yeah. How did you know that? I mean, I'm not but my family is.

Scott Benner 27:03
Okay. I know what's up door. Wow. Yeah. He talked to people long enough. You know, people call those What's that thing? They say you're not supposed to generalize? Yeah, you know, don't generalize about people. People are individuals blah, blah, blah. Yeah, sometimes.

Katie 27:20
Like, I just like, talk to a psychic or something. That's crazy.

Scott Benner 27:23
I just the guy who's recorded almost 1000 podcasts. That's all. That's fair. Yeah. Although, give yourself a gold star, because you're the first person who's asked exploded during their story. So

Katie 27:34
I was gonna I was gonna say at the beginning, I was like, I feel like I have a diagnosis story that I have not heard yet.

Scott Benner 27:40
I have to be honest. Like, I get so excited when somebody tells me something. I think no one's ever said this before. It really makes me feel like I'm digging deep no pun intended on the butt thing. Like I'm digging deep. And trying to like really, like, I'm like, wow, we're you're finding different angles to this. You know what I mean? Like, everyone doesn't come on and tell the same story over and over again, even though it's about being diagnosed. And I appreciate that by anyone listening who has any kind of stories like this, please get on the podcast. I love hearing about stuff like this. I really do. If you have no idea. It's early. I don't like I record at 9am Sometimes my time, but it's not that frequently. And when you started talking, like this morning, I was like, alright, Scott, you're making a podcast, like pull yourself together. You don't I mean, like, let's get going and I am jacked up now. Like, I swear to you, I have like, I'm so ready for this day. Just love hearing that story. I have the right job. I get to go

Katie 28:38
about your day. And you're like I heard about someone's butt hole this morning. Like everything is I'm just so jacked up.

Scott Benner 28:44
Katie, I can't tell you that. I'm gonna tell four people about your ass today.

Katie 28:50
I don't know if you realize but like, how many listeners do you have a few. They're all going to hear about

Scott Benner 28:55
it. I'm thinking in my personal life. I want to be like, Oh my God, how are you? Yeah, you want to hear a story about a girl you'll never meet and then and plus the and the best part of this is that before we began recording, I saw your boyfriend's name. And

Katie 29:11
right we started with the porn star. Oh god I wasn't that wasn't recording.

Scott Benner 29:14
No, we weren't recording during that. But your your boyfriend has a porn star name which is absolutely like, it's just I don't know, the whole thing is to like look at it unless you say something absolutely horrifying. Between now and the end. This is going to be the most fun I've had making the podcast this week. So

Katie 29:30
that makes me feel so special.

Scott Benner 29:33
It really should I have so I have so many inappropriate questions about it that I'm not going to ask because I'm polite even though people probably don't think that's true.

Katie 29:42
Thank you I'm probably gonna have my mom listen to this. Yeah.

Scott Benner 29:45
Oh no, I had all like you were you were like laying out the story and I was like, I wonder if she was shaved the way she wanted to be before this. Right like did you protect your lady parts from like the past and the like the bite like all that stuff? I was worried you had an infection when it was over. You have no idea what was running through my head that I didn't say. I'm really glad you didn't Oh, my God. Well, I said, I found a way to say it anyway without actually asking you like, right. And I don't actually have to answer. Exactly, because it was all in the like abstract. Yeah, yeah, there's a little trick case you ever want to use it? Okay, so you have diabetes. Now. Everybody's on board that this is happening, your infection is cleared up? And do you go back to the people you work with and go, Hey, you guys are terrible at your job?

Katie 30:32
Well, you know, like I said, I don't work in the emergency room. And I understand like, when you come into emergency room, a lot of people don't really realize that but like, they see your main complaint on the paper. And they're like, Okay, let's fix this main complaint. You know, yeah. Okay. They're their job isn't figure out whatever else is wrong with you. They shouldn't be off for that.

Scott Benner 30:51
Oh, you know, emergency emergent. I get it. Okay. Yeah, it

Katie 30:55
makes sense. But I did. You know, I told my co workers on the floor I worked on, you know, hey, you know, that hemorrhoid? I thought I had it's actually type one diabetes. And they all were like, what, you know, everybody was shocked. I had to go through the whole experience again, and yeah.

Scott Benner 31:14
Wow. Wow, that is a gift to go tell everybody because everyone knew you didn't feel well, right. You're probably telling coworkers like I can't sit down. This hurts. I probably have a hammer. Yeah.

Katie 31:24
I mean, we're nurses. We talk about you know, our health stuff. Like I know way more about a lot of my coworkers then I probably should, but yeah, yeah. And I mean, it was it was hilarious, too, and kind of embarrassing. Like, we would get new employees show up and my friends would be like, Hey, this is Katie, have her tell you about her type one diabetes story. And I'm like, Hey, quit.

Scott Benner 31:45
The first day here break the ice. You remember the day your taint hurt Katie? Yeah, bring the new girl. Yeah, bring the new girl over and let her know.

Katie 31:54
Welcome to the new unit new employee,

Scott Benner 31:57
while the new employees thinking like so I've worked with a bunch of nurses who thought that diabetes was asked pain. I'm gonna know more than everybody in five minutes. Did you go to an? Did you go to an adult? No. Do

Katie 32:10
you go to your mom's Endo? Oh, no, no, I went to an adult Endo.

Scott Benner 32:13
Okay. Like found your own doctor started fresh? Yeah, it's

Katie 32:17
in the same. I mean, the area I'm in is kind of ruled by one health system. So it's the same kind of office but a different Endo. I kind of just took the because it took Gosh, at least a month or so to get in with the Endo. Yeah. And that was even just for like a virtual visit. I didn't, I still haven't got my endo in person. But yeah, I just kind of took the first one that was able to get me in.

Scott Benner 32:45
Okay, that's happened around where I live to, it almost feels like a mobster went to every doctor and said, You work for us now. Do it, you know, and suddenly, a doctor you've been using for years. It's like I'm now part of the blah, blah, blah health system. I was like, yeah, they got to Yeah, you know, it really feels like that somebody has you know, the doctors get sold on the like, we take care of the billing, we do this, all you have to do is be a doctor and they're like, oh, that sounds good. Well, honestly,

Katie 33:11
with like your own malpractice insurance and all that stuff. As a physician, it's hard to have an individual practice now. It kind of just makes more sense to be a part of a system on their end. Yeah,

Scott Benner 33:22
no, I can see how it's just funny how they fall like dominoes. Oh, yeah, right. Okay, so. So I'm super interested. Do you have me have four people you're closely related to that have diabetes, you know, have it? Do you go to them to commiserate? You go to them for advice? Or do you just pretend you're an island unto yourself and just start fresh on your own?

Katie 33:47
I'm probably a little mixture of both. I know my little cousin. She's, oh my goodness. I don't know how old she is. I think she just turned 13 So at this point, she was around like 12 or something. And I know that she had kind of mentioned to her mom, like, why am I the only kid in the family that has this you know, why am I the only of the cousins that has this kind of thing. So I pretty much immediately called her up and was like, Hey, you're not the only one now? Yeah. So I really kind of wanted to offer her some some camaraderie and support. It didn't really go so much for advice because I don't know. I don't I don't really know their management. You know, I don't know my cousin say once see or anything like that. But I did you know, my mom offered up a lot of advice. I don't know that I necessarily asked her advice, but

Scott Benner 34:44
I know she's gonna listen to this but like dang serious. I want to talk through this part. Right. So being serious. Did as you were and she were talking you and she is that right? Human she her her would have been wrong, wouldn't it?

Katie 35:00
I think it's she I think it's one of those things where she sounds weird, but that's correct.

Scott Benner 35:03
I made I got that right. Wow, I'm so impressed that That's right. Somebody, you know what I almost had somebody send me an email, nobody sent me an email, I'm, you're gonna get so many emails six months behind on my email, nobody email me. But when the two of you spoke about it did you find yourself thinking, Oh, that's not how you should be doing that mom or did you think okay, like, I don't know anything about this. So this is a good base of information.

Katie 35:29
Um, I'm not gonna lie to you, I kind of have always been that like, that kid that's like, Oh, I know better than my parents kind of thing. So I tried to be open minded and listen, and my mom did, you know, give me really good advice. But I mean, she definitely has a more traditional way of managing things. When I was diagnosed, she was on MBI. I think she's had a pump in the past before. And then shortly after I got diagnosed and got on a pump, she started talking to her Endo, again, about getting on a pump. So we've kind of helped each other in that way. But yeah, she definitely had like some more outdated advice at times. You know, I would tell her that like I would go to bed at you know, and my blood sugar would be at she like, aren't you afraid you're gonna drop overnight? And I'm like, No, it's It's fine. She's so it's you so used to go into bed at like, 121 3150 kind of thing.

Scott Benner 36:35
And how long has she had type one?

Katie 36:38
She was diagnosed when she was I think six. So that would have been 966 or 1964.

Scott Benner 36:48
Okay. All right. So she didn't have the same gear. She is she was she was live in a different situation now. Oh,

Katie 36:53
yes. Totally different. She told me all about I just listened to a podcast you recorded where? I think it was a lady around my mom's age. And she talked about like, the boiling the needles and all that stuff. Like, yeah, my mom's told me. She knew that. Yeah.

Scott Benner 37:08
Wow. Yeah, that's it. So when you hear her say that, and then you look at did you have new respect or understanding after she explained and you kind of held it up against what you do?

Katie 37:20
Yeah, yeah. And I mean, even like, it's interesting, because my endos advice sometimes is more similar to what my mom was telling me. So I'm like, you know, and my mom listens to her endocrinologist and makes adjustments based off what her endocrinologist says, you know, and like, I was like, she's still getting, you know, this semi outdated advice. So, you know, I can't sound like you can blame her for

Scott Benner 37:49
no, no, not

Katie 37:50
the way she thinks. You know? Of

Scott Benner 37:52
course not. I mean, honestly, taking diabetes out of it. It's sort of like, at all when I was growing up, my grandmother would be like your watches. This is amazing. It's Lawrence Welk. And I was like, What the hell are we doing here? Like, this is not entertaining. It's not amazing, but she thought it was like she came from a time where like, That guy was entertainment. I know. That's a reference. Katie. You have no context for what

Katie 38:12
I was just gonna tell you. I have no clue who Lawrence Welk is.

Scott Benner 38:15
Do you know the woman I spoke to yesterday didn't know who Perry Como was Do you know who Perry Como is?

Katie 38:21
No.

Scott Benner 38:21
Do you sing Christmas songs at Christmas time? Yeah, you definitely know who Perry called knows.

Katie 38:27
Okay. All right, then. Yes,

Scott Benner 38:28
I know who Perry I know. You're a liar. Maybe you're super open with your butt. But not with what your knowledge of party coma. That's fine. I watched that in there. Much like I appreciate that. Yeah, much like you had to watch that cost. And you're asked after that. Thank you. Alright, there's no reason to say but a bunch of times anymore. We're done. The story right? So okay, so your mom's stuff is a little antiquated? Is it fair to say that when it comes to diabetes on your mom, is that what we're talking about right now? Or you guys

Katie 39:00
who don't say that let her you know, she's helpful.

Scott Benner 39:05
Oh, where do you so how do you find me so quickly?

Katie 39:09
Um, the good old Google I think I don't know maybe it was on like a Facebook you know, I I go straight to type one diabetes Facebook groups. And you know, I dive right into it. I like to learn when I focus on something I like try to learn everything about it. So within like a week or two, I was on all these Facebook groups I found you know, all these books and all kinds of stuff. So yeah, I found you pretty quickly.

Scott Benner 39:36
Wow. Tell people you don't actually use the other groups anymore. Mine is the only one

Katie 39:40
right? That's the only group I'm in.

Scott Benner 39:44
Are you just being polite or is that?

Katie 39:46
Honestly, that's the only one that I actually am semi active and I guess I think I've posted in there a couple times. But the other ones I kind of look at sometimes and they're just sometimes they're just kind of sad.

Scott Benner 39:59
Yeah. I have a good feeling about mine actually. So yeah, yeah, yours is good. I like how it works. It's all attitude, right? You just pick an attitude and you decide this is how we're going to be. Yeah, I get I get notes like that, that I, you know, obviously, obviously Katie, I don't jump on this podcast and become a different person. So. But I get so many notes about like, you make diabetes easier because the way you talk about it or like that you interject humor into it. And I'm always like, confused by that. And like, I don't purposefully interject humor into diabetes. I just actually find some things funny that I think other people don't find amusing. That's all so. But I like also

Katie 40:38
to like, you know, if you're gonna live with a chronic illness, you got to you got to make some jokes about it time time.

Scott Benner 40:44
Yeah, you can't be so serious, right? It's exactly, yeah, it's a bummer. I mean, it's already a bummer. You have diabetes. So like, making it more of one is just, it's just piling on.

Katie 40:56
Yeah, that was one thing. You know, we talked about how great my boyfriend is, after the whole incident, we're not going to talk about anymore. But he, you know, soon after I kind of I got a little bit down, you know, I was like, Oh, God, like, I, I couldn't even take a pill every day consistently. Like, I don't know, I never had to deal with anything like that. So I was like, how am I going to do this, you know, blah, blah. And he kind of just looked at me and he was like, This is what you do now. There's no sense in being upset about it, or sad or worried about it. You just You just learn about it. And you just do it. So

Scott Benner 41:31
yeah, yeah. Well, that's, I mean, listen, great advice. That's boy perspective, right. There. It is. Yeah. What are we going to talk about this more? Just do it shut up?

Katie 41:43
Pretty much. That's his attitude on everything. Like, why are you worried about that? It's gonna work out. Like, how do you know?

Scott Benner 41:48
Yeah, because we're boys than we don't have the ability to wonder the other thing. Yeah. Like, can you imagine if we were all girls are all boys. Like, you know what I mean? Like, if everybody had like a like that men, classic boy mentality of like, it'd be fine, put your head down and walk forward. We'd all just be disconnected and running into walls. Yeah, we're all girls with the like, Oh, what if this happens, and we'd all nothing would ever get done? Right? We just sit in a circle worry the whole time. So exactly. It's interesting. It is really interesting how people can balance each other out. So have you did you find it difficult in the beginning? Or were you like to do everything you were supposed to do? Or did you pick it up pretty quickly and just do it?

Katie 42:31
Um, I feel like I picked it up pretty quickly. I don't know, I just, I, I kind of just like, did it. I don't know, there's not really a good. I wish I had better, you know, like, oh, I went through this, this and this. And, you know, I kind of just like, Okay, I want, I'm still young. I want kids someday I want to be around for grandkids like I also I should specify that I worked on at that point. I worked on a vascular and cardiac surgery floor. So I saw a lot of diabetics come in and get amputations and I saw all the bad side of you know, uncontrolled diabetes. And so I developed more, I think, a fear of highs than I did a flows. I hear a lot of people say like, they're so scared of going low. I was never scared of going low. Like I've always been, I get a little panicky when I start going high. Okay.

Scott Benner 43:29
Yeah, so what I was saying must have, like, you must have been like, Oh, I agree with this idea. Like when I say, like, I wake up every day thinking I'd rather stop a lower falling blood sugar than fight with a high one like that.

Katie 43:41
Oh, 100%, especially after I had my first like, real, real low. And I mean, I was I tested, I didn't have a CGM or anything at that point. And I tested and I was like, 23 I was home alone. And I was like, Okay, I'm just going to, you know, drink about a gallon of juice and we'll get it up and we'll be fine. And after I came out of that with like, no issues, I was like, Okay, I you know, I can handle it low.

Unknown Speaker 44:10
Okay, which is maybe a

Katie 44:12
little bit of a scary like, my endocrinologist is probably, you know, cringing hearing that but

Scott Benner 44:19
Well, I mean, listen, I think it's the only way to do it. Otherwise you get a blood sugar that's up and he spent the next three or four hours messing with it.

Katie 44:29
Exactly. It took me You know, I mean, that one probably took me a little longer to bring up it probably took me like a half an hour to bring up to you know, normal, but I hate hate hate fighting a high blood sugar.

Scott Benner 44:43
How make how low do you think you were in that moment?

Katie 44:47
My meter said 23 or 27? I think that's yeah, it is really low.

Scott Benner 44:54
You went back of like, did you think you're gonna have a seizure?

Katie 44:59
Ah, Uh, no, I, I didn't like I just I was pretty. It felt like being really drunk, honestly, you know, the seizure didn't even really crossed my mind. But I went back to work and I was talking to one of my co workers, and they were asking me about the diabetes and they're like, you know, what's, how's the lowest you've ever been? And I was like, yeah, one time I tested and I was 23. And one of my co workers popped up and he's like, Yeah, I had a patient one time his blood sugar was 23 he died. I was like, oh, yeah, I probably shouldn't let that happen again.

Scott Benner 45:33
Yeah, I was gonna tell you, Katie, that's really low. So I don't

Katie 45:37
want your listeners to think like I walked around at 23 that happened one time.

Scott Benner 45:40
When I say I'd rather stop a lower foreign budget. I mean, like 70 Diagonal down.

Katie 45:47
100% But like, honestly, I I think in my endocrinologist gets on me about the lows. Like I said, I don't have lows that bad anymore. But like, I I get so afraid of high sometimes that I end up going to blow. Okay. Kind of frequently.

Scott Benner 46:03
When that happened. Did you ever? Well, first of all, I don't know. Do you? Are you MDI, do you have a pump? I have a pump. And do you have CGM? Sometimes? Yes. But the way you answer it makes me think you have a Medtronic or a T Islam. No, no, I have an Omnipod Omnipod. Oh, usually when people are like, are gonna say things that are advertisers. They're so happy to say them. And I thought, Oh, you're trying to save my feelings, but you don't have to do. But like people can say what kind of pump they have. It's what about CGM? What are you using?

