Scott Benner 2/27/23 Scott Benner 2/27/23

#857 Four Time Olympian

Kris Freeman has type 1 diabetes and is a four time Olympic cross country skier. This is his third appearance on the podcast.

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

+ Click for EPISODE TRANSCRIPT

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 857 of the Juicebox Podcast

Chris Freeman is back on the podcast today Chris has type one diabetes. He's a multi sport athlete and a four time Olympic cross country skier. While you're listening today, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin.

Hey, if you're a US resident who has type one diabetes, or is the caregiver of someone with type one, can you please take the T one D exchange survey for me? It will take you fewer than 10 minutes completely HIPAA compliant, absolutely anonymous, simple questions about diabetes, T one D exchange.org. Forward slash juicebox. These answers that you'll give help diabetes research. They significantly help you can be a part of that right from your sofa, T one D exchange.org. Forward slash juicebox.

This show is sponsored today by the glucagon that my daughter carries G voc hypo pen. Find out more at G voc glucagon.com. Forward slash Juicebox Podcast is also sponsored by the Contour Next One blood glucose meter contour next.com forward slash juicebox best meter I've ever used or held. I'm holding up my hand to whatever you it is you swear to like you know when they put your hand on the Bible and the courtroom you're like I swear to tell the truth, the whole truth, not the truth. So yeah, Contour Next One. I love a contour meter contour next.com forward slash juicebox. There are links in the show notes of the audio app you're using right now. And links at juicebox podcast.com to G vo Capo pen, contour, and all of the sponsors. I am

Kris Freeman 2:23
Chris Freeman at diabetes for over half my life now I'm 42 years old. But I've had a pretty good run with it. I've skied in four Olympics, cross country skiing, I've done some Ironman triathlons, I've got a awesome family. So diabetes has not kept me from doing what I want to do. It's just made it

Scott Benner 2:48
interesting. Interesting. So funny word. You are saying those words and at an interesting time, because last week, I put out an episode where I talk to a therapist about that phrase that people say diabetes doesn't stop me. And we talked about how it's kind of a, like a two pronged thing. There are some people I've witnessed, say it and what they mean is, I'm on top of it, my blood sugars are great, you know, blah, blah, blah, I'm living a healthy life. diabetes doesn't stop me. And some people say, from the perspective of like, well, things aren't going great. But, you know, I still went out, I still did this thing I do the things I do. And even though my agency is blah, blah, blah, I don't let diabetes stop me. That's interesting. You know,

Kris Freeman 3:37
I've definitely noticed that too, you know, with all my travels to various diabetes events and stuff, I hear that as well. And you get some people that, you know, it doesn't stop me I went to this event I passed out. And I ended up in the ER, but it doesn't stop me. And I'm not, you know, I'm not I'm not going to judge anyone for not being able to manage their disease because it is a difficult disease to manage. But to me, it sounds like it did stop you.

Scott Benner 4:04
Yeah, no, it's just it's and we talked all through the different perspectives and why someone why it's still a great feeling to have, like, I'm not I'm choosing the most generous side of it by thinking that people are saying, even though this thing is difficult, and I am not doing what I wouldn't want to be doing with it. I haven't given up like I I'm kind of leaning into that idea, but you're just you're just an interesting person because you're incredibly athletic. And you're, you know, a healthy eater, I think probably to say the least, you're a photo of you with a Amit wearing it on the partner Dexcom. If I google your name, and diabetes and look at photos, the picture on my website from 2014 still comes up first. Because I think it was so impactful for people to see somebody as lean as you are wearing those devices and how I think success with them. Well, I

Kris Freeman 5:01
should maybe send you an updated photo.

Scott Benner 5:04
Things gotten away, Chris.

Kris Freeman 5:06
No, no, no, I'm actually, I'm actually still really fit. But we got to get the the Omni pod five up on on. Yeah,

Scott Benner 5:14
that's a good I bought the old one, I imagine that's still there, probably the original pot on you back then. But you know, it's just, you've always you've been on the podcast twice, you're on the 26th episode of the podcast, and you'll this one will probably be in the late eight hundreds. And you're on again a couple of years later. But I've always just enjoyed talking about diabetes with you because you have a very sort of no bullshit view of it. And I've always appreciated that.

Kris Freeman 5:45
I very much do have a No BS view of it. I mean, you you either manage it to the best of your ability, and it impacts your life to a minimum, or you ignore it to your detriment. Yeah.

Scott Benner 6:00
And you've never been afraid to say it. And I always I've always thought that you're, you're helping people when you do that. So I'm my first question that's been on my mind, since I knew we were going to talk is how do you how do you go from, like being in for Olympics, and that being your world and your life and what you train for and what you think about to not doing it anymore, like is the transition difficult.

Kris Freeman 6:27
Um, the transition was difficult, for sure, and I managed it by jumping pretty much right into another sport. So I was able to get some sponsors to go into triathlon. And with the goal of going to the World Championships, which I did. So I didn't train as much as I did for cross country skiing. But I had a coach, I had a training plan. And that really helped me with the transition out of full time skiing. Because it was familiar to just suddenly not do anything. I don't know how I could have handled that. But I'm also a little different in that I've had teammates from the US Ski Team that retire and they say, Oh, my God, it's so nice not to have a training plan anymore. I don't wake up and worry about training. And I don't really relate to that. If I hadn't gotten older, I would still be doing it. Yeah. I love to doing it. And I love training. I love ski racing. But you know, your body does doesn't respond to training at 42 and your maximal ability start to decline. And you can't We can't compete at the Olympic level anymore. Right. So

Scott Benner 7:42
yeah, I mean, it meant more to me, because I watched lasts. Well, last summer, we were at what ended up being my son's last collegiate baseball game. But as the game starts that day, you don't think that's the last game, right? They could have gone on it looked like they were going to. And I experienced something the game ended. And my first thought was, I didn't know that last at bat would be his last at bat. Or I would have I don't know what I thought next. But I felt like I would have enjoyed it differently or looked at it. I don't know exactly. But to me, it was just part of the game. And they were going to play again two days later. And then it hit me I was like, Oh my gosh, like this is it. And I looked around for him. And I couldn't I couldn't see him anywhere. He wasn't in the dugout, he wasn't on the field. He wasn't you know, surrounding the field. And I finally found him in the parking lot, like sitting on a curb. And just he was staring out into space. And I'm always gonna wonder what he was thinking about that, you know, after having done this thing, not not at the Olympic level, but since he was four years old, and I don't know, I just thought I thought of you about that.

Kris Freeman 8:59
I did some staring into space for sure. Yeah. I also, I also in 2018 was my last official pro ski race. And I you know, I told my coach I told my wife that yeah, I don't think I'm ever ski race again because you know, I only want to do this at the highest level I can achieve I don't want to go in and kind of half acid. But then of course it snowed in New England super early the next year and I had skiing at Thanksgiving and I went out and ski and I'm like oh this is fun.

Scott Benner 9:35
I remember this

Kris Freeman 9:37
and then I was skiing a lot and I nationals was in Vermont that year and I called up my old coach and said I think I'm gonna show up and so I showed up in 2019 and I just off of you know residual fitness I got third at Nationals. Well, maybe I will race with diminished abilities as I go on because I still really love it.

Scott Benner 10:00
You know, well, you know, to your point, my son just left a few weeks ago, he moved to Atlanta to take a job. And we're packing up his car. And I saw a baseball glove in his car. And I thought, what the hell's he gonna do with that? And now like, I don't know, like, I don't know if he'll ever touch it, or if he just brought it because he felt like, I'd never go anywhere without this thing. You know, like, but it was a it was an interesting thing. I actually we, as we were packing him up, he forgot something in the basement. And he and I went down together to get it and his, his, his bag was there, the bag he takes to his games, it has all this crap in it, you know. And he saw it, unzip. And he bent down and repacked it the way I'd seen him pack it like a million times and he sipped it up and just kind of picked it up and then sat it back down again. Like he was leaving it there, but taking care of it one more time before he left you know, and I was hard not to cry Chris but then watching him live those next months and reorder his life and and find other things that was that was interesting and and kind of heartwarming, actually. It was hard to watch him go through it but it felt good to watch him succeed and and get that I've seen you do a number of things over the last couple of years and I always have I mean, you're not my son but I always have warm feelings like that about oh, look Chris's, I don't know why he's running over this big thing and down a slide or whatever the hell he's doing. But like That looks fun. And, and it's nice to know that you're that you're still doing stuff. How do you make a living, though? Like that fascinates me. Like I imagined as a as an Olympic athlete. Their sponsorship. But how do you do it? Like what are you doing right now?

Kris Freeman 11:52
I don't make as good a living, not being an Olympic athlete. I did have some sponsors for triathlons and for adventure racing. But I'm also looking for more sponsors, for sure. I think keep it going. It it's it's really it's fun for me to do these to do these other events. Like when I was when I was competing, only in skiing. I wanted to do these bizarre races like I think I sent you a paper I wrote about the infernal pentathlon. Yep. And, you know, I look at that, and I couldn't really do it while I was training full time, because I could get hurt, I couldn't really prepare for it. But I really wanted to do it and that for your listeners, I mean, it's this insane race with a long history on Mount Washington, which is the largest peak in the on the East Coast. And it starts with a six mile fat bike, a six mile cross country ski a five mile traverse snowshoe and then you skin slash hike skinning is when you put skins on the basis of your skis and you hike up a steep hill, or four miles to the top of the head wall on Mount Washington and you ski back down to the parking lot. Wow. And when I first saw that event, you know, of course, one of my first thoughts is oh god, how am I going to manage this with blood sugar? What are what are the things? And that those thoughts motivate me because, well, I can figure this out. And it's never also like, I can figure out how to finish it. It's like, No, I can finish it, I can figure out how to dose myself for this race. And when the thing and those that's just my competitive nature, and it's it used to be about proving to myself that I was still okay, even though I had diabetes, and now I can appreciate it more. It's just the challenge.

Scott Benner 13:54
Well, how do you do something like that? Like, you know, I mean, just why don't we like go back just to cross country skiing for a second, then we'll get back to the thing that sounded insane that you just said about walking up a mountain whiskies on this game back. But just to get up in the morning and go train. Is it a similarity? You keep your meals the same? You keep your nutrition the same? Or is it adjusting to what's happening with your body day to day? I mean, how would you characterize because being able to train is the most important thing, right? Like if you show up and your blood sugars are too high, you're not going to obviously have the success that you need. And if they're too low, you can't do this thing. So and you have to train so how do you make sure that you're where you want to be?

Kris Freeman 14:37
Um, well, I'm, I've where the Dexcom GS six, so I have a very constant idea of where my blood sugars are at. And I never let them get very far out of range, using the I've only been using the deck the Omnipod. Five now for about a month. Besides that, I only had a very short dalliance with a automated system, I used some of the, you know, the off market software, but I'm not particularly adept at software and so I got off of it. But when I'm training twice a day, it's not a it's not a spontaneous thing. It's not Oh, I'm gonna train now it's there's a, there's a prep from a few hours beforehand to make sure that the sugars are right, and I'm eating the right thing that I don't have too much insulin on board that's going to drive me low. You know, I eat a snack right before I go out, I carry nutrition when I'm out there. And then for the second session, I do it all over again. So

Scott Benner 15:40
it's about eating at a time where, excuse me, prior to the training, there's no activates, you want the active insulin from the previous meal to be done before you head outside.

Kris Freeman 15:53
Either that or I want to have very little active insulin. And so you know, if, if I, you know, I can't, I can't live my life completely revolved around training anymore with a four year old and other obligations anymore. So if I want to train in the morning, I would get up and eat a very breakfast very high on protein, take a small Bolus so that there isn't Bolus driving me down when I go out 30 minutes later, and carry some carb with me while I'm going. That kind of finishes the meal as I'm out there and offsets the insulin on board.

Scott Benner 16:30
Oh, that's interesting. And when you What do you carry with you that like, while you're training? Is it like dense things? Like, like, I don't know, like nutrition bars? Or what do you do?

Kris Freeman 16:42
Well, pretty much the only time I eat simple carbs is when I'm working out, like, you know. So, you know, Google packet gels, sport beans, anything, anything that's just basically straight up sugar. Yeah. Because at that point, if the sugar is dropping, you don't want it to be a slow rise, right? I eat the complex carbs, when I'm going to be sitting around for a while or recovering from my workout. Or when I'm out there. It's it's simple, refined sugars. And generally it's you know, it's, it doesn't really matter the brand, it's some type of power bar, Clif Bar type thing.

Scott Benner 17:22
Because of your unique situation, that the way you explain it is so clear. And then when you try to apply that back into a regular person's life, where you hear like, I went to my soccer practice, or my kids soccer practice, and they always get low there, they always go Hi, this thing, or I realized that they're trying to make they want diabetes to fit into their schedule, and you're fitting diabetes into the schedule. Like I don't know if that makes sense, or not, like you're taking it into account as you're setting up your day. And I think other people can sometimes want it just to work, like, and I understand why, like, don't get me wrong, like, it's it's a lot to plan for, and you have kids running around, and where you're an adult who's leaving work and thinks like, maybe I could catch a workout here, you know, like, like, real quickly, you don't plan for it. But then even when that happens, that's when simple sugars come into play, and you kind of buoy yourself if you're getting low in those situations.

