#725 Teacher Mama
Christina is themother of a type 1 and a teacher at her school.
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Scott Benner 0:00
Hello friends, and welcome to episode 725 of the Juicebox Podcast.
Today on the show, we'll be speaking with Christina. Christina is the mother of a child with type one diabetes, and she's a teacher. So we're gonna get her teacher mom perspective today. While you're listening, please don't forget, just don't forget, while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. I'm gonna say it again, because it has to be said, if you're messed up. I'll try again. 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 fill out the survey answer the easy questions. It's completely HIPAA compliant and absolutely anonymous. When you answer these questions, you'll be helping other people with type one diabetes you'll be helping the show and you're just might be helping yourself. Go see Wow. P one D exchange.org. Forward slash juicebox.
This show is sponsored today by the glucagon that my daughter carries G voc hypo penne Find out more at G voc glucagon.com. Forward slash Juicebox. Podcast is also sponsored by touched by type one head to touch by type one.org to learn more. And today's program is what my grandmother would have called it a program. I don't know why she'd say I'm gonna sit down and watch my programs. I mean, I don't know she was from a different time. Anyway, the program is also sponsored today by us med. US med is the distributor of diabetes supplies. It's where I get our hands on the pods. And it's where I get Arden's Dex comps, you can get your things there as well. Go to us med.com Ford slash juice box or call 888-721-1514 To get your free benefits check. Thanks so much for supporting the sponsors. Now let me get you to the program. You know, in my mind now expect the mandrill sisters to come out and sing or Lawrence walk or something like that.
Christina 2:39
Seattle Aquarium.
Scott Benner 2:40
Oh,
Christina 2:42
and yeah, it was really active. It's like climbing all over the glass. So it's my favorite animal.
Scott Benner 2:47
There you go. I was in Seattle. This year. I didn't know that. Yeah,
Christina 2:53
it's not huge. It's okay. It's you know, it's important, but I wouldn't say that you need to like go back specifically to see the aquarium.
Scott Benner 3:01
If you enjoy them and you're ever in Georgia, the Atlanta aquarium is is quite spectacular.
Christina 3:07
Okay. All right. All right. I will tell ya,
Scott Benner 3:11
well, good plans on leaving I for Georgia soon or No,
Christina 3:15
I don't. But now I'm just gonna go just for that
Scott Benner 3:18
feels like a hollow promise to me. But I want to say I was there with my son when he was like 16. And he was playing baseball. At the end of this very long, very hot day. We had this little gap of time, it was the only time we could go to the Atlanta aquarium. By the way, if you've never been there, their traffic is horrendous. So, the CRAM is pretty close to the hotel. And I'm like, Look, we have to go. You know, we're gonna go We're here. We're this close to it. And he just he did not want to he fought it. He's like, No, I'm tired. I'm hot. I just wanna take a shower. I don't want to do like the basically like looked at the floor the entire time we drove there we were caught in horrendous traffic turning what in any normal place would have been like a 15 minute ride until like a 45 minute ride to you know, get in there. And when we leave some hours later, he says to me in the parking garage. I'm glad you made me come to this. Oh, that's good, nicest concession he's ever made to me in my life on something like that. So
Christina 4:24
that's awesome. That feels good as a parent you need those moments brought this
Scott Benner 4:27
up to him recently. doesn't particularly remember it.
Christina 4:33
That's great. Sorry, the he'll probably have similar experience at some point when the tables have flipped.
Scott Benner 4:40
Or I'm wasting my entire life.
Christina 4:43
Yeah, I have those moments. Those thoughts too. It's apparent like why am I spending so much time on this?
Scott Benner 4:48
You kept that like these most like, I kept thinking of it as like he'll never remember it when he was little. But it'll it'll be the building blocks of who he is. He's got Throwing up and sometimes I'm like, I don't think that worked.
Christina 5:03
Yeah. Well, it's like my daughter just lost to her first two teeth. And, you know, it's like, do you what do you because our parents kept ours, you know? And I'm like, I don't, I don't, I didn't want my teeth. Like, it was really strange when my parents handed me my teeth. And we're like, Here you go. And I was like that that's, that was my part of my body. And that's just really weird. It's just one of those things where you're like, I don't think this is going to be important to you.
Scott Benner 5:31
I need to tell you that I've been recording the entire time and starting to think I'm leaving this in. So I'm going to tell you something right now. All right. I don't know why. But Kelly kept the kids teeth. Okay. Okay, I didn't even know it was happening. And when I found out, I found it a porn. And then she told the kids one day, and they, they shunned her. So.
Christina 5:59
So I made the good choice of throwing them out into the garden, basically, although that could be creepy for someone else, and they buy our house and find little baby teeth.
Scott Benner 6:08
You throw them in the garden?
Christina 6:10
I did. I don't know why, but it was like, it feels less abrupt or like less crude than throwing them just in the trash. I don't know why I was like, I'll put them in the bushes. That was like my middle ground, I guess.
Scott Benner 6:29
Yeah, if we lived in a small community in the 1800s, my children would have made Kelly move just outside of the tree line after they told her that. Right, exactly. That's disgusting. And then she showed them and they were like, no, no, no, we don't care about this. Like, why are you showing this to us? Yeah. I can understand. I think I took that opportunity afterwards to go, you know, some of the other things that you're saving to give them later. They don't want that either.
Christina 6:55
Right? Yeah. And there's like, if you save everything, like where do you possibly even put it all? You know, we have to actually hide when things when we when we, you know, purge, we have to hide them from my daughter, before we throw them away because she wants to keep like everything. So maybe she would be the one of the people that would want her baby teeth. But I really got to work on her right now about this because she's going to be like a hoarder. If I don't, it sounds
Scott Benner 7:18
like you're judging her. But you threw their teeth into a bush. So I'm not certain where this fault lies. Exactly. True. True. I will finish by telling you that my mom is 79 now and she just moved out of her home to a place where you know, somebody can be with her a little more frequently. And she has this candle. It's a Christmas tree. And it's maybe, I mean, no lights, maybe about 18 inches high. It's the most realistic looking candle I've ever seen in my life. And I remember it throughout my life. You know, like it's always been around as a decoration at Christmas and my whole life. I've thought, why don't we ever burn that candle? So we're cleaning up her apartment, she's there. And I'm like, you know, there's a lot of stuff she had to get rid of. She just doesn't have the space for it. And I said, Mom, what's the story of this candle? She goes, That's my mom's and I flipped on the bottom. The label on the bottom is actually made out of cloth. And it's just, it's really old. And I said to her I'm like, okay, she's, you know, like, Well, what do you want to do with it? She was I don't want any space for it. I said, I'm gonna take it home. I said, but I'm gonna burn it. But only on Christmas. Yeah. And she goes, Okay, I said, so I'll have it for years, you know, we'll burn on Christmas. So she was at my house on Christmas. I set the candle. I'm like, Mom, I'm gonna light the candle. Is that okay? Like, are you alright with this? Because most of what I'm thinking is the candles neat and everything. But, I mean, if I if I turned to my kids 25 years to now go, Hey, this candle belonged to my mom and it belonged to her mom, they're gonna throw in the garbage.
Christina 8:53
It's like you might as well just enjoy it.
Scott Benner 8:55
That's exactly how I felt. I was like, why don't we just burn the candle and just enjoy it. And by the way, however long ago that candle was purchased, they made candles a lot better because it didn't drip. It didn't smoke. It burns slowly. We have apparently as Americans forgot how to make candles or we don't make them here anymore or something.
Christina 9:14
Right, right. That's not surprising, unfortunately. But that's really cool. That'll be a really fun tradition.
Scott Benner 9:19
Yes, if I can remember the damn candle is next year.
Christina 9:22
We'll see. The other challenge? Yes. Anyway, Christy,
Scott Benner 9:26
you should probably introduce yourself.
Christina 9:29
Yes, yeah. So obviously, my name is Christina and my daughter Annie started kindergarten in August at the school where I also teach fifth grade. So I was hoping to kind of share a little bit about the start of her year in kindergarten and kind of what we're working on challenges that we came up against in the hopes that might help others prepare and get a little window into what to expect.
Scott Benner 9:53
What if I said to you, I don't want to talk about that. I want to talk about candles and aquariums for the rest of you
Christina 9:57
could probably do that, ya know? No, no, please. I could,
Scott Benner 10:01
but you could.
Christina 10:03
I probably could. I'm a chatty person. So especially if it involves aquariums because yeah, I do like marine biology, but I guess we'll give other people a break.
Scott Benner 10:15
Yes, for sure. I will tell you I think that what's sold my son on the Atlanta aquarium with the beluga whales.
Christina 10:20
Oh my gosh, I've never seen I've never seen those.
Scott Benner 10:23
I think that might have been what did it and pretty amazing. There's also like a main tank in there that is so large that it's hard to wrap your head around. Oh, okay. But that's not the point. The point is, you made some babies. How many babies did we make?
Christina 10:39
I've got two. So Annie is the oldest and then Jack is plays a year and a half. A little bit. A lot more. She'll be two in April. Put it that way.
Scott Benner 10:47
Okay. And how old Danny again?
Christina 10:50
She will be six in June. So she's five now diagnosed when she was diagnosed at two and a half, three years. Yeah, we just celebrated this last September. We just celebrated kind of like the tipping point, you know, where she said diabetes in her life longer than
Scott Benner 11:07
not? Would you do fireworks?
