#724 Downton Podcast
Thomas has type 1 diabetes and is a medical school student.
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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 724 of the Juicebox Podcast.
On today's show, I'll be speaking with Thomas, he's in his early 20s, a medical student, and he speaks funny. So don't make fun of him when you hear it's not polite to make fun of the way people talk. While you're listening, please remember that nothing you hear on the Juicebox Podcast are making myself laugh and I probably shouldn't have said that about how Thomas speaks but whatever. But the Oh yeah, 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. Were 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. Join the registry. Take the survey, the whole thing should take fewer than 10 minutes. When you answer these simple questions about type one diabetes, there'll be helping people living with type one and supporting the Juicebox Podcast super simple to do takes no time at all t one D exchange.org. Forward slash juicebox.
This episode of The Juicebox Podcast is sponsored by Dexcom, makers of the Dexcom G six continuous glucose monitoring system, head over to dexcom.com forward slash juice box right now to get started or to learn more. The podcast is also sponsored today. By Omni pod makers of the Omni pod dash and the Omni pod five, you may be eligible for a free 30 day supply of the Omni pod dash go find out at Omni pod.com forward slash juice box. I probably should have said you might be eligible for a free 10 day trial of the Dexcom G six two, but I forgot to say it. So now it's too late. Because of me, am I forcing you into the basement?
Thomas 2:16
Kind of it's actually it's a spare room we have because I live in student accommodation. And my my current bedroom because we live by main road sounds like Yeah, yeah. So I came down here which is cooler. It's cold. I'm fine. I've got a warm blanket over me.
Scott Benner 2:36
So I appreciate the effort very much. Thank you. Yeah, I know sometimes I'm talking to people and i By the way, the recording runs constantly. So it's running now.
Thomas 2:45
Oh, that's fine. Yeah.
Scott Benner 2:46
I'm talking to people and and, like, you know, are you like I hear trucks and cars. They're like, yeah, that's the backside of the house faces towards the road. I was like, could you go to the front side? Because we're recording a podcast. It's audio, you know? Oh, yeah. I didn't think that would matter. Like can you hear the car?
Thomas 3:07
too? Even down here? I can hear the cars and I'm going on now. Is this going to be the cause issue? I
Scott Benner 3:12
can I don't hear I hear you testing your blood sugar. But I don't hear that. Are you testing?
Thomas 3:18
Right now? Yeah. No,
Scott Benner 3:20
you're not without that I heard a click or something like that. Never know. Maybe
Thomas 3:23
this? Yes. Okay, I won't I will not tap that then stop.
Scott Benner 3:29
Stop being alive. While we're doing this. Just sit perfectly still. Doing whatever I was doing. I will stop doing I was your I irritated with myself. I was I listened back to the show I put up yesterday. And in the first 15 minutes. I don't know what I was doing. But I must have been turning my head and looking at a different computer while I was recording. And so once in a while I would hear my my voice go in and out. And it was making me crazy. And I thought I'm probably the only one that cares about this. But you know,
Thomas 3:56
no one else will notice but you're just so hyper aware.
Scott Benner 3:58
I just I just listening. I'm like, What am I doing? I'm an idiot. Anyway, so the way this goes, I don't know how much you listen or don't listen. But the way it goes is you just introduce yourself and we start talking and it's over when it's over.
Thomas 4:15
So sound sounds great. Yeah, I've I think I've been listening for about I won't get into that. But this is about a year now. Anyway, so Okay. All right. It's you know what, it's really odd. Because it feels like I've just listened to the podcast. Your voice is so recognizable. It's it's, it's almost like it's soothing. It's like I've moved house many a time. And yet this you are one of the constants in my life.
Scott Benner 4:38
That's lovely and odd. Appreciate. So, yeah, my wife and I went and saw To Kill a Mockingbird on Broadway on Sunday. Oh, wow. Jeff Daniels last performance and we went to see it and we're standing outside. Off of 45th I think and you know, we're in line and just waiting to qn and waiting for them to open the doors. And there's hundreds and hundreds of people out there. And my wife looks at me and she doesn't usually talk about stuff like this. She goes, Do you think one of these people listens to your podcast? And I thought, I guess it's possible, like, and then we started talking, like, I wonder how many like random people we'd have to pull together before we could say, you know, who watches Curb Your Enthusiasm? Raise your hand. Who does this? Like, you know what I mean? Like, who knows who James Corden is raise your hand, you know? Do you listen to Juicebox Podcast? I'm like, I wonder how many people we'd have to pull together to randomly see. And I told her, My one concern is that one day, someone's just going to turn to me and recognize my voice. Like, I don't think I wouldn't be bothered by it. But I think that one day, it's gonna happen. Someone's just gonna look me in the face and be like, Are you the guy from the thing? I've recognized? Yeah, if that ever happens, I'm, I'm gonna, I'm putting that on my headstone. When I die,
Thomas 5:55
I think you will be I think you'll be surprised actually, how, if you did get people to vote, I think you'd be surprised how quickly you eventually would find someone
Scott Benner 6:04
even just asking how many of you have type one diabetes, like there's got to be, you know, people there. Although, you know, as I say this, it's happened to me twice. I've been recognized in an airport, visually, which I didn't like, and I was on a small transport bus with maybe just eight or 10 people. And I was speaking to someone and the woman on the other side of me, like, put her hand on me and was like, Are you Scott? And I was like, what? I guess now I realized that this has already happened. I'm just an idiot. I don't even remember. But yeah, she's like, are you Scott, I listened to your podcast. And that was weird. Because everyone in the bus was like, Wait, that guy is somehow like she knows him.
Thomas 6:49
With a we just mundanely. That day or something? I was shocked. You're not like a dress like a superstar? I wouldn't
Scott Benner 6:56
even know how to do that. Thomas. I mean, how would a superstar dress?
Thomas 7:00
You know what soon soon you'll be recognized everywhere. From what I'm hearing you put on the Facebook group, you're more and more listening seems to be happening by the day. I'm gonna
Scott Benner 7:09
have to do a setup then if that's the case. So at least one. Anyway, you go ahead and introduce yourself.
Thomas 7:18
Yeah. So my name's Thomas, and I am a British type one diabetic. And I'm also a medical student. And I'm 22. Yeah, excellent.
Scott Benner 7:32
So you're a medical student. Fortunately, unfortunately, why? Unfortunately,
Thomas 7:40
there's a lot less stress. Stress is stressful. And there's a lot there's a lot to do. But it's fun at the end of the day,
Scott Benner 7:45
like it pays always doing something always busy. There's
Thomas 7:49
always things to learn. And there's a lot to do and it's a very kind of
it's very demanding in a different way to maybe use my usual work because we often jump from hospital to hospital at least had to do in the UK. And I will apologize at the beginning AI Rambo, Scott's you, you do need to Oh. And the second one is, if I use any medical jargon, or any British isms, you also going to have to tell me because I'm gonna I feel like I'm gonna say things and they may omit the American Language is a different language to me sometimes. So
Scott Benner 8:28
no, that's fine. I use some British isms. I'm going to be upset. That's the fibers.
Thomas 8:34
I'm just excited for you to present my accent at some point.
Scott Benner 8:36
I don't know if I can. I'm trying to figure out who famous you sound like. Because you do sound like somebody to me. I just can't think of who it is at the moment.
Thomas 8:48
You're gonna have to tell me, I'm scared. Is this going to be a compliment? Or you're going to insult me? But oh,
Scott Benner 8:53
I know. I wouldn't even know how to insult you. Although, I did learn recently speaking to someone that there are portions of the, I guess parts of England where you don't want to sound like other people and they don't want to sound like you.
Thomas 9:09
Yeah, there's, there's a lot of there's a lot of dialogue. There's a lot of like accents in the UK. And I think people would say that my accent, I think I've maybe come across posh, which is has negative intentions to it, but I'm my but then there's like the Yorkshire accent or the Welsh accent, the Scottish accent but even within those areas, like there's like many different types of Scottish accent, there's many different types of southern accent so
Scott Benner 9:37
I say once in a while my brother in law's from Scotland. I don't understand a damn word he's saying so,
Thomas 9:42
and there's some Scottish accents where even I don't understand what they're saying. So,
Scott Benner 9:48
in my mind, he mumbles and then yells i That's pretty much
Thomas 9:52
that's yeah, that's sad. Yeah, that's pretty accurate.
Scott Benner 9:55
Well, you're not in a little earlier on in the day, and I'm like, I don't know what Jim I don't know what you're saying. Oh, So I just listened for keywords and intent. And I watched his face and I wonder if he I hope he listens to this one day, I would love for him to realize. I only understand about 33% of what he's saying. So, yeah, you're just
Thomas 10:12
nodding all the time and you think I'm fully understanding and then one day he'll hear this. It'd be very upset.
Scott Benner 10:17
He just thought, oh, my gosh, I thought everyone really was down with what I was saying. That's something. Okay, when were you diagnosed with type one?
Thomas 10:29
So I was diagnosed on the it was April 2009. Okay, I can't I think the 20th of April 2009. There you go. So I've been I've been diabetic now for 1213 years. 13 years. Okay. Yeah. 30, nearly 14. Actually,
Scott Benner 10:50
what were you like eight years old? Nine.
Thomas 10:52
I must have been I think I just turned 10. Okay. Well, so I was born in 1999. Justin, you were
Scott Benner 11:01
born in 1999 10 years after I graduated from high school. Great. Okay. Lovely. Do you remember much about being diagnosed or how it was handled.
Thomas 11:11
So I remember being so I remember being we were in Portugal at the time. And on holiday in Portugal. And I remember being, you know, really thirsty, and we in loads. And my dad had gotten to his head that for some reason, in in certain countries, you couldn't drink the tap water. And I don't know if this is actually true or not. But he certainly said you can't drink the tap water in a different country because they they treat the water differently or something. I don't got that in his head. And so my dad would buy either, he would buys like apple juice in his cartons from the local shop. And I remember being so thirsty, so I would drink some apple juice. And then I reload. And then I because I was thirsty, just drink more apple juice. So I'm just consuming sugar every time I'm drinking. And then we hang out this sugar. And this just went on and on and on. Until we were walking through some street in Portugal, and it had been like, a few seconds since I last went to the toilet. And my dad tells me from memory that apparently I was just like, we have to do what we had to do we on the street, because I was waiting that much. It was slightly. I was just having to we in the middle of the street lacquers back alley in the middle of Portugal somewhere.
Scott Benner 12:31
This was an indication to them that your health was poor or that you were injured.
Thomas 12:36
I think this was where the maybe the alarm bells went off a bit. Yeah. I read at least the apple juice. Yeah. Well, it was just the constant consuming that when you made things well, I mean, I remember result giving up on not drinking tap water and just drinking loads of tap water because it just got to the point where I was that thirsty that we ran out of apple juice.
Scott Benner 12:56
Water but we're if something's gotta be done.
Thomas 12:59
The apple juice market in Portugal that year must have you know, I was I was holding up the economy, the local apple juice economy.
Scott Benner 13:07
Children everywhere can get their juice.
Thomas 13:09
Yeah, yeah. Yes. And let me we flew back to the UK. And I'm from Nottingham. And I remember land. And when we got back and I was the Easter holidays, and I went back to school. And my dad picked me up halfway through the school day and because he managed to get me an appointment with a doctor. And we went to the doctor and I think you know, took my blood sugar if something like 23 And I realized I'm not going to convert this over so 23 is probably about 400 I think
Scott Benner 13:49
I'm just gonna go to juicebox podcast.com and click on blood glucose calculator and then do millimoles 23 and tell you that it was 414 Yes. And your your average Awan see at that blood sugar is 16. Okay, yeah. Luckily you were standing.
Thomas 14:11
Yes. Wow. Okay. I've never actually converted that to anyone see, that's quite high. So yeah. And I think my dad was my dad was on to it a bit more because the days before we went to the gym, when we landed there was a few days before my school's school started and went to see the doctor. He had some ketone weighing sticks, so you know, weed on these sticks. And I remember my dad looking he was bit disturbed and he bought me a glucose checker and, you know, took a blood sample and checked my blood sugar. And you know, he was high and he was worried and my grandma was a type two diabetic. So my dad kind of knew. Okay, something was wrong. You know, he He wasn't completely I mean, it typed is very different condition itself. But he knew what was kind of going on because he vaguely remembered it from my mom, from his grandfather, his mom, sorry. And so the GP looked at his blood sugar Sorry, I'm dying around, the GP looked at his blood sugar and went, well go straight to hospital. So I Dad drives me to the local hospital. And I remember just having a few blood tests done and from all I remember is meeting my, my diabetic nurse that day, and who I had for the first years of my treatment, and he was called Matt, and he was lovely and fantastic. And he was also a Taiwan himself. So you know, he kind of understood a lot more. And I remember him, you know, vividly this bit telling my dad that I had diabetes, and I just remember my dad crying. And really, you know, trying to comfort him this little 10 year old boy, guys, it's okay. But then me crying too. And I think it's that like, and you kind of feel I owe it you know, you kind of see your dad when you're younger is this kind of you don't like a superhero. It's the first time I saw my, my dad, cry, and also cry about something that was happening to me. And I was a bit like, what's going on? I can,
Scott Benner 16:26
I can remember when I would, when I started looking at my son and realizing he thinks he's smarter than me. And he might be right. And I was like, oh, geez, the illusions over now. Yeah. By the way, I have to tell you, it's apropos of nothing but you basically were in Portugal, then you went home. So you went Oui, oui, oui, all the way home. And I don't know if the Three Little Pigs like reference gets you or not, but it's been stuck in my head the whole time. And if I don't say it to you, then it's just gonna be there the entire time. We're talking now. I'm
Thomas 16:59
glad you know, we have we have the three pigs over here as well. Yeah. I've never thought of it like that. But I feel like that's a good. Can we summarize what happened?
Scott Benner 17:07
Can we break something down that I never understand? And maybe you're the one who taught me will explain it to me. Go ahead. Okay. You went to the local hospital, but your GP told you to go to hospitals. So you guys don't say go to the hospital. But you said go to the local hospital. Why does the word DoD get dropped? Like you get like, when you're right, you went to university, you go to university, you don't go to a university or the university or my university? Why does the word the get dropped out of some of those uses? Is a colloquial.
Thomas 17:44
So I know that I'm trying to check this out where my dad's from, they don't say the so they will say things like get on a bus. Which means get on the bus. And they dropped the the a lot of the time in terms of but yeah, I think that's probably your dad. I think that's a local thing.
Scott Benner 18:02
Okay. All right. I just we just don't say that. I'm, I'm fascinated by it. And then sometimes I'll get stuck. If it happens. The conversation I'll start saying and I'm like, why am I dropping thought? I just thought there was a reason but it's got to be colloquial. I don't know if somebody's gonna tell me one day I actually am very interested in that side. I just don't never. I've never come close. You wouldn't.
Thomas 18:23
I don't think you'd ever say I go to the university. You say I go to university, right? Because
Scott Benner 18:28
here I'd say I go to college. So you don't say I go to college? Yeah,
Thomas 18:33
you didn't say I go to the college. So in the same way for Yeah, in that instance, you you go to university.
Scott Benner 18:39
So College is a is a is a fixture in your life? Not a specific place, right. Like you go to the restaurant. Yeah, that makes Yeah, you're right. But hospital gets picked up into that for some reason. go to hospital. I'm gonna go to hospital all right. I don't I mean,
Thomas 18:56
I think that's probably a duck. That is my dialect. I'm, I'm slipping at my this. So I also my awful English as well. My English is awful.
Scott Benner 19:05
I like the earlier that you were like, you know, my accent can be considered posh. And that's not great. And then you were like, so we were and then you told me you were vacationing in Portugal and the way you said it. I was like, oh, that's why people think
Thomas 19:20
the thing is, when I first meet someone, I'm very I don't know, I put like, I don't know, I get conscious. And I think I pronounced things more maybe. Right. But when I when people know me, I'll start you know, I start dropping a lot of more local. Yeah, I become more Yorkshire for some reason, right? And become more Yorkshire.
Scott Benner 19:40
It's interesting. Okay, so do you leave the hospital with a pen or needles? How did you manage in the early days and who takes care of you? You mentioned your dad a lot, but I haven't heard about a mom. Do.
Thomas 19:51
I have a mom? Sorry. Yeah, I have a mom. My dad was just there. Had that one dealing with it that day. Um, I was lucky enough that they wanted to keep me in the hospital. And my dad was like, No, and not in like a, you know, refusing treatment way. But I was like, Well, why can't you go home and they didn't really have a good reason. And I think at the time, it was kind of standard. You stayed in for a bit, but my dad was like, well, he's not that unwell. Can we take you home? And I remember my dad taking me home that day, and I had an I had an injection pen. And I had Atlantis and Hema lager thing. And my dad buying me a hamster on the way home. Because I think, I think he, I think he felt bad for me. And so I was just like, this is this is great. You know? What, you know, I get a hamster for this. Like, you know, this is great. I love going to the hospital. I get the hamsters since died. But
Scott Benner 20:55
you're still going. That's good.
Thomas 20:57
I'm still going. But But yeah, I went home and I had was injecting. And my I remember they, they've the time, I think it was standard to kind of be on injections for a long time. But my consultant really wanted me on a pump. I was like, we're gonna get you on a pump. So I think six months later, I was put on a pump.
Scott Benner 21:20
That must have had something to do with the fact that your nurse consultant had diabetes, they probably do you think they bumped me? Yeah. It's probably like, you know, knows the benefits of it. And, you know, your dad came off as confident in which might have been helpful, too. Do you have any idea how you were doing? I was, I was talking to my son about this the other day. And I told him how one of the fascinating things about making the podcast is when you ask somebody about their health, like, Hey, how's it going? They go great. But there's no context to it. They just say they're doing great. And I've come to believe that doing great meant I didn't pass out. You don't I mean, like, like, yeah, when you talk to people have had type one for a little longer. But they don't like if you asked me, how's Arden's health Ben? diabetes related through her life, I would instantly tell you that in the first number of years, her agency was, you know, in the eights, then I got into the sevens down the sixes started figuring it out, then I was able to really pull it down, down down into the fives. And now it's been between five, two and six, two for like, seven years. And that's how I think of her success. I mean, I would if you asked me to continue, I would talk about limited variability. Keeping spikes at a minimum, not getting low, frequently, stuff like that. But I think of it that way. Whereas you talk to somebody who's had type one for longer, and they're just like, well, I didn't get dizzy at school. Everything was fine. Yeah, yeah. It's interesting, because the measurement tools have changed. So do you think of like, what do you think of successful now for you? Like, what is it you're shooting for day to day and what was happening back better? Did you not know? Oh.
Thomas 23:03
So in the early days, my blood sugar. I was definitely honeymooning. My regime was so I think was 10 units at every meal. Think breakfast was a bit less but the same units of insulin every meal. So there's no carb counting. And of course, I had to manually when I say manually, I had to actually you know, prick my finger. Get some blood, you know, why seems the old fashioned way now. And so But initially, my blood my blood sugar's were, I think I was had a five point something, a one C. And they were happy with that they felt great. And I was like, Oh, great. You know, this isn't that bad. In hindsight, I realized I was honeymooning. And they put me on the pump. And that was great. And I love my pump. I had an animus a green animus pump.