Katie 46:37
I use it Dexcom. Okay,

Scott Benner 46:38
so were you wearing it when you got that lowered? No,

Katie 46:41
that was like within. That was probably like within a few days of starting insulin. Oh, I forgot to tell you. So when I first got diagnosed, we were planning a trip to Nashville. And I was like trying to get my insulin sorted out before going to Nashville. And I wasn't able to get it. Because like, I didn't understand that the with my insurance I had to the hospital, I had to get the insulin at the hospitals pharmacy. I couldn't use like CVS or anything like that. So I like just went to Nashville for the weekend after being diagnosed with like, no insulin. Wow, zero out of 10 would not recommend. But Wow.

Scott Benner 47:27
She just like it's so new. You don't really know what you're doing. Right? Yeah. 100%, like, you probably you probably went this work, you know, you haven't this low. When you have this low blood sugar public, you know, it's fine. I'm going to eat, I'm going to take my insulin the way I'm supposed to. And then I'll run around and be a nurse for 12 hours without thinking things like, you know, running around might be exercise and exercise could drop your blood sugar and Bob like this, you don't know about any of it. And your mom doesn't even know to tell you about it. Because she would never do that. I would imagine I'm sure

Katie 47:57
right. It's so crazy that like, you know, I people hear that, you know, oh, I have family members that are type one. And I'm a nurse and like so I I feel like I was expected early on to just know everything about it. You know? And that definitely was not the case. Yeah, I feel like you don't really know. Yeah, you don't know anything until you kind of have to figure it out on your own no matter what experience you have with it already.

Scott Benner 48:22
Yeah, I always think it's interesting to when medical people come on and talk about it. Like there was an episode on this week. Guys, like an orthopedic surgeon, this kid gets diabetes. And you know, he didn't either, like nobody knows. Nobody knows. I make I used to make this point all the time. Like nobody knows anything about anything that doesn't impact them.

Katie 48:41
Oh, 100% Yeah. Yeah. And that's what you know, I, I would hear patients say sometimes like, oh, you know, I know my body. I know more about this. And I early on, I was kind of ignorant, maybe. And I was like, well, but you're not a medical professional. What do you know? But now that I've I'm living with something, I'm like, dang, they they were right. You know, you do know your body better than anybody else.

Scott Benner 49:04
Crazy. It really is crazy how quickly, it can become the truth that you have a better handle on something that you previously knew nothing about. That. Yeah. Then your doctor does. Yeah. And you tell people that and at some people I think are met with comfort on that one. And I think some people are met with that, like, well, that shouldn't be the case. It's almost anger. They're like that that couldn't that shouldn't be the doctor should know they need to tell me. And I guess you have to live with it for a little while until you kind of marinate and, and you realize what the situation actually is.

Katie 49:38
Yeah, yeah, exactly. Well,

Scott Benner 49:41
where are you at now? Where you share like where does your what do you call success? What do you shoot for day to day have you did you honeymoon?

Katie 49:49
I don't really think that I ever honeymoon Exactly. Like I've always required insulin. My insulin needs have definitely increased kind of over time, but so Yeah, I'm on the Omnipod index calm. My decks calm settings, like during the day I keep pretty tight. I think I have it set between like 70 and 120. Actually, I, my last day one C was 5.1, which I'm due to get that done here soon again. And I'm definitely not having the lows, like I used to, you know, my main focus now has been trying to keep that tight range with fewer lows.

Scott Benner 50:33
So and is it working? Are you starting to figure things out?

Katie 50:37
Kind of? Yeah. I've had to kind of rearrange my schedule a little bit. As my big thing was like, I would have Lowe's. In the afternoons when I'm off work, we take the dog for a walk at like three o'clock, and my natural instinct is to like eat lunch at like two o'clock. So I'm starting a walk with insulin on board and trying to sort that out. has been a little bit of a challenge, but

Scott Benner 51:04
well, you're so new at it, too. Yeah, you don't realize a year is like nothing.

Katie 51:11
Yeah, it doesn't feel like it doesn't feel like I'm new at it feels like I should have everything figured out by now.

Scott Benner 51:15
Doesn't work that way. I still cry. I was still crying after a year. Sometimes. Yeah. In the shower. Mainly. It's where I like to cry. Yeah. I would go shower. Hello. So you're giving away my personal secrets. I'm gonna tell you, I'm gonna tell your porn star boyfriends name in a second. So, but no, um, you know, back when Arden was little I would just like Kelly would come home at the end of the day. And I'd be like, Oh, I didn't get a chance to take a shower today. Let me just jump in the shower. I just get in the shower and like cry. And then I'd be like, Okay, I can do the rest of this day now.

Katie 51:49
Yep. You got to just let it out sometimes. Yeah.

Scott Benner 51:54
Yeah, it just it just is right. Okay. Well, I guess now that you brought it up, like, Hold on. Let me let me text my plumber. Now that you're

Katie 52:01
putting your business out there.

Scott Benner 52:03
Well, yeah, I mean, now that people know my shower doesn't work.

Katie 52:08
Hopefully people aren't going to assume that. You're only shower.

Scott Benner 52:18
Yeah, I have two showers. I'm very fancy. There's two showers. bougie. Oh, my goodness. You have no idea how fancy everything is. I have a shower and another show. to shower. Oh, yeah. It's crazy. It really is like there's just opulence everywhere. So we have carpeting and some of the rooms. Oh, wow.

Katie 52:41
Yeah, not all bad. Everybody. You're what does that cup of coffee thing you have? Yeah, by

Scott Benner 52:46
me. Your money paid for a rug with it. What do you think?

Katie 52:50
You let Scott afford to hold showers? Yeah,

Scott Benner 52:53
I'm dripping in gold to you should see me. I'm not even sure that my T shirt matches the sweat pants I'm wearing right now. But whatever. Does it it? Probably maybe it does.

Katie 53:03
I don't know what does matching. Anyways,

Scott Benner 53:04
Arden makes fun of me constantly about my clothing. So she's like that. She's that doesn't match. I'm like, How do you know? It feels like it does. She's like it doesn't. She just looked around. She's even rolled her eyes at me. She just looks at me with such disgust. And then it's over. She's like, how can you not know? I don't know. So of course. So this is kind of super interesting. Ready? Like, you have a year into it. You're a nurse, you've got all these people in your family. And you are still going through the same exact stuff that everyone else goes through? 100% Yes, no, you didn't get the past go kind of a situation. You know, people didn't come up to you and just like drip this great knowledge all over you. You're you're starting just like everyone else. You got your you know what I mean? Like, yeah, if

Katie 53:55
anything, I probably started out with like, less information. Because, because my doctor knew like, I'm a nurse. I told him I had, you know, type ones in the family. And so he was like, Okay, well, here's, here's some Lantis and human log, take it, you know, as directed, and I'll get you an appointment with an endocrinologist. And then then chronologist my first appointment. She was like, Okay, tell me about yourself. Do you want a pump and a CGM? Like in it? I didn't get like any education from anybody because everybody assumed, you know, oh, she knows what she's doing.

Scott Benner 54:30
So you know, it's funny. I realized now I've heard that so many times. I just had a different thought about everybody's like, Oh, the doctor just assumed I knew because I was a nurse. I wonder if the doctor didn't think Oh, good. Maybe she knows because I don't. That's possibility. Yeah. Like I do. Like, I wonder about that too. Like, it just hit me. I was like, Oh, I wonder if that's like a safety net for them. Not

Katie 54:51
another funny story too. I saw a diabetes educator with the endocrinologist office like once didn't you know they are very nice, but I didn't find it excruciating ly helpful. But I got a message from the educator I saw maybe like four or five months into my diagnosis. And she was like, Hey, we have an opening at the office as a diabetes educator, like if you are looking for a new job. I was like, I, I'm just trying to figure out my own stuff. Like I'm not really interested in that right now.

Scott Benner 55:24
That's also interesting, isn't it? Because yeah, the the insight there is, hey, you might not know much about this, but you probably know more about it than you know. Could you come on that? You know what I mean? Like, there's no there's no shining. There's no shining hill, where people like who know are like, Ah, come on over here. We've got it. Everybody's in the same boat. Really?

Katie 55:46
Yeah, yeah. We're all just like, you know. What's that Titanic reference, like Jack and Rose out in the ocean. Like, we're all fighting over the door. Trying to climb up on the doors.

Scott Benner 55:59
Not a bed. Like a, like a headboard? I don't

Katie 56:04
know. I don't know that I've ever seen the whole movie all the way through.

Scott Benner 56:07
Wait a minute. You've never seen Titanic all the way through?

Katie 56:12
No, I don't think so. I don't watch a lot of movies.

Scott Benner 56:15
Oh, okay. You're one of those. Yeah. Because that movie was so huge when it came out. People saw it three four times the movie theater.

Katie 56:26
You know, I might have been like a year old when it came out. So I understand wasn't me.

Scott Benner 56:30
I understand. You prefer Caitlin's? Like young or old?

Katie 56:37
What like, I'll be honest, I don't even know if I can tell you. That's rose in Titanic, right?

Scott Benner 56:43
Oh my god. Katie. Katie. Listen, this is gonna I've never I've never revealed this on the podcast before. But you know when you know when couples are like, You know what they call that? Like your? Like Kate Winslet your hall pass? He is. Okay, but I like her older.

Katie 57:01
Oh, gotcha. Yeah.

Scott Benner 57:03
I don't know what everyone says to me. Kate Winslet and I'm like, yeah, no, like, why am I I don't know Kate Winslet. She's not even my type.

Katie 57:12
I feel like she's very like, classy. She's like a classy. Kinda pretty.

Scott Benner 57:19
I'm just telling you. For me. It's Caitlin's.

Katie 57:23
Okay, I'm 100% googling Kate Winslet now.

Scott Benner 57:25
All right. Hold on. Are you doing it?

Katie 57:27
Literally now? Yeah, like literally right now. Alright, so

Scott Benner 57:30
I'm a Google images as well. Let me try to find one where I would tell you. This is the Kate Winslet for me. All right. She's in like a white long sleeve. Her hair is past her shoulder and there's It looks like she's standing in front of a piece of wood. It's like three rows down from vanity. fair.com.

Katie 57:56
Okay, I'm looking.

Scott Benner 58:00
Oh, yep. Okay, that yeah, that Caitlin's that I would buy a car for? Okay. Okay, that's fair. Thank you. I'm just saying this is my situation. Okay. Yeah. I again, actually not even my type. Now, any Kate Winslet pres pregnant picture that Caitlin's what I would buy a house for? I don't even know why. I'm just telling you.

Katie 58:23
Yeah. I don't know why you're telling me that. But now,

Scott Benner 58:24
you know, I want to, I want I want Caitlin's with that my baby I think is what I'm saying.

Katie 58:31
Right? This again, personal is it

Scott Benner 58:33
cuz she's really rich and famous, and I believe married? So. And by the way, that's fair. I'm actually married as well. So I don't I don't think any record coming to fruition anytime soon. I'm just telling you. And then there are pictures of Kate Winslet where I like I wouldn't like I wouldn't let that Kate Winslet clean my house. By the way, I don't have a house cleaner. But I was just I don't know why that. I do. Really wish I had somebody like, do people do that. Katie, do you ever do that? Like the the gifts and may come over and clean the house up ever? Oh, God, no, I can't afford that. I want that so badly. I can't even

Katie 59:08
I'll meet you. 100%. Actually, that's kind of a lie. So I'm travel nursing right now. I'm in a different state than I live in. And my sister in law offered to clean our apartment back home while I was gone, so I guess if that counts,

Scott Benner 59:25
well, I mean, are you paying her? Yeah, I

Katie 59:27
paid her. Well, that account. Okay, then. So yeah, yeah, I guess I can say I have a house cleaner

Scott Benner 59:32
now. Who's bougie? That's so bougie. Okay, send her to me. I need her to I just want you know what I dream of? Like someone just doing like a one deep clean, like twice a year.

Katie 59:43
Yes. Yeah. That's what she like, clean, like thoroughly cleaned the bathroom. The walls like all that stuff. It needed it.

Scott Benner 59:50
Yeah, I just wiped down a room. And as I was doing it, I thought, can I just get to the point where someone else does this for me.

Katie 59:57
That's how I know like, I've made it When someone's wiping your walls, yep, like cleaning out the vents and stuff. Uh huh.

Scott Benner 1:00:05
No, I really do have similar feelings. I was Oh god, I just had a question for you where to go? Dammit, dammit. This question was going to shape the entire direction of the end of the podcast. All right, hold on. Caitlin's lit. That had nothing to do with it. Oh, we did never settle but they were on a headboard and Titanic Matador I think, okay, good enough. So there was plenty of room on it. And there was no reason Jack could not have gotten up on that thing.

Katie 1:00:35
See, I've seen the argument that like the density of the board or whatever, like wouldn't have supported both

Scott Benner 1:00:40
of them. I didn't even try. That's true. They didn't even attempt it. They did and she's British. Those people are lighter. They have bones like a bird. That's fair. I read that on the internet. I don't think that's, that's true. Okay, so Caitlin's it house cleaning bougie. I'm trying to I'm trying to get my mind to get that my brain to say why I had such a good way to button this up. There's something about diabetes to people like, Oh, good. He was going to talk about diabetes and the diabetes.

Katie 1:01:12
I feel so bad. I feel like we haven't talked much about diabetes.

Scott Benner 1:01:15
I'll bleep this out later, Katie, you're at all exploded. So there was no way we were ever going to talk about diabetes? You should have known that. Yeah. I mean, honestly, oh, I found my thought. Okay. At the beginning of the podcast, you said, I'm going to tell a funny story. And that is usually not a good sign.

Katie 1:01:38
Right. That's usually not a super funny story.

Scott Benner 1:01:41
Yeah. The layman don't really know what's funny, you understand? Right? Well, I get it. I'm a professional. I know what's funny. And so usually, when people say that, I think, oh, hell, how am I going to dig out of this hole after they tell this horrible story that nobody thinks is funny. But then because, you know, it's like, it's like, he used to work for my uncle when I was a kid. And there were these short, like, 15, I worked in a sheetmetal shop, it was not a pleasant job, Kitty. And, by the way, I have another question for you. This time I wrote it down. Because I'm not an idiot. I'm not getting fooled by my brain twice today. So you'd get these 15 minute breaks from this horror of a life you were living, you'd have some bad food, people would drink coffee for 15 minutes, you'd kind of relax and get up enough energy to make it to lunch, you know, and my uncle would sit down, he's dead down so I can tell the story. And he would start to spin these yarns that were mind numbingly boring. And he would get stuck on details that had no relevance to what you were talking about. And my best example is that one time, he was telling a story about something and in the story, there was a car truck, and he got stuck on what year like make model year the truck was. And he went to such lengths to come up with the answer to this. That you just thought, well, the whole story hinges on this being a 58 Chevy pickup truck or whatever the hell he was saying, right? Yeah, that after he found the year making model the truck, the truck never came up again in the story.

Katie 1:03:17
Of course not. I thought you're gonna tell me it was like a basic, you know, 1990 Ford Ranger or something? No, Katie, it

Scott Benner 1:03:24
had nothing.

Katie 1:03:25
It didn't even come up. Oh, my God.

Scott Benner 1:03:27
It just nothing. And I sat there even as a young man. so angry that he told that story so poorly. Like I, I hated how badly he told the story. It just made me I was like, you have all of our attention. I could be cracking these people right up now. And instead, you're telling us a bad story and spending five minutes in the middle trying to decide if Chevy made a pickup truck and whatever year you were like, yammering on about Ah. So anyway, when you told your story, I was like, Katie was right. This is good.

Katie 1:04:01
Yeah, like, thanks. So it's, it's been a hinge of my like, story. So everybody I tell it to you is highly entertained, either highly disgusted or highly entertained, maybe a little bit about oh,

Scott Benner 1:04:14
no, no, no, that's just a good trust me. You trust me? Trust God. That's a good story. What I was gonna ask you about is travel nursing. Yeah. So a lot more money?

Katie 1:04:27
Yes, yeah, I should. I could probably say that.

Scott Benner 1:04:30
Yeah. So I'm hearing nurses talking about a lot. And I have a friend whose daughter is a travel nurse. And I've seen some people complain about it. The hospital won't pay the employees. They have a lot of money, but they'll pay a travel nurse to come in and they'll pay them more money.

Katie 1:04:45
Yeah, well, here's the thing that's starting to happen now is that like, and this is why I'm actually probably on my last contract, at least for a little while. But the hospitals now are dropping the rates to where your actual pay He is not much more than their own nurses. But you're going to be making money in like housing and food stipends and stuff like that.

Scott Benner 1:05:12
Oh, so they pay for your apartment.

Katie 1:05:14
So kind of like your agency pays for the apartment, sort of they, you know, they use like government standards for tax free stipends and all that fun stuff. So

Scott Benner 1:05:28
are the agencies actually maintaining residences and then moving people in and out of them?

Katie 1:05:34
Some of them do, but honestly, you know, usually just find like your own Airbnb or, you know, short term leases, and you kind of find it on your own, but you get this stipend every week to pay for it. The person

Scott Benner 1:05:46
I know is using the travel nurse program to like, expand their medical knowledge and to travel. Yeah, right. So like, she went to Baltimore. And she said that in six months, she has now all of the skills she needs about gunshots, for example. And then once she felt she felt like that hospital had everything she could, you know, she stayed a little longer. And then boom, she went out to Arizona, I think, and I think now she's in Hawaii. it for her. Yeah, she's just like, kind of, like, gaining knowledge and having a an adventure, you know, in her in her mid 20s. So, the vertical Yeah,

Katie 1:06:25
that that's kind of our, our process. You know, we haven't traveled super far just because we're both really close to our families. So we've definitely stayed in a couple new places. One that's been enjoyable. But now

Scott Benner 1:06:36
I'm worried Katie that you're that you're supporting this boy.

Katie 1:06:40
No, no, no. He works. He works remotely, actually. And he's in school. Yeah.

Scott Benner 1:06:45
Boy, so it was a wonderful time. So he can just move around because he works remotely.