Kris Freeman 18:21
Yeah, I repeat many times people that the spontaneity is not something that is friendly with diabetes. I can be spontaneous, but it will often mean Eating More Sugar than I wanted to. or not being able to do something later in the day because of what it will impact my diabetes to do something spontaneously active. Yeah. So it's my days are very planned. And then, you know, I even plan playing with my son, you know, if we're okay, we're gonna, we have a half a mile trail down to our playground at the local elementary school, you know, I will plan for that, because I'm gonna have to chase them all through the woods and make sure he doesn't fall off the jungle gym and then carry it back up the hill. And then I'm going to want to go train again. So what I eat, when I eat and how much insulin I have on board is all very planned. And I found that you know, using the automated system, frequently during the day, I'm going back to manual, as opposed to automated because it it can't predict what I'm going to do two hours from now. And if I'm slightly high, I don't want to have it kicking in extra insulin that I'm unaware of that is going to then drive me low or poor surprise me when I'm working out.

Scott Benner 19:52
That's an interesting point is that you can't tell any automated system. I'm going for that walk with my kid two hours from now. So it's it's an thinking the moment and with its eye on keeping stability, not knowing it's coming. Have you tried the activity mode? On it? Yeah, yeah. It's not fast enough for when you make the decision to go or?

Kris Freeman 20:13
Well, I mean, my activity is pretty active.

Scott Benner 20:16
I think that's the other thing. We're not talking about Christmas. And I think you're active in a way that most of us aren't. So, I mean, like intensity. I guess it should be my

Kris Freeman 20:25
I mean, the activity mode. Yeah, that would work for going down to the playground for my son that doesn't that doesn't work for swimming 3000 meters and then going for a 12 mile run.

Scott Benner 20:35
Right? Right. That's two different things. But it is I'll tell you, it's nice to be able to.

When you have diabetes and use insulin, low blood sugar can happen when you don't expect it. G voc hypo pen is a ready to use glucagon options that can treat very low blood sugar in adults and kids with diabetes ages two and above. Find out more go to G voc glucagon.com. Forward slash juicebox. G voc shouldn't be used in patients with pheochromocytoma or insulinoma. Visit GE voc glucagon.com/risk. At some point on your diabetes journey, a person gave you a blood glucose meter. Did they say to you, hey, this is a great blood glucose meter. It's one of the most accurate ones that they ever made. No, no, no one said that. Did they say by the way, there are other blood glucose meters, you might want to look into it. I'm just gonna give you this one because I haven't here in the drawer. Nope, they didn't say that either. They just gave it to you. And you thought, Well, this must be my blood glucose meter because the doctor gave it to me. But there are many meters. And they're not all made equally. You deserve an accurate, well made and easy to use blood glucose meter, you deserve the Contour. Next One. The Contour. Next One is my favorite blood glucose meter. I know that's a strange thing to say. But we've used a number of them over the years. And this one is my favorite. Why? Bright light for use at night, the screen super easy to read. It's manageable. And by that I mean it's a good size. It's not too big. It's not too small. And I love the way it fits in my hand. It's sort of because of the shape which you'll see at contour next.com forward slash juicebox almost feels like you're holding up like a pen in your hand. I don't know how to put it exactly. You'll see when you get to the website. But the Contour Next One blood glucose meter is incredibly accurate. But you might be worried Scott all this accuracy. Is it more expensive? Am I going to be paying a bunch more money? I don't think so. Actually, if you go to contour next one.com forward slash juice box. You can actually buy it right now at a number of online venues. Walmart, Amazon, Walgreens CVS, the list goes on long target Rite Aid. And so when you get to my link, check it out. Because you might be able to save time and money buying contour next products from the convenience of your home. What am I saying? Well I'm saying that it's possible that this meter and the test strips could be cheaper in cash than you're paying right now through your insurance company for an inferior product. How crazy is that? You owe it to yourself to be using the best equipment that you can and there's no reason not to check out the Contour Next One blood glucose meter contour next one.com Ford slash juicebox

it's nice to be able to do that to let the the algorithm do what it's going to do and then if you get to a point where you're like I don't I think I've zigzag too quick for this thing I'll just go back to what I normally do and then go back for it you're probably sleeping much better on an algorithm

Kris Freeman 24:04
right away I mean I I would just like you I keep the numbers really tight and those the alarms just once or twice every night I'd wake I would wake up correct go back to sleep and I would say so and I've probably only been woken by an alarm four times in the last month

Scott Benner 24:26
wow that's great. That's such a big deal and people just you know it's it's that slow loss that you have when you when diabetes comes into your world and then at first you're like oh it's okay I you know I'm losing like an hour sleep I'll be alright or and you think you are but man six months a year into it. You don't realize how you've declined from not sleeping regularly. It's just it's difficult and it's not good for your health on top of everything else. So yeah, I would say number one thing you get out of an algorithm any of them honestly sleeping overnight, such a great such Great part of it, and the good.

Kris Freeman 25:03
I was just gonna say, Yeah, I've been very, that my hope was that it would really aid with my sleeping when I switched to it. And it has. And the other was that it would be a pretty seamless transition transition to go back between automated and manual. And it's very simple. Yeah. Um, so I've been pretty happy with that as well.

Scott Benner 25:18
It's excellent. Very cool. Are you so you're going to have to hold off on G seven Dexcom. Until Ali pod five works with it?

Kris Freeman 25:28
Um, I guess so. That appears to be the case, I'd like to get on the seventh as soon as possible. And, you know, whenever Omni pod has sent me a little evaluations of their new system as keep this thing up to date with the latest tech. I mean, come on. Sevens have been development for years. And

Scott Benner 25:52
they're working. I think it's, I mean, I can't say I'm not allowed. I don't I should say that. I don't know anything. But it's my you know, it's my anticipation that it it all. It'll happen as absolutely fast as it can. But yeah,

Kris Freeman 26:07
I also want an iOS system. I do not want to buy an Android phone. But I might have to

Scott Benner 26:11
Yeah, no, I agree. It's funny to how I'm in every walk of life. That's an issue. I was looking at some technology the other day, I think it was like a somebody who was flying a drone. And their phone was the screen to the drone. I was like, That's really interesting. And like, show that to me, and they're showing to me. And they said, I switched from this drone to this drone, because it didn't have one of the I forget which one it was one of the other phones didn't work with it. And I thought, Man, that's interesting. That's, that's a issue, like across the board, I guess. Like not, I always just think of it as the things that impact my life. But there's something I have no knowledge of, and they have the same problem. The guys over there, like I wish it would just work with this phone. And I'm like, I don't know, like, it just, it's got to stop at some point being a problem. Like I mean, I don't know, I guess I don't understand the technology behind it or why it is an issue. But I agree with you. iOS would be amazing for for Omnipod 500%. So what I don't you I'm going to ask you the same question. I asked a lot of people in this I think I know your answer already. But I want to ask anyway. Do you think at all about getting your son tested? Like through trial net? Do you ever think about that? Have you done it?

Kris Freeman 27:30
I have not done it? I do think about it.

Scott Benner 27:34
You guys ever talked about it seriously?

Kris Freeman 27:38
Well, I will talk we were thinking more waiting till he was about six years old. For now take a look at

Scott Benner 27:46
it. And then how would you see that? Would you see it as like if you know, great, there's no auto antibodies terrific? Or if there are, we'll know what to look for, like, what's the feeling inside when you try to decide to do that?

Kris Freeman 28:01
Well, I mean, if there's if there's signs that he's gonna get diabetes, I mean, I would want to know, so that I could do everything I could to prevent it. What? What is, the feeling would be anxiety. You know, I've obviously learned to manage this disease quite well, but I would never wish it on anyone, let alone my son. So

Scott Benner 28:27
yeah, that well, that's, that's the thing right there. Right. Like, just because you're you found your way with it doesn't mean a no problem. And I've just heard people talk about it. And some people like I don't want to know if it's gonna happen, it's gonna happen. I don't want to worry about it the whole time. I say, well, don't you worry about it anyway.

Kris Freeman 28:48
Yeah, I'm with you. I'm already worried about it. Yeah.

Scott Benner 28:51
Yeah. How would you not think about that, right. So I, I'm in the camp of I'd like to know, and especially with the TCL drug that just got approved from the FDA and the work they're doing with putting off diagnosis for people, just seems like knowing would be a would be the way to go. But I was just interested in how you felt about it. Also,

Kris Freeman 29:10
for my own transition, I was diagnosed so early on, you probably know the story already, but to recount it, I was training with the US Ski Team in Park City, and they gave fasting glucose tests to see how we were handling recovery. You know, so all my teammates are between 70 and 90, and mine comes back at 240. Which, actually, they didn't even tell me but that the first time it was like now if that was an error in the test. Like two months later, I was 270. And I got diagnosed, but at the time of my diagnosis, my agency was only 17.

Scott Benner 29:50
Well, all that activity was probably helping you right? Oh, for sure. Yeah.

Kris Freeman 29:56
But because I was diagnosed so early, it also really helped with transition because I still was in the honeymoon phase for a long time before I was fully dependent,

Scott Benner 30:06
yeah. And you looking back, you appreciate that that honeymoon took a while or because you hear some people talking about both ways, like people with little kids are like, I would just like it to be consistent. You know, I don't want diabetes to come full force right away, but at least it would be consistent then. But for you, I'm wondering,

Kris Freeman 30:24
um, for me, it was it was kind of it helped for sure. You know that. It took some of the some of the pressure off of managing because it helped. The downside was that I was constantly adjust, adjust adjusting doses. from month to month from year to year. What worked here before didn't work anymore. But overall, it helped to still have some of my own insulin production.

Scott Benner 30:53
How old were you at that point?

Kris Freeman 30:56
I was diagnosed just for my 20th

Scott Benner 30:59
birthday. So was that your first Olympics your training for or where were you in your career?

Kris Freeman 31:05
So I had competed in three World Junior Championships. At that point, I was heavily recruited by college, and I decided to go to University of Vermont. I went there for a year on a sports scholarship. And then the US Ski Team offered a residency program leading up to the 20 to the 2002 Olympics in Park City. And I decided to do that. And it was within four months of moving there that I got diagnosed. Wow. So I was initially kicking myself because my scholarship would have been guaranteed. And the US Ski Team, if you don't ski fast, you're gone. There's, there's no, there's no empathy there. So I was certainly feeling the pressure. Yeah.

Scott Benner 32:02
What's the first time you put a pump on? How old were you then?

Kris Freeman 32:06
I used in jet. So I was diagnosed in 2000. And I you I switched to Omni pod in 2008.

Scott Benner 32:13
Okay, so you did MDI for seven or eight years,

Kris Freeman 32:16
then? Yeah, that was all but I was doing it in a way most people don't. I was taking probably at least a dozen shots a day.

Scott Benner 32:26
You were might you were acting like a pump with it with a syringe.

Kris Freeman 32:30
Yes, constant, constant corrective boluses. I was. I was using rapid acting insulin, but I was also using Lantis. On occasion, I will use Atlantis and NPH at night, because I didn't want to have that much Lantis going through the day. It became as the honeymoon phase ended, it became more and more complicated.

Scott Benner 32:54
Yeah. So a science experiment there for a while. I have to just I have to comment that you like you're aging. So well. You look exactly like when I met you. I've embarrassed that at how I look versus how you look at right now. Like I just seriously, I if you were 12 feet away from me, I think that guy's 25.

Kris Freeman 33:19
Well, thank you. I appreciate that.

Scott Benner 33:21
It seems like you're doing really well. I mean, it's a lot, right. Like it's a lot of activity, which guests helps with that. But still it's it's hard on your body? I would imagine skiing can't be easy on you. And then the diabetes on top of that. Are you seeing any ill effects of the diabetes at this point your life or?

Kris Freeman 33:38
I have I have no written up the I know that a doctor has not told me that I got any long term issues developing from diabetes at this point. Also, I've also, aside from you know, the 7.2 that I had a diagnosis I have never recorded and a one C above seven. Yeah, in 20 years. So. So I don't know, how many diabetics are out there that have done that. And I'd really like to know, where are the numbers that are going to contribute to long term problems? Yeah. is below a seven. Enough is below six. Where's the target? And then of course, there's going to be individualism in that.

Scott Benner 34:36
Yeah. No, I think that's a question that runs in everyone's mind. Like, because I get asked it a lot. Like, where's Okay, where how high is too high or how it lows? You know, that's the other question people are like, well, how low should I go? You know, people want to know, like, if I have a low blood sugar, am I okay? If it's, you know, 65 for a couple of minutes if it's this like it's it's always that, that desire to just be Have a goal in mind, you know, I think is this important and studies come out and they go back and forth, and they vary with their answers. And then technology gets better. And, you know, we start talking about time and range the last two years, which isn't something anybody really spoke about before, then. It's a, I mean, it's to me, it sounds like you're doing fantastic.

Kris Freeman 35:23
I remember, I remember hearing about the time and range thing probably 15 years ago. So it doesn't matter what your agency is, it's the time in range. And the doctor just kept ranting on this isn't just common sense.

Scott Benner 35:40
Right? If my if my a one C six and a half, wouldn't I mostly be in range?

Kris Freeman 35:46
If my blood sugar is always 50, or 250? Wouldn't that not be good?

Scott Benner 35:51
Yeah, well, that well, yeah, but you'd be surprised how many people you know trick there a one C test, basically, by being very low, and then alternating with being high and low. And then this test, of course, comes back just showing you a you know, immediate number, and you're like, Oh, my one C six. And, but but more, I guess that it is important to be talking about because more and more I do hear people say my A onesies lower, but I'm not coming upon it. Honestly, I know that. And you know, so maybe they education did work for that. But it's just it's an interesting idea that the way they used to talk about it versus now and that I mean, you've been through some management. You know, you weren't super old when you got it or it wasn't such a long time ago, but you had a little mph in there, but you were never mph and regular. You never were in that. In that mindset, I would think you're doing great. You know,

Kris Freeman 36:43
I never had to use regular. My first two insulins I was prescribed was humulin Hema login mph. And then as soon as Lantus came out, I ditched the MPH

Scott Benner 36:56
is Lance is all you used for those eight years.