Christina 11:13
You would think I would remember what we did for her diversity. But it's kind of weird because of COVID. You know, like the her last couple of diversities have been pretty toned down like the first year we went really big. And we went to Canada. And we had like a three day weekend. And then after that. It was a little bit more scaled down. But I think we just kind of went out. We always go out to dinner and have lots of desserts. We do like a weekend type of thing. So we have lots of dessert that weekend and she gets a little little present and stuff and we just kind of make a big deal of it.
Scott Benner 11:43
Cool. That's excellent. Well, you live in Seattle. I wasn't sure maybe you took over a city block and moved into a bank or something like that.
Christina 11:50
Right? Yeah. Yeah. And we we actually live further north we live in Bellingham area.
Scott Benner 11:58
Christina trying to distance herself from craziness. She's like, I don't really live right there.
Christina 12:04
Okay, Seattle is amazing, but it's actually worse than he was born. But there's so much traffic, it's, uh, you know, crazy. It's just you lose like hours of your day and traffic. So we couldn't do that.
Scott Benner 12:17
Do that, that's for sure. Okay, so any other type one or autoimmune issues in your family?
Christina 12:24
No, you we have type two runs on both sides. I'm pre diabetic, but not type one. It was definitely out of the blue. When she was first showing symptoms. We didn't know what they were. We just kind of she had gotten sick. And we she started drinking a lot of water was the logic you know, those common things and we just chalked it up to her kind of recovering. She had never, she's always had a really strong immune system and had never been to the doctor before ever before being admitted to the hospital. So we just thought that her body was doing what it needed to do to recover from being sick. And then she kept drinking more and more water. And we had luckily caught it before she wanted to ketoacidosis so we, you know, call their doctor and like she's drinking a lot of water. She's wetting the bed, which at that point, she was, you know, potty trained and all that jazz. And so it was abnormal for her. And, yeah, my, it was a kind of a dramatic event because my husband took her into our doctor. And it was like, right at the time when school started for me and the kids. Were starting to come into the classroom and I got a phone call from him saying, you know, he was very calm about it. He's been like, he's been an EMT and a firefighter. And so he like very calmly using his, like, firefighter voice told me on the phone, you know, what was up, like, we need to go to Seattle Children's Hospital. They're saying that she has diabetes. And it was just this very crazy dramatic thing where like, the kids are coming to my classroom and I'm like, running against the tide of students to the off office. And I was like, I have to go now. It was it's always like imprinted on my memory like trying to get down that hallway of students. So but we did catch her early enough to where it wasn't dramatic. She didn't have to be in the ICU or anything. And I feel like overall, you know, our experience with it was pretty smooth as far as being, you know, she wasn't helicoptered out or anything like that.
Scott Benner 14:18
Right. Okay. So some would argue maybe her immune system too strong.
Christina 14:23
Exactly. I know. Seriously, and actually, my, my son has not gotten sick yet. Like he's really I mean, he may, you know, every once in a while he'll have a low grade fever maybe. But it makes me nervous now.
Scott Benner 14:37
Yeah. Ya know, when he like rubs his face on the glass door, and you're just like, Oh, he's fine. Doesn't matter. He's looking handrails. Nothing happens. And
Christina 14:44
yeah, yes. So well. Yeah.
Scott Benner 14:47
Let me say this. No, I'm not pushing this on you. But trial net is in your general area of the country. Like there is the home office there. So if you want to do that with I don't know if home office is the right verbiage. But your hub? Yeah, I don't know. Listen.
Christina 15:03
Yes, we once he, we actually have it in our notes at Seattle Children's that once he turns to we're gonna go ahead and go through that program.
Scott Benner 15:12
Cool. All right. So, very specifically, we're going to talk about your professional expertise and how it's intersecting with your parenting and then maybe some ideas that you might have wrapped around both sides of it. So how long have you been a teacher?
Christina 15:29
Okay, I think I know the answer this question off the top of my head, but I have been a teacher for 11 years now.
Scott Benner 15:36
Okay. And you you said you were teaching fifth grade at the time do you still teach with
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Christina 18:23
I know. It's probably like your son. They're like, What are you talking about? Like this massive life event? For me? It's probably like,
Scott Benner 18:28
can I just check with something real quickly when you are absent one day or you just take a day off? Absent? Like you're not an adult? Let's say you just take the day off? What do they do with your kids? Do they bring in someone to teach them? Or do they put them in a closet for the day? How do they handle it?
Christina 18:44
Yeah, you have to get a substitute teacher. And it's actually a lot of work. So teachers don't often, you know, this year is kind of different with COVID. But you know, that's where you get teachers coming in. They're sick. They're coming in, like, at death's door because it's almost just more work to make sub plans because you have to like, write out every step of like, every minute that a guest teachers in your room what they do prep everything. It's a ton of work.
Scott Benner 19:11
Okay, my daughter's High School now doesn't even bother with it. Which I find disturbing. Interesting. So if your teachers not there that day, they send you to a common area and you sit there and stare at something for an hour.
Christina 19:24
That's bizarre. Do they have subs, like shortages or something?
Scott Benner 19:28
I don't know. There used to be subs and a few years ago this started happening. Weird. And now the teachers tell the kids like hey, I'm taking off tomorrow.
Christina 19:35
Oh, that's that's, that's interesting. Oh,
Scott Benner 19:39
it's not interesting. It's this. It's the feeding. i We I'm paying the property taxes here for that school. And yeah, but that's a different system. I have not heard of that. Yeah, this is how it's being handled how the teacher can't come. That's okay. Just sit there.
Christina 19:52
So interesting. I don't know why. I haven't heard of that. No, that's not a common practice over here.
Scott Benner 19:59
Okay, so So, all right. I want to start I guess with so your daughter's going into school now into kindergarten? Yeah. Okay. And let's start from your perspective as a mom, like what was there to do as she went into school around diabetes.
Christina 20:18
So we, first of all, I started having a lot of anxiety, I think I'd want to, I think I want to start with that, because I, you know, Annie has a really strong, confident young lady has always made friends really easily, I've never would have worried about her socially. And even with that, around like, three months before kindergarten started, I started having just not, you know, waking up at night, worried anxiety about the transition. And I think what I was most worried about was, you know, her, I had these like images of her going in her alarms going off and being kind of like kids kind of judging her being wanting to separate themselves from her excluding her because of her diabetes. And so the first thing that I did when I started experiencing that was I reached out to our team at Seattle Children's, and I asked them to connect me with some families whose kids had gone through kindergarten. So that I could kind of ease some of that and get a more realistic picture of what other experiences were, which is also one of the reasons why I wanted to come on to the podcast, too, because it was really helpful when I was able to reach out to some of those families and say, Hey, did they did your child experience this, and the overwhelming response that I got, and I'm not saying this is true for everyone was that it was, you know, as far as the acceptance socially, was very smooth, there are a lot of other kids who have special needs and classes and kindergarten, everyone's just kind of on even playing field. So that made me feel a lot better. And I would recommend that any other families who are experiencing that also kind of reach out, we don't have a huge community up here. In Seattle, there's a big community, you know, type one community but appear not so much. And so it really is kind of like, a little bit lonely like Annie didn't, we actually just recently met some other type ones her age, but up until even a month ago, you know, it was just kind of so I didn't really have anyone to compare to. So after I kind of worked through that a little bit, in June, we met, I met with over zoom with the nurse and we started setting up some preliminary information to start getting the 504 going, so that she could work on it, write it up. And then we also needed to as part of that we needed to get our paperwork from Seattle Children's that has what they call standing order. So you know, what, kind of directions for how to address her needs at school. But it has to had to come from the, from them. And all of that gets it worked into the 504. And then we met again, in August, before school started to go over that written plan to sign it, etc. So that's kind of like the quick little overview of the setup. So you know, check in the, you know, before the school year yet and prior to start getting that ball rolling is what I would recommend. Yeah, you
Scott Benner 23:13
know, it's funny, as a person who's now had a kid with diabetes go completely through school like Arden's a senior now, and she started school with diabetes. I like my first inclination is almost not to laugh at you, but to be like, Oh, it'll be okay. Don't worry about it. And you know, like, I know you're going to but then I remembered that I think I went into the school like nine months before Arden school year started the tried to get a 504 plan. Yeah. And they were like, Why are you here? Well, they looked at me very strangely. Yes. And they didn't kick me out. But they were like, no, like, we don't do that now come back
Christina 23:48
into, especially right now, because school nurses are so overloaded with COVID. I'm really glad that we and she had reached out to me because of that reason. You know, there's just a lot going on for school nurses in their world right now. I don't know how she's amazing. That's all I have to say. So it helped to just get the Getting Started a little bit earlier.
Scott Benner 24:12
Okay. I am, I would have to say that. I guess I'm interested. Let me just change my my, my thought here for a second. I'm more interested in now that you've seen the whole thing be set up? How many times have you been handed a 504 as a teacher?
Christina 24:27
Oh, frequently.
Scott Benner 24:30
What really happens? Like do you just kind of like listen, do you just kind of like Look at it go, Oh, my kid got asthma. I think you stick it in the drawer. Do you really read it or like how valuable are they?