Katie 1:06:50
100% Yeah.

Scott Benner 1:06:51
I'm a sucker. Katie.

Katie 1:06:54
You're doing it all wrong.

Scott Benner 1:06:54
I am. I mean, I'm sitting in front of almost no equipment. This stuff could travel. What am I doing?

Katie 1:07:01
Yeah, he has like all of his, you know, company supplied computers and stuff and just packs it up wherever we go.

Scott Benner 1:07:08
Let me let me be honest, we let's talk like turkey for a second. Katie. Boy making enough money to support you. Like is he okay? Are we gonna have to look for someone else?

Katie 1:07:17
No, no, he's he's totally fine. And like I said, he's in school. He's getting his doctorate degree. So really gonna

Scott Benner 1:07:22
be good. Yeah, we will what smarty pants getting a doctorate and

Katie 1:07:25
he's getting a doctor education. And he's gonna kill me if I get this wrong, because we only talked about all the time.

Scott Benner 1:07:32
Like you don't love him? If you don't know. So go ahead. Oh, I

Katie 1:07:35
love him. I do not enough

Scott Benner 1:07:36
to know about his interest, but go ahead.

Katie 1:07:39
to higher education, leadership. That's what it is.

Scott Benner 1:07:42
Higher Education Leadership.

Katie 1:07:44
Yeah, I think his ultimate goal, I think he wants to be like, he wants to teach college or be in like administration. At a college university type thing.

Scott Benner 1:07:55
Yeah. Do that remotely. No, no. That's

Katie 1:07:58
why this is a short term thing. Gotcha. Okay. And, you know, we want the kids in the house and all that stuff. So yeah, this was just something we saw the opportunity and

Scott Benner 1:08:08
took it. No, I think it's terrific. Is he an intellectual? Yes. Oh, yes. No, some people think that's not a great thing. Really, you don't you don't hear that?

Katie 1:08:17
No, I've never heard that. Okay. I love an intellectual.

Scott Benner 1:08:21
I don't dislike him. I'm I'm saying that. There are people who would say, Look at me. This has got nothing to do with your boyfriend, by the way. But I think there are people that hear that word. And there's there's, I think pretty two different reactions. Like I hear, Oh, smart, educated person. And some people hear there's a person who has no real world knowledge who will then go shape young people's minds. Oh, see what I'm saying?

Katie 1:08:45
Yeah, I get what you're saying. He definitely has the real world knowledge. You know, he you talked about working for your uncle or with your uncle. He like worked, you know, blue collar jobs for his dad and uncle like, he's he's been out in the world a little bit.

Scott Benner 1:09:02
Oh, well, let's be honest. Katie, he saw your buttocks blood. So I think really, he's got a different level of understanding of the world than most people do. Seriously, if you have children one day when they come out, he'll just be like, yes, it's no big deal. Probably I could totally look at this with no trouble.

Katie 1:09:22
Let me so funny too, because he is like 100% You know, doesn't do well with blood and guts and you know, that kind of stuff. But he sucks it up for the people he cares about, ya know? Or like, you know, our dog too. He you know, he'll clean up after the dog and stuff and you can tell he dies a little bit inside but he doesn't

Scott Benner 1:09:41
kill you. I didn't like that you held yourself up level with dog poop at the end there. But that was that was like the only other example I had necessary drove up parallel. You know whether it's helping me with my butthole Scott or cleaning up after the dogs, they can't make it outside. My guy's a good guy.

Katie 1:10:02
That's all. That's all boils down to. He's a good guy. Yeah.

Scott Benner 1:10:05
boils. By the way. There's something Oh my god. Yeah. By the way, please, please respect the fact that you said piles earlier. And that that's a old euphemism for hemorrhoids. And I did not mention it. I did not know that. No, no, you didn't. But you knew Boyle's? Yes. Yeah, we could do this all day. I mean, I could you probably would get bored by it. It's the people listening, I imagine would be like, Oh, God, let it go. And I'm like, No,

Katie 1:10:32
yeah, just just end it. We can. Alright.

Scott Benner 1:10:37
Well, let's just ended then, Katie, unless we there's something that we didn't talk about that you would like to

Katie 1:10:41
the only thing that I kind of, I read back over my email that I sent you because it's been forever. The other thing I kind of wanted to talk about a little bit was like, I see you have a lot of like, parents of kids with type ones. I don't really see a whole lot of like, kids with parents that have type one. And I know like, parenthood and stuff like that is something people who have type one kind of worry about. But you know, my experience growing up, my mom and her sister, her one sister babysat me all the time. And I definitely saw some scary lows and stuff with my aunt. I think I mentioned in my email, like I remember, you know, pouring orange juice down her throat or rubbing icing on her gums. And like, even after all that, like I still felt like I didn't know much about diabetes. You know? So who

Scott Benner 1:11:36
was babysitting? Who?

Katie 1:11:38
Yeah, fair.

Scott Benner 1:11:39
Yeah. Did they pay you when that happened?

Katie 1:11:42
No, I was young, you know,

Scott Benner 1:11:44
but I'm gonna need that 10 back.

Katie 1:11:48
I don't even think they paid my aunt for babysitting. We both you know, she was she was like a second mom to me. So we both were just so well,

Scott Benner 1:11:54
you get what you get. But, but also your aunt At what age was having like, significant low blood sugar?

Katie 1:12:03
She probably would have been in her 30s or 40s. At the time, maybe?

Scott Benner 1:12:08
And this is maybe how long ago? Do you think 15?

Katie 1:12:12
This is like late 90s. Maybe because I was born in 93. So I remember doing this as like a toddler. So

Scott Benner 1:12:19
alright, so almost maybe 20 years ago? Yeah, that's probably fair. All right, or more. And so her. So part of your aunt management was periodically I'm gonna pass out and you're gonna need to get me orange juice.

Katie 1:12:33
Yeah, she just, she was very like, up and down, up and down, you know,

Scott Benner 1:12:40
traumatic as a kid, when an adult is being put in your scenario. And you're being told this is the person taking care of you. And you know, I might be taking care of them.

Katie 1:12:49
I never really thought about it like that. It was just so because my mom had lows too. So it was just so normal. That it it didn't really like bother me. I was just like, oh, and Terry's low better give her some orange juice. Like, I don't know, it never really like crossed my mind is something abnormal or weird?

Scott Benner 1:13:10
I wish. I wish I don't wish I wonder if Arden was your mom's age. And I was your mom's dad's age. If I would have figured something out differently back then. Or if it would have just felt like a thing that happens to you that you can't impact? Because I imagine that's how they felt right? Like this is just part of it.

Katie 1:13:33
Yeah, 100% like you don't have the resources. You know, you don't have the whole world at your fingertips. Fingertips back then. So it's just kind of like, this is what it is. This is what we do when it's low. And hopefully we can fix it.

Scott Benner 1:13:49
Well, my point. Yeah, but my point was that most of the stuff that you hear about now on the podcast, that seems so obvious, because people have CGM 's, and pumps and stuff like that, I came up with this stuff before that stuff existed for us. Like I was like, like figuring it out the whole time. Like, there's no doubt that the Dexcom like it, it propelled me for my ability to understand what I was seeing. But I was like, studiously every day trying to figure out what was happening to art, and so we could do a better job with it. And I'm sure

Katie 1:14:23
you would have figured out I mean, with the tools you had, I'm sure you would have figured out something like you. I referenced that one lady you had on that was about my mom's age. And I think she mentioned that her dad came up with some kind of formula with like fat and protein, you know, even when she was young. Yeah. So and working with beef or pork insulin or NPH, or whatever she had at the time. Like, that was a recent episode. Yeah, I feel like you would have you would have done something like that. Maybe not math so much, but you would have figured something out, you know,

Scott Benner 1:14:56
like, that's what I'm sitting here wondering. I was like, I'm like, Could I Have? Could I have found a way to make the leap? Or? Or would it have just overwhelmed me? And I would have just said, Okay, well, you know, we'll keep orange juice and icing in the house, because this is what happens. I just, I mean, we'll never know, but,

Katie 1:15:14
but I feel like with your personality, like you wouldn't have I mean, personalities don't. Just because you're in this time, you know, your personality would have been your personality then. So I feel like your personality wouldn't let you just settle for, oh, this is what we do. Keep orange juice on hand kind of thing.

Scott Benner 1:15:31
See, that makes me sad. Katie, like, because I picture when you say that I picture your mom, right? And she's in this situation or someone like her? And for whatever reason, they don't come to the bigger answer or see the bigger picture or something like that. And then that makes all that time seem wasted to me. And then I have such a hard time with wasted time.

Katie 1:15:54
Yeah, that's why like, I've tried to, you know, with my mom now. So that Aunt, by the way, has since passed away, she passed away a few years ago. But I've really tried with my mom, to kind of instill the knowledge I've learned, while also taking the knowledge she's learned and kind of combining them. And maybe we can both come out a little bit better. Yeah, with both our knowledge combined.

Scott Benner 1:16:20
I was gonna ask you about that. But first of all, ask you did your did your aunt die from something diabetes related?

Katie 1:16:26
You know, I'm not 100% Sure. I don't think that there was she passed away in our sleep. So I don't think that there was ever I don't think anybody was interested in autopsy or anything like that. I believe she had some kind of heart trouble, too. So it was probably one of those two things. Yeah.

Scott Benner 1:16:45
The heart from the diabetes, though. If if your blood sugar Yeah. How old was she?

Unknown Speaker 1:16:51
She was yes, D 50. Some? Wow.

Scott Benner 1:16:58
I'm sorry.

Katie 1:16:59

50. So my thank you. Yeah. Thanks. I mean, we were extremely close not to get to, you know, not sad and stuff. But yeah, we were really close. Yeah.

Scott Benner 1:17:08
Well, you know, it only makes sense to bookend an episode that started the way it did with the passing of Your Beloved. And so, you know, because these things do not appear to mesh together well, at all. So it has been a roller coaster. Yeah, we're really getting to it here. I want to know, if you're where I get our 15 minutes into it. My childish brain is finally let me go back to other things. I'm so sorry. Don't be listen. The way this unfolded is the way it unfolded. I think it was terrific. So we're not gonna we're not going to go backwards here. But I'm wondering if you are having you that I did not say you correctly there. But I'm wondering if you were having any luck imparting modern management onto your mom, or if she's even interested in it?

Katie 1:17:55
I think so. Um, like I said, I, she, so she was MDI, and then she had a pump when I was young, I want to say maybe early 2000s ish, she had a pump for a while. And then she was kind of just having issues with that. So she went back to MBI for a long time. After I was diagnosed, I got I got the Dexcom and Omni pod pretty quick. Like, I'm pretty sure I got both of those within a month or two of being diagnosed. And I kind of told her how much easier things felt with those. And she was like, Yeah, I've been thinking about going back on a pump. I was like, I really think that you should give it another try. And she's, she's happy with it now. And I've kind of she's kind of started to accept that, you know, writing in the 70s. And 80s isn't a bad thing.

Scott Benner 1:18:53
Did that feel low to her at first? Yes. Yeah. Good. Has her agency improved since you've been diagnosed?

Katie 1:19:02
It has actually. I think she was I don't think she would mind me sharing. But I think she was like in the eights maybe. And I think she's down into the sevens. Now, what she's trying to get her bees replaced. So she's also been working on getting her agency down for that.

Scott Benner 1:19:19
I see. Well, she listened to the podcast, or is this too,

Katie 1:19:23
I'm gonna try really hard to get her to listen to it. She's not very tech savvy. So it's probably going to have to wait, you know, till I can get over there and whenever it comes out and actually set it up for but I would like for her to listen,

Scott Benner 1:19:35
would you would she listen to like the pro tips or the defining stuff. Do you think

Katie 1:19:41
if I can set it up for her? She might. Interesting. She's retired now. So she should

Scott Benner 1:19:45
what does that mean? What's your mom's name? Her name is Pam. Pam, what are you doing? Just I could use the downloads and it sounds like you could use the help. So like let's just help each other. I think you're a one see, Katie's probably in the 60s Right.

Katie 1:19:59
Um, My last one was 5.10.

Scott Benner 1:20:01
My goodness, nevermind it. Is that from Lowe's a little bit or, you

Katie 1:20:06
know, I'm like that one I think was less than I think it was like less than 2%. Low.

Scott Benner 1:20:11
Wow, how are you eating your best style?

Katie 1:20:16
During? No, not really no, I kind of just eat what I want. I tried to just I figured out what is easy to dose for. And I eat those things. With the exception of like, I go out to eat and stuff. And that's usually the times when blood sugars get a little crazy, but I think overall, I eat what I want. I almost

Scott Benner 1:20:38
jokingly called you a cheater when you said I found out what I'm good at bully stick for getting the fight, Katie tried to figure out french fries.

Katie 1:20:47
I've tried. I've tried. It's tough. I know it is.

Scott Benner 1:20:51
No, I completely know. I keep wondering when Arden leaves her school, how soon it's going to be before she's like, Alright, I'm not gonna beat that anymore. Like, you know, like, she'll just be like, I don't have the time to figure out how to Bolus for that. Like when she's in college, or that's my

Katie 1:21:05
thing like I does, I'll eat during the day, I'll pretty much eat anything, because I have time to figure it out. Like, when I work, I have to get up at like, 530 in the morning for work. So when we're planning dinner, and I don't get off until about 730 at night, so when I'm eating dinner, it's like 830 I don't want to eat something that I'm gonna have to be up late trying to figure out Yeah, so especially for dinners, I try to keep it pretty simple.

Scott Benner 1:21:29
Hey, you wanna you want to sleep? Yeah, exactly. I need sleep. all make sense to me. Okay. Yeah. So I feel like we're done. But I want to make sure you feel good. No, I

Katie 1:21:42
yeah, I feel good now.

Scott Benner 1:21:43
Good. Because you gave and you deserve to get back. Get what I'm saying? Yeah, story anyone's ever told. I mean, I don't remember most of the podcasts. But I hear from other people. It's good. So I assume there have been other good stories. I'm Do you understand that concept, Katie, that I'm the worst person to ask about the podcast.

Katie 1:22:01
I 100%. Understand, okay. Like, I don't even really know we talked about so I'm sure and you record so many of these. Like, I'm sure it's all just flirty. Okay?

Scott Benner 1:22:09
You started explaining something that you were just like, Oh, and this woman came on and blah, blah, blah. And I'm thinking, Oh, that sounds so familiar. Like, I'm sure that did actually happen. It went up two days ago, which means I've no, yes, it did. I forgot about that. So that means I've edited that episode in the last 10 days. And I'm just like, oh, that sounds so familiar.

Katie 1:22:29
Yeah, I totally get it.

Scott Benner 1:22:31
Oh, my God. Like, I don't know if you've ever like seen Isabel helping on the Facebook page? Yes, yeah. She'll jump in. And she'll be like, there's this one, this one and this one? And I'm like, How does she know that? That's that's like, I tell her sometimes privately. I'm like, I feel like you know my life better than I do.

Katie 1:22:49
It's probably does, because I mean, I feel like you probably go on like, autopilot. Sometimes.

Scott Benner 1:22:55
I'm just talking, like, when I talk to people, I just say whatever occurs to me. Yeah, there are times when I think like, you know, Katie, I don't know if you realize it or not, what we really talked about today was, you know, nurses, and medical people, they don't even know about diabetes. So you probably shouldn't feel too bad. If you're not a nurse or a medical person, you probably know as much as they do. Coming in from, you know, from starting at zero, we talked about. I mean, just kind of, I know in ways that that's not what we talked about. But I feel like it's what it's about right like that there used to be ways to manage diabetes, there have not been as valuable for some people in your family, and you're now you're now kind of blossoming with this new technology and new ideas, things like that. To me that says the people keep up with technology. Pay attention. You said Jerry, once he's in the fives, and you're, you know, only in a year makes it feel very possible even though you didn't know what you were doing. You were

Katie 1:23:56
so glad you're wrapping this up, because I was so worried that like, my episode would be one that like people don't get anything from you know what I mean?

Scott Benner 1:24:04
No, I don't know not. Not at all right. Like, listen, you had an abscess in your me it was in your butt. So it's funnier. But you had an abscess from high blood sugars. I hope that sticks with people, right? Yeah, high blood sugars can make your body it makes it difficult for your body to heal from other things. Your mom is in a situation with just an eight a one C which a lot of people would be happy with where she can't get a knee surgery. Yeah, right. So we talked about a lot of stuff like don't let the fact that I copped to liking Kate Winslet in this episode, and that your butthole exploded. Don't let that Mar what we've done here today. Katie, this has been a really informative thing. And the best part is, and this is the trick of the podcast, Katie, is that at the end? That's what people will remember. But they won't know that they learned it. It's learning without knowing. Ah, yeah, fix it. That's what makes it accessible.

Katie 1:25:02
I like it. And that's probably I mean, yeah, that makes sense. That's what keeps people engaged and listening. If you sat here and just talked about, I mean, your Pro Tip series is amazing. But if this whole podcast was all like, that kind of setup, I feel like, you know, yeah,

Scott Benner 1:25:18
it's just too much. It. Can you imagine, like, if I sat down? What if we sat down today? We're like, Hey, this is Katie. Katie's 27. She's had diabetes for a year for people in her family have had it her aunt has already passed away probably from heart failure from diabetes. Her mom's a one season the AIDS and she can't get a knee surgery because of it. By that point, you'd be like, I am out. I want to hear this. Get me out of this. And you lead with the butthole story. So everybody's like, trust me. No one shut this off. Because they're right now like, I wonder what else this girl is gonna say. If she led storytelling

Katie 1:25:52
right there. You got to get them engaged. Yeah.

Scott Benner 1:25:55
And we did a thing where we talked about all your lady bits and it wasn't even sexual was so

Katie 1:26:00
fun. Something my mom can still listen to. Oh, good.

Scott Benner 1:26:02
Yeah. And trust me. There have been times where people are like, Well, great. Now my mom can't listen to this.