Scott Benner 24:01
The one for the ping the Animus. Like I can't think of it. People talk about it all the time.
Thomas 24:07
I can't remember its name. I can't remember. It's Brett. But I know it was an Animus. But I can't remember what maker's animus it was. And it was cool. And I was like, oh, you know, I'm half robot, because I've got this, you know, cool little box attached to me. But I used to do stupid things. I used to get a bus and a train to school. I used to commute quite far. And I would, you know, go and have a shower in the morning and unplug the pump. And then I'd get on a bus and a train to a different city. Went to Leicester and my pump would be on my bed. just sat there. And I'm like, Oh, my dad's though panicking. Having to drive all the way and then drop off this pump like silly things like that. And I think I look back at my so getting the pump was really a messy situation because when I from so I got my pump when I was 10 I was taken off the pump when I was 16
Scott Benner 25:11
Because you kept believing it at home.
Thomas 25:14
No because I wasn't testing my blood sugar enough so I was what I then deemed myself a naughty diabetic. And I always use this phrase naughty diabetic, which is such a bad way of phrasing things. But I always think, Oh, I'm a naughty diabetic, I'm bad. You know, I'm not testing my blood sugar enough. And I got to that point where I was, this is like when I'm like 1314 15 and I'm trying to live like a normal life. And you know, your friends would your friends would run off and go eat but you have to kind of stay behind and that wasn't that it's just not appealing to a 1314 year old. Or anyone else really, because we didn't have the kind of you know, understand like even people were telling me oh, you know long term effects you just don't you don't feel that impact when you're young and stupid. Sure, so I wasn't good with my blood sugar's did not test my blood sugars. And then was often you know, thing when I went to the clinic, they were like, well, you're not testing your blood sugars. And I was like, No, but I don't like to look at high blood sugars. You know, the classic I'd rather not test and rather not know what my blood sugar is. I don't understand. And that's when my my dad found out that he's is if Colin he worked with had a freestyle Libra. And so we basically got ahold of one of them. And then that definitely helped because I was able to see my blood sugars. But just after I got the FreeStyle Libre, they remove funding from my pump. they deemed it unsafe for me to be on a pump
Scott Benner 26:54
because of your blood sugars.
Thomas 26:56
So it's an it's an odd one they were saying because I wasn't testing my blood sugar. Okay. I've spoken to people about it since and they would they would argue they would never take a child off a pump if the child unless the child wanted to, because of course there's benefits to MDI over pumping.
Scott Benner 27:14
Well, if you inject your Basal insulin consistently, if you inject your but yes, and there is
Thomas 27:21
they, they took me off of it, because they the argument was if the pump ever something ever went wrong with a pump, say the pumps stopped working or, you know, something like that, or something where the pump didn't show an error, but if something was off, I would have no idea that the pump wasn't working. Because your blood sugar because I wasn't testing blood sugar. Like I was awful at testing my blood sugar. I can't explain to you Scott, how bad I was a testicle. Bucha
Scott Benner 27:43
days would go by you wouldn't do it. Yeah, yeah.
Thomas 27:47
I think that, honestly, I think it was one tablet back when I can't remember the last time I test my blood sugar, I think was a point when I was like 1516. And he's like, the horrible years where, you know, my mom would go test your blood sugar. And I'm like, I've already done it, even though I haven't I hadn't, because I was just being a difficult teenager. And I look back on that now. And I go, What was I thinking?
Scott Benner 28:09
Well, you know, last night, Arden CGM expired, and we had to put on a new one. So we're in that two hour window on the G six waiting for it to come back up. And she's like, I'm gonna go get a shower. And I was like, Oh, that's great. Just test your blood sugar first, because I'm fine. And I'm washing dishes and I stop and I dry my hands. I turned her and I say art and I say this all the time. I'm gonna say it again. If how you felt was the marker of type one diabetes, and you wouldn't need the CGM we wouldn't need that contour meter. And we would just ask you how you felt and then give you insulin because that's how that would work. Please test your blood sugar she tests her blood sugar and she turns the meter to me and she goes I'm at seven I'm gonna go take a shower and I was like, dammit
Thomas 28:50
because you're slightly hopefully that it's just like something was slightly wrong with that blood sugar's you prove your point. I
Scott Benner 28:54
thought we could just have a nice moment where I was right and she learned something. And instead she was like, I told you I feel okay. I was like but I just smiled. Well, this time it worked out but now you know, aren't you happy to know what your blood sugar is? And she just got up and walked away. Nevermind that was thwarted pretty pretty drastically but so basically what happens here is just for people who are maybe not sure two things I want to bring up. First thing is Thomas You must really understand what I do on on the pot and I say listen, one of the things one of the great things about Omnipod is you don't have to disconnect to take a shower or to go swimming. The rest of that sentence is cuz you know you're gonna forget to put it back on again. You know, or because if you are swimming for an hour or you know, etc, your long time without basil, not good. So that must resonate with you, I imagine. Oh, yes, yeah, but my bigger thought here is if people are not understanding exactly why they would have taken your pump, it is kind of basic thinking but at least if you're MDI, you're shooting Lantus or levemir, or some sort of long acting Basal insulin every day. So, you know, you at least have that background insulin going, but your pump is delivering your background insulin as well as your meal boluses. So when you switch to a pump, Thomas, I know you know this, but I was reminded yesterday that people don't know this all the time, when you switch to a pump, your pump is now handling your Basal insulin with a fast acting insulin. So instead of giving you one big injection, once a day of, you know, level mirror Lantis, your pump has taken that number and it's breaking it down over 24 hours and giving you little bits of it constantly to keep you stable. So if your pump should stop working, gets knocked off, you take it off, forget to put it back on, you suddenly have no insulin in your body. And that is the very fast way to decay. And that can come on you very quickly and be life threatening and very dangerous. So anyway, that's kind of in a nutshell, why somebody would have said that to you. And it seems fair in your situation, because you were testing on Tuesday.
Thomas 31:06
Honestly, it was bad. And I look back and I go What was I? What was I doing but I think I was what happened was I gone from injecting to this pump very quickly. And I think in my head, I thought I was I thought I I didn't have diabetes, and I was living my life. Like I didn't have diabetes. And I and the thing that mate was bad for me is I I've never been hospitalized. Well, in a good way. I've never been hospitalized by diabetes.
Scott Benner 31:34
But it makes you feel like it's never gonna happen.
Thomas 31:37
Exactly. So I've never I never had a it wasn't like, oh, I felt so awful one day, and I you know, and and I was in hospital, and I had to stay in hospital for weeks. And I never had that. So there was that. It's good that I never had that. But it's I never had that feedback. So it's like, it doesn't matter. Like what happens if I don't demand if I don't test my blood sugar for a week? Well, it definitely does. But that was my mindset. And yeah, so and the way that that works here is they just pull the funding. So you can I could go out and buy a pump and fund a pump myself. But
Scott Benner 32:16
it's not going to come through what we would consider to be insurance or something like that.
Thomas 32:19
No, and everything. You know, it's expensive, right? So pump was gone. But I had I had the Libra and I know you said before, but honestly, technically it was a flash glucose monitor but having your blood sugar data is actually was way more valuable to me than than having a pump because I can still give myself insulin with an injection pen. But the knowing what my blood sugar various were doing after I've eaten or before I've eaten or when I've exercised, or while I'm asleep at night like that stuff you can't get without
Scott Benner 33:01
it without Thomas, if you came to this house right now and told me you were taking the Omnipod out of here, I would meet you with force at the door. I want to be clear about that. But I agree with you. If I had to pick one if there was a false choice where I had to pick one, I would pick a CGM over a pump. You know, it just I could do the other stuff with MDI. But without the data it gets I mean you just blind and you're testing constantly you know, to get any kind of reasonable results you know, it's funny all this makes me think of a conversation I was having recently and I don't know if you'll see the connection right away but I was talking to someone about why believe there's community online that's so open and honest about their diabetes around type one diabetes, but not type two diabetes like why do type ones see this immediate need to get a hold on their their health quickly where type twos don't. And I think that the one mean the one thing that makes sense to me is that type one diabetes can kill you today. And type two diabetes feels like it'll kill you later.
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if it's going to and that makes you feel like you have time I think type ones don't feel like they have time. Like you don't have time not to understand this. You don't have time to not test you don't you can't just ignore it for a week. You can't do what you were saying which is try to live like it's not like it doesn't exist because the truth is is that its existence will come on you very quickly if you just try to plainly ignore it. So that wasn't happening to you. So you were doing enough. So were you just like blindly bolusing meals?
Thomas 38:36
Like yes. And sometimes not even bolusing I mean I would sort of either not Bolus or eat a meal. And this was the this this was what I thought was this was a good day for me was if I ate a meal and Bolus after I ate that meal that was that was a good afterwards today. Yeah afterwards
Scott Benner 39:00
so what was your Do you know what you're able to see was around then like I'm guessing it was like eight or nine?
Thomas 39:06
Yeah, my my him going into the Yeah, it could have been higher. It could have been higher.
Scott Benner 39:15
You see where my guest comes from? It's from you're taking your Basal I assume it's about right you're not Pre-Bolus thing so you're spiking your meals are probably keeping you in the two to three hundreds most of the time, but they're not staying up there forever. Do you think you're getting low?
Thomas 39:31
Do you know I had really I had really good hyper awareness and I think that was simply because I was running high. So time so much of the time that when I was going low, it was probably because I put way too much into that I'm really feeling so and then I would just eat and I would and this is true. I would I would feel low and I wouldn't test my blood sugar. I would just eat foods.
Scott Benner 39:50
I was going to be my question so you don't know. But you don't know if you are actually low like numerically dangerously low or if you are just feeling like you could have felt low it like you You know, a blood sugar of last I got like 150 which would be like 11. Or excuse me, like 115 for you is 270. Right? So say you say 10 is 180 for it, right. So
Thomas 40:14
when it is 10 for you, so
Scott Benner 40:15
you could have, you could have felt low at a 10 or a 180 and been eating when you really probably should have just wrote it out, but your body was probably so accustomed to being high that you and we don't even know because you didn't Yeah, we don't like you didn't
Thomas 40:28
find. This is like the my threshold for feeling low would have probably completely changed. And I went when Yeah, especially when I started to actually, you know, take this seriously, I remember feeling lower, you know, values, which now I don't feel out. Because I was adjusting I've all of a sudden was was, was having blood sugars that, you know, 100 and I was, which I shouldn't I feel fine at now. But I was feeling lower because my body has come so accustomed to thinking that this was laughing. No, it's very true.
Scott Benner 41:04
I do a lot of people that when they're bringing their blood sugar's down, the thing I have to tell them is, look, if you you might feel dizzy at 110 You're not in danger, but you are dizzy, like the desert, the desert doesn't make the Disney has any less real, you know, or that feeling any less real. And you kind of have to bring your blood sugar. That's why people talk about bringing your blood sugar down more slowly. I mean, those your decisions, you they're gonna bring it down slowly. So that that can do that, or you're going to live through some dizziness at that, you know, at numbers that aren't actually physically dangerous, except for you know, these now, these side effects. So when, how old were you when you I mean, you just said took it seriously, and what made you do it?
Thomas 41:48
So probably about three years ago, 232 years ago, so I must have been 1920. So I was at
university at this point. And this is, you know, with my placement and going around on the wards, I would see and meet people who were had kind of suffered the consequences of maybe what I was doing. And that was a that was a kick. I think I just grew up as well, I think I matured later than I would have liked and realized that I was just doing a lot of damage to myself. And I think I just remember getting sick and tired or I went I'm gonna sort this out. And I I don't quite know how I did it really the pot that mean this podcast was. It's like, if you know, I, when I'm older, I want to be an endocrinologist, because I kind of you know, have invested interest. And this would be that just prescribe this just prescribe this podcast. It's, it's fantastic. And I will I will, I will sing your praises, and which is what I can probably tell you're blushing. On the other side of this,
Scott Benner 43:12
I'm just being quiet trying to figure out where I jump in and stop you so that I don't feel like
Thomas 43:17
No, honestly, the podcast is great. And if I if I win, I'm a future clinician. It's something I've easily recommend, because it's it's a community and it's it's gives real life advice that makes it all of a sudden tangible. It's easy. I mean, I benefit as kind of seeing both sides of it of being diabetic and being a clinician, and you kind of it's very easy to kind of just, it's very easy to say, I'll just do this, because I knew when I was younger, I need to test my blood sugar. Or, you know, I need to Pre-Bolus but I never really it never really clicked with me until this podcast kind of. I don't know. I'm glad. Yeah, something clicked Scott. I can't put my finger on it. But yeah, let's just say it was me. i i Yeah, it was you. It was all you.
Scott Benner 44:14
I'll tell you one of the things about the show that I mean, if you've ever heard me say that my theory about parenting is that it's my job to say the same things a million times without acting annoyed mom saying it. So instead of turning to your kids and be like, How many times do I have to tell you to do this, you just say it again, in a different way. Try to find a more engaging way. Look for a different, you know, kind of psychological in and I sort of see the podcasts like that too. You know, like it just it's sort of like a daily reminder to Pre-Bolus and you know, check out your basil and understand the differences between different food impacts. But the bigger picture it's a reminder to be engaged and care and You know, not just the kind of carrying that makes you upset because it's not going well. But the kind of carrying that makes you look at the reasons why things are happening and make adjustments. And then, you know, how do you make those adjustments, but you can't be afraid, you know, you can't feel like well, I have to wait for someone else to tell me this is okay. Because, you know, if you're waiting for a doctor to tell you how to get your six, five to a six, you're out of your mind, because your doctor is going to look at the six, five and go, you're doing great. And that's going to be the end of it. To me, the podcast is just sort of, it's like World War Two propaganda radio. Just running in the background remind reminding you that, you know, Jerry is bad. And it's just it's a it's a, it's a white noise that keeps you focused. And I think it's got great information in it. So hopefully, it helps you. Can I tell you this, though, I've been dying to tell somebody this. I, I receive a ton of messages. People say that all the time. Most of them are lying. I'm not. And I got one the other day, from the person who said I saw a graph that you reshard How did the person do this? And I said, Well, I think I responded. I said, this person listens to my podcast, they probably listen to these episodes, gained some knowledge and some tools and they put them to work. Have you tried listening to the podcast? And they responded, I'm gonna get it for you. Because I'd like to. I'd like it to you on the quote. Yeah, I don't want to get this wrong. Hold on a second, because I laughed so hard. When I saw this. Where's it at? Here? It is. Have you tried listening to the podcast? She says I have. But it's just boring, not what I'm looking for.
Thomas 47:01
I think that should that you could quote that and put that on our post.
Scott Benner 47:05
Oh, I'm gonna make it. Solid turned to my wife and my wife laughed at me. And she goes, I don't think she likes you. And I was like, I don't think so either. She goes, Do you think she knows? It's you she's talking to right now. It's like, there's no way to know that, you know? So I responded. And I said, Okay, well, the person got the tools they needed from the show, I hope you're able to find something helpful that you don't find boring, Happy New Year. And I didn't hear back from now I can tell you, I do my best for this not to be boring, but apparently to this person. It is. But here's the thought it got caught my head. Who cares? It's all right here. Just listen to it. And you'll be okay. But the truth is, it matters. And it's what I've been saying forever, is that you can put the secret to life 45 minutes into a podcast. And if the audio is bad, people won't even make it to it. Forget it. If they don't like my voice or my delivery, or, you know, think I'm boring or whatever. You know what it means like so this podcast really only helps people who have motivation, drive. And oddly, it can take me. I mean, you know, I talk all the time about my favorite review, the show says the podcast is great. I don't like the guy. Like to me. That's amazing. Like you listen anyway, even though you hate me, like I think of you all the time, the person who leaves that review should know, I am delighted constantly by the idea that you're forced to listen to me and you don't like me?
Thomas 48:36
I think Well, I think the way the podcast is stroked, I think you're very good at simplifying things, sometimes very difficult concepts, and just kind of humanizing them a bit and making them really appliable. And so I actually think I have to totally disagree with whoever left that review because I think although Yeah, although may people may or may not like you Scott, I find that hard to believe it. Although there may be people out there that don't I think you are integral because you digest concepts and what people are saying and and make it
Scott Benner 49:13
it's very title, I will tell you that my best understanding of this is that I'm adopted and was raised by some very blue collar people. I think my mind works on one level, and my thinking works on another, if that makes any sense. So I talk like an average, hardworking person, because that's how I was brought up and it's who I am like, I've my jobs before this were not fancy. You know, I've I've cut lawns, worked in a sheetmetal shop worked in a bakery, like I've done pretty, you know, regular the Down to Earth quality. I've been surrounded by people who've done those jobs my whole life and I am one of those people you know, so I know how to speak in a plain way, mainly because that's just how I speak. But I do think my brains working thing. I don't know how to put it. I'm finding myself cornered. I feel like I'm going to sound like a pompous asshole in a second. And I don't want. But I might be a little, I might be a little brighter than my upbringing. Let's say that. And so I think that's why I can understand it. But I say it in a way that's digestible. Yeah, yeah, that makes sense. So anyway, I'm glad that it found you. I'm super interested in the idea that you were living a fairly unhealthy life as a child, but apparently, we're focused on being a doctor. Is that right?
Thomas 50:31
Isn't it bizarre? Isn't it? So 20 minutes? I am. I think I just some I somehow I wanted to Well, I wanted to and the weird thing is I wanted to do medicine because of my experiences with my consultants. It's so bizarre when I say it out loud. But I was like, Oh, I like this. I like talking to people. And I like science. And this is kind of a nice mesh of the two. is
Scott Benner 51:06
So yeah, sorry. No, no, don't be sorry. You see your consultants as great partners in your health. Except, honestly, your health wasn't great. So obviously, what they were doing wasn't helping you.
Thomas 51:18
In fact that Yeah, well, what was what was odd? The the doctor, the doctor that removed me from the pump later gave me work experience in a hospital to help me with my medical school application.
Scott Benner 51:31
He knew it was you.
Thomas 51:34
Yeah, she Yeah, she knew it was me. You know, it was,
Scott Benner 51:37
it can help. I'm just assuming a doctor was the man. Everyone always, you
Thomas 51:41
know, well, it's like she always used to say to me, she was used to go, Well, if you want to be a doctor, you've got to look after your own health. And I'm like, yeah, yeah. I mean, it. It's so true, though. It's so it's so it is so true. And the problem is, I think I was just a horrible, horrible teenager. And if anyone is currently having to deal with a horrible, horrible teenager, I will say that when they leave that teenage phase they are will be ever thankful for whatever you're doing, because even though I was probably horrible to my parents, you know, snapping back at them saying, I've tested my blood sugar. I look back now and I go, you know, they've got me through, they got me through the difficult times. Actually, we've a lot, you know, they did a lot of stuff. And I did not share my appreciation at the time. So if anyone's dealing with a teenager right now, just, they'll appreciate the future. Just hold on, hold on.