Kris Freeman 37:00
Like I said earlier, I used mph at night a little bit too. In in conjunction with the Lantis. Yeah, because I didn't want if a big enough dose of Lantis to keep me in range during night would drive me low during the day when I was working out. Right.

Scott Benner 37:16
But you never made it to like the modern ones like Joseba, or those you weren't injecting at that point.

Kris Freeman 37:22
By the time recibo was a thing I was using the Omnipod get Gotcha.

Scott Benner 37:29
Does your I'm always interested in a married situation, how much interaction does your spouse have with your diabetes? Like from none to a lot? Where do you think

Kris Freeman 37:43
she's very good about thinking and thinking about it and understanding when I have to do things because of it. She's always there to flick my syringe before I fill up my pod, you know, if I want to wear it on my back, she'll put it there. She's really good about that. But at the same time, I do my best to not have it impact my family. And the way to do that is to be in range as much as I can. Yeah.

Scott Benner 38:13
Do you have give what you would consider a fuelling style? Like, is there a way you eat? You know, some people are low carb, like, you know, vegetarian? Like, is there a way you eat? Or do you just eat what you want, but know how to

Kris Freeman 38:28
tailor my diet to my activity level. Okay, so on a day when I'm not training, which is rare, Ollie, higher protein, lower carb and lower calorie, I'll try to match my calories to what I'm burning. And then on a day, and then if I'm training a lot in successive days, I will gradually increase the amount of carbohydrate to replace it. Because as the glycogen stores get burned off, the you become that much more sensitive to the insulin in the system. And I can I'm burning that much more carbon. Yeah,

Scott Benner 39:06
you're making me think of watching my son to when he got home from when he got home from college. He, you know, in between his years, he was always training. And even at the end, you know, there's a couple of months there where he just kept going, like, I think out of like, just habit, like he just kept training because it's what he did. But on days when he was going to work out on a baseball field and lift at the same time, there's times I'd look over at him and he'd have a bowl with like pasta, and you know, like there was protein on the side. And he's chicken and I'm like, How could you eat all that and it's like, I don't even want all this, I just I need this or I start losing weight or you know, it was interesting to watch that happen because I don't think most people actually if we all thought about it a little more like that it might be valuable for some of us, but it was interesting to watch him do that. The diabetes is

Kris Freeman 39:58
really instant feedback. Back on whether I'm fueling enough or not, you know, if a suddenly my regular Basal insulin dose is driving me low, I'm probably a little bit carbohydrate deprived and vice versa. I'm driving up, then I'm probably eating too many carbs for my activity level. Yeah. But as far as do I follow a diet, I don't follow a paleo thing or a super low carb diet. But I avoid processed foods like the play. Yeah. But there's the last thing I want to eat. It's it really is getting foods in their natural form. The body just breaks them down. It's more predictable. And it I don't like use the word using the word healthier, but I believe it is healthier. Yeah.

Scott Benner 40:49
Well, you're not a person I've ever looked at and thought to ask what your favorite pop tart flavor was. So that's

Kris Freeman 40:56
all Yeah, I think it's been it's been at least one year since I've had a pop tart. Yeah.

Scott Benner 41:00
I I wonder sometimes when people talk about processed foods, if everyone even imagines the scope of what that means, you know, like, because you'll hear people say, like Whole Foods or, you know, natural, I wanted something that's natural. But processed can mean anything from pasta to bread to a potato chip, like anything that is, you know, I think the simple way people say it is like, if it comes in a box or a bag, I don't eat it. Is one of the you

Kris Freeman 41:29
can totally find organic, non GMO processed food. Yes. It's not hard at all.

Scott Benner 41:34
Yeah, right. It's still, it's still it's that the process that goes into creating that, that thing I know, some people would like, would balk at you even calling some of it food. But to create that food, your body then has to go through more of a process to break it back down again. And, you know, and there's a lot of stuff in there, you just don't know what it is. I am a fan of just I need to know what I'm eating. At the very least, you know,

Kris Freeman 41:59
and that's the it's the, there tends to be a lot of simple sugars and processed food with the fibers stripped out of it. Which makes you know, the blood sugar spike more quickly. It's just it's not a natural food. It's it's more erratic. Yeah. And it very much shows up when I when I'm trying to balance things with insulin.

Scott Benner 42:23
Can you tell? I mean, when's the last time maybe you haven't had a tough time, but I was gonna say, could you tell on your performance if you haven't eaten as clean as you want to?

Kris Freeman 42:36
Um, well, I can't tell you the last time I didn't eat clean before an event. So I can't say on a on a training day. Maybe. But I also if I was doing a heart interval session, once again, I would eat clean beforehand. It's very rare that I don't. And it's generally because there's nothing else available.

Scott Benner 42:57
Do you think that that's just how you're hardwired that like right now that this conversation isn't making you think like, wow, I have not had a cheesesteak in a really long time. Like or something like that, like, you just did you grow up that way? Was it in your family? You know what I mean?

Kris Freeman 43:14
Um, diabetes definitely changed my relationship to food. And it is. And I don't know that this is like, relatable for anybody, but I very much view food as fuel. And, you know, obviously, there's certain foods that I enjoy eating, but I enjoy being able to do the things I want to do in my day more than eating that food. And if eating that food is going to impact the rest of my day in a negative way, or impact my blood sugar's in a negative way. It's just not worth it to me. Yeah. I don't, you know, you I hear people say, a lot of term use and diabetes is I'd get to eat this many carbohydrates today. And I just, I, I guess I try to steer away from viewing food as a reward, and more as a means to an end.

Scott Benner 44:14
But the reason I asked this because I, I agree with you, and I can tell you that from in my personal I mean, you and I are not, you know, there's there's an argument to be made that if we were standing next to each other, we wouldn't be able to. Some people might not think we're in the same species. But my point is, is that I agree with you about eating and on days when I eat like that. Everything's just better. I don't know another way to put it like, you know, the other day I went out and I bought some steak, and I made it up and I sliced it up and I put it back in the fridge and you know, got up and it was late in the day. I took a couple of eggs, I threw in a couple pieces of steak, and I threw it together and I had it for breakfast. I had a great day. You know, put a I had something with a salad. I threw a little more of my steak and I did that, like you skipped throwing croutons on something like I don't put a bunch of dressing on, I have a great day, the next day comes along. I don't know why my brain doesn't say keep going. Like, I don't know why I'm not stuck in it like because I agree with it. I definitely feel better when I do it. And then, you know, by Wednesday, I don't know what happens. Like, I'm just wondering like,

Kris Freeman 45:19
because we're biologically programmed to want to eat a lot of sugar fat.

Scott Benner 45:26
It's a you're you

Kris Freeman 45:27
don't have diabetes. So you don't have an immediate consequence for when you get into it. Yeah,

Scott Benner 45:31
I don't have a thought right away. It's like, well, I can't do that. So that that is really it is that something is going to happen to me that I'm not going to appreciate, you know, somewhere between I don't know how my energy in the bathroom, basically, like in that range. And but it's not, it's not something you're right. It's not something I have to deal with in the moment while I'm eating the food. Yeah, maybe that is the difference. That's interesting. I appreciate you talking about that with me.

Kris Freeman 45:58
You know, I also I wanted to back up to what you were saying about the soccer game. And you know, kids, parents trying to figure out how to dose their kids at the soccer game. And once again, it's that I really believe that diabetes treatment starts with your diet. If you eat a good diet of non processed food, with appropriate amount of calories, that is the where you start. And then you then you go into the various treatments, the various insulins, the various monitoring systems. If you are living on if you're giving your kid Froot Loops before your your soccer game, you are not going to manage his blood sugars during that game, it's just not gonna happen.

Scott Benner 46:41
Yeah, you're gonna need a ton of insulin, either you're going to either you're going to combat that cereal with a ton of insulin, that is probably going to come back to bite you in the ass when they're running around. Or you're going to ignore the cereal, not hit it with enough insulin, have some big high blood sugar that got the kid lackadaisically wobbling all over the soccer. And then you're gonna have hours of a high blood sugar later, and probably the activity from the soccer won't even be enough to get through this arrow.

Kris Freeman 47:07
It's so you know, with all of my activities and stuff. From the scientific method, I tried to get the I'm blanking on the word, the residual insulin, what's the what's the proper word for residual

Scott Benner 47:24
residual insulin,

Kris Freeman 47:25
insulin on board? I tried to I tried to get the insulin on board down to the Basal, right. And that way, when I when I'm working out and something doesn't work, I know why. And I can go back and I can make a minor adjustment. And try again, if you're a parent trying to only correct with insulin once the game is started, it's too late, right? It's two or three hours before the game that's important.

Scott Benner 47:52
Everything you do with insulin now is for later. Yes, yes. Yeah, you're never making a decision right now that's going to impact right now unless you're saving a falling blood sugar. And that's not what I'm talking about. But I like when my

Kris Freeman 48:05
race is, you know, it is my last meal is three hours at the latest before that race. And anything I eat between then and the start of the race is only for correcting purposes.

Scott Benner 48:16
Yeah. Well, I think it's good for people to hear how it works. And listen, it's not going to be the same for everybody. They're not everybody's not going to make the same decisions. But it's always been my Well, Chris, for the last number of years in the podcast, like I've what I've said is I'm not in charge of how you eat. But I want you to understand how insulin works. If you're going to eat Froot Loops, I want you to know how to Bolus for Froot Loops. If you're not, I want you to know how to do that. I think your settings are incredibly important. You need to understand the impact that insulin has on on the carbs, you have to get those carbs and that insulin in a tug of war while you're eating so that neither of them can kind of win, you know, but in the end, my goal is for people just to live well. And it just but it's interesting to talk to you because you are doing it in such a specific way. And you're having such specific outcomes, it shows like, like, I'll tell you when if someone comes to me and says I can't figure out this time of day, the first thing I'll say is why don't you like eat something that's a little less, you know, maybe not as heavy with the glycemic load. And you know, and give yourself a chance here to understand how this insulin works. And then if you want to add you know what I mean? Like, don't make it a college level course on the first day is kind of how I think about it. So I think a package got delivered to my house. And now both of my dogs are making sure that we all know about it. So kind of going back to my question about like, did you grow up in, you know, a setting that would set you up for thinking of food and activity this way? Not so much. It just kind of worked out that way for you. But now your son's gonna grow up in a life where like his father and your wife, if I'm not mistaken, right are really active people. So do you In your mind, I know he's only little. But do you hope that he goes the route of a sport or plays in college something? Or do you have different feelings about that now that you've lived through it?

Kris Freeman 50:16
I'm gonna provide him with as much opportunity to do sport as he can. But I, it's gonna be difficult for me because of my competitiveness, but I'm gonna try to stand back as much as I can, and let him decide what he wants to do. If he wants to be an athlete, he'll be an athlete, and I'll certainly give him every opportunity to pick the sport he wants to do.

Scott Benner 50:37
So, even if it's one you don't like, what sport Don't you like? Do you have one that you just don't enjoy?

Kris Freeman 50:42
Ah, well, not really. I mean, I like playing billiards, but I don't want him to be a professional billiard player. Yes. All right.

Scott Benner 50:57
I'll take a stand right now. We didn't let our kids play soccer. But it was, it was my wife grew up on a soccer field, watching her sister's play. And I think she just didn't have the heart to keep doing it anymore. But okay, so I want to go back all the way to the beginning. You talked about I know, you sent me your article, which I'm going to put up in conjunction with the podcast episode. But you go to this thing where you describing what I mean? Sounds like walking up a mountain and skis and skiing back down and kind of take me through that. That process like, like from a diabetes perspective, how did that day go?

Kris Freeman 51:36
Well, the race starts unfortunately, really early. It starts at like, eight in the morning. So I was up at 430. Make sure that I had my breakfast in by five. And I had to, you know, I've thought long and hard about how I was going to dose for that race. At that point, I was still using, I think you would refer to it as the Omni pod three. I skipped the dash. I went straight from the three to the five.

Scott Benner 52:06
Just you went, you didn't go down. You were using arrows, pods. That's what that's what the originals were called. So you went from arrows, you didn't use a dash. Okay, so you were using that one?

Kris Freeman 52:16
Yeah, when the dash came out, I looked at the benefits. And there's nothing here that I really want. So I just kept going with

Scott Benner 52:22
what I had you were okay with that old PDM.

Kris Freeman 52:25
Yeah, well, well, I also knew that it was, I mean, I've dropped that thing riding my bike at 25 miles an hour and still works so. So I woke up three and a half hours in advance and I wore two pods. And I had each of them giving me point six units per hour, instead of my usual Basal rate of one unit per hour, and that so 1.2 and that was to offset race nerves, just little little disturbances in the morning as you try to set up your transition zones and stuff. I'll no matter how good I am at relaxing, I still get hit with a little bit of adrenaline that will raise my blood sugar's really go through the process in the morning. So then I had that set to drop down to only a quarter unit. So point two, five units from each pod for the start of the race. And I had that running for an hour. Okay. Then, oh, excuse me, I had that running for an hour and a half. Then I had it dropped to a rate of point three combined. After that hour and a half. And I left there for about an hour before I tore one off.

Scott Benner 53:51
Okay,

Kris Freeman 53:52
that's part of the reason I wear two pods is because it's very easy to make a correction by tearing one off.

Scott Benner 53:58
So this is I'm dying to know, like the process here. Like what so what's the benefit of the two pods?