Katie 1:26:08
Well, my mom's My mom was a nurse too. So either way, she was gonna listen to it.

Scott Benner 1:26:11
But yeah, I figured she might have been when I stalked you on Facebook. During the conference. You stalk me on Facebook, you do that? Well, and when we're talking, I need contact. Now that I saw the dog. I saw the boy. I saw you.

Katie 1:26:25
I saw you, right.

Scott Benner 1:26:26
I mean, I I can't say what I was just because. Well, I don't know. Just say it and I'll go ahead. Don't say it. No, I'm gonna say it. I'm gonna bleep it out. Okay. Okay, so this thing popped into my head. It is completely for comedy, right? I promise you. I was gonna say, I'd let him give me a hand. Wish I wouldn't really do. But I was trying the most, like, farcical compliment. The most farcical thing that I thought was also funny popped into my head. And that's what I was gonna say, but this podcast, people don't listen to for that part of my personality. So I didn't say it. Fair enough. Yeah. And it's going to be hilarious later bleeped out. So that's why I'm sure yeah. Oh, my God, just think about it now.

Katie 1:27:17
You know, I'm saying, Oh, my God, I'm gonna I'm gonna cringe. I'm gonna do all the things listening

Scott Benner 1:27:21
to this again. I saw the dog. I saw everything. Also, I saw two dogs, which confused me.

Katie 1:27:29
Yeah, that's my parents dog. I take

Scott Benner 1:27:31
other people's dogs getting your photographs.

Katie 1:27:34
Well, I used to live with them. Also,

Scott Benner 1:27:37
during this episode, a spammer tried to put something up on the Facebook page, which I took care of. Look at you. I googled, I texted with a plumber. In times when you didn't know I did. Are you impressed at all? Haiti by my skills?

Katie 1:27:52
I definitely am impressed.

Scott Benner 1:27:54
Shut up, stop it. You're, you're, you're terrific, by the way. And one of the things you're the kind of person and at the age where I, it gives me a lot of hope that the podcast is actually valuable for people because I really should be you. There's just no world where 27 year old person should be listened to a podcast made by a 50 year old guy. You know what I mean? And that and that you like the podcast, but you never actually said, but I'm assuming you do.

Katie 1:28:22
I mean, I've listened to a lot of them. So I should say that, but no, like, honestly, when I first started listening, I was kind of hesitant, because I think I've heard people say this before, like, well, it feels like it's really geared towards parents with kids with type one and like, so when I first started listening, I was like, I don't know, maybe I'll pick up a couple of things. But I mean, then I just really got engaged. And I feel like I do pick up tidbits from everybody's stories, you know, whether it's a kid or an older adult who has type one or whatever, like, it's definitely you can pick up something that's useful for you, no matter who's talking.

Scott Benner 1:28:57
It's such a simplistic. Listen, I get like, we're all simple people, like people are simple, right? But people do that thing. Like, what's that guy, he doesn't have diabetes, and his diabetes knowledge comes from him taking care of his daughter. So this must be about taking care of kids with type one, like, I get right, I get how that would happen. But, you know, there's a problem when people think there are different kinds of diabetes. You know, there's not the way my daughter's diabetes works is about the way everybody else has diabetes, right? You know, I mean, there's variables and there's personal impacts and stuff like that. But for the most part, insulin makes your blood sugar go down carbs, makes your blood sugar go up, etc, etc. Like there's the you know, it's not it's not 30 years ago, where people I bet your aunt probably told you she was Burdell

Katie 1:29:45
I don't think I've ever heard that term before. But really, they didn't use this Oh, yeah. Before like this podcast and the group and stuff like that. Yeah, I don't. I don't think I ever heard anybody really say that term.

Scott Benner 1:29:55
Aside of the word though. Do you think that was the feeling like oh my boy, yes. out all over the place. There's nothing I can do about it. That kind of stuff.

Unknown Speaker 1:30:03
Yes, yeah.

Scott Benner 1:30:04
Right. Like she they acted like they had a, like a seizure disorder, like you could live for three months and everything would be fine. And then one day just out of nowhere, oh, I'm having a seizure. And in instead of understanding, like the impacts of the insulin was just again, no way they could know back then. I don't think without decent technology that to track it with but anyway.

Katie 1:30:28
Well, I think that's why people get so frustrated too. I know, I have like, when my blood sugar, like last night started going up in the middle of the night. And there's like, I couldn't figure out any reason why it was, you know, and that was like the frustrating part. I eventually figured it out. But like, I think that's when people get really frustrated and upset, and they kind of throw their hands up in the air. And they're like, Oh, this is just diabetes. And, you know, this is how it goes. And I can't do anything about it. But there's always a reason. Sometimes it's hard to figure out. And it takes some time. But I mean, your blood sugar doesn't just go up or down. It's either too much or too little insulin, basically. Yeah,

Scott Benner 1:31:06
I completely agree. Yeah, I just do I know I can. I've had it be that frustrating for me. And I can imagine, especially if you're an adult, right? Or a young adult with type one, you're more on your own. And you just you go to bed with a blood sugar of 110. And you wake up and it's 300. Like I was just sleeping.

Katie 1:31:27
Like Yeah, and like this worked perfectly fine the last 89 Nights, right?

Scott Benner 1:31:31
And how am I going to be aggressive with this, if suddenly, I'm not going to need it again, I'm gonna make I'm gonna make myself low, I'm gonna be asleep. But I get it like it's, it's, it feels unknowable. And there are still times when it's unknowable. But for the most part, you know, with good technology now and some and some decent understanding of terms and tools and stuff you should be able to. Anyway, you should be able to get your knees replaced Katie one day without having to get your agency down.

Katie 1:32:00
Well, I'm hoping to not have to get my knees replaced. But yeah, definitely.

Scott Benner 1:32:04
You know, the man told me the other day, I might need one. Oh, really? I got my knee cleaned out. Right? It was all like painful. And I guess my meniscus was torn up. And so he went in there and cleaned it out. And then he told me afterwards, hey, there's a lot of arthritis on the inside part of your knee. Was that the interior? Is that how the body works in theory and anterior? Is that right? Your nurse gave you

Katie 1:32:26
into an anterior there's like ligaments and stuff that are injured. What do you talk about?

Scott Benner 1:32:29
I'm like, Isn't that how you measure your knee? Like the inside of your knee? Is the interior part in the Oh, yeah, that's right. He says, Katie, come on. I didn't even go to the gym. I go to nursing on this podcast longtime. Listen, it's an hour and a half. You're fine. What do you get tired? Yeah, I'm

Katie 1:32:43
tired. All right.

Scott Benner 1:32:44
You have the whole day off. He told me. Yeah, true. I do have to go do things after this. Oh, that sounds too good to flit around or whatever you do. I don't know what you do. And so anyway, he comes out afterwards. And he's like, you might need a replacement, like 10 years. So I was like, Oh, great.

Katie 1:32:59
That's terrible. I mean, it's it's not it's not as bad as kind of it sounds my dad has had to replace recently, too. He's doing all right.

Scott Benner 1:33:07
He's doing all right. That's not a shining endorsement.

Katie 1:33:11
Oh, I mean, I could tell you like it's been terrible, but it hasn't. He's done. Good.

Scott Benner 1:33:14
Good. All right, Katie, I appreciate you doing this very much. If you'd hold on for a second, I'd like to thank you in private.

Katie 1:33:21
Okay. Yeah, sounds good. Thanks.

Scott Benner 1:33:33
A huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com Ford slash juicebox. You spell that g VOKEGLUC. Ag o n.com. Forward slash juicebox. Also want to thank the Contour Next One blood glucose meter and touched by type one. Come see me at that conference touched by type one.org and get yourself a Contour Next One blood glucose meter at contour next one.com forward slash Juicebox. Podcast. If you're enjoying the Juicebox Podcast, please subscribe in a podcast app. If you're already subscribed. Telling someone else about the show is another great way to support the podcast. And if you need something, or are interested in learning more about one of the sponsors, clicking on my links directly is a huge help. Those links are in the show notes of your podcast player and at juicebox podcast.com. I want to thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. And don't forget if you're a US resident who has type one diabetes or is the caregiver of someone with type one, you can take the T one D exchange survey in fewer than 10 Min. That's this survey is HIPAA compliant absolutely anonymous helps people living with type one diabetes and supports the Juicebox Podcast T one D exchange.org forward slash juicebox

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#702 Bold Beginnings: Honeymooning

Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.

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

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends, and welcome to episode 702 of the Juicebox Podcast.

Today is the first episode in the bold beginnings series. While you're listening to this episode, 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 a US resident who has type one diabetes, or is the caregiver of someone with type one, please consider going to T one D exchange.org. Forward slash juicebox. To take the survey, the T one D exchange survey benefits people living with type one diabetes, it's incredibly easy to do and will take you fewer than 10 minutes T one D exchange.org forward slash juicebox. Also today you're going to hear Jenny Smith. Jenny is a CDE. She has had type one diabetes for over 30 years. And she works at integrated diabetes.com If you're interested in learning more about what she does.

This episode of The Juicebox Podcast is sponsored by Ian pen from Medtronic diabetes in pen is an insulin pen that talks to an application on your smartphone and gives you much of the functionality that you will get from an insulin pump. In Penn today.com. The podcast is also sponsored today by us med. Don't just get your diabetes supplies from anywhere. Get them from us med Call today for your free benefits check 888-721-1514 Or you could just go to us med.com. Forward slash juicebox. Us men always provides 90 days worth of supplies, and they give you fast and free shipping us med.com forward slash juicebox. So we did this little episode recently where we talked about we're going to go through the steps of the questions that people sent in about being newly diagnosed. This is going to be our first episode about it. We have it broken down. It's not really it's still it's gonna be a lot of episodes, but we haven't broken down to honeymoon. What it's like to be diagnosis and adult. different terminology. highs and lows, the 1515 rule long acting insulin, fear of insulin, range and food choices Pre-Bolus ng carb guidelines and impact of food stalking, flexibility school exercise guilt, fear and hope. Podcast the community medical care team journaling, technology and supplies, insurance. And that's it. So that's it. That's it. I have it narrowed down to like I don't know, 15 or 20. Yeah, so we're gonna go through and have these conversations. So you and I put these in order, and we thought honeymooning went first. So we're gonna have to feel our way through this a little bit, because we've never done this before. In the past, I just started the conversation. And then we chatted to where we wanted it to go in the in the in the pro tips. But this one, we have questions from people. So why we thought this was important, is because going into the Facebook group with 25,000 people on it and asking them, What do you wish you would have known or someone would have told you when you were newly diagnosed? So under the heading of honeymoon, the first thing that we have here is a better explanation of the honeymoon phase would have been helpful. Let's talk about what that is.

Jennifer Smith, CDE 4:09
Yeah. Better is is a it's like a rabbit hole of consideration. Right, though, like, better explanation kind of starts with Well, how was it explained to the person or to the majority of people to begin with? Yeah, and I do think it's a concept that's really it's a gray area, have known, honestly. Because it's a time period, essentially, where after diagnosis, you've got some remaining beta cells, at least many people do. Not everybody but many people do. It seems like the sooner you get containment of the blood sugar levels, the more likely you are to have if there are remaining betas, their assistance and they come I'm back to help and that may eventually reduce your overall insulin needs. I mean by how much again, this is a person to person, you may need less overall dosing for mealtimes. Maybe just Basil is holding things really, you know, tight for you in that honeymoon phase. But I think a good word to go along with honeymoon is unpredictable. Honestly.

Scott Benner 5:29
So, the, you know, let me jump to another question, because I think it'll pull the conversation together, right? This person says mi honeymooning, how will I know. And I think that's such a good point. Because you really don't know what diabetes is to begin with. So whatever it is for you on day one is how you imagine it is and a lot of people get caught up in thinking, well, this is it. You know, and someone can tell you in the moment, hey, you might experience a honeymoon, and a honeymoon is going to be, you might have some beta cells that are still helping along with insulin production. That might be great. Because if it's stable, then we'll use you know, less insulin. But it also could wax and wane. It could be one day, you're getting help. And the next day, you're not the next day you are and you know, especially you're probably going to be MDI at that point, right. So you've got to for the most part, right, you've got a fixed amount of insulin in us a basil. And then one day, you're, you know, your pancreas is like, I'll help and no thanks. I already put the insulin in today, and you're feeding insulin all day. So it's a lot.

Jennifer Smith, CDE 6:34
It is a lot. And I think a misconception too, is that it shouldn't really be mistaken. And it could be easy to think, Well, gosh, maybe i i was incorrectly diagnosed. Right? Maybe I am really getting better. Maybe I was just sick or something was going on this downplay in insulin need. Especially being tested. I mean, most people who are who are diagnosed with type one, or assume type one, get the antibody testing and all those things that we've already talked about to to really give a positive diagnosis. But once that's there, even if your insulin needs go down in this expected honeymoon time period, you're not you're not getting better. And that's sad to say it is

Scott Benner 7:27
because it'll hit you that way. Because it happened to me. Yeah, there was a couple of days where art in just out of nowhere did not need insulin. And or at least that's how it felt like, you know, my memory on it could be, you know, right. I'm getting pretty old those long time ago. But right, my recollection is there were two days where Arden didn't need insulin, and I and I've told this story before calling our pediatrician who's a friend. And I preface what I said by going I know I'm wrong. But I have to say this because it feels imperative that I tell you that I don't think Arden has diabetes, somebody made a mistake. Right? And he sat very quiet and sad and said, she asked diabetes, this could happen. You should call the endo and talk to them. And I was like, okay. Yeah, but the problem day to day and why the question gets asked by people who are like, you know, when you ask somebody, what do you wish you knew? I think first of all, you need to know what could happen, you need to know it might not happen. Correct. You know, you might catch diabetes very early. And then your honeymoon might be longer, you might catch it later, it might be shorter, and 1000 other variables that could influence if there's a fluctuation, and if there is how big it is. This person says the lows were horrible. And we had a scary middle of the night, barely conscious, 32 blood sugar, about three weeks after diagnosis. So this is a person who didn't have this information was never told.

Jennifer Smith, CDE 8:51
Right. And that's I guess it also brings in a timeline of when, and that's a that's a major question that's also often asked is, well, how long can I expect this to last for? It could be a week, it could be a couple of days, it could be weeks, it could even be years. And for the most part, the years that length of time in honeymoon. I more often see in adults who are diagnosed who research has has shown as an adult diagnosed you more often have a reserve of betas after diagnosis that's a little bit larger than really young children or even kids or teens really. In fact, there's there are a lot of good studies for kids diagnosed under the age of five. I believe that actually so it's that the onset of type one is much more rapid and much more aggressive. And that there is more likely that there's less or almost no beta cell action left in really little kids were diagnosed very quickly. Yes, yeah.

Scott Benner 10:02
Artem was to and, you know, besides those two days, well, here's the rest of me right. Besides those two days, I'm going to tell you that I didn't notice. But I also was a guy holding the meter and a handful of syringes and a vial of insulin right? There were no CGM, I couldn't see anything happening. And these people who are listening very likely are not being handled a CGM right away either.

Jennifer Smith, CDE 10:26
Many of them are not I've had, in the past couple of months, I've had a handful of people who've actually left the hospital with a CGM on their child. Okay, well, that's fine. But again, that's it's a small percent, but it is encouraging to see how that's progressed in importance for visibility. And or they've left with a prescription to get it within a week or two after leaving the hospital or after diagnosis, which again, is, in my opinion, pretty quick turnaround,

Scott Benner 10:57
the context that the the glucose monitor line gives you, it's just, it's different. Because otherwise, in your mind, it just feels like the blood sugar is coming in and out of hyperspace. Like, it's you know, it's 78. And then the next time you look up, it's 250. And without context for how it got there, your brain struggles to make sense of it, you know, especially when it's very likely that the doctor has given you basic ideas of what to do count these carbs. Use this, you know, use this formula, inject this insulin, if you're lucky, you got that right information. Right. And because we're talking about newly diagnosed and not just children, I've interviewed a number of adults, you know, you know, over and over again, but lately, one that's sticking to my head where they just told her like your take 10 units of this and eat. Yeah, that was it, you know? Right, right, exactly. consideration about carbs or anything. Honestly, it's more

Jennifer Smith, CDE 11:55
than for adults, I've seen many more adults being diagnosed, let's say correctly with type one, but given more of a really old school, way to dose insulin, and prior to giving them any, you know, real information or education, if you will, it's like you said it's eat your meal, take 10 units of insulin, take it three times a day with each meal time and go about your business until you actually see an educator or somebody who can help adjust this for you. Where again, that's it's that's really old way to dose.

Scott Benner 12:34
But you're seeing it more and more you're saying.