Scott Benner 52:37
Don't lose your mind quite yet. There's gonna be Yeah, well, I, you know, I always joke about like, I see a movie trailer for like a movie, it's coming out next year that I want to see. And I actually think in my head, well, there's a good reason to stay alive another year. And you know, that's the motivation I need to do do a sit up, take a walk, I want to see whatever. And sometimes I think about parenting like that, too. Like, I, I want to live to be older, because the day it happens that day, one of my kids rolls into my house, and it's like, Hey, I just wanted to stop by and tell you, I appreciate it. I am gonna, like, it's gonna be the best day of my life.
Thomas 53:13
It's gonna be the, it's going to be exactly what you wanted, when you went out and asked her what her blood sugar was, when she when she was waiting for the Dexcom to warm up, you'll have that but 100 times better feeling
Scott Benner 53:24
and it's going to be my job in that moment not to stand up using my walker, and to better myself, look her dead in the eye and go, I told you
Thomas 53:36
it will happen one day and you will feel fantastic.
Scott Benner 53:39
I'm going to do everything in my power not to say I told you so I'm gonna just say oh, I'm very glad and give her a hug. You know, but to your point, you know, it takes time and that this I mean, listen, I've been doing this a long time I've spoken to a lot of people in your age range. Your story is not uncommon for people who just like I just didn't want to think about diabetes and so I didn't and then I lied to my parents about it and I've had people on here who are the gentleman on recently is an older person that he used to lie to his parents back when he had to run like urine strips underneath a water to make it looked like his blood sugar was low. Like he was lying back then to like, it's it's not uncommon, right? The caveat is, you got to make it to the part where you figure out you want to be healthy with enough health to actually live your life. And I've also spoken to those people who figured it out. And it was too late for them already. And that's a horrifying conversation to have. And very real and more frequent than I would like it to be. So your your health is good.
Thomas 54:45
So yeah, so since all I the way in the in the UK, we're not looking at the way the UK funding works is currently at the moment the Libra the Libra two is what we have in the UK. So if you speak to any most diabetes in the UK, they'll have a Libra to it. And the exception being if you're pregnant, you get the Dexcom. Or if you have, you can apply for special funding to get the Dexcom. Or of course you can pay out of pocket. Right, right. And so with the Libra I think the the reason I mentioned Libra is the cause of the technology of it. I'm I love technology, a bit addicted to technology and all the bad ways. And I think it just hit a part of my brain and I was like, This is great. And so I started hacking my Libra and putting like, Meow Meow on my libre one. And then I've hacked my Libra too. So currently, right now my setup is I have a Libra two which sends data to my phone to extra IP, extra IP then communicates with a Android artificial pancreas system. And that then directly communicates to my dash Omnipod dash are using
Scott Benner 56:01
GPS. Yes. Okay.
Thomas 56:06
Currently, I am months in so if this is my third month, second month,
Scott Benner 56:12
how long have they hacked into the dash? Like, okay, just let me do this real quick. You're using a do it yourself system. It's not been FDA approved. It's not been NHS approved. And somebody has built out an app that works on an Android phone. That's getting Wow, your libre data through? So the Libre is made by that company. You're using the what do they call it? The MT Mt? What
Thomas 56:38
does it call? Not anymore? Now that leap? They've had the libre two, so it directly communicates with the phone. Okay. And and it sends data every minute. Okay, so the phone it? So for clarity? Everything's been hacked? Like the Yes. Okay.
Scott Benner 56:51
Right. And but how long have they been hacked into the dashboard, I wonder.
Thomas 56:59
So the dash has. So the dash there, how they hacked it. And then they released it in beta, November of the end of 2021, November 2021. And the beauty of the dashes compared to the Eros or the pumps is you don't need a Reilly link or anything like that. Because you can Bluetooth from the pod. Yeah, so the pod directly communicates with the phone. And, and all that. Yeah, it's, it's really, I'm really ever hacked everything. So yeah, basically, what happens is, is I don't know who there's some very clever people that figured it out. Now, I know, currently, it's only be in beta. And so it's currently going to release I think in the next month. So everyone who uses a AAPs? Yeah, the Android loop system can can access it,
Scott Benner 57:59
I keep wondering how much longer will the you know, do it yourself systems be worthwhile, when some of these new systems that the companies are coming up with like these, their next generation stuff is already like has learning functions in it? Where where they're going to start making adjustments based on history? And then that's pretty crazy. You know what I mean? So maybe retail pumping, or retail algorithms might actually leap forward, beyond the do it yourself, right. And I listened art and uses loop. So you know, as we're recording this on the pod five is not available yet. But Arden uses loop currently. And I think it's the best. I think it's the best system I've ever seen. And you know, will on the pod five, you know, have a learning aspect to it. I don't even know I haven't seen it yet. But I do know that control IQ is in testing with their next version. And their next version sounds like it's going to learn and change. So this stuff is really going quickly. It's super exciting.
Thomas 59:07
I mean, I remember first reading about Android loop. And it's it does things I'm like how how does it do this? So one of the things it does is every time you put a new cannula in it will see your your glucose data, and then it will go oh, well this site, but you've put this cannula in for some reason is a bit more insulin resistant. And it will say on the side like, Oh, you're 20% more resistant. So when you give a Bolus, we'll recommend a bit 20% Extra Because currently, this site isn't working as well as we'd like it to. Or this site is actually oversensitive. And actually we recommend a little bit of insulin, like how have you worked that out like it has and it works because I'm getting these as you experienced these beautifully flat lines when I sleep and I'm still A bit of a rookie in trying to understand the eating with a loop system. But yeah, it's It's remarkable and that Android APS has all the I could go on all day about I find it so fast, it has all these settings that you can make it. So a phone, a phone, that's not the phone that's connected to the pump, from anywhere in the world can send a text to the phone that controls the pump, and change things of the pump, like change. And I just like wow, someone, they've really used all the resources here to make diabetes like so much easier and used slightly. Yeah, it's just remarkable.
Scott Benner 1:00:39
What's funny, you just brought that up, because Arden just changed her pump like an hour ago. And I just didn't last five minutes, send her a text. So I, when we change the pump, we left the loop open, so not act not working so that her basil would be consistent. Because I know she's going to be a little, she's going to need an influx of insulin to get past this, you know, this site change. So we did a Bolus and left the loop open when we changed it. And I just looked up a few minutes ago and I was like, ah, it didn't work as well as I hoped. And I just told her to use two more units again, because we're trying to get that site working properly so that we can then close the loop up and let the algorithm start working. It's not it's really cool. I'm I love it all like I really do I think it's all just fantastic. I think that if you took no excuse me, let me take a drink I'm not sure what happened. I think if you get in the time machine with on the pod five or control like you are you know, Android APs and go find little 10 year old you and slap all that stuff on you. Most of what you experienced probably doesn't happen. And yeah, I'm really thinking as crazy as it sounds. Your entire problem was was just testing. It was the it was you did not want to test you did not want this thing to be in the way testing was the was the was the bridge too far for you. You're like, Look, I'll give myself insulin. But I'm not going to stop before I eat to test my blood sugar. I'm not going to like that was really it for you. And all this technology fixes that problem.
Thomas 1:02:14
And I think a lot of it comes from me being a grumpy teenager. But I look at it now. And I mean, I'm the Dexcom is probably going to start to be funded on the NHS, for everyone. And I probably jumped to the Dexcom where that happens and you know, because it's I think it's slightly is more accurate than the libre to is. But I just I mean, my my Hesperia ones see now is I'm trying remember the conversion. I think it's five, it's just telling me it's 40 which I think is 578 Something like that. Okay. 5.8 I think I mean, yeah, and, um, and on top, you know, on top of all that is the stress of medical school, which complicates these things. But the, the i Yeah, to this day, I'm still shocked. And I find it really cool that I literally have a device that's constantly tweaking my Basal rate to make sure it's, you know, perfect. That it's not going too high or too low. It's it's really cool.
Scott Benner 1:03:29
Do you agree with me that watching the algorithm work teaches you about insulin toe?
Thomas 1:03:34
Oh, yeah. Cuz I'm like, Wait, why is it why is it deciding to give, you know, to increase my Basal rate? And I'm like, oh, yeah, cuz yeah. Because actually, if that blood sugar kept on going up, I probably would be rocking a, you know, one 190
Scott Benner 1:03:50
Yeah, it's fascinating when you watch it, just like, even make these pledge I've seen Arden's budget could be like at 790. And it's like 11 o'clock at night. And it's like Bolus and point two point 2.4. And I'm like, Oh, my God, like, you know, and it's always it's okay. Like, it's one of those things I would have never known to give her insulin there. She would have gone off, I would have had to wait to my alarm went off at 120 would have said, okay, she's 120, then I would have had to use more insulin than the loop ended up using which may made her low later. And all that just gets avoided because it knows she's heading up and it's trying to stay ahead of it.
Thomas 1:04:25
It's isn't sleep fantastic.
Scott Benner 1:04:27
I feel so much better. I can't even tell you. Now, my life has been changed in the last couple of years. Most by being able to sleep seriously. It was a big problem. My daughter had diabetes for a very long time. I was I was killing myself, like, at times, you know, with with how I wasn't sleeping. Even when I was doing a great job. They were still like that thing. Were like, well, she's going to bed now. I'll wait a little longer to make sure it's okay. You know what I mean? You'd have to wake up sometimes give a little insulin give a little juice And it was just, it was forever I was it was killing me. I think it's taking me years to bounce back from it, it was I was so beat up from it at times. Anyway, how is medical school and diabetes
Thomas 1:05:18
it's, it's, it's it brings different challenges. I mean, it's hard to tell I've what to compare it to the what the hardest thing I think is, which is not exclusive to most schools probably is the night shifts. Because you will have a lovely, you have a lovely Basal rate or setup and you'll have you know, all your everything's perfectly set up on your, whatever device you're using. And then you decide to one day stay up until really, really late until 8am. And then you drive back home, and then you go to bed at 10am. So you stayed up all night. And all those growth hormones or and all those other hormones that usually get released while you sleep, have a bit confused. They're like, but we've not really been sleeping. And so I remember the first time I did a night shift, I think, three or four days afterwards, I was like, I just my insulin resistance just shot up. It's almost like my body was so confused, because it went from, you know, normal nine to five days to now doing 8pm to ATM. And then quickly reverting back to a nine to five. My body, I don't think was used to it either. Now, it's not as bad. And now I have a different Basal setup. If I'm, I've got like a Basal rate before the days before I'm going into a night shifts during the night shift, and then afterwards, because everything changes. At least for me,
Scott Benner 1:06:57
it's all. So the switching of the shifts is the closest thing I'm seeing who is a woman getting her period having those different kinds of weeks of impact and hormones and like different Oh, that's really interesting.
Thomas 1:07:11
That's how I kind of treat it. Yeah, I almost have like it's similar to way that you would you would change women often change their Basal rates based on the monthly cycle. Yeah, well, I'm changing mind based on my, my, your monthly cycle. Yeah,
Scott Benner 1:07:28
my monthly cycle, it's just your cycle of when you're awake, and when you're active. And when you're thinking and doing things. Yeah,
Thomas 1:07:35
that's because it's almost like, the first the first night I'm probably I try and stay in bed as long as I can during the day before to wake up as late as I can. But then your course staying up, I probably wait try and get up at like 1pm. But I'm still then wait, go into bed at 9am the next day. And so that's a long, that's a long time to be working and be, you know, awake. And all of a sudden, my body's like, Well, why? Why are these hormones not being released at this time. So I basically have to have a different Basal rate for that period of time. And that I did that by doing Basal rate checks. during those periods, I was like, oh, okay, for some reason, at this time, I get crazy insulin resistant, I need to bump this up. And that's how I just went from there. But like most of these things, it's all trial and error. And it's kind of adjusting and having the confidence to adjust these things. Because I think I see this was the biggest thing I get when I talk to patients when I when I've worked in in endocrinology is there's a lot of there's like you said, there's a fear of insulin, there really is a fear of insulin. Yeah, there's a fear of hypose. And I completely understand that that fear. But you won't get your blood sugar's down to a range you want them if you're not giving the drug that helps bring those blood sugars down. Yeah. And there's a fear that that people will go see, I used to do this myself, I'd go see my doctor, and my Basal rate was that, and then I wouldn't see my doctor for God knows how long and my Basal rate would stay the same. But my body's not sat there going, Oh, well, we can keep this Basal rate the same? Yeah, my body was changing and growing. And, you know, then I'm wondering why things aren't right. You know, so, having the confidence to go, right, my blood sugar rises in the evening. Well, you know, this could be due to multiple things, but I probably just need more insulin around this time, be that, you know, a different carb ratio or more Basal insulin, you know. And, yeah,
Scott Benner 1:09:46
I'm telling you the one of the things that I learned first, back when my daughter is eight once he was hired, and I didn't know what I was doing is that the fear I had events on had to go away, like everything else that I could see that seemed like reasonable steps, I couldn't get to any of them without getting rid of the fear. So, you know, to me, that's, that's step one. And my best bet, based on everything I've learned and seen and written about and talked about, is that you get your Basal right first. And that at least should keep you from having those low drifts. And like, you know, constantly being low all day, it should help with your meal insulin, then it gives you time to figure out how to balance out the meals and get them working better. So that you're not spiking and not getting low later. But if you're afraid of the insulin, none of that's possible. It's just It's because you're constantly in a state of like, oh, I don't want to do this doesn't seem right. I don't want to change this. And you're 1,000,000%, right? Like, as you're growing, or becoming, even as it gets colder outside, you become more sedentary, it gets warmer outside, you start moving around more, all of these things, change your insulin needs. And we all just act like oh, you know, the guy told me this is my Basal rate, it's gonna stay like this forever. And that's not even true. I mean, you watch the algorithm work. That's not even true, sometimes hour to hour. You know, let alone Yeah.
Thomas 1:11:08
And I remember when I went to you first, I mean, my Basal rate was the same constantly, throughout the day, when I when I used to be on the pump when I was younger. And I look back now and I go, I mean, it may have been right at the time, we don't know, I wasn't testing my blood sugar, but I looked down and I go, that surely could have been right because at least for me, there may be people out there that have a flat base all the time. But for me, my changes throughout the day, from when I'm waking up from from a weekend to a week day, but it's having a big and the problem is you'll never have enough time for the doctor to work out every single scenario in your life. Never has it as it changes. Yeah. Especially as you're growing up when you're young, you know. And so actually having the gaining the confidence to be like I'm quoting you now I'm bold of insolent There you go. To Be bold events, I feel so cliched saying
Scott Benner 1:12:07
I didn't even honestly purpose. So don't worry about it.
Thomas 1:12:11
But honestly, to be bold of insulin is is what you need to be able to do because then you can it gets to the point where I go, I remember going to my I had an appointment with one of my diabetic nurse and I called her and she looked at my my HP on scene she went and oh, that's, that's, I mean, you're so your Patreon see so low. And I was like, Yeah, sure. And she went, Oh, you're like, you're you're not even you wouldn't even show up as diabetic. And I laughed at it. Yeah. And then she goes, you might want to raise it a little bit. I went, what? Why ever questions. This is the thing. I think she was so she was so confused. She was like, but usually when I talk to patients, it's not that but I think she's got worried that it was, it was
Scott Benner 1:12:57
so hard. Yeah, yeah.
Thomas 1:13:01
I remember she's going are you just constantly running in a Hypo? And I went, No, that would, that would be horrible. But I was able to, like you get to that point, you have to speak out like you have to. And the thing is, what's annoying is I look back at myself and I go, I knew my blood sugar was always high in the evening. But I remember I would just sit and watch it get higher. And I'd have to treat a high blood sugar. It's almost like I knew it was coming. I knew this high blood sugar was coming. And I just sit and wait for this high blood sugar. And I was chasing these high blood sugars, even though I knew that was coming. And I just needed to go, right. I know, I'm gonna go high. I get high every evening at this time. I need more insulin at this time. Right. But for some reason that sounds so simple. I it's just I think the fear maybe I had stopped me from doing well, Thomas,
Scott Benner 1:13:51
here's the here's the truth. The fear that I had of the insulin wasn't as strong as the fear I had of my daughter being unhealthy. So I basically just took one fear and overpowered the other one with it. And then that proved to me, I didn't have to be afraid of the first thing. I'm still afraid of the second thing. Like, I still don't want anything bad to happen to my daughter. So when I see a blood sugar, that most people are like, Oh, that's cool, like after dinner. 140 I'm like, wow, what did I do wrong? Like I you know, like, we got to stop this, like, I'll let it go a little bit to make sure that it wasn't just a simple timing thing, and it's not going to come back. But I wouldn't stare at a 140 any more than I would stare to 300 like the reason I don't see 300 is because I don't stare at 140 and, you know, it's just sort of its mindset. And for me the mindset is your blood sugar supposed to be if my daughter didn't have diabetes, her blood sugar would be somewhere between 65 and maybe 140 You know, on the high side, maybe 160 If she had three slices of pizza, you know, six handfuls or rice or something like that. With Chinese food, but that's got to be the goal. And you can't just look at 160 after Chinese food for seven hours and go, it's okay people's blood sugar goes up to 160. Every Chinese food Yeah, it does not for that long. So you know, if if I've worn a CGM, I've, I've pressed myself and driven my blood sugar to like into the 160s. And it'll go up and hang there for a couple hours. But then as soon as the pizza was gone out of my system, it was down again, quickly. You know, it didn't linger for 567 hours. And the problem with that becomes it's sort of like you just get lulled into a comfort zone, you're like, oh, you know, you know, I know my blood sugar. Best case scenario is between this range, but it's only 150. And then you get used to 150, which then makes you Okay, with 160. It's like gaining weight. It's like I only gained three pounds, it's fine. I'm only up 10 pounds, no big deal. And then you reset and you go, I'm only up three pounds. Yeah, you're only up three pounds, and she gained 10 pounds. Now you're up 13 pounds, you know, like your brain. Your brain starts making excuses for you along the way. And that's how people's blood sugar's then end up at 200 All the time they go, it's fine. It's only 100 pounds higher than it's supposed to be. That's not bad. 100 is a pretty relatively low number, it could be 300 points higher. So it's only 100. And that's how you trick yourself out of it. It's your cognitive something. I forget the word. I didn't go to college Thomas. So I don't know everything.