Christina 24:41
I think it depends on the severity of the diagnosis. So for instance, because if I before is is used for a large range of things. What I most commonly use see fiber force for are like learning disorders. So things like, you know, if a student has ADHD or something or something along those lines, it could be asthma related. Yeah. And in general, in, I would say, in fifth grade, it's a little bit different, because fifth graders are much more able to manage themselves. So for instance, if a student has asthma, it's, they're much better about saying, I need to use my inhaler right now. versus, you know, if you are in a kindergarten class, and the kid is unaware that they need their inhaler, and might be like wheezing, you know, get to a point where they're using so. And when it comes to learning, you know, accommodations for learning. That's where it's nice to have that copy. You know, I have like a binder that I use, it's right in front of me. And I have students who, you know, every year who needs special education services, and they have accommodations, and I think it depends on the teacher, perhaps, but I'm constantly kind of flipping back and forth to those to make sure that I'm following them. So even even when it comes to like, when I'm making a new seating chart, you know, making sure that I'm following that plan, and if there's like preferential seating, following through, but that being said, I teach fifth grade, I have one group of kids. And if I, you know, was teaching middle school or high school, you've got a lot more kids. Yeah, it's a lot harder to manage. And I think it's really important to teach kids to, to advocate for themselves, even from a young age. And we're already teaching Annie that as well.
Scott Benner 26:28
I bring it up, because one of the things that I kind of see online frequently is newer diagnose people send their kids off. Ooh, hold on a second. Yeah, I don't, I'm not sure just what happened there. Sorry. I'm trying to get some water while I'm trying to hold on to my idea. So I see newer diagnose kids, right, and their parents have set up this 504 plan. And then something doesn't happen in the 504 plan. And they kind of lose their shirt a little bit. You know what I mean? Like, and sometimes it could be I don't want to say inconsequential things, but sometimes it's smaller stuff. You know, like, it's not like, I mean, don't get me wrong, like I want the kid tested, you know, blood sugar tested, you know, alarms being treated properly, you know, blood sugars being handled, like all the like the like Do or Die stuff, obviously can't get ignored. But when it's some like little weird thing, you put in your 504 plan, and they didn't do it, and then they start running around, you know, yelling about like, we could sue over this. I was like, I don't know what this is doesn't seem important to me. You know what I mean? Like, sometimes, you know, I've only spoken about this a handful of times, probably on the podcast, but my thought process going into the school Saans the first time when I went in like a year before Arden was going to be in kindergarten was I guess I realized in that first meeting, they looked at me like I was out of my mind. And I thought I don't want to be the crazy parent. Like Like, because, you know, once you leave the school, they're just they're people at their job. And, you know, when I walked out my imagination told me that they stood in that office, they're like, What is wrong with that guy? You know, and, and I thought, I don't want this to be the case. I don't want it to be adversarial. And I don't want them to think of me as like reactionary and overreacting. So I'm cognizant about, like, keeping the 504 plan thoughtful, but simple, and followable. And then I just realized at one point, like you can't, like even if you read it, it's not like it means anything to you. If you don't know about diabetes.
Christina 28:40
Yeah, and it's such a, it's such a complicated disease, right. It's not, it's not like, you've taken inhaler, when you have a symptom. It's, you know, it's, it's such an ongoing management throughout the day. And I agree with you, like, even when I even with frequently looking at this stuff, there's absolutely times where I'm gonna forget, because I think one thing that's really important to remember is that it's such the classroom is such a dynamic space. And you have kids who are in the room that have all kinds of needs, and it's not always it's not always physical, right? So, especially, you know, this is a great example, we have a lot of kids who are experiencing trauma, anxiety, depression, you know, who were already experiencing those things and then put a pandemic and isolation on top of it, it's, you know, really, really traumatizing and then and then so you're trying to manage all of their needs, their academic sides, but you're also trying to manage the whole child and think about what they need social emotionally, in order to be just like a good person in society. And so you're trying to meet those needs in addition to the layering on top of needs that are in a 504 and then every day is just really different. It's the thing that I love about teaching is that you go in and your day yesterday is not going to be the same as the one that you're having today. And sometimes that's great. And sometimes that really is challenging. But it? It does, there's so much variability that again, I think it kind of, I think what you're saying is spot on and that you got to be careful about. You want to think about the battles, what you're what you're kind of highlighting most are the battles that you're choosing. And, and that that was one of the things that I was going to talk about too, is just that, we've absolutely had to change some things from how we expected them to go. So Right. So for instance, I can kind of tell you a little bit about how we have it running and then some of the challenges we came across.
Scott Benner 30:41
Can I I do want to hear that. But I want to say first, you got to like when you went to college, you're you have an undergrad and what what's your undergrad?
Christina 30:51
So I have a bachelor's in English and comparative literature. And then I have a master's in education, and my multiple subject teaching credential and my single subject teaching credential,
Scott Benner 31:02
nursing classes. I No. No, pre med. No. How about Psych? Did you take any psychology classes? No, no. So are you trying to say that a bunch of children are coming together that have a lot of needs that, you know, nobody's really qualified to help with like, you're, you're qualified to teach them, and then they they show up with all these other needs. I think it's just very important for the parents to remember that you're not sending your you know, I don't know you're shy kid to a psychologist, you're sending them to an education major. And there's, you know, and you're not sending. And by the way, too, how often do we talk about on here? How nurses don't get any training around? Oh, my goodness. So. So you think they tell teachers about it?
Christina 31:49
Right, or, you know, or even like, it's very rare to find a school where there's a full time nurse just dedicated to that one school. So their caseload is usually spread across several schools. You know, and that's that itself is a challenge. They're not always on your child's campus.
Scott Benner 32:07
I think the last thing I want to add before you move on, is that we are in a really wonderful time around diabetes where everything is obvious to you like I can pick up my phone right now. And I can swipe up and tell you that Arden's blood sugar's 91. That looks pretty stable to me. And like, I know that in the blink of an eye, but hundreds of 1000s, if not millions of children, before your kids went to school with diabetes, and they didn't have a CGM, or some of them didn't even have a meter. You know, and, you know, maybe their long term health won't be the greatest compared to yours. But they did live through fourth grade. So, you know, I think there's a way to, there's a way to what do I want to say here, Christina, I don't want to be too antagonistic. Sometimes, you got to not want to be upset. Because that makes sense. You have to want to not be upset, like, it's sometimes it's too easy to want to want the fight. And yeah, and that's it. That's just my opinion, my opinion, is you're looking for harmony, and as much understanding as you can get, given the situation? I don't know.
Christina 33:20
Yeah. And I think we, you know, I think we're used to having to do a lot of fighting, especially with like insurance and, you know, pushing back against, you know, like, I know that we have done a lot of push back with even just her diabetes care team around her higher blood sugars and said, like, no one, you know, we want to get them lower that kind of thing. And so I think, I think I think, too, we're just we're that's our kind of our natural trigger. And it does take a while to kind of bring it down. And I had to work on that this year, too. And it was kind of good that I knew, you know, I'm obviously, my, they're my colleagues that I'm working with. And so it was kind of nice to have that because I was able to kind of stand back and tell and, you know, remind myself, this isn't just the school nurse, this is so and so I know them, I have a history with them. I know that their hearts in a good place. I know all of these things. And I'm able to kind of step back a little bit more. Yeah. And trust.
Scott Benner 34:18
So you think it's easier, it might be easier for a stranger to look at the school nurse and think she's trying to screw us. Whereas you look at the school nurse and you're like, that's Pat, you and Pat's a decent person, and I've seen them work very hard at their job, and I know they're not trying to mess up with us and you have a little familiar outtie so everyone, you know, I think you have to just assume that in all these situations until it's proven over I'm not saying look there are people have horrendous stories about school. I'm certainly not lumping them into this right little bit of a conversation here.
Christina 34:51
But your times to be upset. Yeah,
Scott Benner 34:53
I'm pleased and I you know, at some point in this conversation will tell you about you know, when I got very upset and did something, but I'm just saying, like don't want the fight, like want to want it to go well. And if they don't get it right away, I wouldn't take that as being as them being adversarial. I would take that as I'm not understanding. That's my point. Yes, absolutely.
Christina 35:17
And I, I think that's a huge point that I want to drive home to is like, it's it's Boy, oh, I guess I'll wait to like go through our process. But I do want to talk about that, for sure.
Scott Benner 35:28
Tell me about the process used?
Christina 35:30
Okay, well, I'll tell you kind of how we decided that, you know, the system that we decided to try out, and then I'll tell you like, the challenges that we came across. So how it goes for us is last summer, before COVID, like delta got all crazy again. But Annie went to this science camp. And I was I wanted to do that, because I wanted to just practice her being away from me, with a team that doesn't know anything about IBD. This just to see how it would go and went really well. It was great. But the system that we had with them was that they would just take a quick little picture of our pump and text it to us before snack or whatever. And then we would give directions or if an alarm went off, we would they would take a picture and send it to us at that point, we were using Medtronic. And they're, you know, we could follow her. But there's always a huge delay. So sometimes up to 20 minutes, you know, if she goes low, or something we wouldn't find out on our phones until like 20 minutes later on. So we use that system. So it was little more real time for them. And we actually came up with that, because I remember the episode where you were talking about how you had this realization that you could just text Arden and she could, you know, text you back what her blood sugar number was, or whatever. I was like, Oh, well, let's try that. So we use that same system at the school, we have like a group thread going that has, you know, parents, the teacher, school nurse. And then she also has some individual parents who are like, support people to school who, you know, check in with her at key parts every day, when things are a little bit crazy for the teacher. And he's got a lot to manage just to as a check in point. So yeah, what what happens is the teacher or whoever's checking in with her will take a picture of her phone, which isn't as necessary anymore, because we were now on Dexcom and Omnipod. But I'll get there. And they send it to us. And there's a snapshot of the phone and we give dosing advice, or, you know, so might say okay, go ahead and have her put in her number and dose for 15 minutes before eating or something like that. They do the same if there's an alarm, we'll say Alright, go ahead and give her the applesauce or something like that. When we sent her to school, her lunches and snacks have like a little sticky note on it, that have the carbs. And then for her lunch, we'll actually write down like how much each item has so that they know how much to make up type of thing. So she doesn't eat or carrots are something which wouldn't be that big of a deal. But if she didn't eat her carrots, you know, they we would know that she gets make up like two grams or something. And then we keep extra supplies at the school like, you know, all of her extra be, especially since I'm there, you know I've got insulin in the fridge, I've got slight changes and stuff in my room. And we I definitely have had to do that so far at school. And then of just, of course, extra snacks and juice and stuff. And the interesting thing is that Annie has to be the one to push any buttons in her pump. And this I have heard is different across schools. I don't mind it, it's fine, because Annie is pretty savvy. And she does you know, she does little things here and there with her care and I know that on crease. But she you know, they supervise her but they can't push anything into her pump. She has to be the one to do it. So another thing too is that they're not comfortable doing any kind of temp Bolus. So like if I want to do a temp Bolus, I've gotta like, go in there, have them bring her over and set it.