US med takes over 800 private insurers and they accept Medicare nationwide. They have an A plus rating with the Better Business Bureau and they always provide 90 days worth of supplies. US med carries everything from insulin pumps and diabetes testing supplies to the latest and CGM like FreeStyle Libre two and Dexcom G six, better service and better cares what you're gonna get from us med head over there now to us med.com forward slash juice box or call 888-721-1514 To get your free benefits check. And to get started, you're gonna get white glove treatment at US med. They are the number one fastest growing tandem distributor nationwide, the number one specialty distributor for Omni pod dash. They're where we get our hands on the pod five suppliers from they also are the number one distributor for FreeStyle Libre systems nationwide, and the number one rated distributor index com customer service satisfaction surveys. Come on us med.com forward slash juicebox. Everybody gets your diabetes supplies from somewhere. And everybody knows how much of a pain it can be. US med says they're gonna give you better service and better care than what you're accustomed to. Today's episode of the podcast is sponsored by Ian pen from Medtronic diabetes. And I would like to tell you a little bit about it. The pen is an insulin pen, but it's not just an insulin pen. Yes, it has a cap. And yes, it has a needle and a cartridge and a little window where you can see how much you're dosing. little knob twist at the end and a button you push. It's an insulin pen, right just like you expect. But here's the stuff you don't expect. How about an app on your cell phone that shows you reports easily shareable reports with data that is generated for up to 90 days in pen can do that because it's connected to that app by Bluetooth. The impact app is also going to give you an activity log so you can see a list of recent actions including doses meals and glucose readings. Your active insulin remaining is right there on the screen. With that in pen app, see how much insulin is still working in your body. And in Penn has a dosing calculator to help you take the guesswork out of dosing your insulin. The app uses your glucose levels and a carbohydrate estimate to recommend the dose that's right for you. That sounds like a thing you get with an insulin pump. It even considers the amount of insulin that's still working in your body to help you avoid lows in pen today.com. Forward slash juicebox. Want a digital logbook, in pen has that one carb counting support Oh, well, the pen app can help you estimate carvers based on your meal size. There's also a fixed dose option that allows you to choose the same carb amount for a specific meal each day seems too good to be true. It isn't in pen today.com forward slash juice box, head over there now get started today. There are links in the show notes of your podcast player, and links at juicebox podcast.com. To the in pen, US Med and all of the sponsors of the Juicebox Podcast when you click the links you're supporting the show. In Penn requires a prescription and settings from your health care provider, you must use proper settings and follow the instructions as directed, where you could experience high or low glucose levels for more safety information visit in Penn today.com. Yeah,

Jennifer Smith, CDE 16:41
I see it, I see it often enough that it sort of frightens me, given all the technology we have today. And the types of insulin we have today and the way that they are meant to work to specifically especially our rapid acting insulins to mimic sort of digestion for the food that it was formulated to cover which is carbohydrate. So why don't we just educate people? Well, give me an idea what your meals look like. I mean, this is pretty easy question to ask people upon diagnosis, okay, your meal seemed to be this. And as an educated clinician, you should really have an idea about how to carb count, especially if you are in the profession of diabetes. And that's you should be able to say okay, let's start easy and just say, for every 15, you take one, right, at least

Scott Benner 17:36
it gives people context,

Jennifer Smith, CDE 17:38
something's starting to work with a starting point, even if it's completely wrong, and they need to be a one to five, at least, then in a couple of days, you can say, well, that's clearly not working, let's adjust it, but they already have the concept of counting and dosage.

Scott Benner 17:52
Your, your your story makes me think that maybe at diagnosis, people are like, well, they're gonna get great technology. And then now this is going to matter. So I'll just say something that won't kill them today, then they can go to the next person, and the next person will do a better job of this. But your point is, I mean, listen, it's not a brag, but I think you could bring me up to any person using insulin. And I think I could probably ask them four or five questions and make a pretty educated guess about how to cover their meal. Yes. So absolutely. Yes, it just doesn't it's not I hate to say it's not that hard. But you know, it shouldn't be if you're a clinician, I guess. Just this next thing here says, What do I need to know, during the honeymoon stage, you really have to put yourself in the position of a person who's just been whacked over the head with a shovel while someone's yelling, you have diabetes. And they're like, wait, what she's she said before they teach carb counting. Like when do I know if it's a true DKA? Or hold on a second? These are broken up questions. So let's skip the car panic and go. When do I know if it's a true DKA situation are just part of the honeymoon stage? What do you think they mean by that?

Jennifer Smith, CDE 19:01
Well, high blood? It's a good question. Because if high blood sugars are just sustained high,

Scott Benner 19:07
and then they again, do ketones because somebody told them if you're over this for a certain amount of time test your ketones, right. And they're fresh from a traumatic moment in their life where these kids had or they had a high blood pressure and they were in the hospital for it. Right. Oh, I see. Okay.

Jennifer Smith, CDE 19:22
I mean, that's what I that's what I would certainly expect but it is it's a it's a good question. But I think it's a pretty complex question. Because if you're in this window where honeymoon could be the case, and all of a sudden you're running high blood sugars, okay, great. Go ahead, do the steps. You know, test for ketones. dose, call your call your doctor and say, Hey, we've been running higher all of a sudden, it seems like without visible illness or stress or anything in the picture. Seems like you're likely at that point then coming out of honeymoon and you actually need To increase your doses, potentially basil to start, maybe the doses that are covering mealtimes, especially if they've been very, very, very conservative. But I mean with high blood sugars, regardless of what point of diabetes diagnosis you're in, if it's a stain high test for ketones, right, good first step.

Scott Benner 20:20
You know, it's funny, I always think about these things, all these topics about I think of them as like, if we were in an elevator for three minutes, and you said to me, Scott, honeymooning, what do I do? I think, and I don't want to give away that I've watched more than one season of Big Brother, which I'm embarrassed by, but I think you have to expect the unexpected. Like, if Thank you, if you just need to live in the in the reality for a little while, that things are going to change more frequently. Or they could change more frequently, I should say. Then you hope and right. And that's where you hear people online, say stuff that I don't like that they say, but I understand where it comes from, like, you know, carbs, times this plus this equals elephant, you know, or when they say like, nothing makes any sense, right. But if you expect it to be varied, then it does make sense, but it's varied. Right, you know, if you if you put yourself in a position where you say, This is what should be happening, I did what the doctor told me, I measured it correctly. This is wrong. None of this makes sense. I give up. You're gonna, you're gonna make yourself crazy. Right? Yeah, you just have to stay very flexible in the beginning.

Jennifer Smith, CDE 21:29
And I think that the flexibility and especially in terms of what people should know, after diagnosis around honeymooning is that expect that it may be in the picture for you at some point, sooner than later after diagnosis. And that once you're exiting the honeymoon, it doesn't necessarily mean that you're doing anything wrong. Right? This isn't it's not really, it's not your fault, that you're coming out of the honeymoon time period that you need more insulin. It is what it is. Yeah. So I mean, there's a lot of, I mean, in the grand scheme of diabetes management, there's like, a lot of psychological stuff anyway. But I think this is a, this is a period where you may feel really, really confident. And honestly, during a honeymoon time period, it may seem a lot easier for some people because they have these really tiny insulin doses is they're only on basil. They feel like oh my gosh, I'm an eating and checking my blood sugar looks like it's in this target range. And they may not even be dosing mealtime insulin, maybe Basil is just cutting it for them, right? And then it starts to inch and creep and change. And that's where again, like that psychological piece of management kind of comes in, because a lot of people think, well, well, maybe I need to cut back. Maybe I'm doing too much, maybe I'm eating too much. So I'll just eat iceberg lettuce. And that means it's okay.

Scott Benner 23:04
It's such a good point that in the beginning, you're very likely using such a small amount of insulin and it can make you feel like I've got this it's so easy. But if your Basal is point one an hour, and you know your whole meal, insulin is like a unit for a meal or something like that, like, I'm not belittling, it's hard, and it's scary and everything else. But you're basically playing wiffle ball in the backyard with your dad, you're not hitting up a Clayton Kershaw right now, yeah, go crazy. When you put the ball over the hedge line, you know, they may just say, okay, and to me, it's all experiences. I mean, I don't know how many times I could talk about it, but you have to do a thing. You have to see how the thing works out. And then you decide, do I need a little more, a little less, a little sooner? A little later? How does this insulin work? And you do it again, and again and again, until one day, it just makes sense every time you do it? And? And the truth is, is that, you know, in the beginning, you do have more going against us than just understanding that you have the other parts, the psychological aspects of it, and what could really be, you could be suffering with depression at that point, or, you know, there's a lot happening. I interviewed an adult recently, she's in her mid 30s. And she said they were explaining to her about her diabetes, and she just sat there thinking I don't have diabetes. Like she wasn't listening to anybody. You know, she's like, a young fit person. And she's like, I don't this is wrong. Like she couldn't get past the I think they're wrong about this. You don't know how many important things were said to you. While you were staring at the wall thinking, hey, what was wrong? Yeah, what the hell just happened to us? Yeah. Okay. Yeah. Is there anything here we're missing? I do want to go to one more question here. But I want to make sure you have everything out that you want to say.

Jennifer Smith, CDE 24:49
Um, I don't. I don't think so. I mean, outside of just one other question that I think has come up in conversation in discussing with some newly diagnosed people that I've worked with, a lot of people end up asking, is there anything that can sustain this honeymoon? Right? And there's, there's only one study that I know of, and it was done in adult men. So not even a broad spectrum of, you know, gender or anything. But it showed that exercise in newly diagnosed men proved that the honeymoon lasted a fair amount of time longer than those who didn't include exercise in that time period post diagnosis.

Scott Benner 25:40
I wonder why that is. So

Jennifer Smith, CDE 25:43
again, I mean, something like that, certainly, you need to study it in more people more, you know, kids, teens, women, but at least it was a good visual that there is that one thing that was shown that could potentially prolong it, and I would, I would expect, it's just from a sensitization standpoint, right building muscle making the muscles work, which makes your insulin work better. And if your body is more sensitive, your pancreas also doesn't have to work as long so maybe it preserves the beta cells longer, right would be my expectation

Scott Benner 26:17
what let's put this part in here to like, so we know about like Tomislav, for example. Right. There's that drug trial. Yeah, about a long gating people's honeymoons? What's the real benefit of that? For the patient? Beyond that you don't need to use insulin, and you don't have to have diabetes, as soon like, I mean, the lesson to think of put off three, four years, then hey, you know, I'm saying, that's amazing. But if I'm just doing something that's going to extend my honeymoon by a week, or a month or two, like, what's the real benefit of that? Is there one?

Jennifer Smith, CDE 26:50
I guess the benefit to me especially would be for if it's even keeping people from some type of diagnosis, you know, in those who are tested with antibodies and are given the drug in order to extend the time without diabetes, any years without diabetes are definitely a benefit.

Scott Benner 27:10
I get that one I'm talking about, like, if running around like a lunatic makes it take three less. Like, if it gives you three weeks back, you know what I mean? Like, like, you've had diabetes for over 30 years? Yes. Would it be any different if you had it for three weeks less? No, no, right. But I would not, but three, three years less, God bless we would like that. Right.

Jennifer Smith, CDE 27:33
Absolutely. Three years less. Absolutely. And, you know, from the standpoint of ease to the body and whatnot, I think more information needs to be gathered as to people who were diagnosed without use of something like this. What type of outcome with control, like healthy management long term? What was their end outcome compared to people who got the use of this drug and had an extended let's call it honeymoon time, where their body was allowed to help them a little bit more. They had to use less injection, less pumped insulin less, right? What did that bring in down the road? Did it improve anything down the road? And that's going to take years to look at differences

Scott Benner 28:26
from I think, from my perspective, from a person who talks to a lot of people. When I hear about people wringing their hands about honeymooning what I really hear from them, mostly, they just wanted to stop. They just they just like, can we just get to the part where this is reasonably predictable? Please? Like, like, what what is happening, Jenny?

Jennifer Smith, CDE 28:46
I don't know. That's not me. It sounds like you're getting a weather. Emergency weather alert.

Scott Benner 28:51
Maybe a tornado here. Oh, great. Now live, you're gonna ever hear this episode? Scott, he's on his way up.

Jennifer Smith, CDE 29:01
I was gonna say do you need to go to the basement? I don't live

Scott Benner 29:03
in that kind of an area. This is the kind of an area where people go like, why don't we get these tornado alerts. But But, but to go back to my thought that was very odd. They just, I mean, listen, if it's a situation where one day your kid can go to baseball practice and the next day, they can't because one day the pancreas isn't doing anything and the next day it is. It's it's it makes you nuts. Like it just does. And I you mostly hear people say I just want to get to the next part at this point. All right. And I don't you know, I don't not understand that. I think but but this person asked this last question that says they're talking about a two year old who overnight is experiencing lows with no insulin at all. And they say he can hover at 90 for hours and then slowly creep down to 70. But here's the thing. Isn't this interesting? If Jenny's blood sugar would hover it 90 For hours overnight, and then slowly creep down to 70. She would text me in the morning, a picture of her CGM ago, look how good I am at this. And that's the thing you don't have context for when you're looking at your two year old baby who's had diabetes for two months. Right? That, you know,

Jennifer Smith, CDE 30:19
there's not enough history to it for it, this example, this family, this person, there's not enough. I, I have a sense of, of what that means to me. I also have a sense, if I got an alert overnight, and I saw what was happening. Even without using the system that I'm using previous to this, I would have a strategy that I 99% of the time would have worked, right to say, Okay, it's drifting, this is happening, this is what I need to do, or I can go back to bed, because I know that it's all gonna be totally fine. Right? So knew there are, there are a lot of kids, especially kids that I work with, who are still using multiple daily injections or MDI. Because once that Basal injection is there, you can't take it away.

Scott Benner 31:09
Yeah, this is an example from someone who obviously pumps because they were able to turn their basil off off, right? If they were MDI, they would continue to get low. It's funny, yes, I just was explained to somebody the other day, a person who just doesn't know anything about diabetes, and we're talking about low blood sugars. And they said, Why does it keep getting low? And I said, well, the insulin is dumb, it doesn't know. I think that the insulin is pulling glucose out of your blood, pulling it out, pulling it out, pulling it out, it doesn't get to a number and say, Oh, good, we're done. It just, it will continue to take glucose out of your blood until the power of the insulin is gone. And it doesn't care that you are where you want to be too low, having a seizure doesn't matter, it's going to does taking

Jennifer Smith, CDE 31:52
correct. And that's, you know, on pumpers if it was happening enough, again, in this particular example, you could say okay, well, this has happened night after night, I've had to turn the basil off. But if you've got a pump, you can program it just program is zero basil from this point of drop to this point of leveling out and and take care of it. You know, but on again, injections, it's it's really difficult. And so often, what we end up having to do is really make sure that the morning is when the Basal is adjusted, assuming that the overnight lows in this case, and assuming it's honeymoon in this case, is the pancreas is just kicking out at this point. Yeah, this is where it's taking most of its action. And so you don't need any injected or pumped insulin here, because your body is helping.

Scott Benner 32:39
And then the last question that people constantly ask is, How do I know when it's over? And yeah, that one's easy, because you need a lot more insulin,

Jennifer Smith, CDE 32:48
your insulin needs go up. And it's again, this is a visible Okay, was it today because it was a birthday party or a cookout or something? And so we just had a lot more that was different, or is it ongoing in the next? Okay, this was today, tomorrow looks similar. The next day, it looks similar By day three of needing more insulin and nothing else has really shifted or changed. You're probably getting to that point of honeymoon is ending

Scott Benner 33:15
experience after experience day after day showing the same thing. Yeah, you're probably not being helped by your pancreas anymore. The other thing too, is I don't want to be like ham fisted about it. But you know, when you have type one diabetes, and you're not getting any help from your, uh, you know, the way I used to explain it to one of my daughter's teachers when they wouldn't understand I said, Look, here's Arden right now, her blood sugar is perfect. If I take this pump for her, take it from her, just she got no more insulin, and we give her a half a bite of this cookie. She's going to be dead in four days. And you're like, I'm laying there like what? And I'm like, Yeah, her blood sugar is going to continue to rise and there is nothing her body can do about it. I said it will put it into decay, it will end her life a bite of this cookie without insulin. And so you can see it. When you don't have insulin, your blood sugar wants to go up. And if you you know if you can, you know, if you have some stability, say you are using a CGM and you have some stability at 120 and then you eat something and you know, you Bolus for it and three hours later, you're 120 Still but then it keeps rising and keeps rising and keeps rising. Your Basil is probably not strong enough. And then you need to probably go over and listen to the pro tip episodes about how to get going and taking care of your blood sugar. So alright, did we do it? Is this good?

Jennifer Smith, CDE 34:29
I think this is pretty good. Yeah,

Scott Benner 34:31
I you know, every time we do this, I wait for you to look at me and go, Dude, you're so wrong. Stop talking.

Jennifer Smith, CDE 34:38
I don't think I've ever said that to you.

Scott Benner 34:40
You just keep there's that little kid inside of me. It's like I'm gonna mess up eventually. And Jenny's gonna be like shaking her head at me and be like, What are you talking about? Stop but I think

Jennifer Smith, CDE 34:48
the only one time that I did correct you is when you told me that I wasn't nurse and I'm like, Yeah, I'm not a nurse, dietitian.

Scott Benner 34:55
I misspoke and there's the truth right now. We're still recording she would stop me if you I misspoke one time in how many years have we been doing this together? Oh my god, you're like, I'm not a nurse. Oh my god, I felt like I was married to you for a second. I was like, Oh, she finally got me he's so excited

new episodes of the bold beginning series will come out every Friday. Thank you so much to Ian pen from Medtronic diabetes, for sponsoring this episode of The Juicebox Podcast. Please remember to head over to Ian pen today.com. If you'd like to learn more about that insulin pen that talks to that app, through Bluetooth, I also want to thank you s Med, and remind you that you can get a free benefits check right now at us med.com forward slash juice box or by dialing 888-721-1514.