Thomas 1:16:26
I think I was at that point as well. I was having I remember going oh,
I have a blood sugar of 175 I was like, Oh, that's good. Because, you know, I
was taught when I first became a diabetic that between 70 and 180 was good. So I was like anything, but you know, and yeah, below 180 Is is fun. And of course it depends where you are in your diabetes journey, I guess. But to me, it was like, Oh, I had one reading below 10 That was good. But actually most of the time I was already above 10 And that's because I got so adjusted to I you know, I'd wake up on my blood sugar be like 21 on the were times that I tested it when I was younger. And I just give a load of insulin and get on with my day. Yeah, and I got so I got so used to that I got so used to this kind of that that that that when I was actually on the high side of good you know 175 ish that that I realized I'm I'm darting back and forth between American and British convert. I actually what I did it actually what I did it I listened to the podcast and I'm going what's what's what's one at a political one at that will be, I'd be dead? Because of course the highest my blood meter can read is 33. Yeah. So 100 Whoa. But I actually then changed all my devices to the American system. So you could be roll with me? A little bit. Yeah. But also because I actually I found the American system to be slightly more tangible for for my brain. Okay. I don't know why I found that the range of 70 to 180 work works better with me than I think that's because in my head, I'd see a blood sugar of one. You know, 200. And that's to me st is probably seems higher than it actually is. Or 200. Really high because to me 200 Sounds like 20, which is a height which is 20 converted over is about 380 I think something like that
Scott Benner 1:18:41
you're using you're tricking yourself, but in a good way. In a good way. Yeah.
Thomas 1:18:45
And I noticed this way. I'm not necessarily advising this for anyone. It may work. It may not. But when I switched it over, my blood sugar range almost just became tighter. It was so bizarre. It was almost like it was because I was having to think about the blood sugar's a lot more. I didn't know what 100 meant. I have to have to
Scott Benner 1:19:03
bring it down. Yeah, I
Thomas 1:19:05
had to go okay. 100 Okay, that's good. Yeah. Okay, it's good. And there's a flat and there's a flat area there. That's good. I'll take that. Yeah. But when was like, Okay, it's, it's 180. And it's got an upward arrow. Okay, well, what's 180? Okay, that's not as good. Right. And so it kind of reframed it. I think I got so used to being blinded by that. Actually, for me switching the system over helped.
Scott Benner 1:19:28
helped you just think it sounds like what it did was it took you out of reality for a second just made you focus on your diabetes for 30 seconds.
Thomas 1:19:35
It got me out of my own habit in a very bizarre way. Yeah, that's
Scott Benner 1:19:39
why I have a list here of the top 50 cognitive biases. And I'm working hard on getting a professional someone who can speak on them thoughtfully to break them down into small episodes because I think that the way people's minds work are Some of the reasons why they they falter with their diabetes care. So I'm going to try to add this to the podcast at some point, just little things like confirmation biases and but there's way more than just the ones you've heard about on TV, there's a lot of things your brain does to you, that that stops you from being successful. So I'm gonna see if I can't make some of those into the show. Because, you know, I've already been put, by the way you didn't like, you didn't just make me think of that. I've been planning this for a while, but I
Thomas 1:20:28
take no responsibility on how that that you know, section of podcasts that you can make your eight games. That's all on you.
Scott Benner 1:20:36
If it doesn't go, Well, you don't want to see one of those reviews. I mean, Tom has ruined the podcast with his ideas.
Thomas 1:20:44
But that actually sounds really interesting. Yeah. Yeah, that sounds really interesting.
Scott Benner 1:20:50
I just really, I tried to like, I tried to sneak in an episode about sunk cost fallacy last year, I was like, I wonder if people listen to this. And but, you know, there, there's just a lot of ways that your brain gets in your own way. And, and it's, you know, it's if you recognize it and see it coming, you might have a chance of, of not doing it. I mean, you don't see it any more and more obviously, in, in modern culture than in social media, where, you know, someone says something, and you see somebody have a crazy hard reaction to it, but another person will read it not see it the same way. But the same thing has been said. So it's, it's often your perspective that's stopping you from taking something in or understanding it the way it's intended. And you can fix that. So anyway, I will say, the only other thing I have left that I need to tell you is that I love the picture from your Facebook page. I don't know. Oh,
Thomas 1:21:45
the one where I'm in snow?
Scott Benner 1:21:47
No, no, the one where you're in a crowd of people in a club.
Thomas 1:21:50
Oh, that one? Yes.
Scott Benner 1:21:54
I don't know how that photo, but it's fantastic.
Thomas 1:21:56
I was in I study I studied at the University of Leeds, which is a city in North of England in the county of Yorkshire. And there's a club called I can't be the same. It's so bizarre. There's a club called fruity. And that's the club I'm at. And there's a cameraman who is at the front of this stage. And I think I remember
as you the picture, I'm I'm not sober in that picture. I don't know if that's good.
Scott Benner 1:22:28
I can't imagine what but there's something about the perspective. It's almost as if you were the only person in the crowd of people who leaped upwards. And so and so they all appear to be like you I can almost imagine the people is water and you popping out of the water. That makes sense. And it's like you've it's like you've you've broken through, you can feel the sunshine. And you're like I'm above the whole thing for a second and that the photo is just caught in that moment. And it's
Thomas 1:22:57
it's an interesting picture. I love it. I've got I'm blushing now I'm blushing. Because I think
Scott Benner 1:23:02
your photos interesting. Stop it. Yes. I love how your mind thinks you didn't care when you were killing yourself.
Thomas 1:23:11
But yeah, exactly. Such a weird weird mind. Such a weird weird mind
Scott Benner 1:23:16
any other autoimmune stuff in your life or in your family?
Thomas 1:23:21
My mom has hypothyroidism.
Scott Benner 1:23:24
Hashimotos or just hypothyroidism? Just hypothyroidism.
Thomas 1:23:27
Okay. Apart from that, nothing exciting.
Scott Benner 1:23:33
Okay. I just I just like to ask. I find a lot of it's just interesting that you find a lot of people here in America whose roots tie back to where you live, who have autoimmune stuff. So I was just interested in like, yeah, everyone in your in your family line is stricken or, you know?
Thomas 1:23:54
No, just mine. Just my mother.
Scott Benner 1:23:56
None of us had I just bred Scott.
Thomas 1:23:59
I didn't even listen to one of your podcast I made I misheard this one. But Wasn't there some link between the coating on pans
Scott Benner 1:24:08
Oh, we I was talking to Addy Dr. BENITO about thyroid stuff. And she brought up just kind of off the top just out of nowhere that she won't use nonstick pans. And I was like, Well, me either. And she's and she started talking about the chemicals. And I was like, I sound like a hippie all the sudden, which obviously Thomas I am not. But I just there are certain things that make sense to me. And coating metal with a chemical and then making it really hot and then touching your food to it has never made sense to me. I don't know if I'm right or wrong. It just throughout my life. I just use stainless steel pans. They're harder to clean and I don't care. So I don't know if I'm right or wrong. I could be I could be out of my mind. It's just it's one of those things it didn't it didn't make sense in my mind. Like why would I heat up chemicals and then rub my food
Thomas 1:24:58
and then yeah, and when you Say it like that it is making me want to throw all of my nonstick pans in the bin. It just feels weird actually, there was a substance on there that stops my food sticking. Yeah. And isn't it that I could go down?
Scott Benner 1:25:13
You know when the venom gets on the Spider Man it to me like that. I'm gonna end I'm gonna end with this. Why are you people taking all of our superhero roles and movies? Can you? Can you just stay over there? Like what's going on? I can outcome every time. I see a character in a movie. He talks like me and then when I hear him in an interview, he's like, talks like you like what's going on? Like,
Thomas 1:25:38
dance a lot is from my understand. I think Superman Henry Cavill is British he is and the spider who is British. Right. Tom Holland is British. Have you seen the new Spider Man?
Scott Benner 1:25:50
It was fantastic. Yeah. Okay.
Thomas 1:25:53
I'm trying not to say too much. Oh, I loved it. It was fun. It was fantastic. But I don't want to spoil it at all of course.
But yeah, so yeah, Tom Holland is was British and I think the guy who played spider man before him Andrew Garfield. I think he's half British. Yeah, we're everywhere. Oh, yeah. And yeah, because Dr. Strange is British.
Scott Benner 1:26:15
Keep going.
Thomas 1:26:16
Oh, come on my brains working hand. Someone else in that film?
Scott Benner 1:26:23
There's a ton of people. I'm just saying you guys like I mean,
Thomas 1:26:26
like, I know Lok Lok the guy who plays Low Keys British. Yeah, we're everywhere. I do apologize. Your fault as I slow down. We just do you know, do you know what I do? You know, this is a thing that I think as as a British person, and I listen to and listen to Americans and I go wow, their voices are so cool. Like you've your accents are just so really, maybe yeah, maybe you've maybe it's the same way that maybe I think my accent is terribly boring. I your accent I hate them. Like, that just sounds so cool. To me. It's that idea. I think if I went to it if I went back to America, I'd I feel like I feel like everyone be fascinated by my voice. But actually, I think it's a very round I think American accent is so different variation.
Scott Benner 1:27:19
It's just wherever you come from. You want something else because in my mind, I sound like I have like a bucket full of bolts in my head for a brain. And you sound you sound elegant.
Thomas 1:27:31
Oh, I'm I'm I know. I know nothing. So this world.
Scott Benner 1:27:36
You don't have to know anything to sound good. Listen to. I'm gonna tell you right now. I think part of my success in podcasting is just that I have a deep voice.
Thomas 1:27:46
I think your voice sounds it's I gotta be careful. I'm gonna sound like I'm flirting. Go ahead. I'll take your your your voice is like deep boomy. But it's good. It's it's good for it's good for radio. It's fantastic.
Scott Benner 1:27:59
It's and I didn't even sound like this in person. I have no idea. I can't hear myself.
Thomas 1:28:04
This is where we find out that you actually put a filter on your voice.
Scott Benner 1:28:07
I am not changing my voice at all. No, I mean, I am. I'm speaking into an incredibly expensive microphone. And it's very high quality. But I'm not like, I mean, I use a couple of digital items to take my voice through an analog microphone microphone and have it picked up digitally on a computer. I don't have any like great setup. You'd be surprised I have almost no overhead. Actually, when I do my taxes at the end of the year, my accountant says to me, like do you not have any bills associated with this podcast? And I was like, no, he's like, there's nothing we can write off. I'm like, it's just me. And that microphone, man. I don't really need much else. And I was like, once in a while, like, I have to buy computers and things like that. But there's no one to like, there's no employees to pay, or I don't have to I don't need an office. Like I don't have any costs that are associated with it. I just have this very expensive microphone. So
Thomas 1:28:58
but it's it works. There was this is probably way too much information. But I remember I'm someone who often sometimes listens to podcasts before I see. And I don't know why. It was the I think it was the Pro Tip series. I mean, I've listened to it probably hundreds of times before. But I was like, I'm just gonna play this before I go to sleep. And then there's like a month where I just every night I would put on a protip and fall asleep. And I don't know a bit me was like maybe if I constantly listen to this while I'm sleeping, but actually, it will get into my brain even more like I remember every word. And then it will it will be so easy to apply to my day to day life because it's like ingrained in my mind.
Scott Benner 1:29:37
I hope that works. I think I think that's how i Alright, I'll leave you with this. But first I'll tell you that when I before I was married, I used to sleep with cello music, but my wife won't let me do it so I can I'm not allowed to do it anymore. But just just unaccompanied cello music is how I used to like to sleep anyway. I'm a senior in high school I'm taking a psychology class, I am incredibly bored by the class, I do not like the teacher. And I It must hit in that time in the afternoon when people are sleepy. Also, we've learned now as I've gotten older, I may have had like an iron deficiency a lot of my life. So I'll blame that a little bit. But I would get to this class every day. And despite my best effort could not stay awake in this class. So I would come in every day, put my head down on the desk and go to sleep. I didn't do the classwork. I was failing this class horribly, it didn't matter. I already had enough credits to graduate, I never once thought about it. We come in one day, towards the end of the of the term, I think this was like a half year class. And we're going to take the final exam. So it's the final exam, but in the middle of the year, and I come in, and I think okay for the final exam, and I put my head down, like go to sleep. And a couple of minutes later, a friend of mine named Mike, who I don't even know anymore. But, Mike, if you're out there, I enjoyed going to high school with you. He reached over and shook me. And I remember him saying, don't you think you should at least take the final. And I was like, that makes sense. So I sat. And I hammered my way through the final exam. Well, the next day, we came in last day of class, and the teacher is handing the final exams back out and he's gonna go over the grading and he looks angry. Like Thomas, I'm not kidding. The man seems pissed. Like somebody kicked his dog and cheated on him with his wife and the whole thing, right? And then, no kidding. Hold on a second. My wife is like you have to stop recording now. I need your help. So anyway, he's super pissed. And he gets up to the front of the room. He leans on his desk in absolute defeat. And says, Does anyone want to guess who got the best grade on the final?
And listen, I'm just gonna say I can be such a dick. Sometimes I raise my hand. I was like, Was it me? He goes, it was and he put his head down, almost like he had wasted his entire life. Do you know what I mean? Like he was like, Why did I do this? Why do I think teaching is important? Why did I go to college? This kids? I'm not like, I'm not overblowing this I slept every day. I did not listen to anything this so I said maybe I just learned it in my sleep. Is that called osmosis. And he goes, I don't think that's what it's called. I'm like, I probably just learned it in my sleep. And we all laughed and I gotta be plus, and everyone else did worse than me on that test. So maybe you are learning diabetes while you're sleeping.
Thomas 1:32:40
You ruin that man's life. Scott, you you made that man think that his his whole career
Scott Benner 1:32:46
was worthless. I felt it very strongly in that moment. Like I Oh god, I bet she's not a teacher anymore. Like and he tried to imagine seriously every day he shows up and does this thing with his high minded idea that he's going to educate people and the one person who didn't pay a lick of attention to him and by the way, I never read anything. It's not like I went home and taught myself it was just psychology was like high school psychologist common sense kinda you know? So I just like I don't know man, I just I'll remember that forever. Anyway. I'm so sorry to jump off quickly for you but I do have to go
Thomas 1:33:22
no, that's absolutely fine. Cool.
Scott Benner 1:33:32
A huge thanks to Thomas for coming on the show and sharing his story. And I'd also like to thank Dex COMM And on the pod for sponsoring this episode, don't forget, you may be eligible for a free 10 day trial of the Dexcom G six go to dexcom.com forward slash juice box to find out. Also you may be eligible for a 330 day trial of the Omni pod dash Omni pod.com forward slash juicebox. Don't forget if you're a US citizen, head to T one D exchange.org. Forward slash juicebox. Take the survey. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
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#723 Bold Beginnings: Long Acting Insulin
Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends, and welcome to episode 723 of the Juicebox Podcast.
When Jenny and I pressed record on this bulb beginnings episode, we thought this isn't going to take long at all. And it didn't take long, but it didn't. It didn't go as quickly as we thought. What I'm saying is, there was more to get into than we initially considered. And that's why I like these conversational episodes. Today's is about long acting insulin. 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. We're becoming bold with insulin. If you're enjoying Jenny, and you'd like to see what she's doing professionally, checkout integrated diabetes.com That's where she works. If you're a US resident who has type one diabetes, or is the caregiver of someone with type one, please go to T one D exchange.org. Forward slash juicebox. Join the registry complete the survey support people living with type one diabetes T one D exchange.org. Forward slash juice box. At the end of this episode, I'll list all of the bold beginnings episodes that have come before it, just in case you have missed one.
This episode of The Juicebox Podcast is sponsored by in pen from Medtronic diabetes. And because this is a short episode, I'm going to give you the entire ad right now. lickety split real quick, you ready. The pen is an insulin pen that connects to an app on your cell phone. When that happens, it gives you much of the functionality that you would get with an insulin pump. It's also completely possible that the in pen may only cost you $35. Head to in pen today.com To find out more. When you get there. If you're ready to try it just fill out the form where it says ready to try and hit submit. But if you want to learn more, do some reading, find out about the pen, insulin cartridge holder dosing window a knob and injection button and a cap just like you would expect from an insulin bed. But then it connects to the app on your phone through Bluetooth, giving you your current glucose levels, meal history, dosing history activity log reports, glucose history, the act of insulin remaining and your dosing calculator. Also I also while you're on the page in Penn today.com You can learn more about the offer that is made to people with commercial insurance terms and conditions apply of course, but you may pay as little as $35 for your in pen. You know what else in Penn offers 24 hour Technical Support hands on product training and online educational resources. All of that is something you can learn about in more depth at in Penn today.com. 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 again, visit in Penn today.com. Today's episode is also sponsored by touched by type one, they'd love it if you'd find them on Facebook, Instagram, or it touched by type one.org. Jenny we have on our bold beginnings list. long acting insulin. It's a pretty short episode, I think based on the feedback but based on people's questions and statements about what they thought would have been helpful to know at diagnosis, we're going to include it here. Okay, so long acting insulin right away hits my brain wrong because I want to call it Basal insulin in my head, right? Same thing though long acting Basal we talked about a long time. Some examples are level mirror Lantis receba God give me more to jail,
Jennifer Smith, CDE 4:15
Basil Glar. I'm Yes. There's also if you want to include it in the same category in terms of considering long acting and basil as one thing, then we also have to include what was the old version of a Basal insulin, and that we now refer to it as more of an intermediate insulin, okay, it's an or NPH it's the kind that looks cloudy in the vial. And that has it has a shorter life. You have to dose it twice a day, but it's still considered long acting in terms of it covers that Basal insulin need, just not as long.
Scott Benner 4:58
I'm realizing as we're talking Get it this is going to be more than just about long acting insulin. So there are places in the country in the world where you may still be given mph when you're diagnosed. That's right. Okay. Absolutely. And that if people are given mph are they going to hear the word sliding scale every time?
Jennifer Smith, CDE 5:20
Many times, yes. Because of the way that that intermediate acting and or NPH works, it does. Today's Basal insulins or long acting are like a flat scape right there like a horizontal kind of, they go in, they start working and they have a flat impact once they're in a steady rate of action, whereas the intermediate acting insulins are dosed twice a day, because there is a bell curve or a peak in action, and then it floats back down, and then you take it again, and there's a peak in action, and then it floats back down. So sliding scale goes along with that, because oftentimes, if you're using n or NPH, you're also going to be using the more short acting kind of insulin called regular insulin. It takes a little longer for it to start working, but they're often dosed together, okay to to take care of two things, one mealtime coverage initially, and then the long acting insulin or that intermediate, and it's going to peak around the next meal time, or that's the goal of dosing it. So you may have short acting, and the intermediate together, the peak of the long or intermediate acting is going to be around a mealtime where you may not take extra insulin, because that peak is supposed to be covered by your next food intake. And thus, the term sort of sliding scale, take this much if your blood sugar is between this value and this value, this number of units of insulin, it's it's not precise. It requires you to get some information from the doctor prescribing that designates a specific amount of food to eat at each mealtime. Because those that sliding scale is specific to an amount of food that cover or an assumed amount of food to cover. And if you vary from that, you're going to have more erratic glucose control.