Scott Benner 38:58
Alright, so that's where so that little bit I can see people getting pissed about that. So the whole thing about like your daughter six, five, and you know, like, she has to push the buttons, which means we think if this kills her, it'll be harder for you to sue us if she pushes the buttons.
Christina 39:18
It's a different Yeah, it's different. Not sure exactly. No, there's an informative and asked, but it's okay for us because Annie was already doing that. Like we already but I don't mind also really good with her numbers. Like,
Scott Benner 39:33
yeah, I see what you're saying like, well, first of all, I don't mind that they do that. I just, I don't. I don't like that it gets like let's not pretend like just say it. You know,
Christina 39:42
the reasons behind it. Yes, for sure. And the other
Scott Benner 39:45
thing is, too, you could have a kid who's not good with that. And then we we have a problem now.
Christina 39:51
Right? Exactly. Which is why you know she's always she's always monitored when she's doing it. So she's never like just handed her pump and told to put it in she's always the one that Like there's always someone watching her, making sure it's all good. But she's fast too. And one that's actually been a stressor for some people at the school is that she'll put in her numbers really quickly and click, you know, to Bolus and they're like, Wait, what did you put in? You know?
Scott Benner 40:14
That shows me the system's pretty imperfect on that specific scenario. I want to stop for a second and ask are you generally what is the word I'm looking for nervous about other things? Or is this just this one thing that got you as she was going off to school?
Christina 40:33
As far as being nervous about the social part? Yeah,
Scott Benner 40:35
like when you were when you talked about, I don't want to get too far away from it. Like when you talked about all that, like concern, and we worry about what would like I just, I'm a boy, Christina, like, I don't worry about things that might happen. I worry about things that are happening. And so like, it's just, it's a different way of thinking, I'm probably not specific to boys and girls, I'm just I was just trying to say that I'm a simple minded person, but you don't worry about it. I don't worry about things till they're going wrong. Now there's, you know, okay, there's, I still pre planned, I did a ton of pre planning to send art into school. But I was never worried about it. And like, that's an interesting thing. Like, I've never worried about, like, if people would like her or not like her or give her problems. And I don't know, I just like, was that something that? Like, do you worry about a lot of things? I guess is my question is, is there something specific about this?
Christina 41:30
I would say that, in general, like, I would say that my husband's probably more along your lines a little bit less worried. I come from a family with high anxiety, I do a lot to like, I do a lot to recognize it. When I have anxiety and take steps to mitigate it, like reaching out to families being like, I was understanding, I'm having this like, movie going through my head, that's probably very unrealistic. And I'm gonna go ahead and reach out. And so I can stop that movie playing in my head. And I also didn't really have any reason to be thinking that because I'm a teacher, I'm in the classroom. I see kids interact. And, you know, I don't see that, you know, but it was still a narrative almost that I had running through my head. So yeah, I would say that. It depends. I think that there are certain things that I get a little more anxious over than others.
Scott Benner 42:19
And that's a good point. I couldn't even think of the word anxious. That's what I meant to say. And I couldn't even come up with the word. Were Yeah. How was your experience as a child?
Christina 42:31
My experience as a child was in school. I was. I was I was strong in school. I definitely got. I moved around a little bit. I definitely got some social, like, teasing. I don't even know if I would call it a bullet. Yeah, I think I would actually call it bullying. So I think that that was probably just something that was a little bit more on my mind.
Scott Benner 42:57
Okay, that's I just yeah, thank you. I should have asked you that. But it's fine. Okay, so you have a pretty good system set up with school, you know, you're sending photos back and forth. So you can see what foods been eaten. Does that end up working for you? Yeah,
Christina 43:13
that's that's actually working out pretty well. The other thing too, that's nice. What is it, she receives all of her care in class, I didn't want her leaving to go to the office. Every time an alarm goes off her she ended check her BG or whatever. She does everything in class. And that has helped enable that to just open up that. It's all it's nice, because everybody is on the same page. It feels very cohesive, like we're a team. And it feels like there's this nice net of people who are supporting each other basically.
Scott Benner 43:42
Yeah, I'm a big proponent of it all happening in the classroom as well. I Yeah. A lot could be lost in the walking around the school. And you know, I'm sure I've told this story on here a million times. But leaving second grade, we thought Arden had a serious math deficiency. And it turned out that she was just going for like a scheduled blood sugar check. At the same time every day, and it was cold. It was it was corresponding with the math lesson.
Christina 44:08
Yeah. And the office is a busy place. It's the people in the front office, they do so much. So you know, you might have a child who's you know, unless she's going low or something, it's not an immediate emergency might sit there for 10 minutes. You know what I mean? Well, they're dealing with other things. Yeah,
Scott Benner 44:25
maybe maybe it would be better just to react and handle it. Right there. But do you but can you possibly. I mean, is it possible that one day you could run into a teacher says, Look, I don't want to be responsible for that. Absolutely.
Christina 44:37
Yes. That part of the reason why this is working is that the team is on board. So her teacher has been amazing. And he has been all for it, I think in some ways. Okay, so he sets timers on his phone at key times during the day to just check in with her, you know, ducks Come and check in with us. So it's very structured. And I think in a lot of ways, it's nice for them not to have to make the decision about what to do, because we are telling them what to do. So it takes some of the pressure of, okay, just going low, how much do we give, etc, off. That's, that's been good. I mean, one of the drawbacks, though, is that it is an interruption to him, like his flow of like the classroom, which is why they have ended up bringing in a couple of folks to help with some, some times of the day that were a little bit busier for him to where he wouldn't need to stop the flow. And like a key part of the class there are, as a teacher, there are just certain times a day that a little bit more crazy. And so we were able to mitigate the interruption by just bringing someone else in. And it's fun, because there's more people in the team that can help out so that if there's one person gone, everyone else knows what to do, and how to respond,
Scott Benner 45:55
how did you end up getting them to pay for another person to be in the room.
Christina 45:59
So we are a title one school, and we receive additional funds. So there's these amazing people called calm parents, and they're there as support for kids and academics, primarily. But they're also the people who are our yard supervisors, they fill lots of different roles. And it's like a five, their their day is very scheduled out. So like from this time to this time, they're doing math support, for instance, for k one. And then from this time to this time, they're outside on the playground. And what they did is they just built in a five minute chunk of time, you know, across a couple of their parents days to just do a quick check in with Annie. And it's just very, very quick.
Scott Benner 46:41
So there's no like person sitting in the corner of the room like a broom, waiting to be needed or something.
Christina 46:47
It would be as if the the person who's out on your yard supervision. When they come in, they just check in with me real quick and then go back out. It's it's very quick. It's not like, yeah, it's not like paying for an additional person to be honest people who are already at the school. They just have that one quick check in built into their day.
Scott Benner 47:04
That's excellent. Like when Artem was young. They just that didn't exist. Yeah, there was a you wait, quite literally had to hire a person to be in the room. Right. Right. That school was never going to do that. For Arden.
Christina 47:16
That's for sure. Right. Yeah. I mean, it would I feel, I don't know if that would be possible at every school. But it's it's been, it's been really amazing. And I have any feels very connected to her team. So that's been really good. And it you know, like I said, she didn't she hasn't had to go to the office really at all, like so far this year, which is great. And there have been a lot of challenges. So basically, you know, everything around diabetes is based on patterns. And everything changed when she went to kindergarten. I don't know if you remember this was happening with Arden. But it's like when the times that she eats her snack times her periods of active play completely changed. And the type of outdoor play chain she had she was in preschool before this, but they didn't have you know, a big playground that they're running around playing on it. Typically when we would go to the playground, when she uses lots of muscle groups and is running around. She just like her blood sugar just tanked. So usually we'd have to give her like a good 15 to 20 grams uncovered before we go to the playground, just to keep her even. And so that has been what we've been experiencing pretty much right from the beginning of the year is that she was kind of constantly going low. And that that was challenging, obviously, on the team on the teacher was really stressful, especially with you know, it's a very, one thing to keep in mind is that a lot of it's a very scary diagnosis, right? For people. It's just, it's an intimidating dynamic diagnosis in general and stressful for us. But especially for people who feel you know, are at the school and feel like they're responsible for her not dying, you know, it's there's definitely this urgency to it to where it's pretty stressful. So there's been a lot of adjustment that's had to go on. They at one point asked us to her high alarm goes off at one originally was going off at 140. And that was also stressful. The team was you had had experience with type one before, but not with like a CGM or a pump. So it's a different kind of stress, right? And that it's awesome to know their number. It's also a lot of information and the alarms that were going off can be very, you know, triggering and scary. So they asked us, you know, to basically bring up that bring up that high alarm, and that was really, really tough. I had a hard time with that. I was actually kind of really surprised at the emotional reaction that I had to it and in some ways it kind of felt like I had failed, or that, like me, I felt judged I guess kind of like that feeling you were describing when you came in that first meeting and walked out feeling like they think you're crazy. You know, I kind of felt that way. Like maybe people were thinking that I couldn't take care of her. I felt a lot of shame about her blood sugar numbers and, and I had a lot of like anxiety about the stress and or the perceived stress and burden that I thought it was putting on people.