It would be a great companion to these episodes to become a member of the private Facebook group. For the Juicebox Podcast. It's absolutely free. But it's a private group so that you can feel comfortable speaking openly with other people who are living in a similar situation as you it's called Juicebox Podcast type one diabetes, you'll just have to answer a couple of questions to prove to that Facebook algorithm that you're a real person, and then you'll go right in to a space with over 25,000 members. There's so much activity on that Facebook page every day, there's bound to be a conversation. That's about something you've wondered about something you're experiencing, or something that you know enough about to help someone else with Juicebox Podcast, type one diabetes on Facebook, in that same group, at the feature tab at the top, you'll see lists of other series of the Juicebox Podcast, like the diabetes pro tip episodes that have been mentioned, or the defining diabetes series, which will also be mentioned here. If we haven't already, everything you need to know is it juicebox podcast.com are right there in that private Facebook group Juicebox Podcast type on diabetes. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Let me just remind you again, before we go that Jenny works at integrated diabetes.com If you're interested in hiring her, she's interested in helping you. Also, for US residents, T one D exchange.org Ford slash juice box, it really is a valuable thing for you to do to complete that survey. And it genuinely helps people with type one diabetes, and it supports the Juicebox Podcast. So if you can spend just 10 minutes today taking that survey, I would just greatly appreciate it t one D exchange.org. Forward slash juicebox. I've seen listeners of the podcast be involved in a number of different trials around diabetes, they got the opportunity from the T one D exchange. The one that comes to mind right now is that there was one person involved in a new adhesive study for the Dexcom G six. But there are many other opportunities. So beyond answering the questions in the survey and helping people with type one by lending your your data to the T one D exchange and I don't mean like super personal stuff. I mean simple questions about type one diabetes, which by the way, are HIPAA compliant and anonymous. Anyway, by by answering those questions in the survey, you will also give yourself the opportunity to hear about trials and studies. T one D exchange.org forward slash juicebox

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Test your knowledge of episode 702

1. What is the main topic discussed in Episode 702?

• The Bold Beginnings series introduction
• Insulin management tips
• Carb counting techniques
• Diabetes complications

2. What is the purpose of the Bold Beginnings series?

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

3. How many topics are covered in the Bold Beginnings series?

• Around 5 to 7 topics
• Around 25 to 30 topics
• Around 10 to 12 topics
• Around 15 to 20 topics

4. Who is Jenny Smith?

• A fitness trainer
• A nurse
• A nutritionist
• A CDE with over 30 years of type 1 diabetes experience

5. What is the honeymoon phase in type 1 diabetes?

• A time when diabetes symptoms are most severe
• A period after diagnosis where remaining beta cells still produce insulin
• The initial shock period after diagnosis
• A period of denial about the diagnosis

6. What can influence the duration of the honeymoon phase?

• The type of diet followed
• The initial insulin dosage
• The level of physical activity
• The timing of blood sugar containment and the remaining beta cells

7. What is a common misconception about the honeymoon phase?

• That it is a permanent state
• That it means the person is getting better and doesn't have diabetes
• That it requires no insulin at all
• That it happens to everyone

8. How should you manage insulin during the honeymoon phase?

• By stopping insulin completely
• By maintaining a fixed insulin dosage regardless of blood sugar levels
• By closely monitoring blood sugar and adjusting insulin doses as needed
• By only using insulin for meals

Submit

Change Answers

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#701 Child of the 60s

Monica has type 1 diabetes and was diagnosed at age three.

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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 701 of the Juicebox Podcast.

Today we're going to talk with Monica who was diagnosed at three years old. But today, she's 61. Monica has a rich life full of interesting experiences. And she's here today to tell us about them. 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. You do not have to ask a doctor to go to T one D exchange.org. Forward slash juicebox. Join the registry and fill out the survey that you can do have your own a CT T one D exchange, Ford slash juice box when you take the survey, you're supporting people with type one diabetes, and the Juicebox Podcast. Are you looking for the diabetes Pro Tip series? It begins at episode 210. You can also find it at diabetes pro tip.com and juicebox podcast.com. Or in the private Facebook group Juicebox Podcast type one diabetes, there's a list of the diabetes Pro Tip series, and all of the series within the podcast. This episode of The Juicebox Podcast is sponsored by Ian pen from Medtronic diabetes in pen is an insulin pen that talks to an application on your smartphone and gives you much of the functionality that you will get from an insulin pump. In Penn today.com The podcast is also sponsored today by us med. Don't just get your diabetes supplies from anywhere. Get them from us med Call today for your free benefits check 888-721-1514 Or you could just go to us med.com forward slash juicebox. Us men always provides 90 days worth of supplies. And they give you fast and free shipping. Us med.com forward slash juicebox are you wearing a headset?

Monica 2:25
I'm wearing yes like your pod thing. earbud whatever you call it. It's working on the computer I have doesn't have like a plugin for the other kind. And I was like oh, crap. I have to this was before I have to buy some Bluetooth ones.

Scott Benner 2:44
I think you could have gotten a adapter. You were looking for an excuse to buy yourself some nice bluetooth headphones marching?

Monica 2:50
Yeah, yes. It gave me a great excuse. And I'm always looking for those.

Scott Benner 2:56
It's okay to say that to me, by the way you are being recorded. So whoever whoever you were hiding the purchase from right here this one day.

Monica 3:03
I don't really hide them.

Scott Benner 3:06
The other day my wife says to me, I bought a sofa. I like wet wipe. Hello. What's happening? So she's completely overtaken our dining room COVID You know, and I think she's learned that she likes working from home. And she thinks she's going to be doing it at least a number of days a week. Forever, probably. And she says to me, I'm I'm gonna get rid of the dining room table, take this light off the ceiling, get a desk and put a sofa in here. And she was just saying it. You know what I mean? Like, I was like, oh, yeah, whatever you want to do. And meanwhile, I was like, Where are we going to eat? But it's fine. You know, I guess we didn't really use the dining room that much anyway. And then one day, she's like, I ordered a sofa. It's pink. I've always wanted a pink sofa. I said okay. Okay, I didn't even know what to say. I just not a big deal. Well, Ben, I didn't. I didn't care. You just she just bought a sofa. Now I feel like if I would have bought a sofa it might not have gone the same way.

Monica 4:12
May have been questions.

Scott Benner 4:13
Somebody would have been like, let me see this sofa. Why do you think this is necessary? Where's it going to go? Please explain your actions. I just stood there. I was like, Okay, so anyway, Monica, you seem pretty relaxed.

Monica 4:27
So I wrote this little note down that I'm nervous. But it was funny to me because a number of years ago I had media training because I would go on TV, radio, etc. For the state Dietetic Association and I also spoke to a lot of groups, nutrition, just kind of, you know, basic things, but um, and I'd always have the little trickle of sweat down my back and then I was good. And then I thought Why am I nervous? I'm, you know, I'm talking to one individual You know, it was just a funny thought.

Scott Benner 5:02
Yeah, no one's ever gonna write. You know, the funny thing is, is that if that was local television, you were doing. Yeah, you might be talking to more people doing this than you have in the past, but it's still just you and I speaking at the moment, so it's no big deal. Yes. Yeah. Well, that's great. What

Monica 5:19
I did learn when that the radio shows that I did, often I did them around the holidays, and you know, talk about tips. And people might call in or might not, I learned that years later, they were still replaying them. And some of them went all the way across the state of Arkansas. And I was like, wow, I didn't know that. But I mean, I didn't care. It was just kind of a funny thing. When someone said, they heard me again on the radio, and I thought, that was like two years ago.

Scott Benner 5:46
So I've done the I forget what they call them, but they put me in a room. And it was you're on a set, right? And you're you're dressed nicely and miked up, and it would go back and forth. Like you'd be on like morning television. And then you'd be on morning radio, then morning, radio the morning, and it would just and I did it for like, I think four or five hours straight. And I was dizzy. By the time it was over. I did it with a I think with a nurse practitioner. I don't remember her name. And we only talked about sending your kids on sleepovers when they had diabetes. Oh, wow. It was just it was exhausting. I couldn't believe how difficult it was by the time it was over.

Monica 6:29
Yeah. Well, great that you did it. I'm sure it was appreciated by a lot of people.

Scott Benner 6:34
Oh, your eye? Let me be clear. I was paid to do it. That's okay. Okay. It's all good. It was it was interesting. I you know, it's funny, it was back around. Do you remember Lilly diabetes? Had those little Disney books? Yes, they actually stopped. I think Lilly and Disney stopped their. Their partnership recently. I don't know if they've announced it yet. But I think it's done. And, um, and it was around that first book. It was like Coco's first sleepover or something like if I'm remembering it, right. And we just like, I'll never forget getting that call. And Lily was like, Would you do this? And I guess so. So I went to New York City, I spent the night got up early in the morning, went to a studio and just talked about sleepovers for five hours. We're not going to do that. Now. Tell me. Tell me how old you are. And when you were diagnosed?

Monica 7:26
Sure, I am 61 years old. And I was diagnosed when I was three, which would be 1963 1963 61 years

Scott Benner 7:37
old. I have to admit, I thought you had diabetes for a long time. And then when you came on, your voice sounded so young that I thought maybe I read the wrong description for a person when I sat down.

Monica 7:48
So I'm so lucky that, you know, the two gene pools mom and dad, on my mom's side, there was always this youthful appearance and energy and all that and my dad's side, they just seem to look older. And my they were my parents were only nine months apart. But people used to mess with him. Like who's that young girl you married, you know, and they thought there was about a 10 year age difference. And so I'm fortunate I followed mom's side. Great as my dad was I've just for the for the other part.

Scott Benner 8:22
Yeah. You just have a great voice. And I wouldn't Oh, thank you, I would not have been able to guess your age from your voice, which is neither here nor there. But that's how it struck me when you jumped on. Okay, so you were diagnosed in the early 60s? How old? Were you again? Yes, three, three.

Monica 8:39
So I my mom kept so many things. But what she told me my mom and dad are both now deceased. My mom died a little over a year ago in 2020. And she was 90 So longevity there. But she said over the years that I started asking for sweet drinks, I don't know if that was soda or what or juice and I began wetting the bed and that that was very unusual one they didn't they didn't give us a lot of sweet drinks there might have been some fruit capital juice, orange juice, milk, you know those kinds of things water and so those were unusual and so she took me to the doctor so I never was like deathly ill. And the cute story and that I also remember like these you know you have flashes of the kids stuff. I never felt bad so she took me to my the family doctor Doctor fulsome isn't that funny? I remember his name. Um, and then I don't know what I think they did a blood test and then they sent me over at Children's Hospital of Los Angeles because we lived in Los Angeles then. And I I'm guessing that the care there was really really good but I I never felt bad. And during the hospital stay of a couple of weeks they wish they would be looking for me. Because I there was a chair by, they put me in like a crib, and there was a chair by the crib. And I figured out how to climb out and I go visit what I called the sick kids. And so my mom said, there'd be these paging overhead, you know, looking for me when they came, you know, because they'd have to go home at night to sleep. But anyway, it's just funny. Just, you know, I was never I never felt sick.

Scott Benner 10:34
You couldn't think you didn't think yourself that way. Was that even at a young age? You didn't think of yourself that way that that carry through your life? Yes,

Monica 10:43
absolutely. Um, I mean, I've never felt funny about talking about being diabetic. But I also never, that wasn't my first thought. You know, I, I was a tomboy, I was active. I going through these records that my sister in law sent when they packed up my mom and dad's house. I was in every imaginable play, tumbling. Everything from, you know, as young as you were able to my mom signed us up at the different, you know, little theaters and Parks and Rec and whatever kinds of things were available to us. Yeah.

Scott Benner 11:24
And I'm assuming that your management allows you not to really think about diabetes too much, right? Because you were probably just getting, I mean, was that even I wasn't even regular an MPH at that point, right. That was, was that beef and pork.

Monica 11:38
It was beef and pork. And I don't know which one I was on. I was on one shot a day. And it was, it was not I remember your other person you interviewed not too long ago was talking about lenti and semi linty. I was never on that. And they, they use these glass syringes that they stored in a metal pan that had a lid on it, and there was alcohol in it. And I heard another one of your interviews with somebody, somebody they boiled there's I'm sure they did that too. But between boy liens, it was in this metal pan. And that stayed in the master bathroom or the bathroom attached the master bedroom. And I also found, again, my mom, I guess semi hoarder, the dietitians notes of how to feed me, in essence, and they followed the tag total available glucose method, which accounts for the Calculate glucose effect from carbohydrate, protein and fat. And that was in 1963. Yes, and my mom had the records from 1963 in 1977, that the dietitian had given her and there was a couple of questions. My mom was a health nut. So asking about tofu at some point. Grilled liver was on my food list. Somewhere in there, I must have had that.

Scott Benner 13:05
I'm gonna say that doesn't sound good. Did your mom keep the syringes? Or the vials or anything?

Monica 13:11
I don't I don't have any of those. Because so we've, we lived in Southern California for a long time, but then there have been several moves, following that. So I think in the course of some of those moves, those things didn't follow. So and I, I don't know, I can't remember at what point I went from one shot to more, but have you know, you have these little flashes of things. So I remember we were struggling with blood sugar, I must have been preteen ish teen, and nobody could explain why. And finally, we ended up with a female physician. And she said, Well, it's probably her hormones. And you know, it's just weird how information comes in, in those old days and quotes, you know, and so I just, I just know, I was always able to be super active. I was, I did everything

Scott Benner 14:13
you have. I have a couple of questions. So first, let me say this before because it stuck in my head. Now. I don't know what episode it was. But I remember someone talking about having broken their glass syringe and that and it being a like a significant financial strain on the family. And they didn't know what to do. So they actually went to the pharmacist who gave them another and then put them on a payment plan. And then their parent had to show up at the pharmacy weekly and put a little money on it. Like it was almost like layaway that you got to take home with you. Oh my Monica, you're banging something on the desk. No, not fidgeting or touching things. Oh, I

Monica 14:53
did take one sip of a drink. Oh, no, you're allowed to. And I guess when I set it down musta come through very

Scott Benner 15:00
low. Yes, yes. That don't worry about that. So, but I'm always really interested about your remembrance of how you tracked your health back then. Were you peeing on sticks or what were you doing?

Monica 15:15
It is, I mean, you think about so the dark age thing. It's comical, but my dad had some mathematical formula and lucky for us, he got his bachelor's degree in mathematics, and he'd always been doing that or engineering type things. But he was given some formula and I just remember him taking the dipstick results. Okay, the dipstick, so you're you're either showing ketones or you're not, I mean, the dipstick. And so the urine dipstick, he plugged some number in somewhere, they came up with how many of these total available glucose glucose grams I was going to eat, and the resultant amount of insulin. And I just remember him standing in, in the bathroom, he had some little logbook notebook something there, and he would run his formula. I don't have any record of that. I just, you know, again, young kid watching your dad while you wait on your shot.

Scott Benner 16:18
Your father figured something out on his own to help you.

Monica 16:23
The I think the hospital taught them something. Okay.

Scott Benner 16:27
But it was a lot of fun.

Monica 16:30
Yes. No technology and periodic go to the family doctor and get your blood drawn. Where you don't have. Yeah,

Scott Benner 16:38
where are you getting? So there was no blood draws to track your health. Was there be were you peeing on sticks to get color? Yes. Okay. Yes. And what did they What did those colors I see I'm always amazed by this because the color would tell you you were too high or too low, but then there was no next step to take right? Correct. Yeah. That's why people's

Monica 16:59
blood draws were at the family doctor. I don't know the frequency. But I go in there and they find out my blood sugar. periodically.

Scott Benner 17:09
Yeah. And that was it. Was that an A onesie even back then? No, it wasn't no, no, no

Monica 17:15
a one sees we're not like tilba atds That's what I keep. My brother was diagnosed with type one and not teen 75 So they live dark ages for probably seven eight years. Also

Scott Benner 17:27
Wait a second. So your your brother older or younger brother.

Monica 17:31
Younger, I've got an autoimmune family. I've got psoriatic rheumatoid arthritis with my older sister and I've got type one diabetes with my brother. Younger.

Scott Benner 17:41
How bad is that arthritis.

Monica 17:44
With Tullis is in rough shape. Unfortunately, she carries some extra weight. She also has hypothyroid she has all matters of stuff and I'm not sure she's had all the right testing done. I was texting with her the other day because I was listening to your your doctor. That's the specialist in thyroids. And I figure I got to keep learning on that side to try to I didn't even realize all these other autoimmune stuff. were tied back to the T one D people. I had no idea until I started listening and seeing I guess I just lived in this pretty good world. It didn't happen to me, you know?

Scott Benner 18:24
Yeah, I'll say this that. I don't know a ton about the arthritis. But I can tell you that if her thyroid isn't well managed, then she could be having pain, joint pain, stuff like that. They might not be helping the arthritis. Yeah, you know, could be making things worse, at the very least.

Monica 18:45
Yep. I plan to kind of talk further with her. And we'll try to figure out next steps, but because I think that somewhere there's missing puzzles. She has really severe asthma. She has a number of things.

Scott Benner 18:59
Asthma, too. Hmm, Hmm. Interesting. How old is she now?

Monica 19:04
She's two years older than me. So she'd be 63. And my brother is five years younger than me.

Scott Benner 19:11
Okay. Did you and your brother have any kind of kinship around diabetes? Or were you? I mean, he would have still been in the house when he was diagnosed. Right?

Monica 19:22
So sort of, so what happened? I was 15. So I was I was talking to him last month or so. And I was just asking him questions, too, because there's stuff that I don't remember. And I said, so keep in mind when I ask you these things, one, I'll we I got moved with my dad temporarily to Virginia, not because of a separation and my parents had two jobs. But my brother was diagnosed right before that. And I'm 15 I'm a rotten teenage brat. You know, I'm a girl going through hormones. I'm in high school living my life. And so I'm not he's my little brother. You know what I mean? Not that I didn't care about him. But it's just kind of, it's just kind of how it is with siblings. And I remember they, he had a one year honeymoon period. And all the only thing that I can clearly remember that is they told my mom, just don't give him ice cream at night. And if you do give it to him during the day, so and let him play it off, run it off. And so he got to go along for a year without insulin. And somewhere in there, my family, my mom and my brother moved to join my dad and I in Virginia, and he ended up with a really good endocrinologist at Georgetown, because they were so near DC. And he's always done really, really well too.

Scott Benner 20:48
Interesting. So you guys, so your parents had some background a number of years in fact, and then they got another child diagnosed and then they got a different kind of medical backup. Did you see his care being much different than yours?

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Monica 25:14
Yes. When he went to so first of all, he was on to two types of insulin, but they were still, he said, purified pork was his initial long acting. And he, he went to this doctor at Georgetown, and the doctor told him, here's my plan. And it was kind of rigid carbohydrates distributed through meals and snacks, the rest of his food intake, because he was growing. So 11, almost at that point, is whatever you want protein or vegetables or you know, other things can fill in the gaps. But he basically told my brother and my mom, but my brother because he wanted to influence him. If you don't do what I tell you, you won't be able to be my patient anymore. And something to the effect of and I'm really good. You know, and I believe because of how well my brother did, he was probably kind of accurate in that.