Scott Benner 7:40
Can I ask you why in 2022? Would people be given that insulin still
Jennifer Smith, CDE 7:45
depends where you are in the world? Okay. And we live in a very, I mean, we have a community here in the United States. That is, we complain about what we can get, but we can really get we shouldn't have complaints compared to third world countries and places that just really, I mean, they may not even have a glucometer to use in their own home. Right?
Scott Benner 8:10
Well, even beyond that, I still hear from people in some provinces in Canada, who are given mph when they're diagnosed and sliding scale and told shooted at this time of day, eat this many carbs at this time of day. And that's I mean, that really is management. Like you're saying based on modern management now, that's managed from the 80s.
Jennifer Smith, CDE 8:32
Yes, yeah, that was my management. Yeah. Hi, I did it.
Scott Benner 8:39
But it leaves you it leaves you open to a lot of, I think unknown sweat. Like I can't imagine doing like a regular and mph regimen and wearing a CGM. Because you probably see your blood sugar's get pretty high, stay high, come down low get low, like the whole thing.
Jennifer Smith, CDE 8:57
I believe that there will be a lot of frustration. Another reason that in again, a good number of the people that I get to work with are pregnant women, right. And there are still some OB practices that move towards the potential use of the n or the MPH at a specific time of day to cover a hormone impact that may not be being offset the right way, even if the woman is on a pump. Or we've navigated by adjusting doses and everything. Because the short action time of that n gives the allowance for peaking at the point of where you want more insulin really heavy hitting and sometimes it can be a beneficial added tool in that particular you know population
Scott Benner 9:51
but if I'm just a person diagnosed now modern times and somebody said here's it's regular an MPH and you're going to eat on a sliding scale, that's a red flag. To me, right? Yeah. We give like a lot of it's funny. I don't think of this as an advice driven podcast at all. Like, I never think to say like to somebody like don't. But if somebody says that to you, if you want my opinion, either tell the doctor, I want more modern insulins like the ones we're going to talk about in a second. And if the doctor doesn't know what you're talking about, you're looking for another doctor.
Jennifer Smith, CDE 10:20
Move on. Yeah, exactly. Yeah. Because especially if, and this again, is speaking to the terms of access, right? What people with good health care coverage and whatnot do have access to you should not be being put on an MPH and and regular insulin from the get go, you should have the option to do a much more flat acting insulin. And the oldest on the market is Lantus, at this point, followed pretty closely by love Amir, and then the newer ones are the two Jao and the truss EBA and the basic glower and you know,
Scott Benner 10:58
we're going to talk about them. Now, I just, I'm just going to add here, if for financial reasons, you're on regular and mph. I mean, Jenny's talking to you right now, many years later, after using it, it can be done. It's just not, it's not a preferred method at this point. So if you can get
Jennifer Smith, CDE 11:13
Yeah, and the biggest thing there is a little bit more scheduled to your day, can it be done? Absolutely. It can be done, and it can be done with success. If that's the case, then I you know, encourage trying to figure out a set structure to where you put your food in the day, because that's how your insulin is working.
Scott Benner 11:33
How much I don't mean to get off on a, like a personal conversation here too long. But how much of your, the cure Am I think of you as a person who eats without trouble? Like, I don't think of you as a person who eats healthy foods and is like the moaning at the whole time? Or does what they're supposed to do? And they're like, I really wish this was a flaming hot Cheeto. I wish I tried once, and I don't understand why you people like those. But that's okay. What I'm saying is this, how much of your regiment as a child, do you think impacts your eating style now? Has to write
Jennifer Smith, CDE 12:09
absolute? No, that's a, it's a great questions. question I've been asked a number of times, otherwise. I think it influenced a lot. And I think it influenced a lot because that was what my parents had to go by the I mean, the information was like, this is like the Bible to follow, right? You will feed your child and get her up at this time, and dose her insulin, she will have a snack here, it can be these types of foods. And it was figured out according I mean, you know, my my macro needs based on my growing body, it was figured out in that realm from a dietitian standpoint, as well as from a diabetes need standpoint. And I think a lot of that definitely moved me into kind of where I am today, as you I mean, as it is, I still get up. I am quite certain that the reason I'm an early riser, is because I had to take my insulin in the morning at a very specific time. Because my evening insulin was also a very specific time, and it had to be like 12 hours apart. And my parents were very strict about you know, so I don't get up early
Scott Benner 13:23
your health now is a is a testament to their taking that sliding scale seriously and really sticking to it. But it just occurred to me now it's like, oh, that's probably why your regimen you're regimented person because of that, you know? Okay, so
Jennifer Smith, CDE 13:40
it's also just my personality, and wherever it came from, I don't know. But yes,
Scott Benner 13:46
like your parents, obviously, were regimented to some degree too, because they were able to put it into I mean, listen, someone came along, like, Hey, your kids got all this stuff. And they're like, no problem. I'll have her up at 603. She'll be eaten at 645. It's gonna be 17 and a half carbs, you know, and we'll inject this and it's gonna, I interviewed a guy the other day, who grew up with a type one dad back in the was that was born in the diagnose the 50s. So it was a long, long time ago. And he said, one of the things he remembers and almost resents from childhood is that they had to eat at the exact same time dinner every night. So it didn't matter if he was playing. Everybody else would be like, Oh, come in later. It's like we had to eat because of my dad. Yeah, yeah.
Jennifer Smith, CDE 14:27
But I think it helps eventually. I mean, my dad was diagnosed with type two diabetes later, you know, in life. I was in college once he was diagnosed. And I think that sort of helped my mom move into that management with and for my dad, too.
Scott Benner 14:44
So she probably didn't have she was probably like, oh, this will be easy. Like I got this Hold on, let me get out my old books and Ledger's. But so Okay, so you're diagnosed. Hopefully you don't get mph and regular. Hopefully you get some sort of a Modern Basal or long acting insulin. Jenny just went over them lever Mir and Lantis are the older ones to Jao and TriCity Barsi. But the newer ones, depending on which one you get their action times are going to work differently. So the story I always tell is that Arden got that's funny now that I think about Arden got Lantis and it burned. So they, so they moved her to love Amir. And I remember being told that either Lantus or levemir definitely lasts for 24 hours, blah, blah, blah, this is how it works. You inject it once a day, and 24 hours later, you injected again, but we were seeing these highs on the level mere about 18 hours after she injected basil. And that's the first time somebody told me oh, you should try splitting your Basal insulin putting in some of it now and some of it 12 hours later to keep the coverage. more even. That was a big deal for us when she was MDI you know, splitting that love Amir, but now the more modern ones. You like I know you don't you're not in favor of splitting Lantis right. Personally,
Jennifer Smith, CDE 16:06
I'm not personally in favor of it. I've had probably definitely less than a handful of people that it did seem to work. Okay and and better for, but in general know, the Lantus, the two Jao, the, you know, trust Seba, all of those they are definitely supposed to be a 24 hour acting insulin right. Some people do find that Lantus doesn't quite get them to that 24 hour mark, that it sort of legs off, maybe somewhere after about 20 hours, and they have a little bit of potential need for more insulin, and that may be accomplished by just adjusting the dose of the rapid acting insulin if a meal falls within that time to make up for that little bit of deficit before you retake it. But the newer insulins definitely especially true Siva, Siva has a definite 24 hour and often in other in many people, it actually has a longer lingering effect.
Scott Benner 17:11
So I've anecdotally heard a few people who split Atlantis and say it works but you are very steadfast about saying that you don't so love Amir. Sure, you could split it if you don't think you were getting 24 hours. It worked for us, Lani, people need to split love Amir right. Lantis maybe not. Now those others? Definitely no. Yeah, they're just a no, don't split your Seba. Don't none of those they listen, you're saying they last 24 hours. I hear from people who say that it feels like it overlaps into the second day sometimes Correct, right?
Jennifer Smith, CDE 17:46
Yeah, in fact it in. I worked with a couple of like high school athletes, boys, who were MDI chose to be MDI for a number of reasons. And we worked it out, you know, to the point that we could navigate but what we ended up finding was that with the dose of True Seba, they actually needed a titration down in the dose by the end of a full week of athletic overlap, because there was so much overlap of the truck Seba and the activity factor that they were running in the toilet almost able to eat without bolusing for meals days by the end of the week, because because of the action.
Scott Benner 18:32
Oh, isn't that interesting? So So here's the thing. These are all injectable insolence. If your MDI are using an insolent, you know, or a pen or syringes, it doesn't matter which way multiple daily injections if you're using, you know, needles and not an insulin pump. So if you're using again, like with the mph, if somebody says, Hey, here's mph, say please don't please give me more modern insulin. And if someone says to you, hey, here's love America, please don't Can I have a more modern Basal insulin, please? Yes, you know, it's going to make things easier. Because Basal insulin, long acting insulin, whatever your doctor is going to call it is the background insulin that is working on. Basically its job as body functions, right body functions to try to push up your blood sugar, it's trying to keep you stable somewhere it's got it should have nothing to do with how you're impacting your food. In a perfect situation. You don't you know, you inject it once a day, it kind of think of it as time release, it kind of stays in your body and slowly gives off itself and works over these hours. It's, it's really, really important. And if you go back and listen to other episodes of this podcast, you dig into the Pro Tip series or any other stuff, you're going to hear me Jenny, anybody who's talking about say, Basil first, you have to get your basil right or other things are not going to work. And so you these First couple of leaps you have to get past are you giving me love Amir? Or are you giving me true SIBO? Are you and by the way, I don't know who makes there's there are different companies and etc. And you might have to work a little bit to find the insulin that works best for you. I don't care which one you use, I'm just saying you're gonna have different expectations, depending on which drug you have. Correct. If you don't have your basil correct, it's going to impact everything else, it's going to impact bolusing for meals, it's going to impact sleeping activity, it's going to mess with everything.
Jennifer Smith, CDE 20:34
Yeah, it's it's like building the foundation of your house out of straw instead of concrete.
Scott Benner 20:42
We did a nice stable base and is your long acting or Basal insulin. Now, some statements from people correcting overnight or splitting my Basal insulin was a huge help. So they were it sounds like they were correcting. They were probably shooting their basil in the morning. And by the late night, it wasn't working as much. So they were using corrections which now that's not long acting insulin that's fast acting insulin or meal insulin, but you may hear it called like Novolog a Piedra fiasco looms Avalon compute a few Milan for some reason, which is weird. And sudden this person realizes Oh, I don't have to correct your Bolus in the evenings if I just get my Basal insulin right. Yeah. Next person says, I wish I would have known the onset of action in the duration of action. From my long acting, considered splitting if appropriate, some long acting insulin so they're making our point for us. Since newly diagnosed will be MDI a nutshell summary of long and short acting insulin, perhaps with the end for emphasis on how Basal insulin impacts everything. So these this these are people who love the podcast are like if this is what I wish I knew now that I knew before. Okay, so let us dig into that for just a second here. A Nutshell summary. I think we've kind of done it long acting insulin Basal insulin. The ones we mentioned, short acting insulin meal insulin, again, the ones we mentioned, but what are they for? Basal insulin, again, is a base stability for your body function, you know, other stuff. Meal insulin is there to correct a high blood sugar or to combat food that you're eating. Correct. That's it, right? Yes, absolutely. One of the most frequently confused things the beginning of diagnosis is Basal and Bolus is Basal and
Jennifer Smith, CDE 22:39
Bolus. Yeah. And I think the words are, again, they're really clinical words, if we just broke it down to say, this is what this kind of insulin I'm prescribing is going to do for you. You must take it every day at about the same time, every single day, this is going to give you this background coverage that has nothing to do with food or anything else. You need it because your pancreas would be dripping this all day long. You know, and then the other explanation just being this one is going to work when you choose to eat food. If you don't eat, you don't take it unless you're high. And then here is your correction scale, blah, blah, blah.
Scott Benner 23:17
Yeah, it's just over the years, all the words have been co opted, you know, people explained the mountain and said Oh, correction insulin, that is a good way to think of it. I'll call it that. Instead of calling it Bolus insulin or mealtime insulin or and you'll The truth is, I don't know, Jenny, a couple of months into this. That's all going to make sense to you. Right? Like we're talking about it now. Like we're just like, you know how green is grass and blue is the sky everyone. When you're first diagnosed, you're like Basal Bolus long acting short acting. To Siva, who names that things
Jennifer Smith, CDE 23:52
when you want to take with you. In fact, for newly diagnosed I often recommend when you get those prescriptions home, make sure you read how to take them when to take them in the refrigerator, put a note on them a sticky note, something that specifically says this is your right away 6am In the morning long acting insulin. This is my take with food, correct blood sugar, insulin, and as long as you need to keep those sticky notes on there until it clicks in your head. Which one is for what? Keep them on there? I mean,
Scott Benner 24:25
once a month without fail. In the Facebook group. There is a long thread where someone says, Hey took the wrong entrance with the wrong insulin. What do I do and it always goes this way. It never goes the easy way. It never goes. I meant to take four units for a meal when I put it for extra units of basil. It's my basil 20 units and I just took it I just took 20 units of Novolog instead of 20 units of land. Yes. And what do I do? Beautiful watch people come in. They talk them through it real quickly do the math 20 units. So I know it sounds like a lot on how many carbs covers 20 units, it's snack time. You know, like, that kind of thing. And people I watched them get each other through it. It's really it's, it's, it's beautiful.
Jennifer Smith, CDE 25:11
At some point, I mean to delve down the rabbit hole a little bit, honestly at some point, there will hopefully be micro dose glucagon. That would help in an instance like that mistake that you know nobody intended to do, but that you wouldn't have to end up eating 200 grams of carb to offset what you did accidentally, right that, oh, I can do this much glucagon. And this will take care of this much of it and right
Scott Benner 25:41
without eating a pint of Ben and Jerry's ice cream or something like that. Yeah. Now, here's the thing, right, you're newly diagnosed, this all is probably what you're hearing because you're MDI, but long acting insulin, when you move to an insulin pump, if you move to an insulin pump will be replaced, you will not use with a pump, you will not use long acting insulin anymore. You'll use short acting meal insulin Bolus insulin in your pump, and your pump will replicate a Basal program for you, giving you tiny little bits constantly throughout the day to create. So instead of you kind of putting in that quote, unquote, time release Basal insulin and it being let go, you know, pharmaceutically, it's going to go into a pump and be electro mechanically
Jennifer Smith, CDE 26:26
Correct, right? Think of your pump like your pancreas. Honestly, yeah, your pancreas doesn't use two kinds of insulin. It uses the same type of insulin that those little beta cells pop out. And it does it for different reasons, right. So the pancreas or the pump is going to do the same thing. Use one kind of insulin, but in a different way. And here's where in vs. Big dose in,
Scott Benner 26:52
right. And here's where you start gaming. You know, if you asked me what the difference between pumping and MDI is, the first thing I think of is having agency over the Basal program and being able to change it. So earlier in this episode, Jenna use an example of young guys, athletes who are on MDI, who have a Basal an amount of Basal they're shooting Monday, Tuesday, Wednesday, Thursday, Friday, but because their activity is getting greater and greater as the week goes, the truth is that their Basal needs get lesser at the end of that active week. If you were on a pump, you could I'm just gonna make up numbers, you could be using one unit an hour on Mondays, one unit hour on Tuesdays, and Wednesdays point eight Thursdays point seven, right and to, to make adjustments based on what you know, that activity was going to do. Right? I'm not trying to tell you, you have to have a pump, I think any way you manage is is great if it works for you. But you do get more control over your Basal profiles once you're on a pump. And it is really amazing. And if you ever get past regular pumps into algorithm based pumps, you can really start seeing how manipulation of basil creates the
Jennifer Smith, CDE 28:05
precision comes in. Yeah, even Yeah, much clearer, because you
Scott Benner 28:09
go it's funny, we kind of made a timeline here. I want to say by mistake, but I was kind of thinking about it. So I'm gonna take a little bit of credit, but I'm back from the mph to the more modern Basal insulins to the idea of pumping to the idea of algorithms. Yep, just all those things are different levels of insulin being used in the correct amount at the correct time. Right.
Jennifer Smith, CDE 28:37
And it's an evolution definitely, I mean, what you're talking about is a is a movement forward from what was to what we have the opportunity to use now. And I think it's interesting having lived you know, 34 years with with diabetes, I have evolved through all of this now, I didn't start that with like boiling my needles and only peeing on a urine strip. Thankfully, I had some technology at my hands when I was diagnosed, but I feel like I've lived through a lot of the the true technology shift and change. And it's, it's amazing. It really is. So
Scott Benner 29:18
so I'm gonna I'm gonna recap, which I don't ever do. Someone gives the MPH go. Can I please have more modern insulin someone gives you Sorry? Pharmaceutical companies, although I don't not apologize, though, pharmaceutical company. They're doing okay. You know, if someone gives you 11 Mirror Lantis say, could I get something more modern than this? Once you've got that figured out. If there's more that you want, well, then you're probably interested in an insulin pump. And after you have an insulin pump, and you understand how that works, you might be interested in an algorithm. So this is an I don't know what comes after algorithm.
Jennifer Smith, CDE 29:53
I don't maybe a truly closed loop system that requires very little thinking other than Oh, it's the day that I have to put on my new pump and fill it up with insulin. Here you go.
Scott Benner 30:02
So in your mind, is that like a dual chamber with glucagon and insulin?
Jennifer Smith, CDE 30:08
That's what it would have to be, honestly, for it to truly work the best way possible. Yeah.
Scott Benner 30:15
Okay. All right. Well, if you're just diagnosed, don't bother thinking about that yet. I've been hearing people talking about that for 10 years, and I don't think we're anywhere near and so just
Jennifer Smith, CDE 30:25
the basic, learn the basics. Just be happy.
Scott Benner 30:29
Understand your insulin today and go about your. Alright. Thank you very much. Cool. Absolutely. All right. So we got that one out of the way. I just as I was reading, and I was like, There's way more to this than what the people asked
Jennifer Smith, CDE 30:40
what it's good to have brought in, I was hoping that you would bring in the fact of pumps, because we refer to Basal Bolus and a pump. But it's a change in mindset. I don't know how many people ask, even in today's world, when they're starting on a pump with you, they're like, well, when do I do I still keep taking my Basal insulin at the same time. I'm like, Yep, no, put it in the fridge, put a sticky note on it that says Do not touch
Scott Benner 31:05
Done with this now. Done. Yes. I mean, I told you the story recently, right of I don't mean to use her twice in the same series, but a woman who had had diabetes for like, 40 years. Yeah, I asked her about her Basal insulin, and she told me the wrong insulin. It's no, that's, that's something else. I mean, that's basic stuff there. We need, we need to understand that.
Jennifer Smith, CDE 31:27
Well, and that also speaks unfortunately, to whoever her practitioner is, has clearly not asked enough in terms of discussion, that's a back and forth discussion, to hear that this person was completely missing, or misunderstanding or whatever it was, I mean, that should have been addressed in the clinicians office.