Scott Benner 50:19
See, this is where you and I will like, like, we have different. We're from different, like generations, because I heard that and I was like, Well, I don't care. Like somebody. That's your job and someone's paying you with the thing stresses you out, see a therapist, but I'm not putting my kids blood sugar higher for you. Yeah, that's a, that's a generational like, disconnect for me.
Christina 50:41
I and that would be like, if
Scott Benner 50:43
my garbage man said to me, it's so hard to lift up this trash. I'd be like, Well, you might not want to be a garbage man, then, you know, like, like, seriously, like, I'd be like, Dude, that's part of the job. You know, it's
Christina 50:53
it's, it's interesting, because when I hear type ones talk about judgment, when they go to the doctor, you know, when they have to when they're showing their CGM, it was kind of like that it was, it was really frustrating. Because before she went to kindergarten home, she was Breyers, very stable, her numbers looked great. And then all of a sudden, it was like, what is happening? It just made her care a lot more public. And it I just felt kind of naked about the whole thing. And
Scott Benner 51:18
now it's interesting, because I really do. Yeah, it's
Christina 51:21
it, it's feel you feel very naked. And you feel like, you almost feel like you want to like defend yourself. Like I promised, we were really good at this. But we're just and one thing that I kept, I think that was really helpful is reminding everyone that we're in the data collecting stage. And that kind of helped them and me in the sense that, you know, I had to remind them, you know, everything's my pattern with type one, everything's changing with their schedule. We're collecting data right now, we're constantly changing little things in our pump. We'll get there. But we need information to see like how her body's reacting to situations, because she also has PE now, you know, a lot more physical exercises she has, you know, she's constantly doing like, up and down movement and lots of thought of dancing and total physical response and kindergarten. And so it just has been really, really interesting. And then on top of that, you know, I think she's just going through a ton of growth, like I can see it. In her she is shooting up. She's lost two teeth there, as I said, the bushes she's growing new ones in, and I can just see her physically changing at an incredible rate. Do you remember this with Arden at all? Of course, do you think like five is nuts?
Scott Benner 52:37
Do you think that you care more about how the teachers feel? Because you know them?
Christina 52:43
Um, no, I don't think so. I actually think it's easier for me to talk to them in about it. I think, you know what, I think I think that there's a lot more trust because I know them, and vice versa. So I think when I'm telling them, you know, this is a data collecting stage, we're getting information, we see the number we just, it just gives us information to chew on how to react to it. I think that that has actually been helpful knowing them, because I think that there is trust there. And, and the other interesting thing, too, is like so yes. Okay, so we brought up her high alarm to 180. But the reason why I was okay with that was because we have such a strong check in system that they're not just like letting her fly all day, right? Like there's there's check in times built into the day, she never gets up to 180 or unless she's got a site failure, which we started. That's another thing that happened. She started having increased site failure, she was on the Medtronic pump. And they changed the we were on the Meo sites, and fusion sites, and they just weren't working for us. So we were that had happened right around the time that she entered kindergarten, and we just started getting high blood sugars at school, it was really weird. And we ended up deciding Medtronic isn't working for us anymore. And we decided to switch her to Omni pod early. We were planning on switching her during the summer. But we just said, you know, this is like a nightmare. I'm having to do site changes at school all the time. Like we're just gonna change her. And that also was another big transition. Because Omni pod how they like their dosing increments for basil are different. And so that was kind of like trying to figure everything out again,
Scott Benner 54:33
starting over a little bit. Yeah, I'm doing my best to get past like, I know, I'm 50 and I don't know how old you are. But I I grew up on the maybe the East Coast. You grew up on the west coast, but I'm literally stuck on the beeping makes me stressed out. I swear to God, if any one of my kids teachers ever says something like that, to me, they're not gonna like where the conversation goes after that, and I'm gonna lose a lot of academic or intellectual cred because I'm gonna lose my shit. someone says something like that. And I'm like, oh, no, the beeping is bothering you. She's got diabetes, you're moron. Like Like, this is the situation. And I don't care how you feel like I, this is probably a good time for me to tell this story. So when Arden was first in school, we had a system set up as well. And I want everyone to remember, Arden didn't have a CGM back then she was on, you know, injections. And we had this system set up to at certain times, certain things had to happen. There was this one time before recess during the day, she had to go to the nurse to get checked and then we would kind of like bumper around with food if we had to before she went out. So I have for all of you are wearing index coms. You know, keep this, keep this idea in mind. It's art and going to the nurse. She's five years old, same ages, Christina's daughter now, and it just doesn't happen one day. So one day, the the nursing staff doesn't call the classroom and ask for Arden to come down, which was the process. The teacher who had at that point, had Arden for three quarters of a year, just, you know, doesn't notice it. The kids go out on the playground. But I know because I know the schedule, and back then Scott paid attention like a, like laser focused. So what would happen was they'd call her down to the office, they check her number, they would call me on the phone, and then I would tell them what to do. And this happened every day before recess. So a couple minutes after recess goes by I don't get the phone call. I tried to be reasonable. 10 minutes later, I call the school I get put through the nurse's office. I'm like, Hey, I did not get my call about Arden pre recess. And the woman that the nurse who I still know is like a friendly like neighbor. I just heard it go, oh, Arden and then she hung up the phone. And I was like what? So I'm sitting there like she hung up on me. And I'm sitting there and five minutes later the call comes. Hey, Arden's blood sugar's like 50. Another student came into the nurse's office was an emergency around his heart, they had to put him on a heart monitor at the exact time they were supposed to call and have already brought down. And so I had been telling them that this process that we set up wasn't good enough for ever, and they would ignore me. This is the day that Arden got somebody to help her with this. And we took it off the nurse because I, after Arden was okay. Put myself in my car, drove over to the high school where the superintendent work, walked into his office demanded to see him sat in his outer office until he saw me sat down, explained the whole thing to him, and then said, Do you think it would be cheaper to hire an aide or for me to sue you when my daughter dies, which do you think would be easier for you? I was like, because if you guys kill my kid, I'm going to spend the rest of what I'm assuming is going to be a long and sad life making you miserable. And I just want to be clear that I'm not that person today. But I think I would be that person later. So many goes here, we'll get her an eight. I was like, great. There we go. Like so Arden had to almost pass out by the way, they found her on the monkey bars with our 50 blood sugar. Like, like up on the monkey bars. So if someone were to say to me, the beeping makes me nervous. I think I would laugh at them. And I'm feeling bad about that as I'm having that thought.
Christina 58:33
Right? Like well and too, I mean so, so there you were advocating for your kiddo. And also, I think for me, it didn't really put me off when they first so first of all, they didn't they weren't necessarily telling me in those words, you know, the beeping is stressful. That's my teacher perspective coming in and knowing what it's like to be teaching class and then to have to have a lot of interruptions whether it's beeping or some other I mean there's 1000 things that interrupt your teaching in a day so I just want to be clear that that was not like the teachers complaining but just that they did they did talk about how the alarm seemed like unnecessarily low like when it was going off because we because we are checking it through so often so that's why like I said I was okay with like, doing that system and at that has worked out bring it up to 180 is totally fine.
Scott Benner 59:30
Lovely that you guys found a like a workaround that worked for everybody. I think that's amazing. And, you know, but I would tell you that I was once told, you know, well, we're not going to correct Orton's budget or that's not what we do with the other type ones and I was like so there are four type ones walking around the school have a one season the eights and you want me to shoot for that
Christina 59:49
like right and that that actually we did talk about as well because I as part of the conversation about raising a per you know her high alarm that was brought up like she is the most managed type one that we have. And you know, and just kind of saying that, you know, most most kids, they're a high alarm goes off at 200 or something. And I said, well, that that's not, I'm not okay with that, basically, like, I had to say, I'm not okay with her sitting at 200. And so I did have to push back against that. And I did say I'm okay with bringing it up to 180. But with the, you know, what, with the understanding that she's going to be checked, and so it was a little bit of that, like, No, I'm not okay with this. I'm only halfway here. As long as this is also happening,
Scott Benner 1:00:39
you are so lovely, because I probably in that same situation would have said, I want you to imagine many years from now my daughter is seven years old, and she drops dead, but she could have lived to 77. But you the beeping was bothering you. And I would have said something completely. By the way, I'd go against everything I've said earlier in the podcast, which is don't be adversarial. Right. And I want to be fair, I was only adversarial. Being serious in the office with the door closed with the superintendent. Like with the nurse, I completely understood the kid with the heart monitor, I understood the situation completely. It wasn't their fault. It was a weird scenario. But that wasn't my point the entire time. Like I can't just leave this up to like, hopefully that the nice lady remembers to call the class.
Christina 1:01:27
Yeah. And you know, we, we had gotten her so stable and stuff before kindergarten, kindergarten happened. And then like I was saying, there's just so much change that has happened this year, that we have the opposite problem, you know, we don't even really worry, we're not have to worry don't have to worry about the highs as much because we're constantly trying to figure out the lows. And I really think a lot of it. In addition to the changes that we've noted in the changes in her schedule and activity, a lot of it just has to do with her growing. We have noticed that with Annie, I think we talk a lot about I hear a lot about high blood sugars with hormones, we get kind of this weird thing where she'll go high, you know, at night. And we'll have to do with Temp Basal, and then she'll go low during the day. So I don't know if you've heard anyone else talk about that. But a lot of times when she's having a growth spurt for like, a week or something, you know, she needs more insulin at night, but then during the daytime, we're fighting lows. It's really interesting. Yeah.