Kris Freeman 54:04
The benefit of the two pods is one if one fails, which does happen still have I can instantly just changed the pa i can i can get the controller and change the dosage as I need to. So it's kind of a failsafe and a longer race. The other is that if I'm running equal boluses I mean, equal Basal rates as I'm going along, and I am trending low without having to take the time to pull my PDM out change the dose I can just pull the pot off. Interesting. Okay. Wait half my dose

Scott Benner 54:40
that well, that's that's really a Chris, you've been at this a long time. You are your own science experiment, aren't you? And so you got

Kris Freeman 54:50
I have to tell I just have to say that Omni pod I believe absolutely hates that. I wear two at a time because they that goes against every legal.

Scott Benner 54:59
I would imagine that So it's not an FDA approved situation. But you're in a unique situation, right? Doing something that No, nobody's going to do really like I mean, anybody else, you know, if their pod, their site goes bad or their pod stops working, they can change it and go along their way. But you know, those people aren't climbing up a mountain on skis, or how far was a? What races? Did you compete in in the Olympics? How far were your cross country races?

Kris Freeman 55:25
So the longest race I did was 50k. About 30 miles and depending on snow conditions, that would take between an hour 50 And two hours and 20 minutes. Wow. Whereas this race we were just describing took me so I'll go back through the events again. So I did a six mile fat bike through the snow on cross country ski trails, so it's pretty slow. But that takes that took me about 25 minutes. Then I switched to a 10k cross country ski. That took me another 25 minutes. The snow shoe was just God awful. I was through like two feet of snow and I kept postholing. Do you know what postholing is? No, I stay out of the snow. Falling is if there's like a little bit of a crust on the snow from when it melted and refroze you kind of run along for a couple of strides on your snowshoes and then all of a sudden breakthrough up to your groin. And you try to keep going. Well, I was the first one through and I was just postholing for five miles. So it was God awful. That took me over an hour. And then it's the last event is called it's actually called US Ski mountaineering and got this super lightweight carbon equipment. And you've got skins on the base of the skis. And the skins are like a fabric that allows you to glide a little bit, but also kick on the ski, so you can just run on them. And I wore those as I ran up Mount Washington, to basically the top of the head wall. And then at that point, you ski down the head wall and back out to the parking lot. Just so it was three and a half hours in total.

Scott Benner 57:11
Does everyone finish? No, no. I mean, I'm imagining there's a dropout. A significant like, what do you think? How many people do you think started? How many people finished? You know?

Kris Freeman 57:23
I don't know, I think there was about 80 individuals. And then there's a team event as well. I don't know what the dropout rate is? I didn't I didn't really look there. But for sure, when you got five events. And you know I did in three and a half hours, a lot of people are taking over six.

Scott Benner 57:45
So what would have to happen, Chris, for you to give up in something like that?

Kris Freeman 57:52
I'd have to, I'd have to have an extreme blood low blood sugar without a means to correct it. Or I'd have to be extremely high without a means to correct it. Or I'd have to hurt myself. Yeah.

Scott Benner 58:07
So obviously, if you hurt your leg, you'd stop. But what if you had to hurt myself badly? I was gonna say what if he just fell and broke your elbow? You'd keep going? Right?

Kris Freeman 58:19
You Yeah. And I think that might be that might be genetic. I mean, my, my father is 75 years old. And four years ago, he was doing a ski race. And he fell. And he broke his pole. And he hurt his arm. And he got another poll, but he couldn't really use it. You know, someone handed them another poll. And I saw him at the finish of the race because I did the race too. And I saw him skiing around with one pole and thing down as he broke his pole. And I get over there. He's a Can you help me? I think I think I might pass out. What's wrong? He's like, I think I broke my shoulder.

Scott Benner 59:04
He was, uh, let me see if I'm remembering this right that he do some sort of farming when he was younger.

Kris Freeman 59:09
Yeah, he was a pig farmer in Iowa. Okay. So, you know, I drove him to I drove him to urgent care. And sure enough, he had broken his shoulder. And I said, I said to him, dad, you know, you broke your your broken shoulder at a point on the course where it was only one mile back to the lodge. Yet you skied five miles out of the way to finish the race before you got there with a broken shoulder. Why did you do this? I didn't think it was that that.

Scott Benner 59:38
You have any siblings? I have an older brother and an older brother is the athletic.

Kris Freeman 59:44
We he was at the 2006 Olympics with me in cross country skiing. No kidding. Okay. Yeah, he was he's the loser of the family only went to one Olympics. Just one

Scott Benner 59:54
Olympics. Reminds me this week, I keep seeing the The Kelsey brothers as the lead up to the Super Bowl comes up the one guy is the Senator for the Eagles, the other guys the tight end for the, for the the chiefs, and they're trying to talk about which one of them's more successful. They've both been like, you know, a handful of Pro Bowls and both won a Super Bowl. And I was like, I don't know how you can't really denigrate one of those resumes, you know what I mean? So, yeah, just one just one Olympics. So,

Kris Freeman 1:00:24
basically, my point is, is you know, the, the way I interpret pain, it might be different than others on my father has incredible pain tolerance, so does my brother. So, you know, when I was a kid, my we would wrestle with my dad and he would make us say mercy, but he couldn't make my brother Say mercy. And he even said to me, once, my dad said to me, I can't make him say mercy, because I'm pretty sure to do it, I would have to break his arm. I'm not gonna do

Scott Benner 1:00:53
that, to give up, but I'm not willing to go that far. Well, it's a hell of a good trait. I mean, it's obviously serving you well. And it's laudable. Hey, other other autoimmune issues in your family at all, have celiac. Hashimoto hypothyroidism. Yeah. with you or with somebody else.

Kris Freeman 1:01:13
I'm borderline. I'm kind of that. I monitor it very, very closely. And if if I crossed a certain threshold, you know, I start probably having to take small doses of levothyroxine. But my father has been hypo 30 years.

Scott Benner 1:01:34
Okay. And his his Hashimotos Do you know is that autoimmune? Yes. Yeah. All right. I can't thank you enough for coming back on and doing this with me again, you're one of my favorite people to talk to about diabetes. And, and I just I really appreciate your perspective.

Kris Freeman 1:01:52
Oh, thank you. It's always fun to talk to you too. Thank you.

Scott Benner 1:01:59
A huge thank you to one of today's sponsors, G voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox. You spell that g VOKEGLUCA g o n.com. Forward slash juicebox. I also want to thank Chris Freeman, remind you to find him on Instagram, and Facebook. I'll tell you a little more about that in a second. After I thank the Contour Next One blood glucose meter contour next.com forward slash juice box when you support the sponsors with my links. You're supporting the production of the show

on Instagram, Chris is Chris Freebird, KRISFRE bi or D. And on Facebook. Chris is always accepting new friends on his personal page. Chris thought Freeman dot 5836. But you'll see him there's a picture of him skiing in this like black suit with a number one on his chest and might be a seven with another set but the number seven on the chest. Sorry. Check him out. He's great. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

#856 Best of Juicebox: Texting Diabetes

Episode 482 Too Much Insulin? was first published on Feb 23, 2015. Text messages to manage Arden's type 1 diabetes, who knew that would be so effective?! While at school or anytime that Arden is out of the house, the simple process has led to lower a A1c, better grades, an increase in self-confidence and much more.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, welcome to episode 856 of the Juicebox Podcast

Hey everybody, we are back with another episode of the Best of the Juicebox Podcast today, we're gonna go way back way back February 23 2015 Episode number four. It's called texting diabetes. I know right? Like how do you text like hello diabetes? Are you there? No, not quite like that you'll see. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise please Always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. If you have type one diabetes, or care for someone with type one, and are from the United States, please go to T one D exchange.org. Forward slash juicebox. Join the registry complete the survey. This helps diabetes research it significantly helps T one D exchange.org. Forward slash juicebox take you fewer than 10 minutes. Help people with type one help yourself maybe definitely helped me.

This episode of The Juicebox Podcast is sponsored by cozy Earth. Cozy Earth has been featured on Oprah's Favorite Things list like five times. Their products come with a 10 year warranty and cozy Earth bedding is temperature regulated and is available in either viscose bamboo which is what I have or linen. Cozy Earth loungewear offers optimal comfort while maintaining a flattering and elegant fit. You can imagine me in pajamas looking elegant, and don't miss their new waffle collection towels. And somebody online just told me they bought them last night and we're very happy with them. Now here's the best part when you go to cozy earth.com and shop sitewide no matter what you buy. All you have to do at the end while you're checking out is apply the code juicebox one word juicebox to save 35% on your entire purchase 35% What did I just say? 35%. It's an amazing amount of money. Head over Now get yourself some sheets or some socks or some jammers. I don't care what you're up to.

Unknown Speaker 2:37
Just don't forget to save the 35%

Scott Benner 2:39
you know. Welcome to the Juicebox Podcast episode four. I'm Scott Benner. This podcast is if you're just finding it a conversation about being the parent of a child with type one diabetes. Episode Four is going to take a an upbeat turn because Episode Three got kind of somber at parts, even though I thought the information was good. And I don't want to I don't want to have to bummers in a row. So although I don't think Episode Three was a bummer. I actually think it's a it's an uplifting story. It's just sometimes the topics are heavy, you know. Anyway, episode four, we're going to talk about the way that my daughter Arden and I manage her type one when she's not in my vicinity, when she's not with me. This is just a this ends up being such a great but you know, thing that happens by mistake by you know, by happenstance that ends up just informing so much of how we handle type one today. It has to do everything with an academic upswing for my daughter, it has everything to do with how an A one C that wasn't too bad to begin with is now fantastic. It has a lot to do with her confidence. It has a lot to do with the fact that she can now you know, change insulin pumps on her own. This this one moment really is a big moment. So I'm gonna take you back to Arden in second grade. She's in fifth grade now. She's going to be 11 this summer. But I'll take you back to second grade. She's upstairs in a two story house. We live in a two story house. And I need to know what her her CGM says. And to be honest, I just didn't want to walk upstairs. So I texted her, just said CGM question mark. And she sent the number back. And that was it. I was hooked. I was like, Wait a minute. Is this fantastic? But beyond it just being fantastic that I didn't have to get up and walk upstairs all the time or go find her if she was somewhere. I started realizing. Like right there. I was just sitting on the sofa thinking what's the difference between upstairs and at a friend's house? What's the difference between upstairs and in the backyard? Oh my god. What's the difference between upstairs I was at school, and there really is only one difference. It's my sense of being in control. And can you hear basil snoring? I hope you can't. A puppy he snores like crazy. It's my sense of being in control, right? It's the largely false feeling that I have that if something were gonna go wrong, I could somehow be Superman and stop it. So you can't really stop something from going long. You can plan well, you can, you know, give the right amounts of insulin, you can understand all that stuff, that stuff helps keep problems from happening. But if something unforeseen was just gonna go bonkers, that it's gonna go bonkers whether I'm upstairs or downstairs, or she's out back, or she's at her friend's house, or she's at school. We just need to be sure that there's an adult there, if that ever happens, that understands and can react, and it doesn't need to be me. And that was really a huge leap. For me, I just, I let go of that feeling that false feeling that I was somehow a guardian completely in control. And that nothing bad could ever happen if I was around. This text message ends up being the text message that launches 1000 chips, because it allows me to recognize that, you know, I falsely have an idea of control. And it gives me the bright idea that we could utilize this texting in other places, you know, when Arden's out of the house. And we do to so much success, in fact, that it starts just becoming everything, you know, it's everything. It's it's how we do school lows, highs, meals activity, it's how she goes to her friend's house and plays in the snow yesterday. It's how she's on a school trip today. Without me. It's that one little moment of letting go, that builds and builds and builds to where we are here today. So let me let me tell you some other good stuff that came from that. So first of all, in second grade, we were beginning to become concerned about artists academics, because she was falling behind in areas where we did not expect you know, as people who feel like we're reasonably, you know, we're not over or under estimating learning, we know who she is, as a person as best we can. I'm telling you Arden's grades and her grasp of concepts was not where I expected them to be for her. And, you know, you start getting worried that it's just you know, Arden is going to be a person who struggles at school. But in the end, what ended up happening was, she was leaving class to go to the nurse. And a lot of times, because of the timing of the nurses visits, it was coinciding with learning something new. So her teacher would begin to teach, she'd get out half of a thought it would leave the room come back five minutes later, and because Arden coming and going seems so natural to the teacher. And even though she's a fantastic teacher, it just seems so normal for her to come and go that it got away from her that Oh, Arden walked out during the during the explanation of this. But that didn't stop anybody from moving on the day just kept moving. So Arden would miss the direction, the instruction and then be expected to do the work. And she was struggling. We got lucky. The teacher that Arden had in second grade was really a fantastic teacher and she moved with her whole class and there's a word for it educators, it's popping and educators were heads right now I don't know it, but she moved with her whole class to the next grade. So in third grade, I didn't have to start over new explaining diabetes to someone this you know, day one was, was fantastic. But we made a big change. And here's the change we made. So we go into the 505 go into the 504 meeting after second grade in the summertime, sitting in front of a teacher and two nurses and you know, an assistant principal and I think there's a counselor there and it's me now I've been banging on these people's heads for years. Arden has to go to the nurse she's gotta go at this time. And this time she's got a test here here we can look at the CGM but there we have to test I need her to Pre-Bolus for a meal. So she's got to come down early. You know, I made them give her the aid when she was in kindergarten like there was so much that went on about Arden needs to go to the nurse she needs to go the nurses is very important. And I go and I sit down and had 504 Meeting look, everybody square in the face, thank them for the year, how great it's going. And then I say now next year, I don't want Arden Dakota, the nurse at all. I want her to stay in the class. So a couple of lucky things happen where that made that possible. First of all, her 504 plan covers her having a cell phone. The second thing that helped with the idea of Arden not having to go to the nurse's office was our outgoing governor that year, signed a bill that said that children with diabetes could test anywhere in a public school didn't have to be a nurse's office. It could be in the hallway, it could be in the bathroom. It could be anywhere you want to be so armed with the idea that a Arden was now allowed to test anywhere she wanted to, and be, I saw the light about me not needing to be so involved or anyone needing to be so involved that I thought, Okay, well, we can do this right, we could just do this texting thing while she's in class. So in that 504 meeting, after second grade, I dropped the bomb. Next year, I don't want to leave the room, she's going to test give herself insulin, you know, drink juice or eat food, if she needs it. She's not going to go to the nurse, if we can help it, and I don't want or need the teacher to be involved. It'll be between Arden and I no different than if she was upstairs in the bedroom. Now, you know, if something happens, then the teacher would spring into action. And of course, I was a little nervous about that. But because this teacher was a second year teacher that took away a little bit of that uncomfortable feeling, which is one of the lucky things. And the people in the room. You know, we had built a very good relationship slowly, brick by brick over years, people trusted me. And I think they saw a person who was like no look at she has to be in the nurse's office all the time, who flipped and said, No, she doesn't and thought, well, if this guy is saying she doesn't have to be the nurse's office, you know, maybe we don't have to. But still, you could see the the anxiety like they those nurses were going to be out of the loop. The school was going to be out of the loop. And I and in the end, what I said to them was, Look, she's my kid, if I do something wrong, if I give her too much insulin, or not enough insulin, let's be honest, it's not on you. You weren't involved. There's nothing legally that you did. So this is kind of lightening things for you. And I think that was what pushed him over the edge or like this guy's right, you know, he could, he can mess up as much as he wants. It's not on us. I think that's what they were happy about mostly. So the third grade year of school art and never goes to the nurse one time, never once. And her academics pick up.