Scott Benner 31:49
Yeah, you know, we're still recording Jenny, just because I didn't stop it. But and this is going to come up later in this series about picking medical help. But there there is definitely something to be said for that. Like, not everybody knows what the hell they're talking about. And it doesn't stop them from talking. You know, so you're you are newly diagnosed, you don't know what's happening, and you take everything as gospel out. You know, my my little story about insulin that I'll add at the end of this episode is that Arden uses a Peter to works really well for her. But we were given Novolog in the hospital, which is fine. But the point is, is that when someone handed me Novolog, and said here, this is insulin, I thought, well, this is insulin, there's this is it, there's no other insulin,
Jennifer Smith, CDE 32:37
insulin is just insulin, right? The word insulin indicates one thing.
Scott Benner 32:41
I even think it's ridiculous when we're rattling off, all the names are different than something how many of these do we need? Exactly. But you know, like, I just thought Novolog is insulin. It's for her Mealtimes are her corrections. And when NovaLogic didn't work, as well, for Arden as it did for other people, it never occurred to me that I could just say, can I try a different insulin, please? Yeah. And it? Because that's the I mean, to somebody's point earlier about having something drilled in your head in the 1515 episode. It was it just I believe them, like a person in a white coat, handed me over log and said, This is insulin, and my brain just said, Okay. You know, and then that stops you from asking questions. Yeah, yeah,
Jennifer Smith, CDE 33:22
absolutely. And I think I think there too, is the word insulin. And it really encompasses a lot. And there's a lot to understand about it, as we've just talked about. I mean, my understanding of insulin definitely shifted. Once I had done my own research when rapid insulin came on to the market. And I was reading more and learning more myself. And I went to my own doctor, and I said, Hey, I have to take my insulin, like 45 minutes before I can start to eat. This doesn't work with my life. There's this fancy new, more rapid acting insulin, can I please get a prescription for it? My doctor was like, Sure. Here's your new blog. Right. And before that I had been using our I mean, that dramatically changed. And my doctor knew about it, but I don't know that my doctor would have brought it
Scott Benner 34:22
up, right? No, because it's working. And why by the way, did you ask that question with a perm? Did you have a perm when you were saying that? I actually way up in the air. Well, I actually
Jennifer Smith, CDE 34:33
have naturally curly hair, so I've not ever had a perm. Is your hair straightened? It straightened right now? Yeah. I never think of it that way. But it's naturally curly. Otherwise,
Scott Benner 34:45
yeah. And to your to just tack on to that idea. The looms?
Jennifer Smith, CDE 34:50
They did have the big big bangs.
Scott Benner 34:52
You have big metal here. Did you have metal hair at any point?
Jennifer Smith, CDE 34:55
Oh, I guess maybe that I don't know that it was metal hair. I don't think my dad had would let me leave the house looking like that quite honestly. But I had the big bangs like the get it up there.
Scott Benner 35:07
A lot of girls I grew up with looks like that they put their finger in a socket and when their hair shot up in the air, they just sprayed it. They're good. All of us had molds at some point or another. But what was I gonna say? Oh, fie Aspen loon Jeff mealtime mealtime insulins that have a quicker onset? Yes, if they work for you. That makes Jenny's point right Jenny used to have to take regular and mph Wait 45 minutes to eat. Somebody gave her human log and suddenly you only had to wait what? 20 minutes to eat maybe? Right? Yep. And we'll talk about this in the Pre-Bolus episode that's coming up. But at the same time fiasco loom Jeff more modern fast acting insulins they hit even quicker. And you know, and who knows what comes next. I always think about when I was first getting into this interviewing people, I think I was talking to Aaron from the JDRF and he said we need faster acting insulins and better cannula material and I thought like huh, that's interesting, you know, like what he's seeing the other part like because your cannula from your pump to explain that idea looks like a foreign body to your to your body so kind of gets attacked by white blood cells. Eventually it could stop the insulin from working as well as you want to bring but not infection but just the inflammation to the air information which slows down the the absorption of the anyway, Aaron's like we need better cannula material and faster acting insulin. And those are two things you wouldn't think to pray for at night when you went to bed. But if you have diabetes,
Jennifer Smith, CDE 36:38
and smarter insulin I'm it's interesting from a JDRF perspective, it was years ago when I attended a JDRF. It was like a scientific presentation in the evening. And there was a gentleman from the East Coast, I think he was somewhere in the Boston area. A scientist who had done enough studies to get it to the animal based study of insulin that had almost an on off switch or a thermometer, if you will, that you injected it. I believe it was once a day. And that dose allowed your glucose level to stay within a determined target range turning on when it was climbing and going above that turning off when it was falling and coming down to the lower end of the target.
Scott Benner 37:26
Yeah. Which well make no mistake. That's the that's the golden chalice right there. Right? Yeah, yeah, I mean, and we can stop doing this podcast and I bad news for all the pump companies. You're out of business to
Jennifer Smith, CDE 37:39
be living on the beach in Tahiti? Well, probably not because that's pretty expensive.
Scott Benner 37:44
Chinese, like I'm taking whatever money I made telling people about diabetes, I'm going to the warmest place I can find I'm writing the rest of this thing out.
Jennifer Smith, CDE 37:52
So read books and
Scott Benner 37:55
does it I'm gonna let you go. But it feels like that. Right? Like, if somebody just took diabetes away, you'd be like, I've done enough for one lifetime. I'm good.
Jennifer Smith, CDE 38:03
Yeah, absolutely. I mean, I if there if there were there is a need in diabetes. I, I hope that I can continue to work and help. But if there is ever something that comes out, that's like, no, people don't have to think anymore. You still have to eat your food and drink your water and get exercise. But here it is. I'll be like, fantastic for everybody.
Scott Benner 38:25
Big Mike drops, and he's like I'm out of here. You get in the car or you're not coming because I'm leaving. Excellent. Alright, thank you so much.
A huge thanks to Ian pen from Medtronic diabetes for sponsoring this episode of The Juicebox Podcast in pen today.com To get started, where to learn more. Thanks also to Jenny Smith, who works at integrated diabetes.com If you're interested in procuring her services, that's where you would do it. I also want to thank you for listening for sharing the show and for being terrific. The other day, I received a photograph from the ninth listener who's bought a vanity plate for their car for the Juicebox Podcast. That is um, that's some cool listeners and some great dedication from you. Thank you so much
if you head over to the private Facebook page, which I'll do right now with you Juicebox Podcast type one diabetes. Get yourself in there scroll to the top click on Featured Isabel has all the lists set up for you Pro Tip series variables, etc. One of those lists is the bowl beginning series. I will read from it. Episode 698 defines the ball beginning series lets you know what we're planning on doing with it. Episode 702 is about honeymooning 706 adult diagnosis 711 terminology Part One 712 terminology part two, Episode 715 is fear of insulin and episode 719 is the 1515 rule. And of course in this episode we talked about long acting insulin. There's also a list there for defining diabetes that's 44 episodes of terms defined for you that you use every day with type one and type two diabetes very often. How about a nine episode series talking about celiac, and type one, or a 10 episode series about disordered eating 19 episodes dedicated to just me talking with kids, lots of interviews with me and the children 26 episodes Excuse me 27 episodes after dark series everything from drinking to disorder to eating psychedelics, living with bipolar people who have type one diabetes, and other extraordinary challenges often will be found in the after dark series. There's a 411 list called juicebox Asst. That has 16 Very popular episodes in no particular order. How about a 14 episode series about algorithm based pumps from loop to Omni pod five control IQ and there's way more coming in that series. Very soon. You can learn how to Bolus for fat and protein. And there are so many ask Scott and Jenny episodes where Jenny and I just answer listener questions. There is a growing list about mental wellness and type one many of the episodes are with licensed Marriage and Family Therapist Erica Forsyth, a type one herself. We have a small but but but strong list of type twos. I really would like more of you to reach out to be on the show always looking for type twos to be on the show. Please reach out if you're interested in coming on and building that series up for others. Defining thyroid is a 10 episode series that will help you understand thyroid disease. And our pregnancy list has just grown no pun intended to 12 episodes. There's a how we eat series where people come on to talk about their eating style carnivore plant based low carb Bernstein FODMAP keto flexitarian intermittent fasting vegan, that list is also on the move, looking for more people to come on and talk about how they eat. There's a quickstart guide episodes from episode four all the way up to episode 100. These are the episodes people say if you listen to you'll get a vibe for how I feel about type one, and it gets you into the podcast. And that's the Quickstart list. Don't miss the diabetes variable series 22 episodes, giving you looks into things that impact your blood sugar that you would never think of like hydration, sleep, weight gain, and more. And of course the diabetes Pro Tip series 25 episodes with Jenny and I are starting at episode 210 newly diagnosed you're starting over taking you through all the steps that I believe will help you bring your agency to where you want it to be. I hope you check them out. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
Test your knowledge of episode 723
1. Why is recognizing the symptoms of type 1 diabetes important?
2. How is insulin therapy tailored to individual needs?
3. What is the significance of carbohydrate counting in diabetes management?
4. What role does technology play in managing diabetes?
5. How should diabetes be handled during sick days and stress?
6. What impact does physical activity have on blood sugar levels?
7. Why is building a support network important?
8. How can staying informed about advancements in diabetes research and treatments help?
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#722 Jesse Was Here Part II
Michelle has been a strong advocate in the “d” world since her son, Jesse, was diagnosed with Type 1 diabetes in 2000 at the age of 3. After the sudden loss of her son at the age of 13, she continues to advocate and educate.
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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 722 of the Juicebox Podcast.
Today's show features a returning guest. Michelle was on the show back in 2016. On episode 90 She was here at that time to discuss the loss of her son Jesse, in an episode called Jessie was here. A few years ago, Michelle wrote a book also called Jessie was here from the perspective of a grieving mother. And she's back today to catch up with us. Tell us about a new books you'll have coming out pretty soon and all the rest. While you're listening. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you have type one diabetes and are a US resident or are the caregiver of a type one, please go to T one D exchange.org. Forward slash juicebox. To take the survey, that's all you have to do. Join your registry take the survey takes fewer than 10 minutes you're helping people with type one diabetes, you're supporting the show, and you're possibly helping yourself. P one D exchange.org. Forward slash juicebox.
This episode of The Juicebox Podcast is sponsored by Dexcom, makers of the Dexcom G six continuous glucose monitor. Find out more about the Dexcom g six@dexcom.com. Forward slash juice box you may be eligible for a free 10 day trial of the Dexcom GS six. The episode is also sponsored today by Ian pen from Medtronic diabetes, head over to in pen today.com To learn more about that insulin pen that talks to that app that gives you a lot of the functionality that people with an insulin pump get all that from a pen. That's right in pen today.com
Michelle Bauer (Alswager) 2:11
I am Michelle Bower formerly Michelle all swagger and I am Jessie all swaggers mom.
Scott Benner 2:18
Do you remember what episode number you were on the first time because I can look?
Michelle Bauer (Alswager) 2:22
Oh my gosh, it was it. 31 or 71? I know I looked when I read listened to it recently.
Scott Benner 2:28
I'm gonna find out right now. I have access to this as you would hope. You were episode 99. December 13 2016. I put that up.
Michelle Bauer (Alswager) 2:43
- So not that long ago? Well, no, I guess that is six years ago. Lots have changed in 66 years.
Scott Benner 2:52
What has changed?
Michelle Bauer (Alswager) 2:54
Well, I think the last time I talked to you I was working at right was my writing. Yeah, writing on insulin. So I was helping with the ski, snowboard Mount Bike camps all over the world. And I wanted to stay in diabetes and David Edelman, who you may or may not know whose CEO, he was CEO of diabetes daily, kind of took me under his wing and said, Hey, do you want to sell the advertising on our website was like, Yeah, sure. So I've been there for four years, still working in diabetes. But we sold diabetes daily, actually, to everyday health. And so now we're just drivable, which is fully market research. So we do all the market research for all the big med tech tech, you know, to see what's coming down the pipeline. That's interesting.
Scott Benner 3:36
I met David, I've met David a couple of times, actually. And he's, that's such an interesting story, right? Because didn't he start diabetes daily with his wife who was type one? He did a divorce, and he kept the website going, is that do I have that story? Right?
Michelle Bauer (Alswager) 3:54
You haven't absolutely right. I believe it was 2005 when he just wanted to put a community together. And then, you know, years later, you know, he's remarried. He's on child number three with his wife, Carrie. And this company has grown like by leaps and bounds since I started. So what I thought was going to be, you know, working with all the Abbott's and tandems of the world selling advertising now I'm working with them on market research.
Scott Benner 4:20
Oh, that's pretty interesting. No kidding. I, I should have. I should have been talking to you over the last six years because the way I got my advertising is just, it's all by luck. I got cold, like I cold emailed people. In the beginning. I was like, Hey, I have a podcast, you should buy an ad. They got back to me. And I was like, Oh, my numbers must be okay.
Michelle Bauer (Alswager) 4:40
Yeah, I mean, if you have good numbers, I'm happy to help you with some of that thought process because I definitely do know a little about that.
Scott Benner 4:47
Tell you, Michelle, I don't know everything that I'm doing right now is just working by luck. So that's funny, but Okay, so to catch people up, and you know, it's been a long time And people might not know. But back in. I mean, a long time ago now I guess you you had a child who had type one diabetes, Jessie.
Michelle Bauer (Alswager) 5:10
Yes. So Jessie was diagnosed with type one diabetes when he was three back in 2000. I kind of dropped everything to just immerse myself in the world of diabetes for him. You know, whether it was skiing, snowboarding, being a director of JDRF, you know, just kind of getting really involved in, and then my son when he reached 13, said, Mom, stop talking about diabetes. I'm so sick of talking about it. So I went to work somewhere else for a while. And then action on February 3 2010. At the age of 13, is when Jesse passed away from DK, and 12 years,
Scott Benner 5:42
it's been 12 years since he passed. Yes. And how long has it been since he was diagnosed? Do you say 22 years? 22 years? Wow,
Michelle Bauer (Alswager) 5:51
he would be 25 right now,
Scott Benner 5:52
right now he would be? Yes. Okay. That's crazy. I just I'm drawn to ask you, if telling me that or saying that to someone? Does it stir the same emotions as it always has? Or does it morph over time?
Michelle Bauer (Alswager) 6:12
That's a great question. It depends on who I'm talking to. You know, I, you know, since I last spoke with you, you know, I've done a lot of public speaking and right before COVID hit, there was a between beyond type one and JDRF, there was the talk of having me speak at the summits. And then COVID happened and all the chapters closed down. And you know, that went in a different direction. You know, just yesterday, I went for a bike ride, I did a bike ride with the JDRF group. And there was a young girl named Kaylee who I had never met. And of course, she's like, Oh, what's your connection to diabetes? And I pointed to her Jersey, where it says mile 23, which is a mile of silence, the startup projesi. That's for anyone who's lost someone to type one. And she choked up. And so when it's like that, I hate telling them because I know it brings out emotion for them because they have the disease themselves. But, you know, it comes up in almost every client call, I have to be candid, you know, I say, Oh, I've been involved in diabetes for my adult life. And they're like, Oh, how's your son now? Or how old is your son now? So you just kind of roll with it after 12 years, I think. Yeah.
Scott Benner 7:16
Yeah. Do you have other children?
Michelle Bauer (Alswager) 7:19
I do. I have. So I have a stepdaughter from a previous marriage. She's actually 41. And then my daughter just got married. She's 28. Jesse would be 25. And then Joey, the baby is turning 22 In a couple of weeks. And I actually got married in 2018. So that's where the power came in. And I have two really great stepkids. Claudia and Alex, who are 23 and
Scott Benner 7:46
- That's a big family. That's what it is. Yeah. So children who are who are blood related to Jesse? There are some in there, right? Yep. To he was middle. And not that this matters. But just for context. You were with Jesse's father. At the time of his diagnosis or No,
Michelle Bauer (Alswager) 8:09
no, at the time of diagnosis. Yes, I was actually. He was he was three and I was pregnant with my now Joey, who's turning 22. I was four months pregnant and married to Tom. When Jesse passed, we were divorced. However, we remained friends. And in fact, I would I would say, losing Jesse has brought us actually quite close. So we go, we go to his bar sometimes for happy hour Packer games,
Scott Benner 8:34
stuff like that. It's nice. Other kids have any autoimmune disorders?
Michelle Bauer (Alswager) 8:41
No, and knocking on some wood, right? They're still young. But no, not none. None have surfaced. I mean, they've been my inspiration of, you know, getting the first book written. But I'm, you know, the start of a second book for sibling grief is just starting with interviews.
Scott Benner 8:56
Okay. So this is a book you're putting together what you're building it right now.
Michelle Bauer (Alswager) 9:00
Yeah, yeah, to piggyback off the Jesse was here book, which is, you know, the whole story of, you know, the, the first year of grief, and then at five years and 10 years of what that looks like, the real feelings, you know, and I just, I just realized with all these parents that I've connected with, you know, I know about their kids and the struggles that they have. And so, I've been putting together a list and I have about 25 people who lost a sibling, whether they lost them, you know, when they were nine years old, or maybe they were an adult and lost their sibling, just just, you know, kind of how they feel and how they managed and questions that might have come up for them. Over the years.
Scott Benner 9:36
Do you find the grief that stems from loss is any different than grief that comes from other things? Like, you know, be just being diagnosed, for example, like, do they do they share traits?
Michelle Bauer (Alswager) 9:49
Yeah, that's a great question, too. You know, in my book, I actually talked about it like I the day Jesse was diagnosed. I thought it was the worst day of my life, right, like and so I can relate to any parent who's getting a newly diagnosed child. I know it's the worst day of their life, I can tell you the day of loss and the 12 years that followed, don't compare. It's like it's such a black hole, and hard to explain, nor do I want anyone to understand it. Because who wants them in their shoes? Right? Like, one of my very good friends just in November last year, son, Cade to fentanyl poisoning. And, you know, she called me up and said, I'm in your shoes, I had no idea what it's like to really stand in your shoes, you know, and now she does, unfortunately. So it's definitely different.
Scott Benner 10:37
I just interviewed a woman recently who lost her son to heroin and, and other addictions. And it's just, I find it to be an unfathomable discussion. Like, I don't know how to even I don't even know how to relate, I just all I can do is ask questions that pop up. Because, you know, usually in the course of one of these conversations, I'll end up saying, like, oh, like something similar, like that happened to me. And you kind of tried to find a, you know, a level ground where you can talk through things, but this is just one that's, you know, it's out on the edge.
Michelle Bauer (Alswager) 11:08
Yeah, I mean, the whole common ground, you know, like, we all kind of say the same things about like, like, I talked about it, my book about things not to say I have a chapter called, I don't care that your cat died. And it's just about all the like, kind of weird things people said to me over the years. You know, like, my cat had diabetes, I was like, great, that has nothing to do with my son. But in the end, what my the information I give back to people is, we know that you don't say it to be weird, you're probably just fishing for anything possible to relate to your point. So you know, we're forgiving on it. But yeah, sometimes just saying, I don't know what to say, is a really good thing to say.