Scott Benner 1:02:27
I mean, you just have to be flexible about it. Like when that happens. You you know you're gonna have to I mean, does the teachers have any comfortable? Like, can you set temp? basals? Yeah, yeah, so
Christina 1:02:44
yeah, exactly. Yeah, it's nice. So I can just come in quickly do it, or a couple times, they've walked her down, and I just said, a Temp Basal. And that helps out a lot. What's frustrating, I think one of the more frustrating things has been, you know, we'll notice a pattern, we'll make changes in our pump. And then, you know, that'll be good for like a week, and then she'll gotta go back to her other her other pattern. So there's just a lot more of that this year. And it's been a lot more of a roller coaster. And I think just a lot of it, like I said, has to do with the amount of change physical change that she's going through
Scott Benner 1:03:16
almost a lot of growth, right. Yeah,
Christina 1:03:19
I mean, I'm almost to a point where I'm noticing a pattern that I'm just setting a Temp Basal for like a week, and then just backing off with them again, because every time I feel like every time I go in and change something or pump, it's like a few days later that all of a sudden, it's back to where it was. And I'm like, Okay, we did, we did have to bring down her carb ratios to like once we switch to the Omni pod, we had been bringing down her BS rates because she was constantly going low. And it was interesting, because when you're looking at her line, it was just flat across the whole day, but Skerton that low line, and and she was getting a lot of uncovered carbs. And so we kept bringing down our basil thinking that that was it, because she wasn't like having a huge crash. It was just like floating below. And then it was they were ridiculously low. At one point I decided this cat like I if I give her any less basil. I just don't even like let's try carb ratios. And that actually ended up helping quite a bit. But it was weird. It was kind of like almost reversed of what you would expect would need to happen.
Scott Benner 1:04:17
Well, there you know, there are people who manage to different ways they like there's a lot of different ways to manage. You could manage good solid basil that holds you nice and steady away from food. Or you could be one of those people who uses less basil and crushes meals with a lot of insulin. And to me that's I don't know if there's a right or wrong way. I mean, I guess it's obvious if you listen to that, I think the way to do it is to start with basil and then get your meals right but you know, that comes from a lot of MDI people I think, like Yeah, you know, like there's not an MDI. A lot of times you'll have a heavier Basal than you end up needing when you're on a pump. You don't realize it and you're maybe you're just eating In the right times, or you're feeding your lows or something like that, but I can see how if you had stability and we're in, it wasn't crashing low, that you might have thought basil for up. But that's really cool that you figure that out, too.
Christina 1:05:12
Yeah, it's doing a lot of work. And it's again, it's like, we'll figure it out. And then the other thing, too, she got her COVID shots. So you think about that, like, she got her flu shot one week, next week, she got her first COVID shot. And then two weeks later, she got a second COVID shot, I mean, between their two, like we had crazy numbers. So basically, pretty much from the time that she has started in August, she had like, a few weeks of really stable numbers. And then beyond that, we've just had so much change. And I think, basically, we're still working on getting her all figured out. And I and I think the big change that I've seen with our team is less fear about the number. So I she has an amazing teacher, he's really actually very interested in learning more about type one, he's actually started listening to a little bit of your podcast even because he just finds finds it fascinating. So we've kind of scored there. And he's just worked really hard to just know how to respond. And he he's actually been able to predict kind of what how will the other good thing about the text message that is that they see the patterns and how we respond. And so they get feel a little bit more confident in what they would do you know what I mean? So it's like, I, you know, I, this is the number and then he'll guests kind of make a guess about what I'm going to say, and see if he's right. So their instincts are growing.
Scott Benner 1:06:36
I like that. That's a great way. That's how I do it with Arden, actually. You know, just like, hey, what would you do here? When she was younger? Like what do you think this is like? What do you think the right numbers? How many carbs? Do you think this is like that stuff all is? It's a great way to learn this?
Christina 1:06:52
Yeah. Yeah, no, that's been good. So I guess like my advice for my, you know, big takeaway advice from this. And like I said, by no means is this a perfect thing. We haven't got her totally stable. We're still figuring it out. Oh, the other thing, too, it's cold now. And the other thing to think about with COVID is that we have to keep windows and doors open. And we've had a super crazy winter here. It's been snowing and stuff, we've got snow on the ground right now, which is not normal for this time of year. And it's freezing. So she's in a classroom, and it's cold. And I think she's just like burning a ton with her body trying to stay warm.
Scott Benner 1:07:28
I'm confused. You have to open the windows because of COVID.
Christina 1:07:31
Yeah, so with COVID, you want to keep airflow. So you have to like I turn up my heater and stuff. But the idea, of course, being that more airflow, the less likely that you're going to have an outbreak in your classroom. Gotcha. Yeah. So my big takeaway for advice is just you know, one thing is, you know, pack snacks. So we have pack two recess Snacks, where they have two recesses, the other kids just have one snack recess, but Annie always has snacks before her recess isn't. And we also pack a snack on Pete for PE days, kind of like you were talking about how you know, just pump are full of little extra carbs, which has been super important. And then I would say, you know, this system that I'm talking about, we're on a thread, the benefits would be, you know, take some of the stress off of decision making for the team for the nurse and the teacher, there's increased communication, we always know how her day was where she was at. So we don't really need to look at her data, there's a much faster response time to her needs. So instead of having to go through the office or something, it's immediate, it feels like a team. And it's easier for the team to kind of notice patterns and how learn how to respond to her numbers based on how we respond to, you know, whatever texts are sending to us. And it's also nice, because the staff can input in from you know, suggestions too. So for instance, if my husband responds, Alright, go ahead, and, you know, cover her snack or whatever, their nurse, sometimes we'll pipe in and respond, you know, remind us, hey, just a reminder, she's got music, and they do a lot of jumping up and down and music. And so I'm like, Oh, that's right, let's, let's keep the two grams uncovered or something. And so it's a nice little safety net, and it feels like it's kind of going back and forth. And that we're all I'm all have eyes on it together. Yeah. And the challenges of that the what we're doing, of course, you got to have a teacher who's on board and a staff that's on board. If there's tech issues, like sometimes her teacher, someone has gone to send a picture of it, and that's not working or something, you know, usually that warrants a phone call, that always warrants a phone call instead, which is not a big deal. And that, you know, the classroom teacher might feel overwhelmed or uncomfortable with an interruption to the day. And I think again, that's where the teacher perspective comes into play, like recognize just recognizing that there is there the classroom is so dynamic, and so it is very triggering to kind of hear feedback about numbers and alarms and also We'll just try to imagine like, trying to imagine, like being in a room trying to herd a bunch of kittens around while like something's on fire, like that's sometimes what teaching feels like. And so, and then also having like this alarm going off, it's just a very, especially with young kids. There's a lot of needs. And so taking those deep breaths when you're having those conversations can be helpful. And
Scott Benner 1:10:29
I can tell you that, you know, first of all, it's good to remember that when I'm talking about when our son was younger at school is a really long time ago. Oh, yeah, well, and
Christina 1:10:38
like you said, No CGM. That's, that's scary enough.
Scott Benner 1:10:41
Yeah. Well, even the idea of like, why couldn't the nurse set an alarm? The nurse couldn't set an alarm because cell phones didn't really exist,
Christina 1:10:47
right? Yeah. Oh, my gosh, I didn't think of that. Yeah, you're right. It didn't come for another year or so after that. We're just like snapping a picture.
Scott Benner 1:10:55
Yeah, yeah. There's no, there's no taking pictures of anything. And nobody had an iCloud account. And a lot of stuff didn't exist. But, you know, what I can tell you that I think has been most valuable through the whole journey was that in the beginning, we had some sort of thing in place. And then if the thing didn't work, we adjusted it. And if the school was helping, that was great, and if they weren't, then I pushed back. But I did not push back just for the sake of pushing back, I pushed back when it was a dire situation, right, plenty of little things that happen, that I could have gotten upset about that I let go. I think I left that school. That elementary school people liked Arden and didn't have a bad feeling about or or me, which I took is a great accomplishment. And why that was very important, is because then when I went to the middle school, to a new place, and tried to explain to them all over again, this thing we've been doing now for years that was working great at that point, they right away, threw their hands up like, Oh, that's not how we do it. But you know, who I brought along to the meeting? I brought the school nurse from the elementary school, who said, you should probably just listen to this guy. Yeah. And so I had a friend and I moved them along. And by the way, when Orton went from the middle school to the high school, the middle school nurse came with me and said the same thing to the high school nurse who immediately heard what we did, and said, No, no, no, we won't be doing that. And I went, Oh, we are. And you know, and she's like, well, I like to know the kids with type one. I want them to be in the room. I'm like, I don't care if you ever meet my daughter. Yeah, yeah. You know, so like you you're there's this transition that always happens in every year, I would strip out any unnecessary stuff from the 504. Because you're gonna find that the 504 plans when they're younger, are overkill as they get
Christina 1:12:40
older. Yeah, absolutely. I'm excited about that, actually. And the reason
Scott Benner 1:12:44
that's important is because it gives the teachers less to be nervous about. So take away the stuff that doesn't matter as you're moving forward. And, you know, having snacks in every room or hidden around the school, you'd be surprised as they get older and older into into high school. What that turns into, like, for the last handful of years, we take, listen, I'm gonna tell you something right now. Arden takes in an omni pod, an omni pod, no insulin, a glucagon? Four or five juice boxes and some test strips. Like, I don't even know why we throw the test strips in there. Yeah, yeah. It's to make the nurse comfortable. Right, right. So what if Yeah, so we'll put this in, because they're like, oh, we have a drawer for her. And I'm like, yeah, she's never gonna come here. But that's not right. And so like, here's some things that make you think I'm taking you seriously. And then that makes them happy. Now this is more 10th 11th 12th grade. And you know, Arden's got a juice in her purse. Yes, that's the extent really, of how we do it. Now. Although I will say this year as a senior, she has a teacher who pulled her aside and said, I bought a whole bunch of snacks. And he opened up a drawer and he goes, these are for you. Oh, she came home. And she was really touched by that. She's like, he bought like all kinds of food in case I get well, and you know, and one time this year, it actually came up where Arden had a low that that we couldn't fix with the juice. And her options were go to the nurse and get the juices that we stashed there. Were I guess she has some in her car, she could have went and got but she's like, I'm just gonna go over to his class and grab, like one of the snacks he has for me. It's really sweet. Yeah, so it just it's going to morph. And yes, I mean, my best advice is, like I said, just set it up so that it works. You know, hope to hell, you don't run into people who aren't going to be helpful because you have a really, you know, a great system. They're set up with great people. I've also interviewed people who that the teachers and the staff, they don't want to be involved at all, you know, right. And that's a different problem, obviously, yes. But at the communication and get get a system in place that works as well for your situation as you possibly can.