Scott Benner 26:18
Okay, so he just sort of gave him the high school football coach version of like, you're gonna do it my way or you don't get you don't get to be on the team. And did he have better outcomes than you? Are we still not measuring outcomes at that point? We're not right. 75 we're not measuring

Monica 26:35
anything. I think that. I mean, he probably had some more hypoglycemia, but it's hard to know. But like me, I mean, he played sports, he played soccer that traveled up to Canada and all over he, he just did well. I was in a Girl Scout troop that backpacked all over Southern California, we would be in the mountains, the desert, the beach, you name it. We were camping out. And I did that. And, and I don't remember episodes of hypoglycemia through that. I tried to ask my sister because she was older than me. Do you remember me having any struggles like that? She's like, No. And she didn't remember what I carried to help me. She remembers my mom giving me juice, you know, here and there. But well, I only have one. I'm sorry. No,

Scott Benner 27:32
no, we're just gonna say when you're doing those one shots. If you're eating, there's probably not a ton of opportunity to be low. And you're I mean, because what do you think your agency probably was?

Monica 27:45
I don't know. Because the first one I got? Well, I don't know what it was. But I know when I wanted to get pregnant with my daughter, which was she was born in 88. I knew I had to have to under seven a onesies. And I worked out continuously and I achieved that. And I plan my pregnancy carefully. Luckily for me, things worked that way. And I was able to have her at the right time. She was only born four days early. She was seven pounds normal size, you know, all the things went right. So

Scott Benner 28:26
let me take a tiny bit of a detour here for a second. I just had you ever have those shocking moments when you realize you're older than you think you are? Yes happened to me a moment ago when you were 61 years old told me that your daughter was born the year before I graduated from high school. But in my mind, you're 61 I know this is stupid. I'm 50. And you're much older than I am. Except you're not. Like it didn't stop my heart. But it froze me for half a second. You were like she was on an ad. I was like, oh god, why am I so old?

Monica 29:02
I think about all the time because my daughter is 33 years old. And I'm like, No way How

Scott Benner 29:11
when I hear that. I'm like, Oh, she her daughter's kind of getting older. younger than me. But that really took me for a loop. So, Mike, what really stuck to me was is that you had an 81 C in the eights I'm guessing and you exercised your way into the sevens

Monica 29:30
I don't really know what it was for all I know is I I've always exercise so that makes it sound like I I overdid it. I just made sure that I didn't miss any consistency. And I I always ate pretty well. But all of us have our little things now and then. But I did. I did have a turning point with when I was a dietitian in Washington DC that made me really focus on my eating. But I'll tell you that in a second. And so I just made sure that I wasn't over seven by being a little extra careful. And then the next time I have record of an A one see is when I went on my first pump in 1992. And it was my baseline before the pump was 7.8. So not terrible.

Scott Benner 30:18
Yeah, it's really interesting. Any of your How many children do you have in total?

Monica 30:23
I just have her because in spite of the fact I did maintain really good blood sugar's and agencies and all those Now granted, because we don't know what things like timing range where then I was pretty clear of any problems, side effects anything. And then I was in my somewhere in my pregnancy with her and I was working at Johns Hopkins Oncology Center. And I needed I went to see the eye center there, which is world renowned. And they decided I needed a little lasering to to keep my eyes good. There was some beginnings of retinopathy. So I did that. I had her. I start jogging to get back, you know, the pregnancy weight off. And I had a little little retinal bleed. And I went in and I'm like, What the Hey, and I said, I thought I was so good. And they just said that. The way my little capillaries grew Rama, I it made them more fragile to the jarring movement. I don't know. But I was jogging. And so they they treated me again. And then I was stable. Pretty much forever retinopathy has been my only side effect. But I have full sight. I just, you know, have had to keep on it and keep treating it.

Scott Benner 31:47
It's interesting to listen to somebody talk about that many years ago, because, you know, when you're you're saying, but you know, I got it to the sevens. It was good. You know, that whole thing? I think now pregnancy, they want you in the loaf, like in the fives, or to be pregnant.

Monica 32:02
Right? Those are those days,

Scott Benner 32:04
of course. But I'm saying I'm not judging it. I just think it's interesting to hear it. And it's it's good of you to talk about the retinopathy issue too. Because even though that was the standard, everyone, I'm guessing based on technology, this was kind of the best anybody could do. But you still ended up having an issue with it. And because there are people nowadays who hear well, like I have a seven, I'm okay. And I'm like, Well, for now, maybe, you know, like and there's all this stuff that you could be doing or ways to understand your insulin better. That could put you in a situation where maybe you're not getting your eyes lasered one day, you know now yeah, what was that experience? Like?

Monica 32:49
Um, it was, I mean, it wasn't terrible. It's just depending on how much they did at a time. I might have a nagging headache afterwards, but I normally drove myself to and from I didn't you know, it wasn't something that took away my day.

Scott Benner 33:03
And we've helped stop the progression

Monica 33:07
for the most part and then so fast forward, I'm living in where I live now in Arkansas, and I had just been to the to see the ophthalmologist, my eyes were good, my Awan see, because once I got on the pump, my onesies stayed like 5355 up to low sixes. I think I might have hit a 6768. Occasionally. This is without CGM. But so I had like a massive bleed in my left eye. And I just like the day after, I'd been to the eye doctor, and I just I got on their emergency line, like what in the world. So they, they told me you know, raise your head up, do this, do that. And all the blood cleared and ever since I think there's probably been somewhere in there that was probably a little more laser treatment is kind of hard to remember before after that. But every time I go now and only go once a year to the specialist, the retinal specialist. He's like you have a perfect macula. Everything looks so stable. They're always pretty amazed. But again, that's because I kept my control. Good.

Scott Benner 34:28
Yeah, you did get it lower too. And as the technology I mean, you did what I think is the greatest thing. You know, as the technology became available, you didn't shy away from it. And that's really important, honestly, Hey, you. What did you What did you do for a living as an adult?

Monica 34:46
So I have I graduated from the University of Connecticut with my Bachelor of Science in Clinical dietetics I became a dietitian and I did clinic work for a while. And then I ended up getting with, I always liked the idea of being with corporations because you had job advancement opportunities. So I ended up with a nursing home Corporation. And I kind of covered like a lot of the East Coast, Virginia, Maryland, DC, I went to their nursing homes and did sort of quality assurance and some charting and just made sure they were feeding people appropriately. And somewhere in there, the people that were in charge of writing the menus, and this was a large company that were like 1200 nursing homes, wanted to move the position out of a dieticians basement in Pittsburgh, into the corporate office that had opened in Arkansas. And so they start talking to me about it, because I, I've always, this is gonna sound very braggy. But I'm pretty smart, you know, I do pretty well, I can stay organized. So those things were recognized by other people. And so I applied, and they moved me into here in their headquarters, which it doesn't the company doesn't exist anymore, eventually went away, got bought and this and that. But they had me run their menu program, which I had to supervise like dieticians in certain regions to make sure the food match the food preferences of the people that live there.

Scott Benner 36:32
Monica, are you are you telling me that you followed your husband to Virginia, so he had to follow you to Arkansas?

Monica 36:39
i Okay, so I am on my third marriage, which I've been in 20 years. So I, I left a husband back in Maryland, and brought my daughter she was three and a half to Arkansas. And the job opportunity was great, because then it could, you know, help that happen. And got here and you know, because in your in your different segments, you do things with mental health, I did two bad choices. Who knows why? Because I'm assertive on the job, but apparently not so in my personal life or wasn't. And so after some therapy, I became the same person across the board, you know, assertive able to speak for myself? Well, and I always tease my current husband, you're probably Sorry, I got all that therapy.

Scott Benner 37:31
Of the three of them, you're having the least good time, just so you know.

Monica 37:37
Although he's hung with me 20 years, so it's all good.

Scott Benner 37:41
When you got married the first time.

Monica 37:43
So I was 26, I believe, and then my daughter two years later. And then she was three and a half when I decided he unfortunately had some problems and drinking and some things that just we needed to go to for the best of both of us. And yeah,

Scott Benner 38:05
talk about for a second, though, what you mean, what you meant by not being as assertive. You like just letting things happen that you knew weren't right. Or you didn't? Yes, yeah, the Speak Up that kind of stuff.

Monica 38:17
So, my, my parents, so this is what led me to this place that my parents always tried to help in the communities and things. My dad was active with fair housing, in our Southern California town, so that, you know, whatever you look like you could move into that neighborhood. And it was a super wonderful mix of ethnicities and races and things like that over time. And so, in that mindset of helping people, I think I took on the wrong belief that you could not just help them but fix them. So I apparently started to attract to myself fixers, you know, people that needed fixing Yeah, and instead of just people that could be your partner, and I had that happen twice. The first one, you know, you had somebody on the first one, because of his alcoholism ended up being somewhat abusive, more verbal than physical, but a little physical. And so when I left that situation, I didn't get help right away to get me past that. And it's easy then to fold yourself in with someone else. Not exactly the same, but just not right. And so those those things happened, but fortunate for me, my best friend is like a psychological examiner. So she's got her master's in psychology, and she was able to get me to somebody that was really competent, and very, very helpful.

Scott Benner 39:59
Thank you. Free of the idea that, that you were going to be able to help people who maybe didn't want the help, or were beyond the help, or maybe it just wasn't your job to begin with to help them.

Monica 40:11
Correct. Correct.

Scott Benner 40:13
Okay. Well, that's, that's amazing that you did that. In, you know, I see takes

Monica 40:20
work and stress and things

Scott Benner 40:22
like that. Yeah, that's really cool. And it benefited your daughter, I imagine.

Monica 40:26
Yes. Yep. And my, my husband now, he's, he's just, she's a part of the family, you know, because it's been so long when we got together his son, he has four children, but his youngest was nine. And my daughter was 13. So kind of, you know, they, they learn to go together? Let's do things. Yeah.

Scott Benner 40:49
Does your daughter have any autoimmune issues?

Monica 40:52
Not that we know of at this point. And, you know, I, I was taught that, you know, if you want to birth them, and you breastfeed them, you have the potential to protect them. That may not be true, but I breastfed her for several months, like her attached to me. And then when I went back to work, I did pumping, so I could keep her on breast milk for almost a year, just frozen, you know, we thought out and give it to her. So I always felt like that was healthy.

Scott Benner 41:25
Yeah. Did you do that? Because somebody told you to, or you just had a feeling like this could maybe help and I have diabetes. So let's give her the best chance was that the vibe

Monica 41:35
somewhere in there? I was told that I cannot remember the exact source. You know, again, things were evolving in knowledge and all that. Yeah.

Scott Benner 41:46
Can we take a detour for half a second? Please? You said your mom lived to 90. And you worked in the, in the in the system where people are, you know, helping older people live at the end of their life? Did your mom have to live in a facility ever?

Monica 42:03
Yes. Let me think about it. My dad lived to be 87. So my mom had a stroke when she was 78. And she, she was super healthy. I mean, this woman worked out did yoga did all kinds of things. But they said, Just genetically and it was blood pressure related. Probably what happened sooner she hadn't eaten the way she did and exercise and maintain being quite thin. So she has a stroke. My dad's trying to help take care of her and my, my sister because I don't they were in Northern Virginia and I'm now in Arkansas, my sister was kind of keeping an eye on what was going on in my dad's start to be a little different. So ultimately, we figured out he had Alzheimer's, and it just needed, they needed to be somewhere safe for them. So they moved him into an assisted living place, initially, and then, over time more to a memory care unit in the same facility.

Scott Benner 43:02
Talk about for a second, what people should be looking for. We're like, well, what are some red flags when you're looking at places like that?

Monica 43:11
My sister did more of the research, but we looked at the ratings that the state gives them. We looked at, you know, their staffing ratios, what kind of programs they offer, you know, that's social programs. And when they're in assisted living, they can often go on trips, you know, they carry them in a van or a bus to activities. So they did theater, they did different things. And my parents because we grew up in California, they always enjoyed wine. And so they do even like little cocktail hour at the assisted living and people had a glass of wine, you know, and some appetizers, so they did a lot of things that fit the lifestyle for them. By the way, I didn't stay with long term care. I ended up in pharmaceutical sales. So doing that, well. That's where I spent 22 years also well,

Scott Benner 44:05
I you know I just something wrong in my head a minute ago, and I kind of was googling while you were answering that question. This is interesting. Some people are starting to call Alzheimer's type three diabetes. Really? Yeah, so I'll read you something from Healthline. Some research studies have proposed that Alzheimer's disease should be also classified as the type of diabetes called type three diabetes. A term has been proposed to describe the hypothesis that Alzheimer's which is a major cause of dementia is triggered by a type of insulin resistance and insulin like growth factor dysfunction that occurs specifically in the brain. And if we if we google Alzheimer's, autoimmune new research published in the Journal of Applied laboratory medicine identified specific auto antibodies that mistakenly target the body's own tissues in the surgery Well, in the cerebral spinal fluid of Alzheimer's patients, I guess this is a doctor's name says adds to the evidence that this might be an autoimmune disorder.

Monica 45:20
super weird. What is your my brother and your mom has always been biological research. So tying back to this just quickly, he, at one of the companies he worked at, they had developed some kind of a evaluation to see if you might be at risk. There's certain things in your in your bloodstream, and he tested himself and my sister, and they didn't match up. And I was like, Oh, great. I'm the only one you haven't tested. If one out of five or something can match, I might be in that mix. So

Scott Benner 45:57
I meant I'm sorry, I started to step on you. But I'm glad you finished your thought first. But Did your mom have any autoimmune stuff?

Monica 46:04
Um, no, um, she had some asthma. And then somewhere along lines, even though she was never a smoker, she ended up with a lung cancer tumor that they luckily were able to radiate and stabilize, and it never progressed. But that was kind of that's kind of all for her.

Scott Benner 46:27
I don't think that it's categorized yet, excuse me this way. But asthma is caused by an overreaction from the immune system to certain triggers. So you might not ever have had a chance you and your you and your brother and your sister, you guys were you guys were you might have been destined for this, you know?

Monica 46:47
Yes. And you know, there's in the town that I live in, there's a an osteopathic medical school. And when they first opened up, I think it's been three years ago, now, I met the team that was going to be instructing the students there. And one of them was, or maybe more than one was an adult onset type one. And he got approval initially, to do research with the people that are adult onset type ones. And I don't know what happened, because I don't think they're still at the school. And I was super curious about that. Because I've known some people that, you know, had that. But I always thought, man, they need to just study broadly, these crazy auto immune families, you know, and fit that in the mix. today.

Scott Benner 47:39
I have talked to enough people at this point where I just think it's, I mean, it's, I don't I can't say I'm not a doctor, I haven't done a study, but it's fairly obvious, you know, that autoimmune can travel in bloodlines. And that's really something but can I ask you, overall, looking back? I mean, you had diet, you've had diabetes for the 58 years. Geez. And do you see it as a major impact on your life aside of health? Or do you not feel that way about it?

Monica 48:15
I never have. Like, I mean, I just do everything. And, you know, in the last few years, but these are the things that nobody, people make assumptions about longtime diabetics, especially those that have some science backgrounds, that we know everything we need to know. But I didn't know, all the things were at risk of like, and some of your other people have talked about this carpal tunnel, trigger finger, frozen shoulder, all those things. I didn't know there was higher risk, because I was diabetic. I just, you know, I had I've had those things that they're not still present in my life like that, you know, they've been fixed, or, you know, I do the work to help them go away. But I just I think, well, people need to know at least what to look for. And the more the reasons why to take better care of themselves. And I know you think that some of the people that were without technology always believed hyperglycemia was better than hypoglycemia. But in my family that wasn't it because we always felt like you can fix hypoglycemia, you know, you can drink some juice, you can eat something. But you can't fix that chronic needling away in your bloodstream and your nerves and your because

Scott Benner 49:39
you didn't have an insulin that you could just try to correct with. You were stuck. We know the next time to inject and that was that.

Monica 49:47
But we also I just I can't remember a time I wasn't on my bike at the playground, playing basketball or football with the boys. I just can't remember not doing that stuff. And I think it, it my my current nurse practitioner says, I think that's why you're as good as you are now.

Scott Benner 50:11
So active. Yeah. Well, I mean, you grew up in a warm place to in the 60s. Yes. So, you know, I'm assuming there was a lot of like, Bye, mom, and then you come back eight hours later, stuff like that going on, right? I mean, that's what we used to do. Just we run out the door in the morning and never come home. So absolutely, yeah. Yeah, it all makes sense. I mean, activity is incredibly important. It is. It definitely helps insulin work better, it helps you that, you know, helps your digestion and you know, digesting your food through you shortens the amount of time that it's in there impacting your blood sugar. There's all kinds of great reasons to be active for certain for everybody, not just for people with type one. Yes. Now, so you didn't really feel a big impact on your life. But I do. I do want to ask you, maybe I don't care what the answer is. I'm just interested when technology became a part of your life, and I haven't asked you like you pump or no.