Scott Benner 11:47
Yeah, that's what I find I, I've actually come down to just like, I go, well, that sucks. Because I don't know what what could I say that would bring you any kind of comfort? So it begs the question, then, what does bring comfort at that point? Because what what stops you from? I mean, everybody listening, who has no context is thinking I couldn't do that, that would destroy me, etc. But here you are, you're not destroyed. So what are the steps you took to avoid this being the end of your of the end of you as well?
Michelle Bauer (Alswager) 12:19
Yeah, also a really great question, Scott. You know, it's, it's one day at a time, it's Evan flow, it's everything you kind of hear people say about grief that you got to you don't have a choice, you're still going to wake up tomorrow. Right? And I would say, for me, in the early days, it was my kids, right? Like, I had two other kids that I had that put on a face and, and you know, be okay, for them and with them. You know, this is kind of how it goes, you know, and I say in my book, that I was never going to take another family photo, I was never going to send a Christmas card, just because my family wasn't intact, right? Like, never would it be intact. And I said that it may be your one, set it again at your foreign the book, and then, you know, flash forward 2018 The day I got married, you know, we took our first family photo. And here we are, you know, 12 years later, and I'm pondering that this year might be the year to put out a Christmas card.
Scott Benner 13:16
So time,
Michelle Bauer (Alswager) 13:19
time, and you have to allow yourself joy. And I think, you know, the group we put together at beyond type one back when Sarah Lucas was CEO, and then Tom, we put together Jesse was here. And there's another place I find a lot of comfort is it's all these other parents who've lost a child to type one that can kind of commiserate or talk about happy moments or, you know, how, how they're managing their guilt on that day. Maybe?
Scott Benner 13:48
You know, since you brought them up, let me ask you so I have a tiny bit of knowledge here. Not very much. So Tom passed away unexpectedly. Were you working together when that happened?
Michelle Bauer (Alswager) 13:57
Yeah, Tom and I were very close friends, actually. Tom and I had a habit of, you know, when something got controversial, he saved got a minute. And then we'd get on the phone and have a virtual Happy Hour and just vent for, you know, an hour and have some fun. Yeah, he was only 33. He passed away in his hotel room in when he was working in New York, and I don't have any information. I wish I had information, but I don't know what happened.
Scott Benner 14:25
So I didn't ask you to ask about him. I asked to ask you. What's it like when you experience a loss again? Oh, I
Michelle Bauer (Alswager) 14:33
gotcha. Yeah, well, I mean, that is a great question. It was probably the closest person I lost since Jesse you know, that I spent a lot of time with Yeah, it brings a lot to the surface a lot of why and you know, yeah, I mean, when they're close to it hurts. But yet, you know, my parent loss. I know this is gonna sound really weird, but like it was, I think more doable, because I had already lost Jessie like I already lost a child. So like, I kind of know, the depth of pain, at least that was chronological. And maybe with Tom it just hurt because he was still young. Right?
Scott Benner 15:12
Well, it's such an interesting like to keep talking for about this for a second Sarah, but I interviewed once to say, I know it would be a fallacy it but I mean, I, I talked to her for an hour once. And then she had significant health issues, and that she's like, Listen, you know, for for a couple of hours to a few days. But I was rocked by that a little bit just because I had met her. And it seemed out of the blue and she was young, etc. And it it it impacted my life for a couple of days, not nearly the way it would you or somebody who knew her well. But that's what made me ask because because I I'm at best tangentially related to this person. I hear that news. And it's shocking to me. And I was just wondering if, you know, if you had similar experiences, just well, death engine,
Michelle Bauer (Alswager) 16:03
I can tell you what happens to me with death. You know, when when Sarah Lucas, you know, after her brain aneurysm and her retirement from beyond type one, she lost her husband, Don, suddenly, and it's like, my first instinct to anybody is I wrote a book. It's about grief, can I send you a copy of my book, it's just like a knee jerk reaction that I have with everybody. Like, you know, we have a house, like a cabin up on a lake. And we spend a lot of time there. And it's funny, because this little bar has copies of my book on the shelf blocker because I'll get to talking to somebody and they're like, Oh, I just lost my wife. And this happened. And the bartender will come forward and go, here's a book. That's I can't help myself. Like, I just, I just, it's my goal was just to help other people through their pain and know, they're not the only ones that feel everything, that feeling.
Scott Benner 16:53
So now I feel like I've, for the first time have an experience that's commensurate to yours. Because when I feel when I hear people talking about their struggles with diabetes, I'll say to them, like, I have this collection of episodes that will help you like I know, I know, in my heart, they will help you or at least they have a really great chance of helping, and it feels like a compulsion to explain it to share it with them. Yeah,
Michelle Bauer (Alswager) 17:15
yeah, absolutely. That's just that's that's been my reaction ever since he passed is just like, How can I help people with my experience?
Scott Benner 17:22
Right, right now that's really something okay, hold on. I got over a little tiny bit overwhelmed. Michelle, give me a half a second. i In fairness, the people listening know this, I have sometimes trouble with my iron levels. It's a little low right now. So I'm closer to crying than I usually would be in this situation. So give me a half a second. Anyway, I'm getting an iron infusion next week, and I'll be okay. But, but it's, it's funny, when when it dips down, I go, like in two different directions. Like you can either make me angry quick, more quickly, for no reason. Or I get a little weepy if something sad comes up. So the whole day getting ready to talk to you. I thought, I hope I'm okay. Like, I don't like act like just in a way that isn't appropriate. But I'm okay, I'm doing alright. Well,
Michelle Bauer (Alswager) 18:11
you won't be the first person I made cry this week.
Scott Benner 18:15
Better, I gotta tell you something. Michelle. That's usually my line. Just so you know. I've been making ladies on the internet cry for years. But about diabetes, and some guys. So you so your first book has been out for quite some time. Right? Am I right?
Michelle Bauer (Alswager) 18:33
If it was slated to publish in April of 2020. And as you and I both know, that's when COVID smacked everybody. But we the idea was JDRF was gonna have me on and like I said, and and then to be able to go into libraries and and do book talks and grief groups and things like that, which, obviously, we just continued to release it and get it out there. But yeah, it just went into another revision, which just got loaded up on Amazon. And now we have an e book.
Scott Benner 19:01
Oh, cool. So I'm looking at it now. Just it's Oh, that's Oh, that's interesting. So it came out kind of 2020. But you did the revision more recently, because I see the date on the Kindle is is newer.
Michelle Bauer (Alswager) 19:13
Yeah. And it's still in the process of changing over the book cover. We changed the book cover. Because you know, right now, you know, it's a picture. It's a real picture of my son with his thumbs up walking away. It was the last family vacation, it felt really appropriate for the book. But we kind of felt my publisher felt well, maybe p only people who have a child with diabetes are reading it, or maybe people who lost a teenager think it's relevant because of the cover. So we changed it to be a little bit more general because the the notes I get from people like on LinkedIn, people who've picked up the book and read it. I mean, it's not just people who've lost, you know, a teenage boy, it's someone who kept miscarrying or somebody who lost a child at age one or, you know, someone who lost a sibling. It's really been interesting. So we just wanted it to feel more are like this isn't just a story about what it feels like to lose a teenage boy, you know, I know that other people benefit
Scott Benner 20:15
let's talk about the Dexcom G six continuous glucose monitor for a moment, shall we? dexcom.com forward slash juice box. Classic spelling on juice box all one word, the Dexcom G six continuous glucose monitor. Listen, I don't need this website. My daughter has been using a Dexcom oh gosh, for a really, really long time. I said, oh gosh, because I can't I can't even think of a time when she didn't have it anymore. How long it's been. I've picked up my phone by the way. And I'm going to tell you a little story about how we use Dexcom in just the past two hours. So Arden left a lunch today she went out to lunch, she came back and her blood sugar was a little high around 150. But she wanted a piece of cheesecake. We made her a cheesecake here at the house. Actually Arden and I made it it actually came out really good. We were really proud of our stuff that has nothing to do with the Dexcom ad. Nevertheless, we needed to Bolus for this cheesecake in a way that would not let a high blood sugar happen later. But you've got this 150 ish blood sugar and what are you supposed to do? Right? Well, here's what we did. We made a Bolus for the cheesecake that also incorporated a correction for the 150. All right, these are our results and yours may vary. But we watched the Dexcom as her blood sugar decreased. And then when we got to right where we thought was the right spot, which by the way for us in this scenario was 117 Diagonal down. Because yes, the Dexcom shows you not just the direction but the speed. It's falling. And so that diagonal arrow tells you something about the speed. But I digress. We cut the cheesecakes served it up. And it is now let me give you an exact number I can look right on the graph. It is now let's see that happened at 420. And it is 547 now so it was like an hour and 15 minutes ago, right. Guess Arden's blood sugar right now. And the cheesecake is long been eaten since now. Blood sugar is 78. That is an example of how we use the speed and direction and number that Dexcom gives us to make a good Bolus. And there are many other examples and ways that I'm sure you will find to use Dexcom for you dexcom.com forward slash juicebox. When you get there, if you try to leave the webpage, it might say to you are you interested in a free Dexcom G six sample? Well, if it says that just click on Request to sample. It's that easy. The N pen from Medtronic diabetes is a reusable smart pen that uses Bluetooth technology to send dose information to a mobile app. That mobile app will be on your cellular device. Do people even say that any more cellular device No, they just say phone at this point anyway, not the point. Anyway, here we go. And back to it. When you have the M pen, it's going to help take some of the mental math out of your diabetes management by offering dose calculations and tracking the in pen for Medtronic diabetes is an insulin pen. It's everything you expect from an insulin pen. But then that app it gives you current glucose values meal history, dose history and activity log reports glucose history active insulin remaining and a dosing calculator. If you're ready to try it, just scroll down at ink pen today.com and fill out the very short form and hit submit. If you want to know more continue to scroll and learn more about the ink pen. Head over today because some people may be eligible to get the M pen for as little as $35. In pen today.com in pen requires 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 blood glucose levels. For more safety information visit Impend today.com. I had so such a similar experience. I wrote a book a long time ago now. And it was about being a stay at home dad. But there's a chapter or two towards the end. That's about Ardens diabetes, but the book is far and away. 95% has nothing to do with type one. And when I hear from people who have some sort of a connection to type one who have read it, they feel like the books about diabetes. It's funny, it's so interesting. And then people who don't have a connection to diabetes are like Oh, I was interesting to learn something about diabetes at the end of the book. It's very interesting to see what people connect with I guess and and then therefore how they interpret it. And I saw I take your point. So
Michelle Bauer (Alswager) 24:59
yeah, I mean some then that made me think of that I think is pretty great about 2022. There's not a lot that's great about 2022. But is that people's resources are so much better than even when Jesse passed in 2010, as far as me connecting with other people who, who shared what happened to me. And what I mean by that is, you know, I lost my son to type one diabetes, I think it helps me so much that I have these people that lost their child that type one, so it's very relevant. Whereas I may not feel as connected as someone who had a miscarriage or someone who lost a child to suicide. Right. So now we have this ability to talk to people who truly are sharing the exact grief we have.
Scott Benner 25:40
Yeah, no, it's the podcast has taught me that, honestly. Because prior to the podcast in 2015, I would write something online and get a couple of notes. And people were like, Oh, your blog really helps me or I found this interesting or helpful. Thank you like that kind of thing. I now know, over exaggeration, I hear from 10 to 15 people a day now. So just the ability to share information in a different way, has opened up. And you know, like you're saying, in this time, where everybody kind of got stuck in their house for a second. Even the people who are probably not using the internet so much, are like, well, let me see if I can't see more of the world here. Since I'm stuck in my bedroom, or wherever I am. You know what I mean? I just think it's, it's, it's and it's really valuable, like I getting, you know, you can have this book. And if you can't get it the people. It doesn't exist, really, you know what I mean? You have to be able to put it in their hands. So who would you say it's for the book?
Michelle Bauer (Alswager) 26:42
The book? Yeah, I think it's anyone who's experiencing some kind of grief, or anyone who wants to help someone through their grief. I think, like, I've heard from a lot of people whose like, maybe their friends child died. They read the book, and it helped them kind of see inside their heads, I think. I think like I said, like, you know, I know people have stayed at my cabin, like you will we rent out our cabin. And now she's a newscaster, and she had a lot of miscarriages. And she just happened to pick up the book and read it. And she was like, I had no idea I had not dealt with my grief, completely. She's like I sobbed through your whole book. She's like, I just nodded and was like, that's so helpful, like someone else felt my pain, right? So I think it's anyone who needs closure to their grief, and just needs, you know, to feel like to nod with somebody, right? And so yeah, I was in target. And I saw a cute little four year old boy in a cart. And it made me mad because he looked just like my son, and I miss my son, and it's life's unfair that you get to keep us on, right. So you know, anybody who's experiencing grief, I know people who just lost a parent, like, it's always I try to explain it that it's always as good as like your worst loss. Meaning, if the worst thing you've ever lost in your life is a cat, right? That's only lost, you don't know any other kind of pain of grief, right? And then maybe you lose your parents. That seems like the most painful, right? So it can be anybody's grief, even a pet.
Scott Benner 28:12
It's why I tell people that you can't you can't judge your thing against other people's stuff. Because the worst thing that's ever happened to you is the worst thing that's ever happened to you. So, you know, you can't say, Well, you know, I have diabetes that's worse than this, or, you know, I have diabetes that's better than that. Because it's, you know, the next person might I was interviewing somebody recently, and their lives were just going along, like nothing was wrong, you know, what I mean? Like things were going the way they expected and health was all great. And then all the sudden a thing happens. And it's a tragedy to them. Because their their level of expectation was different. And, you know, is it fair or not fair? Like, I don't know, that seems kind of arbitrary, you know, to say that, I mean, it would be nice if everybody got the same level of happiness and then fulfillment. But I mean, that's seems kind of unreasonable. But But I just again, I just really take your point that it's I don't know, like, it's not a thing you can put yourself in your shoes, but it is nice of you to be able to look up and understand like this is, you know, the example of the cat, like if it's, you know, if you're 25 years old, and your cat died, and it's the first thing you've lost, it's, it's pretty crazy.
Michelle Bauer (Alswager) 29:24
It's a major loss to you. Yeah, yeah. It's funny too, because, you know, most of most of the reviews I got on Amazon or, you know, the five star and really good nice write ups. And the people who complained were the ones that were like, I have a child with type one. And she doesn't tell me exactly what happened to him, and then gives me a lower rate. I was like, Well, the book wasn't about you finding out how exactly my son died. Even though I have a chapter. You know, a lot of people ask me exactly what happened and I don't normally share it because I try to explain. I don't want to go through that day again, ever. Like I don't want to relive that in my mind. I did it, just in reviewing my book like 10 times during revision until my publisher Dan, I'm like, I don't ever want to read that chapter again. Right? Like, I'm done with that chapter of my life and I thought worth revisiting. And so I always say to people, when they say, Well, what happened? And Michael, you're welcome to buy the book.
Scott Benner 30:18
I'm not saying it again. Yeah. You know, it's funny, through my experiences with people, my expectation there is that they want to reverse engineer your experience to stop it from happening to them.
Michelle Bauer (Alswager) 30:31
That's what yeah, they want to hear that I did something wrong, because that
Scott Benner 30:34
will make them feel like it's not possible. Yeah. So you know, excellent. Michelle, I, since you said it out loud. They, they want to know you did something wrong, so that they can have the belief that as long as they don't do something wrong, it'll be okay. Yeah, I mean, false comfort you try to give yourself when your kid has diabetes is using insulin.
Michelle Bauer (Alswager) 30:56
I mean, there's two things I've noticed the most about having it's maybe something more listeners hearing that have kids with type one is, number one, is DKA, is worse than going low in a lot of ways. Because people let their kids rock a 600 blood sugar and let them eat or drink a root beer. And I sit there and cringe and I'm like, your agency is going up and going up and going up. And then when something bad happens, it's going to happen real fast. So I've been doing a lot of education on DKA, because a great number of the parents that are finding me and Jesse was here at the Facebook group are losing their college aged kids to DKA. That's what I'm seeing more of the positive. And, you know, granted, I'm not a survey taker on the Facebook thing, but we're seeing less and less of people losing their kids and onset, which I applaud, it means we're getting the word out of warning signs and doctors know the warning signs. Otherwise, I'd be seeing a lot more people coming through our door, and it's less and less with those people.
Scott Benner 32:01
That's that is good to hear. It really is I that's something so kids go away to college, they either don't know how to manage themselves or decide not to, and their blood sugar's rise and rise and rise, and then they then the dka comes.
Michelle Bauer (Alswager) 32:18
Yeah, I mean, it's that burnout, right. 10 year mark, for a lot of people is a burnout. You know, you know, we got to put our mental health first for some of these kids that, you know, they got, you know, it helps them to deal with it. I mean, I know people whose kids are, you know, for three weeks not taking insulin and not testing, just because they want to feel normal, and they're at college. So the parents don't know what they're doing or not doing. I mean, luckily now they're CGM. But But yeah, I mean, it's these college kids, or these college kids that do die from DKA. They don't tell their roommates, they have type one diabetes. And it's a hidden, it's a hidden thing. So when they're acting funny or being weird, they're not. They're not saying hey, man, you gotta call your parents or, Hey, you gotta get to the hospital. They just think they have the flu or something.
Scott Benner 33:03
Right? Yeah. So that idea of I'll hide it, nobody will know. And I'll get through this. It's all I mean, whether it's not taking your insulin or not telling somebody about it, that scenario, it's all function of just trying to pretend it doesn't exist. Yeah, it is not something you can pretend
Michelle Bauer (Alswager) 33:18
away. That's for sure. And the other thing I find fascinating, even in like, you know, my current group of friends, I, you know, I'm very proud that I still stuck with all my type one word friends and ketones. I am flabbergasted at the number of adult friends I have that never test for ketones.
Scott Benner 33:37
So we tried to, we tried to like lay that out in the podcast, the best we can because there's there's a couple different ways to think about, like, if you're eating low carb, like you're using a certain lifestyle, you might see ketones in your diet, like in yourself no matter what, right? But ketones from not using insulin. That's different. And the one thing I find that confuses people a lot is that they don't think you could have ketones at an enraged number with which you absolutely ketones can exist whenever there's not insulin present. So if you're, I don't know, sick and your blood sugar won't go up, and you're afraid, well, I'm gonna get too low. So I'm gonna shut my insulin off here. And your blood sugar hangs in the 80s or the 90s. You think, oh, this is great. It's not great. You could still develop decay very quickly, too, because you've you've taken the insulin away.
Michelle Bauer (Alswager) 34:24
100% Yeah, exactly. Well, well said,
Scott Benner 34:28
well do my best to tell people and it's a it's an uphill battle sometimes because it is. It is one of those things like the the alternative is, you know, if you spike once the 200 and come back down an hour and a half, you probably don't have to check your ketones. And so you're trying to keep a balance between, you know, being aware and vigilant and not being so hyper vigilant that you're, you know, busy making yourself crazy in times when it isn't necessary. It's a it's a balancing act.