Christina 1:14:58
Yeah, absolutely. And you That's like the big thing too is just like expect, expect change. So, obviously, but sometimes dramatic change, like I said, I mean a lot has, for instance, when we went in thinking that we were going to be dosing for fat and protein still, we don't doser fat and protein at all at school, because she just burns it off, you know, she's just running around like a banshee just like playing like crazy. And I when I see her at school, on the playground, she is just red cheeked huffing and puffing like going crazy. So I think that probably it also just depends on the kind of kid you have to you know, not everyone is Annie. But, you know, I think just like, realizing that those first months, possibly even up to for six months to a year, we're just collecting data and trying to figure it out and and just expect some pretty big growth spurts at this time, you know, yeah, there's a lot of hormone fluctuations. And that's been, that's been something that I didn't really expect. And, and again, just like I said, everyone's been very accepting of her. And so if you have any anxiety about your kiddo starting out, it really isn't as scary as you would think it
Scott Benner 1:16:11
is. Everyone goes to school, it'll be okay. Yeah, and hormones were just to get their period.
Christina 1:16:17
I know I am dreading or laughing
Scott Benner 1:16:19
at you right now. What do you think of that?
Christina 1:16:21
I know, I know. Seriously, I think about that, too. And like the cash, this is just kindergarten. One interesting thing. I know we're close to that time. We had we did have a slip up on our end. We had you know, we should we put sticky notes on her lunch with the total on it. My husband had written, you know, 32 grams on her lunchbox, but he had accidentally like looped the end of the three. And so it kind of looks like an eight. So I was in class and I look at the letter CGM. And she is just tanking like dropping and like what is happening. And they had dosed her for 82 instead of 32.
Scott Benner 1:17:02
See, now that's interesting to me. The nurse didn't notice that one day, suddenly, she was getting four times. Well, this was in
Christina 1:17:09
the very beginning. This was literally like, first lunch. So and they don't have any perspective, right
Scott Benner 1:17:15
at that point at that point. Okay. I understand. At that
Christina 1:17:17
point, they don't they notice the pattern over time, like now, if that had happened, again, they would have been like e to that's like, way different. Right? But at that point, they don't. And as a matter of fact, you know, we have kids who, when the nurse was talking to me about this later, she was saying everyone's different, like every type one needs differently. So you had some kids who they might actually eat at to your, you know, grams of carbs in a sitting so it's not really they don't I have no reference. So just be really kind of, you know, clear about
Scott Benner 1:17:49
I understand, hey, did the did the cops have to come when you beat your husband when you got home? Or did you?
Christina 1:17:55
Oh, my gosh, I I actually I felt so I felt so bad for the team. I I've never seen her her teacher looks so just just hangdog. So down. I felt so I actually felt like are you okay? Because he was just so worried I was it was just like, this will never happen again. I was like, well, on our end, either. But really, when they showed me the stick, and I was like, oh no till that toy, it looks like an eight.
Scott Benner 1:18:23
My husband will never make this mistake again. Because his hands are broken, and he can't write. So
Christina 1:18:28
well. And her and her teacher made a joke like, you know, I can send home some handwriting sheets for
Scott Benner 1:18:33
which I thought was pretty funny. You should definitely still do that. That's great. I
Christina 1:18:38
should have put some in his stockings
Scott Benner 1:18:39
to practice your cursive on these dotted lines.
Christina 1:18:44
Oh, yeah, it's been good. It's just been, like I said, you know, a lot of me kind of having to step back and reminding myself not to be judgmental of the journey either. And just recognizing like, man, we've been through a ton of stuff this year. And of course, her blood sugars are going to be need some kind of constant adjustment right now. And just being okay with that. And so,
Scott Benner 1:19:07
I'm just gonna say this to everybody listening, if you think that your insulin isn't gonna be constant adjustment through your life with diabetes, you're fooling yourself.
Christina 1:19:14
Well, I think that's also part of it, though, too, right? Is that I'm like, I'm, I feel this pressure to kind of get her to be like perfectly even throughout the whole day. And then I'm because I feel like, like, it's just crazy. And then there's the other part of me that's like, but she's always going to need adjustment. You know what I mean? Yeah, so I guess that's where I'm at in this journey is me trying to see what normal looks like at school because it is different now. So I'm trying to find the new normal and trying to get her to the most stable spot. And I'm just starting that journey of seeing like, what is a pattern of like, how often I'm actually having to make changes. So that's where I'm very much a newbie. Yeah,
Scott Benner 1:19:59
just because that you don't forget that your new normal might only last for three weeks.
Christina 1:20:04
Okay, yeah. So basically what I'm hearing you say is this is normal. Yeah. And this is this was art in in school. Yeah. Like she was constantly making adjustments
Scott Benner 1:20:13
you, you're because you're newer at it. And you're just seeing this for the first time. You're just you're seeing the same things I saw, you're thinking about them backwards of how I would think of them. So you're, you're seeing she needs more, she needs less activity, like, how do I find normal? Where do I get this? So it's on like, autopilot. Again, I don't think about diabetes like that. Like, I just think it's going to change and you just, you just adjust with it. So there are days when she'll need more and days when she'll need less and you just give her more or less.
Christina 1:20:44
Okay, that's helpful for me. Because yeah, I just feel like, Man, am I just not doing a good job with this? Because like I said, before she wanted to school, it was pretty, like I didn't really think about it that much. And even when she's at home, yeah, I don't really think about it that much. Because she's
Scott Benner 1:21:01
you found the pattern that works,
Christina 1:21:03
right? But school is such a dynamic place. Like I said, yeah, there's more
Scott Benner 1:21:06
going on. And there's and those are all variables for diabetes. And a lot of the very opening it wants to
Christina 1:21:13
write exactly. Okay, here's how helps me just to hear that. Yeah, I
Scott Benner 1:21:17
would judge a here's how I would judge your success or failure. Not to use words that some people don't like, but I have a limited vocabulary. So. So here it is, How frequently does her blood sugar get into an emergency low situation where you're in a panic?
Christina 1:21:34
Well, it depends this year more often than normal. And I guess it depends on the week and a week. I mean, like I said, we've had so many variables, but I would say in a week. She like the week before we left for school. She was getting there probably like once a day. Okay, like a panic, panic being that she has got a low well, so her low alarm goes off at 75. Okay, so you're gonna miss time respond. So that's not panic. But if it but panic, as in maybe she's like, 6620 down, and she's like, on the playground or something.
Scott Benner 1:22:10
Here's the thing, I would adjust your theories about panicking. And then that would be one thing that would help. So I think you're doing good there. What's there anyone say?
Christina 1:22:19
Her last day when she was 6.3?
Scott Benner 1:22:23
And how frequently do you think she's over? 180?
Christina 1:22:28
Well, she's been going high at night. We just started sending Temp Basal. The last week, she has been going high at night, like every night. And then we just were like, just set the Temp Basal. So that was taken care of. Do you mean Hi, what put a number on high for her is 140. Okay,
Scott Benner 1:22:43
you're doing great there. I told you. You're doing fantastic. So your kid has had diabetes for a couple of years, just started school. You had you were living through COVID There was a lot of like, stability, because there. There were far fewer variables. You've introduced a ton of new variables. You have a low six a one C, she doesn't get emergency low more than a couple of times a week, and you don't normally go over 140.
Christina 1:23:11
Well, she'll go over 140 her high alarm has over 140. But I get your point. We're doing all right, you're doing great.
Scott Benner 1:23:18
Listen, I'm gonna say something to you that I end up saying to a lot of people more privately than on the podcast, but I'll say it here. Your desire to do well. Is why you're going to do well. Yeah, yeah, it just it just takes time. You need to have these experiences they have to happen kind of over and over again so that they start to make sense to you. So that you're not chasing them around, but more making meaningful adjustments. Yeah, you know what I mean? Like there's Listen, art and didn't seem to feel well, yesterday. This is Christmas break. She was just very kind of like laying around quiet. She had food that I thought we Bolus pretty well for. And then suddenly, it just, it got away from her. And I got it and she tried to Bolus like before I got to her and it just didn't happen. Like her blood sugar went up to like 200 and it sat there and we crushed it. And it just went up more.