G's really, like a like a rocket, they they go back right to where you think they're going to it took a little time she had to catch up. But, you know, now in fifth grade, I don't think of Arden as having any academic instabilities, you know, it's amazing. And that's just I'm telling you, just from not going to the nurse, third grade, no nurse, now we're going to transition to fourth grade. And in our district, that means Middle School. And I know that's probably early for middle school for most of you. And it's an overcrowding issue here. But nevertheless, she's going to have to transfer into another building, same district, different building. Different building means new nurse, different building means new, you know, new principals, new counselors, new people who don't know me, and people who have no reason to trust me or understand what we're doing. So what I did was I brought a nurse from the elementary school and Ardens, teacher to the 504 meeting for the middle school, and I just let them explain it. The nurse didn't have a lot to say she was I didn't see Arden once last year. And that's it. There were no emergencies, nothing we had to run and go find her for it. She said I think she fell on the playground, I had to give her a band aid once. But we never spoke about her diabetes, the teacher spoke to the fact that Arden was falling behind academically and took a little bit of the blame. In the meeting. She said, I really feel like I should have seen it. But it was just such a normal part of the day, he just escaped me that she was leaving all the time. Hey, everyone, it's Scott, I'm just going to take a quick second out from the show to tell you that I'm very interested in talking to you, the parents of children with type one. If you are interested in being on the Juicebox Podcast, please go to Ardens de.com or juicebox podcast.com. Scroll to the bottom, click on contact. Send me off a quick note. I would love to talk to you on the show about type one about parenting about technology, about diabetes, about your frustration, great ideas. You have questions, anything at all, anything, you know, parenting or diabetes related, though, go ahead, send a note. We'll get you on the show. Now back to the podcast. It really is a matter of perspective on it's on saying that she was leaving all the time, isn't it but because you know, as a person who is thinking about diabetes in that way, like oh, I need my kid to go to the nurse's office, she only goes four times a day. That's not too bad. But if you get up, walk to the nurse handle what happens in the nurse's office takes a few minutes come back. It could be 10 minutes, a short trip could be 10 minutes, and you do that four or five times a day you've lost 45 minutes or an hour. Now if I told you I was going to send your kid to school today, and randomly take an hour of their day away from them, you'd say no, you can't do that. When you say oh, you're gonna do it because they have to go the nurse for their diabetes. Oh, that doesn't sound too bad. 15 minutes we'll be fine. It's not fine need to be in school. It was a bit of a hurdle at fourth grade at the middle school. The nurse felt so uncomfortable not being involved, but I could see in her face this the same thing I was going through, you know back before For the texting, she didn't want to be out of control. She didn't like the idea of there being a child in that school that she wanted to keep safe and healthy, that she wasn't going to have input into. And what I said to her was, look, it's okay. Arden's my daughter, she's had diabetes, and she's two, I know exactly what to do, we are going to talk all the time. And if there's a failing in the system, then she'll come to you. If she can't get a hold of me, or I can't get a hold of her, then she'll come to you. I said, but no, this if our text me from class and says, Hey, my blood sugar's 60. And it's falling. I'm not sending her to you, I wouldn't, I wouldn't call an ambulance at home. So she's gonna drink a juice box, she and I are gonna stay in contact over those next couple of minutes by text message. And when I'm comfortable that she's stable again, she and I are going to stop talking. And that's going to be we're going to keep going about our business. Nothing special. So couldn't be more, genuinely couldn't be more happy or proud to tell you that in fourth grade. Arden never went to the nurse for a diabetes related situation. She was down there if you know her insulin pump, I think twice kind of errored, and I went in and switched and we switch them in the nurse's office because there was privacy there. But Arden's never had to go to the nurse for anything diabetes related now in third grade, in fourth grade. And now this year, halfway through fifth grade, never once been to the nurse, it's so glaring, that the nurse sometimes sends me a note to say if our never just wants to come down and hang out or say hello, you know, we really don't feel like we know her. And I very privately think I'm glad I don't want her to know you. i She doesn't need to know you. She doesn't need a nurse. She's She's good. Today Arden is on a school trip. This is the first school trip I haven't gone on. And the very simple reason why I didn't have to go today. Now. Last year, I wouldn't have gone either because of the texting. But there was still an issue of insulin pumps. What if there's a real like kind of catastrophic incident with her insulin pump and it needs a new pump. I wanted to be there to change it. Up until a few months ago, Arden could do all the steps, but she'd never done all the steps start to finish. It ends up being another, you know, happenstance, he kind of thing that gets Arden to putting her insulin pump on her on the pod on by herself. So just like the text messages is born out of me not wanting to get off the sofa one day. My wife and I, Kelly and I were away for a business thing for her. Well, it was an overnight event. It wasn't very far from home, we were about an hour and hour and a half from home. But just far enough that you needed to spend the night Arden and her brother went to her aunt's house. And I think we were like on the last day of an insulin pump. And I kept saying to Kelly on the way out the door like maybe we ought to just switch this thing early. Because I have a feeling it's going to just it's going to you know, it's not going to make it till tomorrow, it's going to need to be swapped. But our blood sugars were okay. They were just starting to get stubborn. You know what I mean? And by the time we had dinner at this event, args blood sugar was great. And then all of a sudden, it just started heading up and she's texting me, hey, my blood sugar is going up and we're poor and insulin. And it's not going down. And so I guess about 45 minutes or an hour later, I texted her and I said look at it that pumps gotta get changed, you know, it's the site decides done and it can you do it, I'll walk you through it, I'll text you through it, or I'll call you if you want me to. And and I said you know what, that's a good idea. I'll call you and I'll walk you through it. Go ahead. I told her Go ahead, fill the pump with insulin and prime it and then send me a text message. And I'll call you and we'll go through the rest of it. About three minutes goes by but in my mind, you know I said to my wife like it's been a long time I told him to prime that pump and I haven't heard back from her you know something's wrong. She's lost her nerve. You know something I'm gonna have to drive home you know, I explained to my I'll explain to your sister over the phone. I'll you know something. But I had every bad scenario going off in my head. Next text message I get back from Arden is a response to me because I'm not texting her. Hey, what's going on? And she goes, Oh, I'm done. And I thought she meant that she filled the pod and primed it. I said, Okay, I'll call you and let's we'll talk about the rest. She texts back because you don't have to call. I said I'm done. I put the pump on. It's all done. I'm finished. And I was like, Oh my God. That's fantastic.

But it's the situation that made it happen. Right. Like she was in a room with a person she knew. Didn't know as much about her insulin pump as she did. She was with her aunt, her aunt knows a little bit about it, but certainly not as much as Arden does. I wasn't there. There was no one to bail her out. This was on her. And bang. She takes care of it just like that. And I really do think diabetes. You know, in the diabetes world and outside of it. Children just get so much out of being challenged. It really does bring the best out in them and this certainly was one of those times. Now that Arden can change your pod without me being there. It's a game changer for For us, and it's why I'm not on some school trip today. You know, Arden is at a science center or a Space Center about an hour and 45 minutes from our home. And isn't it great? I'm just I'm thinking now I'm not really sure where she is. I'm not 100% sure if she's at the Space Center or the science center, it doesn't matter to me. It doesn't matter where Arden is. She's on a class trip. You know, her blood sugar today's never been over 170 hasn't been lower than 115. She was 115. When they got on the bus at the end of the day to come home. She's probably on a bus driving home right now the last time she and I texted, she's like, Hey, everybody is gonna have a snack and have a snack. She Bolus for it. And she's on a bus right now laughing with her friends. I don't even know where she is. It gives me so much joy to tell you that I don't know where she is. Because she's fine. And nothing went wrong with her on the path today. She didn't need the extra pump. She took her the insulin she talked about, you know, but it's right to take the stuff. But had something gone, you know, funky, she would have just found a place and changed the pod and gone about her business. I know she would I know she would have done it. And it all starts in that second after I text her back in second grade from my living room to the bedroom upstairs. What's your CGM say, it all starts in that moment afterwards, when I start realizing I just need to not be that involved. You know, she can do more than I expect. But I don't want to throw it on or all at once. And that has been a really huge benefit of the texting at school, which is different situations come up every day, you know, everyday is not always the same with diabetes. And so their experiences, you know, a little bit of a high before a meal a little bit of a low after a meal a low before gym a high before gym? How do you handle all these things? Well, you have to, they have to happen. First of all, you can't stop every bad thing from happening or every undesirable thing from happening. Because if you stop those things from happening, you never have the experience of them happening. And you know, as well as it, you can't always stop, you know, undesirable moments with diabetes and always stop, you can't hardly ever stop them. So the only real benefit in these moments is learning from them. That's what's been happening with the text messaging. And it's been happening, you know, slowly over time Arden gets to see a situation arise, she gets to hear in the tone of my text messages that I'm not upset. I'm not frantic, I know what to do. Sometimes we choose what to do, and it doesn't work out really well. And she doesn't, you know, we have to make another adjustment. But that that's not a big deal either. And these experiences continue to help Arden grow as a person who lives with type one diabetes, to the point where she's not thrown by things when they happen. And that's probably the biggest that's probably the biggest impediment is not to see a low number and start running around with your hair on fire or not to you know, not to set a correction into into motion and the correction doesn't really affect the high blood sugar. You can't be you know, throwing your hands up constantly and going, oh my god, I can't believe this is horrible, blah, blah. You can't be like that all the time. It's just got to be what it is. I got a high I put some in some oil, it's not working. What are we going to do next? We're going to adjust the basil, are we going to? Are we going to inject some insulin? Are we going to try a new pump? You know, are we just going to Bolus again, you know, maybe this is just a carb counting mistake on our part. Maybe we should just Bolus again or she's low. not to panic when she's low. You know, everyone's got their own level of comfort and I completely respect that. But I see online sometimes people are like, Oh my God, my kids blood sugar was 70. And it was an arrow down or CGM. They almost died like oh geez, you know, most die. 7070 is a great blood sugar. I mean, the down parts not fantastic. But really think about what that means and arrow down to 70 means you're falling about two points per minute, which means that five minutes from now you're going to be 60 which still is not a panic situation for most people drink a juice. It'll stop at 60 The arrow kind of curls back around again before you know it you're fine.

Unknown Speaker 24:14
Reed trying to block his teammate Chris butcher. Here's the checker I thought I

Scott Benner 24:18
would take a second to let you know that the next episode of The Juicebox Podcast will be an interview with 21 year old NASCAR driver Ryan reed Ryan just won in Daytona in the XFINITY series. And we're going to be talking to him about his type one diabetes diagnosis, racing with type one and find out what it feels like to win a NASCAR race.

Unknown Speaker 24:39
Day total What a finish.