Michelle Bauer (Alswager) 34:57
It is. It is and you know, I mean Um, I have a friend who competes as a skier and she would go over to Austria and I kind of was her like diabetes mom to keep her motivated. And, you know, I'm like, she's like, I'm throwing up, I'm sick. When I'm in Austria, I don't want to go to the hospital. And I'm like, Lauren, you're rockin, you know, some pretty, pretty high ketones. As much as you don't want to be at the hospital, you need to be around around the right equipment. So
Scott Benner 35:24
yeah, sometimes you just have to stop and do the right thing. It sucks. And, you know, I listen, I went got a blood test this morning, before I talked to you, because I'm like, I know where I'm at. I know what I have to do. If I don't have this level of reading, the doctor is not going to help me. It's going to take some days to put into practice into into motion, like, let me just go do this thing. And it's important to put yourself first and are the people you're helping and I guess we're I guess we're people. I mean, again, you told the story about the skier. It feels a lot like the idea of people who go away to school who are just like, like, let me just push this on the backburner. I just want to pretend it doesn't exist. You know, no, no, I understand. Let me just switch gears for a second. So you said you were at diabetes daily, which then eventually became, which got sold, and then the business moved to thrival? Is that right?
Michelle Bauer (Alswager) 36:17
Yeah, that's always been somewhat, the parent company is thrival. So we just got rid of the website, part of what we do. So now we're a panel of, I mean, as far as it relates to diabetes, we have over 50,000 people living with type one and type two diabetes in the US on our panel doing surveys and interviews for every company you can think of. So it's been it's been a ride, like, it's, it's a lot of fun.
Scott Benner 36:42
So when a company is thinking of making a new thing, or changing something, or adding a feature, and they want to hear from people who have diabetes, they can send you a survey that you can then send out to the people who are in your group.
Michelle Bauer (Alswager) 36:54
Yeah, so um, that's exactly what happens is a company will reach out to us and say, Hey, we have needs for the coming year. And maybe I work with marketing teams that are trying to figure out how to get the messaging, right. I work with the products where, you know, maybe they send the product to, to the person and they get to test it for two weeks or like, think of a telehealth app. Maybe they download the telehealth app. And then they give feedback over an interview and say, How did you like it? Did you find it easy to you know, What didn't you like? And so those are the product managers. And then there's some ones that are bringing product. You know, it hasn't come to market yet. Right? Like maybe it's a new wearable, you know, that right now is in France, but it's coming to the US. So they just hit me up if they want some surveys done in diabetes, we actually do mental health and a few other areas now, but But yeah, that's what we're doing.
Scott Benner 37:42
That's interesting. It's a people who listen to the podcast also are people who run these companies. So I thought I would just like, you know, let's just say it there for a second. I appreciate it. Listen, I You're a friend of the show. And Dave is I feel very warmly about Dave over the years. So absolutely.
Michelle Bauer (Alswager) 38:01
Well, and you know, do you know who we scored may 1 to work with our company know, Manny Hernandez.
Scott Benner 38:07
Oh, Manny. I love Manny. No, when we
Michelle Bauer (Alswager) 38:11
Yeah, so we have Manny, he he is the person that's in charge of all of our partnerships and then doing like finding more panelists, right, and getting good relationships with like Ada, Ada and things like that. So that we find the right populations
Scott Benner 38:24
to ask Manny basically put together what I think of as the probably the first big online community for diabetes that doesn't exist does it not exist anymore.
Michelle Bauer (Alswager) 38:35
So diabetes Hands Foundation, and I believe your plastic can also have to diabetes. They did it what happened was when Tom shirt was up on tech one he worked with Manny to bring it on board to be on type will be on type one is now called Beyond type two.
Scott Benner 38:51
They blended it with that I see. Yes.
Michelle Bauer (Alswager) 38:53
And all the Spanish. All of Bian type one and type two is also in a lot of languages, but a big Spanish population as well.
Scott Benner 39:01
Yeah, no, I get contacted constantly about translating some of the series in the podcast, I just can't figure out how they will accomplish it. So well I can I just don't have the money for it. But I need to voice I basically need to voice actors to sit listen to stuff. And then you know, speak it as it's happening. And I just don't know how to get it together. I guess is my is my problem. But to say that I hear about it a number of times a month from somebody is not an over exaggeration. Like Please can you please translate this into Spanish so I feel the same
Michelle Bauer (Alswager) 39:35
way about we didn't do an e book at first we finally put the eBook out and I'm getting so many things for that. But same thing got like doing the we got to find a voice actor to to do like, what do you call it books on audio? We haven't done audio yet.
Scott Benner 39:48
Yeah, that's um, it's just it's just I looked a little bit closer. I keep saying like somebody should sponsor it. You know, like, wouldn't you want to be the one to sponsor the Spanish content, like say it and I say it and I keep waiting for somebody to spring forward. But hopefully one day someone will. So I keep talking about it. So hoping, hoping someone will hear me. That's interesting. Okay, so Oh, and Manny did me a long time ago when I was trying to figure out what direction to move the bloggin. Many. He really gave me a lot of good advice. He's such a sweet guy.
Michelle Bauer (Alswager) 40:23
We really, I'm sure he'll listen to the podcast. Oh, well,
Scott Benner 40:27
hi, Manny. How are you? Should come on. Yeah, I mean, that's a that's an interesting story about what he started and what it grew into, and how he I mean, he left it, it got melded back together, like that whole thing is, people don't people don't know the effort that goes into you having a board, you know, web space where you can go and talk to other people at diabetes, it's a lot more effort than you might think. Michelle, is there anything we're not talking about that we should be talking about?
Michelle Bauer (Alswager) 40:54
No, I don't think so. I mean, the main thing was the grief book, Jesse was here. And if there's anyone listening that knows somebody who's lost anyone to type one, because we do actually have it for spouses and siblings at such, at beyond type one that Jesse was here, and then look for the new sibling book that will should be out within the year,
Scott Benner 41:16
you're gonna have your next book will be out in about a year you think? So? Yeah, writing a book is, it's so much work. I, I just, people say to me, are you gonna write another book? I was like, Ah, it's a lot easier to make a podcast, though. Maybe when the podcast is over? All right, one more, but it's just a lot of effort. And
Michelle Bauer (Alswager) 41:35
I think for me, it comes down to like, I look at my two birth kids, Samantha and Joey. And, you know, I dedicated my first book to them, like for giving me a reason to tie my shoes in the morning. You know, that was my dedication. And then there's so much I don't know, that's gone through their heads, right? Like, did I do things right that I did I neglect them, because all I talked about is Jessie. And so I'm really wanting to dig into those siblings brains, doing it for them, you know, to get this second book. So it's really their story is coming together. In this next one, about, you know, I named it tentatively, but I'm still here. You know, like dealing with the kids that are left behind and doing right by them.
Scott Benner 42:12
So that's interesting, right? Because those siblings have, there's a duality going on, right? They lost a sibling. But then they lose a parent, but the parent is looking them in the face still. And that must feel like you're almost purposely ignoring them, even though obviously, you're going through a situation that you just can't break free of at the moment. So is that? Does that feel like abandonment?
Michelle Bauer (Alswager) 42:39
Yeah, you bet. Like for sure. I mean, I both of my kids would tell you that. They've had lots of apologies for me. And like, Man, if I wasn't with it for those first five years, like, I did my best I got you to school. I said, you know, but I probably dropped some things that wouldn't have dropped, like, was it that important for him to, you know, for joy to play baseball, Little League. And, you know, I just didn't push in those directions. But we're all really close. They're, they're so close. You know, we worried when Jessie passed that, you know, there's eight years between Samantha and Joey. And like, how are they going to bond? Right, like, there's the middle kids not there and flash forward. My son, you know, pays rent and lives with my daughter. So,
Scott Benner 43:20
so Joey would have been thriving through nine he was three years younger than, than Jessie. Right?
Michelle Bauer (Alswager) 43:27
Yeah. Yeah. So he was nine when and he's turning 22.
Scott Benner 43:30
So you're saying it using him as an example 1011 12 1314 You're pretty checked out for him?
Michelle Bauer (Alswager) 43:38
Pretty checked out. That's how I remember it. I don't really know how he remembers it. Because that goes into the other topic, which is, everybody grieves differently, which is a very true statement, which means I'm grieving the way I agree, which is, I'm very vocal, the more I talk about it, he's still here. He's still, you know, his life purpose, right? Where Joey never talks about how he felt through it all. You know, he talks to me about other things, and he's doing he's really healthy. But, but we don't talk about those that day, or those years where my daughter will talk about it. But my daughter, you know, when I was publishing a book, she's like, well, I'm never gonna read it. You know, she's like, I lived it. I don't need to read all that terrible time. And then all her friends bought copies, and she's like, Oh, I'm gonna have to read it now.
Scott Benner 44:24
Can I ask you a difficult question? Sure. Did you ever consider ending your own life after he died? No, that never popped in your head?
Michelle Bauer (Alswager) 44:35
No, and I'll say it differently. What pops in your head? Is this utter black hole of pain? I don't know how else to say it. That it's you don't want to die. You don't want to wait to have to see them. I don't know if that makes sense to you is it's like I said it early on. When it first happened. I no longer feared death. Like I could die. tomorrow and I wouldn't care. Like I didn't have the will like a will to live like really, really interested in. If someone would have told me in 12 years, Michelle, you're going to be happily married, you're going to have a beautiful cabin and all this fun and, you know, great kids in your life, right. But flash forward, you know, it's very different. Like, like, I'm glad I'm here. I guess it's how I would say it. I could tell any parent is you'll be glad you stayed.
Scott Benner 45:27
Right? Okay. I understand. Yeah, just because you hear people say that's a knee jerk thing. People say when they hear about somebody losing a child, they're like, Oh, I couldn't go on. Like that kind of thing.
Michelle Bauer (Alswager) 45:38
Every parent would say, I have no other choice. Right? Gotcha.
Scott Benner 45:43
But it doesn't mean that the pain you're talking about? Is it? Um, is it omnipresent? Is it like a headache? Or does it come and go? Are there? Do you wake up in the morning? And not remember, he's gone for a few moments like this, that kind of stuff happen?
Michelle Bauer (Alswager) 46:01
The true statement? Is it never, it never hurts less? It hurts less often. So, you know, like, I was telling my husband the other day, I had, I bet you had 10 dreams about Jessie and one night, but then I'll go six months without one. But the reality is set in so much to me, where I used to have the dream. And I'd wake up and go, Oh, man, right. He's, he's gone. But now my brain is so trained, like, even during the dream, where I'm seeing him and talking to him. And in my dreams, it's always me trying to find the insulin and trying to find test strips, because it's been 12 years, and I gotta get him to an endo. But they're going to be like, what were the healthy men for 12. And then in my dream, I stopped myself and go, This isn't real. He's dead. Wow. And truly comes to me and my dreams as that, so I don't know how to explain it better or worse. It just is,
Scott Benner 46:50
right? No, no, I am. That's the closest you came to make me cry that time. So just don't be sorry. I because I'm going to tell you right now, like, I'm a person who connects like that. I think things through ahead of time. And you know, when I was a little kid, I remember, like thinking through, like, what would I do if my parents died. And I don't, and I don't do it constantly. You know, I did it that one time. But the way it's kind of morphed as I've gotten older, is sometimes I look back and I remember things that way. And like, oh, I don't know, I think of the day that Cole got accepted on his first like all star team when he was like four years old, five years old, something like that. Actually, it was six, excuse me. And I remember taking him to a baseball field, where he was going to look for a list that was supposed to be hung up on a bulletin board. And he was super excited. And I it was a long walk from the car. And then we got the list. And he in his excitement, didn't see his name on the list. And he turned around, and you could see him like he was he was rejected, but he was trying to he was trying to be happy. Like he was trying to act like it was not a big deal. But I had already seen his name on the list. And he turned around, he's like, I didn't make it. But he was trying to smile through it and and I turned him back around and had him look again. And I remember the excitement on his face. And I'm telling you right now, it doesn't matter where I am, I can put myself in that car, take that walk down that path and experience that entire thing every time. And it used to be a happy feeling. And as he gets older, it's starting to become a sad feeling for me. And I just, I just think that's because he's, he's not a little boy anymore. You know? And, and I just, I know, I imagine, Michelle, that if I was in your position, I'd have a hard time not doing that. Because I think I would be one of those people who would run myself through scenarios, and I'm not certain if that would be good or bad. So
Michelle Bauer (Alswager) 48:55
I you know, whatever you think is the worst possible, like, whatever you can drum up in your mind of what it would feel like to lose your child. I can tell you, it doesn't come close, nor what I want you to ever feel what it feels like. The word I hear the most and I've used is it's it's it's a it's terror. The moments are it's just terror, and you don't wish that on anybody. Right and and so I make a point of I don't put sad scenarios for my other kids. I can't think that way they know that I always tell them like you have to call me more often than the normal mother because I need to know that you're breezing over there. If I don't hear from you for four days I'm going to worry so you know they know that
Scott Benner 49:41
they let you do they let you track them on Find My iPhone so you can see where they are.
Michelle Bauer (Alswager) 49:46
I don't but I will say I probably Snapchat with my daughter every single day. And and knowing that my son lives with her I'm okay.
Scott Benner 49:56
So this is this will sound I don't know how this will sound I don't actually don't care how it sounds, but you know, on the Find My iPhone app on iPhone, like my whole family is on there, even like my brother. And there's kind of a widget on my screen where it pops up and like everybody's little icons pop up and underneath of it, it tells you kind of where they are. And there's something incredibly comforting to me to watch people move around. And like, I don't, I guess it's because i that means they're alive. Right? Like, yeah, yeah. And, and, anyway, it's my brother. Let me my brother's 35 Michelle, you know, they mean, and like, Yeah, I'm like, I see him at work. I see him at home, I see him by the lake. And it just makes me happy to think that he's out there doing that.
Michelle Bauer (Alswager) 50:43
Yeah, I mean, my kids when they were younger, to like, you know, if they didn't answer a text right away, or answer a phone call, I used to, like lose my brain and try to explain to them why I'm irrational. But my daughter, actually a quick story is she when she was younger, but she was driving, she took Joey to target, just to go shopping something to do. And I'm like, Okay, fine. And I'm driving, and I'm probably a mile from Target. My daughter calls me and she's in sheer panic. She can't find Joey. They set his name over the loudspeaker. He's not coming to where he needs to be in. I'm in like, I'm losing my mind. So I'm like, Okay, I'm on my way. I'm coming. You know, I'm coming, I'm coming. And every bad thing is going through my head. And I could tell it was it was happening for her to where she used to think I was being irrational. But then it was real for her, too. And so to make it worse, I'm like, Okay, I'm a mile away. And she said, Mom, not at that target. I'm at the one on the other side of town. And then I became crazy mom, that was like, you put them on the phone right now. And I'm screaming at customer service and saying, You need to put an alert act as if he's been taken. I'm like, calling his name over the loudspeakers and doing it and do it now. And then I remember saying something like, I've already lost one sound, I can't lose another one. And I remember saying it to this customer service lady, of course, my son was playing video games, you know, listening to his name,
Scott Benner 52:05
ladies, is at the front of the target running the running this the loudspeaker and she's like, I don't make enough for this. This is,
Michelle Bauer (Alswager) 52:12
oh, my mom's screaming like, I can't lose another job.
Scott Benner 52:15
But it's, it is interesting, though, like, because I'm drawing a parallel in my head about diabetes. Because when you try to tell your kids like, look, it's important. You know, I need you to test or I need to know or you need to know, or somebody needs to be looking. And they're like, whatever, it's fine. You're like, No, you don't see the bigger picture, you don't understand what could happen. You have to me, Michelle, you have what I would consider to be the ultimate perspective. Yeah, that's all your perspective is just an you know, I kind of talked about it sometimes the way you talk about understanding grief, which is, you have a level of perspective, I don't wish on somebody. But but but we should take your we should take your opinion, seriously. Because you see, you see an aspect of life that that others don't get to say so.
Michelle Bauer (Alswager) 53:03
Yeah, but I stick with my you know, anyone that I meet who has type one, or their kid was just diagnosed, I'm like, you gotta let your kids live their best life. Like there's nothing I can tell you. That happened to Jesse that I would do differently as far as living life. And, you know, getting out there and doing what you can.
Scott Benner 53:20
Yeah, I'm always, you know, as time passes me, I lose what episode it was. And I can try to look real quickly. But I had a mom on once who lost her son in college. And she just said something during the conversation about she would have rather him have 21, great years than 40, soso years or something to that effect. And I've always, always tried to hold on to what she said, because I thought it was brave of her to say after he was gone. Because when Bell was at will hovers. Yes, we'll have a response. That's exactly who it was. And I just find that to be that that is a helpful statement for me as I've raised my kids, that, you know, we don't want something bad to happen. But we also don't want to get to the end and realize we've lived half a life, trying to make sure we get longevity. There seems to be a balance in there to me.
Michelle Bauer (Alswager) 54:14
Yeah, I actually got to meet Lindahl face to face. We're both doing a JDRF bike ride and Amelia Island a few years back. Which was which was great to experience with her.
Scott Benner 54:26
Yeah, she was she really she made a big impression on me early on when I was making the podcast. So I've always really, I've never I don't know if I've ever told her but I've always appreciated she was on the 19th episode of the show.
Michelle Bauer (Alswager) 54:38
I mean, keep dropping all these names. I'm going to end up tagging all these people.
Scott Benner 54:43
Do you think I'm just bringing up people to try to like get you to share the podcast with more people?
Michelle Bauer (Alswager) 54:50
No, I was still in contact with Lindahl so I hear from her quite a bit she still posts a lot about well,
Scott Benner 54:55
okay, thank ya know she she made a big impact on me. So, alright, well miss So I really appreciate you doing this. You would prefer if people bought the book on Amazon. Is that the best way?
Michelle Bauer (Alswager) 55:04
Yeah, I mean, that's the best way to go, I think as Amazon will get you faster. And of course, if someone wants to reach out to me directly, they can find it's on Facebook as Jesse was here, author. And I can do sign copies as well. Very nice. Thank
Scott Benner 55:18
you so much for doing this. I really appreciate it. Thanks, Scott.
Michelle Bauer (Alswager) 55:20
Thanks for having me on, of course.
Scott Benner 55:28
I want to thank one of today's sponsors in pen from Medtronic diabetes, and remind you to go to in pen today.com To get started with that insulin pen that talks to your app, and gives you all that information that many people have come to expect from an insulin pump. Thanks also to Dexcom don't forget that you may be eligible for a free 10 day trial of the Dexcom G six, where do you find that out? dexcom.com forward slash juice box. There's also links at juicebox podcast.com. And in the show notes of the podcast player you're listening to right now. But you can remember it dexcom.com forward slash juice box and of course in pen today.com. And if you're interested in hearing Michelle's first interview with me from 2016 It's called Jessie was here and it's episode 90. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.
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