Monica 51:07
Oh, yes. So um, two years ago, 2019 late, to be honest, this time I got on. So I've been doing technology, but not so much with CGM. I got on a tandem with a Dexcom G six. Love, love, love it. And before that, I've worn a pump since 1992. The model of pump I had before the tandem was one of the Medtronic models that did have a CGM associated with it. So if somebody out there gets mad for me saying this, I was on a model like a paradigm five, it's an older model. And the then, CGM I felt was terrible. So what I didn't wear it for the longest time, and then I began to wear it. You'll love that every other week. And I don't know why I picked that random thing. But I just thought at least now and then I can be checking, you know what it looks like. So I did that for a few years, or a couple years anyway, but I just, I didn't like how it had to be applied that it only lasted six days. Just things so the decks calm. And I started researching these different CGM that I also looked at before I changed to the Tannum. I did get an omni pod sent to me the little trial thing, I did several things. I think I wanted the technology of 10 I'm only had the Basal IQ at the time. And then I knew in six months, the CIQ was coming. And I wanted that, and I didn't like the Medtronic system, deciding your Basal for you and doing all those kinds of that auto mode. Okay? Even though I know you can do adjustments with that. And I, no one, no one really taught me and this so I don't mean to be blaming someone else. You're I'm responsible for me. But the Pre-Bolus ing thing was only ever brought up to me on pomp therapy once or twice, but in my sales job and some of my other things I did. I tried that. And I had so many word follow up the bottom events because of you'd be out eating food never came different things that I stopped doing that and I would just dosed when I saw the food. And so I probably had the bouncy effects, you know, you go up and then you normalize you go up, and then you normalize. So the tandem with the Dexcom has given me a lot of information. And I really, really value it. And it's the tandem community on Facebook, the private group that led me to you to your podcast.

Scott Benner 54:00
Oh, good. That's lovely. I have a question. Do you think that when you switched from your older pump, and I Oh, by the way, I think this is the part where I say I'm sorry, Medtronic, I don't control what people think about your stuff. And then we move on to where I did not know any of this about Monica, please.

Monica 54:18
I actually really respect them and their research and their it's just personal preference. I understand that's their science is good. So I don't have a judgment on that.

Scott Benner 54:28
It's just become a running joke in the podcast. That's all so I just have to keep it going. But my question is, is it possible that prior to Dex calm and control IQ, where is it possible you were running heavier basil than you should have been? Do you remember your basil going down when you got to a CGM?

Monica 54:51
Um well so because of my age in my life have changed some. The answer is actually no but um But I know like,

Scott Benner 55:03
because why asking Monique? why I'm asking is I'm picking through the idea of is it possible to before you could see your, you know, you could see your blood sugar in real time where you were maybe doing that MDI thing of like, heavier Basal, to keep your agency lower, and then kind of feeding the insulin before you got low situation and then Pre-Bolus and wouldn't have worked for you. Do you know what I'm saying? Does that make sense?

Monica 55:27
Yeah. So I think that so the old rule that the the, the people like the nurse practitioners, they would talk to me about is Oh, you don't want your Basal to be greater than 50%? I think that rule has changed a little bit. But so mine was sometimes 5557, something went in there. So you're probably right, in terms of their thinking at the time, too. But yes, and yes, yeah.

Scott Benner 55:57
Interesting. Yeah. I mean, it's just, it's just being able to see your blood sugar is obviously just as such a game changer, you know, at about making decisions, and then the algorithm on top of it is probably magical to you after living with diabetes for this much time.

Monica 56:13
Yes. And my since I've been on this system, my agency has been essentially five to 5.3, so since two years ago. And so that's great. And it's consistent that way, and my time in ranges 93 to 95%. With a standard deviation, it depends, but sometimes it's 27. Think it's gone up as much as 33% 33 standard deviation, but it's really terrific. Oh, yeah, always within the acceptable range. And you know, it's interesting, my brother uses a Dexcom. But he does MDI, and we were talking about that, and they'd always just looked at is a one C, and he said, he's changed endos. And the one he has now was talking about time and range. And they ran his and his, like, either 95 or 97%. I don't know, his standard deviation, but he's, he's done really well.

Scott Benner 57:12
So that's really cool. It's amazing, actually, I mean, that you guys have been persevering like this, and doing such great jobs for yourselves. And it's even nice that you're still considering looking out for your sister. Really, really wonderful. Because people need help, you know, that you can't, you can't know everything about this stuff. You know, and you find information and, and it's, it's great to pass. I mean, you said that somebody from a tandem group told you about the podcast.

Monica 57:45
Yes. So, um, I don't know. Okay, I wasn't a Facebook person. And then when. So in, in 2020, I began my dietitians private practice, I left the pharma and I opened up my own, it's just part time but business. So I got on Facebook to do some of the intandem said something about to look at something of theirs. You should go on Facebook. I don't know as a video or a Facebook Live or something. So I thought, Okay, I'm gonna get on Facebook. And part of that was a time factor in my old job. I just had too many things to do on a computer and I didn't want one more thing. But um, so I so I got on there for dieticians, Facebook Lives, tandems Facebook Lives, and then I saw this tandem group. And in there, people will ask questions a little bit like the Facebook group for juice box. And people would offer their advice of either the sugar surfing book, and or your podcast, and they might even cite an episode. And I was like, I guess I need to go over and get on that podcast. And so I've been just picking and choosing some of the episodes initially, and then I'm ultimately I'll get through all of them, but I chose the ones that would help me best with the CIQ because I was still struggling with the Roly Poly thing. You know, I was like, come on. Yeah, you guys see me is the answer that I want. And I'm only seeing it sometimes

Scott Benner 59:22
way episodes helped you with the loop episodes about the algorithms. or

Monica 59:28
so Pre-Bolus seen the things like feed on the floor, because I would always say to my, the nurse practitioner, I see. I get up in the morning, I'm at seven, I walk around for a few minutes. I I didn't always drink water first thing in the morning, which is something I know as a dietitian anyway, but I didn't know how to do it initially. And I'm like, up to 130 What is going on, you know and so, so just things like that. And just again, though being able to see it, you know, and I also started looking at my night times, which are not bad. But I was like, Why do I have these little, these little rises and you know, peaks and valleys. They're narrow, but they're in there. So I, I adjusted my Basal, and it's pretty much straight across now. So yeah,

Scott Benner 1:00:21
that's so cool. I'm glad it was helpful I really am. If it was helpful at all, it's amazing.

Monica 1:00:25
Really, it's been really, really good. And you and Jenny are amazing in the tips and things. And so I went, I mostly referred to things that were related to me and pomp therapy. So if there was a pro tip on MDI or something, uh, bypass some of that. And, you know, certain things I go past, just because I needed specific things.

Scott Benner 1:00:51
No, I understand. I really do. I think that, um, you know, just the, the, the act of listening to the show, I think is helpful. And I would, I could, you know, I can make a reasonable argument that even if you listen to the stuff you're not interested in, that there'll be something in it that could help you, you know, meaning like MDI when you're pumping, or vice versa. But I take your point, and I mean, it's not like you have I mean, there are 500. And I don't know how many episodes, honestly, I don't know how many episodes are anymore, there's a lot of them. So you can't just listen to everything if you don't have the time. But well, I

Monica 1:01:26
just prioritize them. It's not really that I don't plan to listen to them. I sort of made it, you know, listen to the ones that were going to have more what I felt like immediate

Scott Benner 1:01:36
effect. Oh, you liked the podcast, don't you? I do. Excellent. Yes. Well, I want to come on.

Monica 1:01:44
Um, well, just thinking about, I think, and I said in the, the email that just, I feel lucky, but lucky with the fact that I also have, you know, invested in doing things for myself, just because I came into the timezone that, you know, people didn't do well, in terms of 1963, you know, and matter of fact, I went nine years to a diabetic camp for kids. And sorry, I'm adjusting my, your thing was crawling out of my ears. Could I do something? Can you hear me? Okay, good. Yes. Okay, um, where there are, there are people from that camp that I went for years with that are blind, dead, et cetera, and, you know, amputations and things like that. I have a friend in St. Louis, from there that just got out of the hospital, because she was, you know, having terrible blood sugars. And so though, the people that I was around, and, you know, we came through a good camp that was based out of Loma Linda University and taught a lot of good things, but there just weren't, there weren't the technology and things to help make that journey? Better? Like it is now?

Scott Benner 1:03:03
Yeah. Do you think candy now? Do you think that the information? I mean, there's an obvious question, but the information from back then versus now is just, it's night and day, right? It's like there's, I mean, was there anything that you were taught back then that has real value in today's world?

Monica 1:03:20
Right, well, that staying active, yes. And I probably do some of the things you guys talk about with, you know, kind of think about the too much insulin thing, but I think back to what I'm eating, and so I'm like, do I need to have that much of that food, because it's gonna lead me to take a big old giant dose of insulin, I probably do. That's, that's old world thinking. And I probably have a little bit that hangs around. But if I really want something, I'm going to try to figure out how to do this for it. And forget the amount of insulin.

Scott Benner 1:03:59
So a good balance of common sense and technology. Yeah, that's excellent. That's great. Do you have a particular eating style or not really,

Monica 1:04:08
I'm not really but what I what I've done because again, my my life is a little different. So days that I have clients in the office and I'm going to be in there and sitting for a good portion of the day. I mean, I get up and walk around the block and near my office because you know, it's a decent downtown area. I will tend to eat a low carb lunch so I go get a grilled chicken salad, something like that, where I've always been so active that for fitness reasons I ate high carb, more than 55% of my diet was carbs. Because of how much i did i i bicycle that I ran I strength train. I did all of it. So now because I'm a little little less active age, we move just a number different things. I don't have that level of, you know, I don't go on a Saturday go ride 30 miles on my bike anymore. Yeah, so that doesn't mean I don't do things I'm you know, I do things but different. So I so I can give myself the freedom to not think I need to have my glycogen all built up for that long run or ride. I'm okay to eat a low carb lunch and think different about it. But I've been playing around with some vegetarianism and like we had something last night I tortured my husband with trying my new ideas. But, you know, I don't have any style.

Scott Benner 1:05:39
I'm sure he was thrilled. I'm sure he was absolutely thrilled. Like it whenever you made did it end up being good? Or were you in the state actually

Monica 1:05:47
was good we just had it was red lentil and sweet potato soup. And so vegan, and it was spicy, but I was like, it's spicy without flavor. What's the deal here? And he's like, it just needs salt. So, you know, I've been trying to cut back on sodium for both of our good health. And so it's finally like, Okay, put some salt in it.

Scott Benner 1:06:13
And some cute dup sirloin steak. And

Monica 1:06:17
so that's the funny thing about him. So I'll think, Oh, I'm gonna make a pot of beans. And I'm thinking, you know, onion, celery, jalapeno, something. And he's like, where's the meat? And he literally said, Just get me a can have spam and I about gag when he talks about spam. But you could eat spam.

Scott Benner 1:06:36
Oh my god, I think I've had that as a child. I think we fried it. Yeah, that's what he said he did too terrible that I'm thinking back on it. That's really terrible. Oh, my gosh, Monica, is there anything that we haven't talked about that you hope to?

Monica 1:06:52
I was going to say that people on both Facebook sites yours in the the one to 10 him talk about endocrinologist. And oh, you need to get with your Endo. So even though I live in what's considered the second or third biggest city in the state? We have for more than a decade. been lucky if we have one endocrinologist? Lucky, which is the situation now. So when there were none. And I needed to find somebody. Because I was in my pharmaceutical job. I, you know, just asked a doctor to the side, it was like internal medicine, you know, would I need to find a doctor? I have type one diabetes, would you be willing to care for me? And almost universally, it was like, huh, I'd really prefer not to. And I'm saying well, do you know that I'm also a whole person, and I'm over the age of 50. And I need other care, not just the diabetes? And unstable. You know, and it was really bizarre. Yes. So finding good care is a luxury.

Scott Benner 1:08:13
It certainly is. Yeah, it certainly is. Yeah, it's not that easy. And that's why diabetes, and to be perfectly honest, most health, most health issues that run long term, you need to understand them for yourself, like you can't just go to a doctor and then shut yourself off, and then wait to go back to the doctor again. And then if you have problems, just go I mean, I did what the doctor told me. You can't you have to take real agency over yourself. And you just need to, you just need to there's no, there's no way around it, you're not going to do as well, if you wait for someone else to help you. It's it's just it's it's just, I mean, I've just seen it be true over and over again. And I don't think it has, like I said, I'm beginning to see that I don't think it has as much to do with diabetes. It's just in general how healthcare works. And not to even say that it's bad. You know, it's it's cutting edge. It's probably as good as it's ever been on the planet. But it's still people aren't with you every day. They don't have the same concern about you as as you have about yourself. And yes, and they see you as a management thing, which is reasonable. And you're you're trying to live a life. So taking good care of yourself is the best thing you can do. I think that's why the podcast does as well as it as it does. Yes, you know what I mean? And I'm happy that it was valuable for you or anybody who listens honestly.

Monica 1:09:41
And I think that that people saying oh you're in you're doing good or whatever is usually relative to their uncontrolled folks be a type one or type two. So they're and I would have this fighting with the endocrinologist when we had like four of them in town. A Um, you're saying I'm doing good, but my agency went up. And it's still inside the mid sixes. But it used to be closer to five, seven or something. And I was like, you know, we need to adjust something. Because this this level of good is not my good.

Scott Benner 1:10:20
Yeah, good is an interesting word. I've noticed when talking to people, it's always relative, it's always compared to just something that's worse. And no matter what it is, you know, like how you don't say, Oh, I'm good. You know, your leg got chopped off and an accident, but you just saw a guy who lost both of his arms strike while I'm doing better than the guy with no arms. And it just it really, it really is. It needs to be and that's why I always push people on it. When they say something like, How's you're able to say it's good? What does that mean? You know what I mean? Even like you, you know, back in the day, they told you, you're seven, you're good. And well, you know, could have been better. They didn't know it back then. And you could be in that situation, modern day where you're at a practice where everybody's got an A one, C, you're sevens, or eights, and your six nine looks genius to people. And they're like, Oh, don't do anything? No, not that I'm telling you. Your six nine is bad. It's just there's room, you know, you can you can do something about it or your variability, you know, I think is probably as important. You know, I mean, I can't make the distinction for you. But it's as important to share a once a, you know, it's, you know, you don't want your blood sugar to be bouncing around.

Monica 1:11:33
And the other thing that I believe now, so as more and more people are on the technology. So I said, I'm fortunate the nurse practitioner I see worked in the endocrinology department for years and years and years, and she's a CDE. So she's really on top of things. But I said to her, and she was training another nurse practitioner. I don't know why the postprandial glucose is at two hours. For people like me, you and I wasn't criticizing you and people like you should be asking us to be under 140. I mean, preferably lower, but I'm just saying that's a normal person's to our postprandial glucose can go up to 140. And why we're still using that 180 number as good in quotes. Doesn't make sense in a sign of kind of like a hybrid closed loop. You know, we're almost like, pancreas is over here. You know, and, and so. So I'm going to try to talk to you about being under that. 140. And actually, obviously, strive for better than that, but just as putting a lower cap

Scott Benner 1:12:44
on things. I and yeah, I think I say it here pretty often. But to me, you know, if you get the 140 after a meal, like Okay, I think of 160 as a miss and 180 as a spike. Well, yeah, like, that's how I think of it. Yeah, you know, like, I'm not saying your blood sugar is always going to be like super 83 You know, 8590 201 You know what I mean? Like, it's gonna go up, sometimes you're gonna miss on your, on your Bolus at times, or miscalculate carbs, or whatever is gonna happen. You have a site that's going bad, there's a million things that could happen. But it's about to me, it's about stopping it, and not letting it get out of hand. And then that's where you run into problems where, you know, people who are, haven't been around type one as long or haven't heard about, you know, ideas are going to start telling you well, you can't stack your insulin, you're gonna get low. And you know, I don't think you should stack insulin either. I'm not saying that. But if you Bolus for 45, carbs reach 130 and your blood sugar shooting up. And it turns out the meal was 55 carbs, well, then putting in the extra insulin is not stalking it's covering the carbs. Yeah, but it's a it's a distinction that gets lost on people sometimes. And then they watch their 140 turn into one ad, and they're one ad to turn into 250. And they're 250 turned into 300. And then they get caught in that, you know, that that like void of like, oh, well, it's going to come back down. I don't want to put in insulin and make myself low and they just start staring at the high blood sugar and waiting and waiting and waiting. And before you know it. They're They're super high. They don't have any idea how to bring it down. And eventually they are going to cause a low because it's going to take so much insulin to break it free. So yeah, I like using insulin sooner to avoid highs. I also like it because it it often means you're using less insulin, which should result in fewer lows later.

Monica 1:14:43
Precisely. Yeah.

Scott Benner 1:14:44
That's just how I think about

Monica 1:14:45
it. Yeah, so I have two meals that I haven't figured out and it's I like cottage cheese and a lot of people don't and up in the morning sometimes I'll have some cottage cheese on the side of a piece of toast and I'm like, I don't care what I do. At this point, I haven't figured that one out, it's going to shoot up to 180. And I'm like, I keep bringing that Pre-Bolus earlier. And oatmeal. Oatmeal is like the greatest food but I have not gotten that one quite worked out, right. So I'm like, we're gonna keep playing. I'm not gonna let it win.

Scott Benner 1:15:19
Keep keep fighting and trying one day, you'll find it to one day, you'll find the measure and mix of, you know, Pre-Bolus and amount and you'll just be like, Oh my God, it worked. And that's it, then you know, you'll be like, sick. It'll be sick of oatmeal because you tried it so many times.

Monica 1:15:35
Exactly. Anyway, but those like, I've figured out most of the foods, but those two are still a little uphill climb, but I'll figure it out. Good

Scott Benner 1:15:43
for you. Well, Monica, this has been terrific. I really appreciate you coming on the show and talking to me like this. I had a really good time. And you have a lot of wealth of knowledge and, and perspective, and I appreciate you sharing it with everybody.

Monica 1:15:56
Well, thank you for letting me it's been really enjoyable. And I enjoy listening to all of your interviews.

Scott Benner 1:16:02
Thank you. Well, I think people will enjoy this one as well. Thank you so much to Ian pen from Medtronic diabetes, for sponsoring this episode of The Juicebox Podcast, please remember to head over to in Penn today.com. If you'd like to learn more about that insulin pan that talks to that app through Bluetooth. I also want to thank you s Med and remind you that you can get a free benefits check right now at us med.com forward slash juice box or by dialing 888-721-1514. I'd also like to thank Monica for coming on the show and sharing her story. And thanks to you as well for listening, downloading, subscribing, and sharing the Juicebox Podcast. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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