Scott Benner 24:42
If my daughter was a panacur because she saw a low number, then that would keep us from transferring the responsibility to her. She can't be someone who panics. And I'm not someone who panics. My wife's not someone who panics and we're teaching her that but slowly through Experience is not by saying to her art and you can't panic if your blood sugar gets low, that's not teaching anybody. You can't teach people how to be. They have to just grow into who they're going to be. And so this simple, silly idea of just texting has facilitated all of this. It has been maybe one of the best decisions I've ever made by mistake or not on purpose and in my entire life. The handoff of Arden's care happens constantly. It's exponentially growing. It's not as slow as it used to be. It used to be one little thing every couple of months. Now I can see her gaining confidence constantly. You know, whether it's today's trip, or yesterday at a friend's house playing in the snow. You know, yesterday is a great example. My son was playing in his final freshman basketball game yesterday, I really did want to go see him play. So Arden comes home from school, I say to her look, we're letting the dogs out. As soon as the dogs are done outside, we're gonna get everything together, and we're gonna go see Coldplay. So he just pack your bag up, you know, bring some snacks if you're hungry, whatever you want to do, but we're gonna go and so she's running around packing and I'm running around with the dogs. And her phone. She gets a text on her phone from a friend of hers. Can she come over and play in the snow? Now I really have to go or I'm going to be late like I need to go. So I said to her, you can go that's fine. But you know, we got to do it right now. Like there's no time to make big plans. I can't call my mother. You know, I said what's your CGM say it's on the low side. I think she was like it was after school. She hadn't had a snack yet. I think she's like 85. And I said, okay, just you know, let's get going. But you have to have a snack before you go outside. So we drove up the street. I dropped her off at her friend's house with a study 85 on her CGM. And I said to her before you go outside and play, have 15 carbs of something. Head out, put your CGM in your pocket, make sure it's zipped up so that you know it can't get wet. Pay attention to the alarms text me if you have a problem. That's it with that I dropped her off. And then I drove about a half an hour from where she was to watch my son play basketball. And not a problem. Not a problem in the whole world. Nothing went wrong or blood sugar didn't get high didn't get low. But if it had CGM would have beeped. And she would have done something about it. And you know, if she had to go inside and talk to the mother that was there, even though that mother's not, you know, some diabetes guru, she would have been fine. Absolutely fine. I was never, never nervous or never uncomfortable yesterday, even though it was a last minute thing, even though it was not a perfect situation where I was leaving her even though she was going to be doing something strenuous. I never in that hour, I watched my son play basketball. I did text with her once or twice, but I was never uncomfortable. And she wasn't uncomfortable. And that is a just a gift. Because I have spent a lot of my life feeling uncomfortable in situations like that, as I'm probably sure that you have also. But it turns out that while we've been texting back and forth, and she's been slowly, you know, her her care, her responsibility, the onus of that has been slowly shifting to her. My anxiety has been slowly shifting away at the same time. And it's always unplanned moments, moments that are not within anyone's control, and certainly not how I plan these moments are the ones that teach me to just mellow out a little bit. And a great example is that Arne and I have alarm set up throughout the day, you know, talk at this time, you know, before snack or before lunch, these are the to our texting times because the day gets, you know, out of hand I sometimes forget. And she sometimes forget. So these alarms keep us in sync with each other. But I do have a couple of alarms that I think of as being maybe not completely necessary. And so if my alarm sounds and it's one of those unnecessary times, and Arden never texts me say she never texts me. I'll throw one text Hey, what's your CGM say?

Unknown Speaker 29:15
But if she doesn't get back to me, I just imagine that she's in her classroom,

Scott Benner 29:21
you know, taking a test or you know, in their group study talking with people. My mind doesn't jump to like Arden's not texting me back because she's dead. But the first couple times it did. The first time she didn't text me back. I was like, I have to call the school. She's not answering me. This is a problem. Obviously she's died or laying on the floor behind a water fountain having a seizure. You know, every bad thought runs through your head. And the best thing I was able to do for myself the biggest gift I've ever given myself in my life is that when those things ran through my head, I told myself just to shut up, just stop. She's in a building with an adult. They're aware that she has type one diabetes, she's got a monitor on for God's sakes, the beeps like crazy, if she's getting too low, the odds of something happening to her, it is dire are so much less than the odds that she's just not hearing her text message. Or the alarm went off, and she didn't hear it. That's what common sense tells me is probably happening. So it was anxiety ridden for me the first couple times, the first couple times she didn't answer, but every time she does an answer in one of those very non critical times, takes away more and more of my anxiety to the point yesterday were when I went to that basketball game, I realized, you know, I am as I am just about as, okay with this as I could possibly be. And I don't mean, we're not paying attention to the details, I don't mean that, you know, we're just gonna throw our hands up in the air and be like, Hey, we're wild and free, and nobody's paying attention anymore, we're still paying attention to it. But in those gaps of time, there's one of my there's an alarm right now that's Arden's pre bus alarm. But of course, today, she's out on a school trip. So I've already spoken to her that one doesn't kind of count today. My point is, very simply, diabetes doesn't get easier. The concept, the very real concept that too much insulin could kill a person, that doesn't stop being true. But when you live through the situations over and over and over and over again, and build a database for yourself of, of experiences that you can draw on, you can learn to let go of your anxiety, and you can raise a child who doesn't have that anxiety. And without that anxiety, they make much better decisions about their care. Now, you know, very soon, and by very soon, I mean, in the next few weeks, Dexcom is going to release that new, a new receiver that's going to have the share built right into it. So Ardens Dexcom receiver, you know, by the end of March 2015, is going to send a little Bluetooth signal to her phone, there's going to be an app on her phone that's going to send her blood sugar to the cloud. And I by then I'm going to be able to look at it on my cell phone, or an iPad, or, you know, the Apple Watch will come out the month later if I don't have one of them. But I mean, these are the possibilities. And I keep thinking, I keep thinking, Okay, I do want that, I want that. But I only want that for the alarm. Like I want that. I don't want to look at it all the time. And I don't want to micromanage her type one diabetes, because me constantly telling her, Hey, your blood sugar is going up, or your blood sugar is going down, do something about it, is just going to do the opposite of what I want to know, in my mind, it's going to do the opposite of what I want, what I want is for her to go and no one's here to change my pot, I'll do it myself, hey, my blood sugar is going up, I'll take care of it myself. I'll be proactive, I want proactive. That's what I'm hoping for. Now, having said that, if there's this little gadget that'll throw me an alarm that says, Hey, your kid's blood sugar is 50. And it's going down. I'll take that I think that's great. I mean, I guess in the same way, if there was a magic, you know, a magic siren that would go off. If my son was about to be hit by a car five minutes from now, I would like that too. But there's no value in me walking around behind my son for the rest of his life going, don't get hit by a car, don't buy a car, don't get hit by a car that he's not going to grow up to be or he's not going to grow up to be a rational person. If I'm up his ass like that. Trust me, I get as well as anybody what the, you know, what the concerns are? I know how dangerous insulin can be. And I know how sometimes things just happen that you don't plan for you don't expect and have no way of seeing coming. But you know, my experience is telling me that those those moments aren't that frequent. And we have the technology I mean, make no mistake using an Omnipod insulin pump. And moreover, probably the Dexcom you know, continuous glucose monitor these items make everything that I'm saying a reality without a CGM. I, I'm not nearly as good at this. I'm not making all these boastful statements about I just sent it to my friend to her friends asked to play in the snow. If she didn't have a glucose monitor. I'm not sending my kids at somebody's house to go play in the snow. I would go and hang out and be there or I would be nearby or it would be a much more regimented schedule of when we were going to talk. It wouldn't all be like loosey goosey like it is now that I completely completely want to be clear about and honest about but we do we're lucky enough to have the glucose monitor and so I'm lucky enough to be able to make these decisions. Okay, hey, episode four. Right? I got four episodes going. You know, I hope you're enjoying it. I mean, I guess if you're listening still you must be enjoying it. I did see that. in its category on iTunes Juicebox Podcast is rising in its category, which is very exciting. It would help the podcast immensely if you could go to iTunes and give it a review either, you know, five stars or actually write a review. iTunes takes that very seriously and it helps the podcast quite a little bit. So if you can do that, that would be fantastic. The Juicebox Podcast is online at juicebox podcast.com on social media at Juicebox Podcast, my type one diabetes parenting blog Ardens. De is at Ardens de.com and on social media at Ardens. De you know, come find us. Check us out Facebook and Twitter is a great way to find out when new episodes go up. But you know, subscribing at iTunes or Soundcloud or Stitcher is another great way to to find out when episodes arrive. New episodes are on Tuesdays. And what else I know what else music for the Juicebox Podcast composed and performed by Sydney Mueller, Sydney. I continue to be in all of your town. Thank you very much. This is Juicebox Podcast. I'm Scott Benner. Thank you very much for listening.

Well, I bet you wish Scott in 2015 had this microphone, because he would have sounded way better. Anyway, thank you so much for listening to this episode of The Juicebox Podcast. And don't forget to head to cozy earth.com and use that offer code juicebox to save 35% on bedding loungewear sheets, my sheets are super comfortable. Check them out cozy earth.com. And don't forget to use that offer code juice box to save 35%. If you're looking for support around diabetes, look no farther than the Juicebox Podcast, private Facebook group, answer a couple of quick questions to get in proved unless you're a real person. Because it's a private group. We want you to feel comfortable there. So just a couple of questions, you know, just kind of shows the algorithm you're real. And once you're in there, 35,000 members strong support, advice, conversation, camaraderie, Juicebox Podcast type one diabetes on Facebook. And it's not it's for everybody. That's diabetes, you know? So head on over. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Did you hear me earlier? I was like there are new episodes on Tuesdays buys. On Tuesdays, there'll be a new episode of the podcast. That was a long time ago. I got more content for you now. Don't you worry. What a terrible microphone to and so like their recordings noisy and but I have really upgraded for you folks, don't you think? Ah. You're welcome. I was just kidding. Why would you thank me for that, like make a podcast you can understand. I didn't know what I was doing back then. I mean, that was 2015 and February. I had been at it for like four weeks. I mean, you gotta admit contents rock solid, but I mean, it sounds like I'm on a rail car going through the Midwest hoping that a hobo doesn't steal my can of beans or something. It's very noisy. Anyway fixed all that. And I'm not sure what purpose this serves. Probably not. Quite me giddy at the end of the day. Alright guys. I don't know. I'll be back. There'll be more. Please listen. Thanks for subscribing, downloading telling people about the podcast. That's all very important and very much appreciated. Anyway, seriously, I'll be back soon. I'll talk to you later.

#855 Discussing Suicidal Ideation

Erika Forsyth is an LMFT who has type 1 diabetes.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to episode 855 of the Juicebox Podcast.

On today's episode of Juicebox Podcast I'm joined once again by Erica Forsythe. Erica is a licensed Marriage and Family Therapist out of California. She can also see patients right now, virtually, who live in Utah, Oregon and Florida. She's adding more states all the time, check her out at Erica forsyth.com Or by calling six to 63442263. Just a little heads up, you'll see by the title Eric and I are going to talk about suicidal ideation today, and everything that goes around that, how to spot it what to do, how you might be able to help someone. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please Always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you're a type one who is a US resident or a person who is the caregiver of someone with type one, filling out the survey AT T one D exchange.org. Forward slash juicebox will go a long way towards helping type one diabetes research. complete that survey AT T one D exchange.org. Forward slash juicebox. If you are currently having suicidal thoughts or just want to speak with someone just pick up your phone and dial 988 That's the suicide and crisis lifeline 988. You can also look online Samaritans hope.org Or just go to Google and type in suicide help. All kinds of local returns will come up for you. This episode of The Juicebox Podcast doesn't have any ads. But if you're interested in supporting the podcast through one of the advertisers, there are links in the show notes of this episode. And at juicebox podcast.com to all of the sponsors. Okay. Hello. Hi, Erica. How are you? Hi,

Erika Forsyth, MFT, LMFT 2:09
great. Thank you.

Scott Benner 2:11
I appreciate you. Oh, I'm already I just hit record. And I'm already doubting that I should do this. But I know I'm no I know I shouldn't I know it's going to be valuable. But I'm gonna get upset at some point while I'm doing this. So let me let me lay out how we got here. A lot of people write to me, that's the thing you hear a lot of people say most of them are probably lying because they're trying to make their social influence seem more powerful. But I get a ton of emails, private messages, so many so that I mean, I read I read every one of them. But sometimes they'll sit in my inbox for a month before I can get to them. And I got a note from a girl a while back now. And it was pretty long and descriptive. And and they wanted to come on the show. They didn't mention any mental health issues. But I would say that the letter had some signs of it in there. Sometimes you can kind of tell by the length of the letter or details get over shared things like that, like I can I kind of have like maybe a half a sixth sense for it. And so I got right back to her. And I see you know, would love to have you on the show, let's set it up. And then I never ever heard back from Oregon. And I mean, like a year went by. And then she responded to the email, as if I had just sent it like the week before. And we were talking and here was the conversation again. And they were very excited to come on the show. And this time I got her booked onto the show. And it takes about six months after your book to get on the show. So about two months before, about two months before she was supposed to record with me. I got this very strange email from somebody I don't know. And it became obvious that the person was trying to tell me that their daughter had passed away without using the words. And then as I read a little farther, opened up and said yes, she had passed, but then I realized they weren't going to say how. So I was like, okay, and at the end of the note, it said that at at their daughter's funeral. They wanted to take donations for the podcast. And this was at his daughter's behest. And I was just like, I mean, if you could try to imagine my wife and I are sitting in our car outside of a restaurant, just waiting for our takeout. You're not I mean, and I'm like, Hey, look at this and I'm reading it we're both trying to make sense of it. it and the gentleman says, leaves his phone number and says you can call me. And I thought I said to my wife, I'm like, this is I don't know what to do about this. But I can't just email back. I don't know what the right thing to say like this has to happen conversationally. And so I just called him from the car. And he never said how, just that his daughter had passed away that morning. And, and then I started putting it together. And I realized, I think this girl took her own life. And I think I'm in her suicide note. Like, like, you don't I mean, because you don't like and I'm obviously making a couple of leaps. But you don't walk into a bedroom and say to your parents, like, Hey, I'm gonna go kill myself now. But at my funeral, could you please handle donation like, so I started thinking like, Oh, my God, I'm in somebody's like, like, last last will and testament, basically, you know, and it freaked me out a lot. And I held myself together. And I talked to him, and he was barely holding himself together. And I told him, I get back to him the next day. And so I'm sorry to say that in that moment, I didn't realize that his daughter was the person who I described as the person I was emailing with the beginning. And I put a lot of effort into it. I asked people online, Jenny and I talked privately, and I ended up giving him three places. I said, Look, I can't take donations from from this. I was like, but here's, I gave him touched by type one. I said, this is an organization that helps children, I gave him diabetes sisters, is an organization that helps women, and we are diabetes, for eating disorders, and things like that. And I was like, these are three places I think, would be very valuable. And, you know, I can't like I would never, I said, I'm not a I'm not a charity. I'm like, I don't even know what I would do with money if it came, like, you know, I'm not going to take but but he but he kept saying, but my daughter wants you to have it. And I was like, I can't take it. Like I just can't, you know, and so we set this up, everybody was okay with it. Like two days later, my cell phone, I'm sitting right here and my cell phone rings and I don't recognize the number and I pick it up. And there is a crying woman on the phone. Before she says hello, she's, she's crying. But she's also doing the dishes. So I can hear someone crying and doing dishes at the same time. And I just thought, Oh God, this is this girl's mom. Like it is she's got my number because I called her husband. And we just stayed on the phone for maybe 20 minutes. She described what the podcast meant to her daughter how much it had helped her through her life. And told me that never never used the word suicide never said took her own life. She didn't use those words. We all it was spoken around the entire time. And and she just thanked me and then asked me if I had any insight about her daughter. And I told her that I would be happy to share the emails that she sent me and I sent them back to her. And I've never I've never heard from them again. I did tell the woman like it was like if you ever want to come on the podcast and speak about your daughter, you know, eulogize her memorialized or anything at all? Like you could I took from the conversations that she had a lot of different problems. Some were physical and some were mental. And that she had really succeeded through her life she'd I think become a nurse and like, done a number of things going to school the way she meant to, I hope I'm not miss speaking about what she accomplished. But she had gone to school she was working towards she had a life you know, but the mom said something. And I'm not going to get it right word for word, but I'm never gonna forget the intent of what she said is, this was always how it was going to end she said, I've been waiting for this for a long time. And I thought and again, not her exact words, but I think I think it was I think what she said word for word as close as I can get to it is we always knew this was going to happen. So I'm assuming there were fits and starts and attempts and things along the way. And so I of course not to make this about me because it certainly is and I want to shine a light on this and help people understand how to identify suicidal thoughts, how you can help people with them, etc. But just telling you the story because that's why the episode exists. I I was I don't know anybody who's suicidal, I don't think and then it made me think or do I and I don't know, because this girl did not seem suicidal in these emails. She just seemed a little I don't know, all over the place a little bit but not but in a way that would have put up a red flag for me, you know? Certainly. Anyway, I, I just wanted to help people recognize it and others and know where to go next. So if you can help me with that, that'd be great.