Christina 1:24:18
Yeah, that's happened to us recently, too.
Scott Benner 1:24:21
So it took me a minute to go okay, like I don't know what happened here. But I can't be making incremental adjustments to this. I have to throw a lot of installers to fix this. And and I did and will that happen today? Probably not. You know it but it might and if it does, I'll do it again. But what I was good at was pivoting like I didn't get stuck in dough. This should be working. I got I was like able to look and go this doesn't work. Do something different. Yeah. And
Christina 1:24:54
there's been a lot more of that this year where I have no clue why she is the number that she is. Like I'm just like This is unexplainable right now. But we'll just deal with it. But it's just it's I think it's been a weird year that way. And I guess I'm, I guess it's a little, like a little baby Prelude prelude to puberty. But because I know that it's like crazy pants around puberty time with with blood sugar numbers, yeah. But I can I can understand like, why, you know, it's just, it's frustrating when they're going through a lot of change hormonally to just because you're like, Okay,
Scott Benner 1:25:25
I guarantee that two years from now. Well, that's unfair, because this might take six months to come out, let's say three years. So now, they say three years from now, if you go back and listen to this again, you won't recognize the person on this recording.
Christina 1:25:39
Yeah, very interested. That'll be Yeah. So this, this even helps, though, like hearing it, because like I said, we don't have anyone to really compare to.
Scott Benner 1:25:47
Yeah, no, I understand. Listen, part of my job is just like, like, you know, you know, when the coach like slaps you on the boat, when you run out in the field, and I go get him, you're doing great, you know, and he, and you run away, and he's like, Oh, this guy's falling apart. But like, it's his job to go like, you're doing great. Sometimes it's my job to tell you, you're doing great. Because you are, and you don't know it, because you have nothing to compare it to. And it feels like an utter failure, because you had such crazy stability earlier on. Now, who knows? If it was she was more sedentary because of COVID? Or maybe she was honeymooning a little bit, and you didn't realize it. Yeah. Like there's all kinds of things that could happen. But if you keep assessing her if you assess her Basal, and remember that she's going to keep growing and as she gains weight, she's going to need more insulin. If you keep doing that, you're going to be fine. The biggest favor you could do for yourself is stop to stop expecting that you're going to find like the place where it's all sweet spot. Yeah, yeah, there's there's no sweet spot so far that I can find an artist. Okay. I just had diabetes for 15. I don't know, hold on a second. to seven. Yeah, like 15 years. And the amount of times where I've sat back and gone. I've got it. It's over. It's very infrequently. So
Christina 1:27:02
yeah, yeah. Okay, that actually helps me, I feel like I can remind myself to put that one down a little more than
Scott Benner 1:27:08
Yeah. And if it gets to be too much for you just walk into the woods, and
Christina 1:27:15
perfect, I have a lot of, you know, what's around here, so
Scott Benner 1:27:17
I just wander in a direction and tell your husband like, I'm done goodbye.
Christina 1:27:23
And Backdraft
Scott Benner 1:27:26
it all I can do can't do anymore. Gotta go. Now you're gonna be you're one of those people who's going to be terrific. You just have to stop fighting with reality.
Christina 1:27:37
Yeah, that's helpful to know, I'll carry that one with me.
Scott Benner 1:27:41
Good for you, I listened. It's a hard adjustment to make, because it feels like it feels like it's a problem that you're going to solve. Instead of a life you're going to live. And it is just not listen, you know, are into diabetes for a really long time. And just the other day, I found myself getting in the shower and thinking, this is not what I thought my life was gonna be like. Yeah, and I felt sad about it for a minute. Yeah, it's not what I thought her life was gonna be like, I don't want any of this to be in my life. Like, I don't want this for her. But there's no amount of hoping or that's going to change that. So you might as well figure out how to do it. Well.
Christina 1:28:29
Yeah, and that's a big push for me is like, No, I don't, I don't want to I need to see me responding in a very, like, negative emotional way to her numbers, you know, because I really want a model for her like it's a number and this is what we do next, you know. And, and I think that that's also one really great thing about her team is that they're all really really positive. Even admits that yeah, chaos. So I think that that's probably one of the biggest things that I'm taking from this conversation too is just reminding myself of that goal. Yeah, it's good for you
Scott Benner 1:29:07
listen. Try to keep your variability lower so not as much up and down. Don't be feeding basil. You know, don't be feeding lows. You know, Pre-Bolus your meals try to stop lows before they happen without causing rebound highs. It's pretty much it just timing and amount on the insulin and just the rest of it is not getting sucked into the into that other stuff, Whirlpool where you just constantly worried and anxious and concerned that you're doing a bad job, like like that, that you thought putting up her alarm at school was an indication that you didn't know what you were doing. tells me you have a lot of like, personal stuff to work out around it. Yeah, for sure. Yeah. So little therapy wouldn't hurt. Yeah. That's all. Your thing. Are we good? Did you? Did we talk about everything that you wanted? Yeah, I
Christina 1:30:07
think I think I think I said all the things that I wanted to say, excellent. I hope it's helpful to people who are starting the journey themselves. So
Scott Benner 1:30:15
I appreciate you taking the time to do this. I think it was really helpful. And I'm being texted by my children who are like you said you would cook 20 minutes ago?
Christina 1:30:25
Well, I really appreciate your podcast and your time. So thank you.
Scott Benner 1:30:28
By the way, they can cook for themselves. This is laziness, that they'll sit next to me while I'm cooking. And be like, Oh, look at him cooking their backseat cooking. Yeah, yeah. Oh, they will do that to you don't do this. Right. Like, just take the thing and do it yourself. Tastes good that way. The only mistake you made was having kids. Other than that you're doing great.
Christina 1:30:52
Yeah. All right. different paths, that's for sure. I just
Scott Benner 1:30:56
just 20 years from now, you might be making them eggs. And they while they critique that your eggs are too moist.
Christina 1:31:01
Right? All right. In my cooking class, they said,
Scott Benner 1:31:06
Oh, yeah, because they know anything. Trust me. Right? This isn't gonna end and it would have just been something else if it wasn't diabetes, so don't feel like you were like, seriously, you would just be upset about something different. Right? Right. Anyway, I really do appreciate you doing this. We'll hold on for one second for me, of course. Yes.
Uh huh. Huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox. you spell that GVOKEGLUC AG o n.com. Forward slash juice box. And to get your free benefits check from us med go to us med.com forward slash juice box or call 888-721-1514 Thanks so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Before I go, I'm just going to apologize for the reference I used at the beginning of the of the show. I've done a little checking. The mandrel sisters are in their late 60s and early 70s and Lawrence Welk has been dead for three decades. And so I'm realizing that the reference I used was from my childhood, which was 40 some years ago. Anyway, I hope you enjoyed the program.
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#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.
If you're using insulin, the Dexcom G six continuous glucose monitor will make knowledge your superpower. The Dexcom GS six will show you your blood sugar in real time. And it will indicate to you if that blood sugar is moving in a direction like up or down. And if so, how quickly and this is all at a glance. You can see this information either on your Dexcom receiver or on your Apple or iPhone device. Arden's blood sugar's 149 right now and I just sent her a text that said push that BG look these are results and yours may vary but I'm looking at a graph right now I'm looking at the last time we used insulin the last time she ate, and I'm thinking we did not do a great job bolusing for that last meal, it's okay to correct this. I'm going to use the Dexcom to watch now as we correct, if she starts falling too quickly or not enough, I'll be able to see that in real time on my iPhone and Arlene can see it on her iPhone as well. The Dexcom G six features customizable alerts and alarms, readings right on your smart device, Siri integration. And of course, you can share your data with up to 10 followers, like I'm falling garden right now, I can do that. And so can nine other phones. If we desire dexcom.com forward slash juicebox. Head to the link learn more and find out if you're eligible for a free 10 day trial of the Dexcom G six, you can do that again@dexcom.com forward slash juice box. There are links in the show notes of your podcast player and juicebox podcast.com. If you can't remember dexcom.com forward slash juice box. Did you know that you may be eligible to get a free 30 day trial of the Omni pod dash right now. And if in fact you want to move on to the Omni pod five at some point, that's no problem either. Because with the Omni pod promise, you can upgrade to Omni pod five at anytime through the pharmacy benefit once it's covered by your insurance. Learn more today on the pod.com forward slash juice box. When you get there, you can read all about the AMI pod whether you want the Omni pod five, which of course is the first and only tubeless automated insulin delivery system to integrate with Dexcom G six, or you just want that on the pod dash. Everything you need to know is that on the pod.com forward slash juice box, click on Check my Omni pod coverage to see about your insurance coverage, you can click on on the pod dash free trial to learn more about that if you just like to speak with a specialist, there's a tab for that as well talk to an omni pod specialist. So whether you're looking to get away from your old insulin pump, where you're using multiple daily injections and looking to upgrade, you can do that with on the pod on the pod is a small wearable device that is waterproof, like you can shower with it or go swimming, whatever you want to do, you don't want to take it off. It's not connected to anything like other pumps with tubing because it's to Bliss. And it's terrific. My daughter has been using one since she was four years old and she just turned 18 on the pod.com forward slash juice box, it is definitely worth checking out for full safety risk information and free trial Terms and Conditions. Plus, on the pod promise Terms and Conditions visit on the pod.com forward slash juice box. There are links in the show notes the on the pod Dexcom. And all the sponsors Those links also exist at juicebox podcast.com. Let's get back to Thomas
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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