Erika Forsyth, MFT, LMFT 10:15
Yes. Well, yeah, it's obviously a tragic story. And it's such a painful and sensitive topic. And I know that our community responded as well, there was an outpouring of love and support for this, this woman. So I think one of the main things is often you, as you were sharing, just through the email, we might not notice any significant red flags you hear a lot of family members talk about when their child dies by suicide, which I just want to note, it's, we really don't want to say committed suicide anymore is if it's like they committed a crime, and it's died by suicide. And so they reflect back and say, gosh, we really didn't even notice any signs, maybe they were sad, at some certain moments, there was you know, irregularity in their emotional regulation or their their functioning. And that might feel scary, but some things that we that you can do that one of the myths out there is that we don't want to ask if someone's suicidal, or if they have any thoughts about suicide that maybe in so doing that might plant a seed, but that's actually a really false myth. And so, by simply asking, Hey, I noticed you've been down or sad for a while, or you don't just seem yourself, have you been thinking about wanting to harm yourself? Have you been thinking about killing yourself? That that is disclosing and showing them that you care, you see them, it is not planting a seed? And, and if they say, No, that's also great, because then they know maybe if they do ever start to feel that way, they know that you're a safe person to come to. So simply just by asking, is not going to plant a seed, and it's showing that you care, you notice, and you're in your safe, right?

Scott Benner 12:20
Yeah, I I've wondered about that. Because even with a lot of parenting or, or issues or friend, you know, even like, personal relationships, it is difficult to say the thing out loud, is what's happening. Are you cheating on me? Are you like, you know what I mean? Like, like, that kind of stuff. And there are people who will live their entire lives, wondering about something, never saying it out loud. And maybe a it's not true. And you've made yourself worried about it for no reason, or B, it is true, and you could have maybe made your situation better. But the fact of the matter isn't going to change, whether you say it out loud or not. So you might as well, right?

Erika Forsyth, MFT, LMFT 13:01
Yes, and it, it can be so scary to say and obviously, as a clinician, I am trained, and I've practiced and it's I'm more comfortable doing it. And so as I coach parents to do this, I know there is that moment of it's fearful, it can be scary. But it is not. It is not what you think it's going to do. It's not going to plant the seed. And I know a lot of people might also not want to ask the question, because then they feel like well, am I responsible? What if they do say yes? And now am I responsible to make them feel better or to care for them? And you are, you are not you are then well, you're responsible at that point to get them, you know, to a trusted adult to call, you know, depending on the severity of the situation, 911988, which is the national suicide line. But you're not you yourself are not responsible to save them and make them feel better, right? You're that kind of first line of defense, so to speak.

Scott Benner 14:02
I would say that, um, I understand the fear. If you've never been in that situation, it's not something you'll get ready for. I've I've been in at one time. And I certainly won't share anybody's personal details. But as I was heading to the place where this person was, I called a friend of mine who's a police officer. And I said, I'm about to walk into this situation, and I don't know what to do. And, and he said, Okay, he goes well, just, he's like, you're gonna have to assess what's happening. He's like, is it something that's just being said out loud? Is it they're distraught about something because they, you know, something happened? Is this a real thing? Is it ongoing? And then you need He's like, he's like, then there's this important part. It's interesting. I never thought about it because you want to get this person to go seek help on their own. And I said, why? And he said, well, most of the time this works out And I said, okay, and he goes, but if you have to be taken in by force, it changes a lot about how the rest of your life goes. And I said, Really, and he said, he said from owning a firearm to like a number of different things, he said, He's like, he's like if you can get this person to go on their own. And when I got there, all I knew for sure is that I didn't understand how this person felt. And they did not seem to be the best arbiter of the next thing that happened to them. And so I made this description, I said, Look, I was told, if you go get help, you're probably going to be okay. And later, you're going to really be happy that you did this on your own. And they did that they were assessed by a professional, came home, we're okay made up an appointment with a therapist to therapist now we're doing very much better. But had that had that moment boiled over and somebody would have called a cop that would have changed their life forever. And I and even that's got to be in people's minds, right? Because like, am I going to do something? Is this a momentary thing? I'm going to this person up, you know, for the rest of their life. I can see why people would be concerned about what to do next afterwards.

Erika Forsyth, MFT, LMFT 16:13
Yes, yes. And I? For sure, yeah. The sense of responsibility, am I going to change the course of their whole entire life if I feel like I need to make this call because they aren't responding? I think it's really important for for you, as the person who's you know, attending to someone who is severely depressed or suicidal, is to give them that sense of control. Like, let them decide if they're, if you feel like they truly can. Hey, what do you need from me right now? Do you need me to stay here? And maybe elicit the help of other family and friends to take shifts? Do you need me to call you every day? What would be good for you at this moment? check ins, you all that type of stuff?

Scott Benner 16:54
Well, okay, so the thing that I was involved in was, was sprung on me, I didn't know it was happening, you know, an hour before I was there. I was, I was doing the dishes if I'm being honest. And so but if, if I'm, if I'm in a home with someone who I think feels this way, now I bet it because we've we've gone over, you can ask somebody, you know, how do you feel? So what are we what are we looking for exactly like the NIH says that warning signs of suicide are if someone is talking about wanting to die, talking about great guilt or shame, talking about being a burden to others, that those things can be indicators, you agree with that? Absolutely. If they talk about feeling empty, hopeless, trapped, or having no reason to live, if they talk about feel if they have feelings of extreme sadness, more anxiety, agitation, or a full range, or full rage, excuse me, and then an unbearable emotional or physical pain, if they feel that way. Now, they also say to look for change in behaviors, making a plan or researching ways to die, withdrawing from friends saying goodbye giving away important items, or making a will, taking dangerous risks such as driving extremely fast, displaying extreme mood swings, eating or sleeping more or less using drugs or alcohol more often than you would be expecting from them. You agree with all that? Yes. Is there anything to add to it?

Erika Forsyth, MFT, LMFT 18:24
Well, I think one thing that might get confusing for people, you know, the extreme sadness, or the even the suicidal ideation, I think can be confusing, and a lot of you know, websites and any if you Google, you know suicidal ideation. There's not a TED talks on this as well. Because a lot of people who are depressed, and I hear this in my office as well. It's kind of like a release valve for them to say, I don't want to kill myself. But sometimes it just feels easier to envision myself not being alive. Or just things might be easier if I didn't have to feel this pain, this weight. And so they're, they're thinking about it, but not they don't have means or a plan. Right? That's those are the questions you'd fall up with. If someone says yes, I have been thinking about not wanting to live, then you would say well, do you have means meaning? Have you do you have tools that were What are you? How are you going to do this and then then a plan. Now most of the time, people will say no, I don't have means or a plan. And they ideate and it's it's really not there's no it's not an active thought. It's more of a passive release.

Scott Benner 19:35
So, release is the word I was going to use. So if you are trapped in a situation, say I take a perfectly healthy, jovial person, and I locked them in a box, and that at some point, they're going to think I have to kill myself to get out of this because there's no way for me to get out of this. So that box could be an overbearing parent. It could be an abusive spouse. It could be a situation that they can't find another way out of and so they're not people Who in any normal situation is that what you're saying would consider ending their life it's just the only thing they can think of conceive.

Erika Forsyth, MFT, LMFT 20:08
The only thing they can think of or and, and the experience that that their lived experience for the day, the season, it feels so overwhelming that they feel like the only way to have any kind of relief from the physical and emotional pain is to envision them not being alive. And so it's more of a Yeah, it's a release is really the best word from that current lived experience. But they aren't saying well put in I'm gonna go do this and this and this to actually make that happen.

Scott Benner 20:40
Yeah, but just just imagining it puts their puts their brain in a place where they don't exist in the world anymore. And therefore all this anxiety and pressure and stress they feel doesn't exist either. Yes, a way to make it go away. Yes, yes, yes. Is that the if I'm wrong about this, you'll stop me. But I only know enough about this from talking to other people who have gone through these things. But is that sort of the intellectual exercise? That would be the physical equivalent of cutting? Like to like to interesting to see what I mean by that? Maybe I'm wrong.

Erika Forsyth, MFT, LMFT 21:13
Yes. I mean, I wouldn't make that like in total equal comparison. But yeah, I mean, I think if that helps kind of understand the concept,

Scott Benner 21:23
right? You're gonna say something so bombastic that it just everything, all the feelings go away, and you can just feel yourself being hurt at that moment. Right. Right. Right. Right. Which doesn't work, by the way, like it just it works. That's why cutters describe how often they have to do it, because the release and the relief is only momentary for them.

Erika Forsyth, MFT, LMFT 21:41
And then usually, what ensues is shame after that, whereas I'm not sure you know, that, that, that release of thinking about not being alive, if shame follows that. So there might be different patterns after that kind of experience. But yeah, I think that's, that's an interesting comparison.

Scott Benner 22:00
And again, I interviewed a few people, like, involve themselves in self harm somehow, and they all seem to when they're on the other side of it, they seem to talk about it that way, a little bit. So

Erika Forsyth, MFT, LMFT 22:10
I think, yes, I mean, the the list that you just described, is comprehensive. And I think what keeps a lot of that hidden, is shame. I think one of the things, I just heard this great example of thinking about yourself as a student in junior, and you know, elementary school, high school, even college, and the teacher has explained something over and over and over again, you still aren't understanding it. And you know, you want to raise your hand, you want to ask the question. But you're kind of embarrassed to raise your hand, maybe you feel like you're the only one who doesn't understand the concepts, you don't raise your hand. And this the same thing applies for someone who is who is suicidal? Is there so much shame? Am I the only one who feels this way? And so they aren't raising their hand for help. And so by you taking kind of the heavy lift and taking that initiative, of saying, Hey, I noticed you just don't, it can be very simple. You just don't seem yourself. Have you been thinking about hurting yourself, harming yourself? killing yourself, you are doing that you are raising the hand for them, because they might be trapped in a lot of shame and feelings of isolation.

Scott Benner 23:23
Okay. And it's important to be very clear, when you um, I see you using the same words over and over again, not, don't dance around it don't know, euphemisms like, Are you thinking of harming yourself killing yourself? Like be clear? Yes, yes. Is it reasonable to expect that if they do feel that way that they will tell you?

Erika Forsyth, MFT, LMFT 23:44
I mean, typically, in my experience people do and then they will clarify it? So if they do say, Well, yeah, actually, I kind of have then they'll then you can ask those further questions. Like we just said around double, do you have to have you thought about how you would do it, you'd have to say means and plan that's kind of clinical language, but have you thought about how you would kill yourself and you're using that specific language? Because they know that you are taking them seriously. And they in that process, they feel validated, heard, taken care of all of those things. And so then they will help kind of differentiate that for you by saying, Well, yeah, I have and I have these things, or no, it's just kind of this idea that I'm feeling so overwhelmed. I kind of don't want to be alive right now.

Scott Benner 24:29
And am I right to say that a person with suicidal ideation or thoughts, they don't have to be depressed, and like depressed people don't, that being depressed doesn't necessarily make you suicidal. And being suicidal doesn't necessarily make you depressed.

Erika Forsyth, MFT, LMFT 24:46
Right, because you can, I mean, obviously, they go hand in hand often, but there's, there's so many different levels of depression, and you might be a fully healthy be functioning adult, and have a really hard day, maybe multiple days in a row and feel like, Ah, I just don't want to be here right now. Yeah, I wish I could not be living at this moment and have that fleeting thought,

Scott Benner 25:13
when we were first married, my wife worked at a company who brought a very popular anti depression medication target. And so my wife would come home and say, Hey, we're seeing in the data, that sometimes there are suicidal people who are so deeply depressed, that they can't even work up the energy to hurt themselves. And then they took the medication and the medication lifted enough of the of the of the weight, that they could actually harm themselves. They were seeing people, like, does that make sense that they weren't they were so chained down by their depression, they, they they wanted to end their life and they couldn't, and then the medication would take away enough of it that they could go try to harm themselves. And that was obviously I think, unexpected in the beginning when these drugs were being like that.

Erika Forsyth, MFT, LMFT 26:04
Yes, that is, I have I have heard of that. And I also have heard of when you start medication, they why they say wait for three or four weeks for any kind of change to take effect. Because oftentimes people who are experiencing depression and start taking medication, they have so much hope in the medication. And then they don't feel any change quickly or quickly enough that are within their expectations. That then is when maybe the suicidal ideation becomes more severe. And there are more attempts. So that's why it's, we really want to emphasize it. Finding the right dose and medication takes time. And to be patient with that

Scott Benner 26:46
the idea of like, well, this is going to do it for me, and then it doesn't, and then

Erika Forsyth, MFT, LMFT 26:51
that all hope is lost that yeah, there was the straw

Scott Benner 26:55
that broke the camel's back, like, well, if this isn't gonna work, I'm out of here. Yes, that's so crazy. What are the numbers? Do you know them? Like how many people do this? A year? I

Erika Forsyth, MFT, LMFT 27:04
don't know. I know the I know that seven purse. This was a couple of years ago. I don't know actually the exact year but 7% of the population have identified as being depressed. I don't know. The numbers of suicidal attempts. I'm looking here or death by suicide. But I think that the depression is it's so common. But we you know, everyone has their their fear and shame to talk about it.

Scott Benner 27:39
A fsp.org is American Foundation for Suicide Prevention. on their front page, they said suicide is the 12th leading leading cause of death in the US in 2020 45,979. Americans were successful in their attempt 1.2 million tried. That's a wow, astonishing thing. The rate of service 2020 2020 additional facts about suicide in the US. The age adjusted suicide rate in 2020 was 13.4 per 100,000 the rate of suicide is highest and middle aged white men and 2020 men died by suicide 3.88 times more than women did. On average, their 130 a day. White males accounted for 69.68% of deaths in 2020. And it looks like in 2020 over 50% where a handgun was involved that firearm was that's really something and for my again from my perspective, I've never known anyone personally who's who's done this or tried it. I've known a person who's obviously spoken about it in a in a tense situation. And I have this experience with the listener and her family. I can tell you that I don't know what it's like to be her parents. But but I am pretty far outside of this girl's sphere. And I was really really impacted by it. It stuck with me for quite some time it made and I can see where the feelings come from because I the first thing I thought was and this is ridiculous right but had I got her on the podcast sooner like maybe we would have talked about something that I'm sure everyone feels like that when the bargaining yeah like maybe I could have helped me well that's ridiculous. How was I gonna do for you didn't mean like I don't know her I don't know her life. And I'm not I'm not trained in any way you don't I mean like but I still had that's that's silly. I can't imagine that our parents must feel that. You know every second like what did I not do? Or do And so what happens then, if you're, if you find yourself in this situation someone is able to help you you do get to help is that I hear people talk about being scared of the help too, though. And, and a little bit of the cost. I hear people worried about the cost the help, they say, there's no good facilities around them, then you hear people who have been in the system, and it's difficult to find good facilities, is there a way to help yourself in that to go in the right direction?

Erika Forsyth, MFT, LMFT 30:34
Yeah, I mean, those are all sinking significant and valid concerns, the costs, you know, if do you want to be an inpatient care, outpatient care, one of depending on, you know, your insurance and your ability to pay for treatment, one of the best things I know that helped people who are severely depressed and in this suicidal space, is giving giving them a purpose to get up every day, because perhaps at that point, they've lost the ability to, to function to get to go to work to get up and take a shower. And so there are, you know, treatment facilities that aren't necessarily fully inpatient, or fully outpatient, but you go just for the day, and part of the the intervention. And the kind of reward of that is you have to, you have to get up, you have to show up at 9am. And you're there, you're accountable. You're learning, you're also being exposed to community, and you come back. So that's a kind of a good middle space, if if going into a full inpatient treatment facility, doesn't feel appropriate for all of the reasons emotional financial. Because it's that finding that purpose. And if it's just to get up and get out of bed and report to a support group, every day, for a certain amount of weeks. Yeah, you, you, you receive so much out of that, right. I think one of the fears of a family member who has was trying to support someone who is severely depressed, is that they might not want it right, they there's resist, they're resisting, they're saying that they're not going to kill themselves, but they also don't want to go to any treatment facility, or they don't want to go to therapy, they don't want to take medication. And if you are feeling trapped in that place, I know it can be so overwhelming and isolating. But you get to the point where you know what I need to help my family member, and they're going to be mad at me, but they're going to be alive. And so getting to that place of I need to find the right support, whatever it is, if it means having a family intervention, friends coming over, and that and that fund member is going to be mad at you, because you've exposed them to get to a place of being okay with them being mad at you for that because they're still going to be alive. Yeah, it's

Scott Benner 33:03
the it's funny, it's the one instance when I can think it's okay to ignore their wishes, right? Because because the end result is is so finite, you know, if you anything else, I could see if they were like, I drink too much we're gonna or maybe we'll work it out. If you know that you can say alright, mate, because there's another day, there's another possibility of being hopeful and finding another answer. But when when the idea is this, there's there's nowhere to go from there. That's Do you think? I don't know what the question is, I guess, in your personal like, experience to people who identify these things and seek treatment? Did they end up with a different reality later? Do they often get through it?

Erika Forsyth, MFT, LMFT 33:52
Well, I would say, you know, the people who I see are either they aren't at that. I don't see people who are at the severe clinical stage of depression who need this, you know, more intense, either inpatient or daily treatment. So the people that I interact with more might be, you know, grieving from a newly diagnosed diagnosis, right of diabetes, and they're feeling so overwhelmed by all of the things. And that's when I hear pretty frequently those feelings of gosh, I just, it's so hard to juggle family and work and now having to figure out this diabetes for myself or my child. And there are days where I just feel like I don't want to be here. And life would just be easier if I didn't have to face all this. And so I associate that, you know, technically it is ideation, but that's connected with grief, and kind of the shock of all of it. And so working through all of the emotional, the grieving from the diagnosis, is really the ideation is relieved as we process the diagnosis and the grief If that makes sense,

Scott Benner 35:00
no, it doesn't. It's there is hope. Yes. But I just think that most people listening to this are going to if they if they intersect this, it's going to be more on that level. Like, I don't think that if you're if you have a loved one who's institutionalized and you know, like and is on, I don't think this is they you probably would have stopped listening to this a while ago. So I mean, it's it this is for people who find themselves with a new situation that people respond to sometimes in the way you described, are offhanded. Like, like, what about offhanded jokes? Like when you? I mean, I have my opinion, I want to hear what you think like if you if somebody says like, Oh, my teacher gave me a beat, I'm gonna kill myself. And you're being that's, that's not a that's not the same thing. Right. That's a colloquialism.

Erika Forsyth, MFT, LMFT 35:47
Yes, I Yes, I hear that, you know, and I, I'm sensitive to it in the in the fact that yes, it's a colloquialism. It's like, Ah, I'm so frustrated with myself. And so if I'll hear a client or a child, say that, say, hey, let's, let's just use a different word, you know, not not overly do it in terms of having a conversation or do it, you really want to kill yourself? I mean, obviously, I would do that if I saw some other signs and symptoms. Yeah, but let's just use another word like, Oh, I'm so frustrated with myself.

Scott Benner 36:23
Yeah. And it's, but it's a very, listen, it's an incredibly common thing. Like people say that, I mean, people who are not suicidal and not depressed, just they say it, like, it's like, it's a silly thing. And so but um, my point is, if your kids walked in through the room, and they're like, I gotta be on this, I'm gonna kill myself. Like, they do have to turn to them and say, Are you really having? Like, do you need me like, where's the line? And and I guess that's for everyone to decide. You know, like, where is like, when is somebody being flippant? And somebody's really having thoughts like that? And is is, is the flippancy happening over and over again? Is that is that an indicator? Like? Is that person trying to say something to you? Or are they really just a person with what you might consider a wide open sense of humor? And a dark sense of humor, but they don't have any thoughts like that?

Erika Forsyth, MFT, LMFT 37:12
I would look at if that was my child's saying that over and over again, I would look at, you know, the context, and how are they functioning? How were their friendships? How are they doing in school? Are they? Are they saying, Are they stopping doing things that used to find pleasure in or enjoyment and? Or are they still are they still, quote, normal functioning, I would just remind them, let's choose a different word. But I think it's also something just to be, you know, gut checking yourself and saying, Gosh, they are saying this a lot. And I also noticed that he's sleeping more or she's deciding not to play tennis anymore, or you

Scott Benner 37:48
know, to find that find the, is this just the thing, and there's no thread to something else? Where am I? Like, do I can I step back, see the big picture. And notice, wow, not only am I hearing this, but I do see some of these other things that we listed earlier.

Erika Forsyth, MFT, LMFT 38:01
And there's there's nothing wrong and asking, there's as we already said, In the beginning, like you by asking your child or family member, are you thinking about really killing yourself? Are you thinking about harming yourself? And they say no. Okay, now they know you're an open field member to talk about it. If they do ever feel like that.

Scott Benner 38:22
Yeah. And you might end up in another situation, helping them I'll tell you, the person that I had my interaction with. Thanks me, like every couple of months, just they'll just get like a random note to say, I appreciate what you did that day. And, you know, I'm doing well and that kind of stuff. So and it's just, and it was in a situation where I noticed that a lot of other people were like, well, let's just be done with this person. Like, it's enough already. And P and people got frustrated. And I just I was the opposite. I thought, well, we're not going to quit on this. Right, this would be a silly time to like, give up here. So, I don't know, there's just a lot of intricacies, especially within families. And, you know, like, there's, there's politics and families you don't even like probably think of it that way. You know, but

Erika Forsyth, MFT, LMFT 39:15
well, and I think yeah, that what you just said, you know, people kind of giving up on someone or maybe like, Oh, this is just you know, Bobby being Bobby, you know, he's just got to get over it. Well, I just heard I think Bill Bill Burnett, just saying the the lat the depression is the lack of ability to get over it. And so they have someone who is clinically depressed, has probably tried to get over it and isn't able to get over it. Yeah. And so it's it's a real true thing. And so, by by going there and you know, using you talking to them in a normal voice connecting, seeing them for who they are as human beings and not seeing them as this You know, sick, scary person, I think is also really important.

Scott Benner 40:03
I've had a number of meaningful, life altering relationships through this podcast, by taking on people to come on the show to talk about things that most people would not have talked about. And I've seen their lives change. I've seen, I understand better I get a note online from one from a from a person who's been on this podcast, they send me about one a year. And it just says, Why don't you know I'm doing well, this is my one, see, if I respond, they will not respond back to me. But this person just reaches out to me about once a year to let me know they're doing okay. And and I can see why people wouldn't, why you'd be afraid to get involved. Because I also have an experience where someone, there was a clear cry for help in the Facebook group. And everyone tried to help this person. So there's this kind of like, they run into the group, there's a cry for help post, then they don't respond. And you trying to decide like, is this? Are they? Is it just attention seeking, like, what is this exactly right. And so you don't want to make the decision. You don't want to just brush it off as attention seeking, because what if they really need the help, but a lot of people tried to help, they were actually able to contact people in this person's extended family, like, you know what I'm talking about, like, Yes, I'm dealing with that way. But there was a moment where I couldn't let these attention seeking posts happen anymore. So I stopped, I blocked the person from being able to post, but I didn't just block them and walk away. I sent them a private email. And I said, I don't know you, I don't know your situation. But I do understand diabetes, and I can help you if you want. We can sit and talk privately. I'll call you on the phone, whatever you need, ignored me, ignored me ignored me. And then an email comes back. Everyone always says they're going to help me and no one does. And blah, blah, blah. And I'm like, okay, so I responded back one more time. I said, Well, I am telling you, I will, I don't know that for sure if I can help but I'm happy to talk to you. And then it was vitriol back at me again. And I went okay, well, now we're done. Okay, so like, I've tried, I've tried, I don't know, you, you're you seem like you just want this dance to keep going. I can't fix that for you. That's a hard thing. So I stopped answering. And then that person went around on social media and tried to like hit me every place they thought they publicly could, then I put a stop to all of that. And so do I wish I didn't try to help that person? A little bit. I do wish I didn't do that. Right. But I think back on the others, where I took that chance, and it went really well. And I guess I thought, well, this is the this the price of doing business, right? If I'm gonna forget to help somebody, it's not always gonna work out. Right. So,

Erika Forsyth, MFT, LMFT 42:54
and they, you know, at that point, she wasn't ready to receive it. Ya

Scott Benner 43:00
know, there's compatibility. They all the reason, oh, my God, they might send it out six months from now and be like, Hey, I'm so sorry. I should have said, Yeah, let's chat. I wasn't in that right place. Or maybe it's a internet troll. Like, I have no way to know, you know, so. But in your real life, there's, you will not be let down. If you try to help somebody. That's from my perspective, it will, it will help them and it'll help you too.

Erika Forsyth, MFT, LMFT 43:26
So, yes,

Scott Benner 43:28
we're missing here. I'm sorry to cut you off?

Erika Forsyth, MFT, LMFT 43:30
No, I was gonna say I think it will. And that piece, I think I know, I already mentioned it, but I think it's so it's such a huge factor in why people might hesitate in asking the question, because of that fear of I don't know, what am I? What do I do? I'm just a person, I'm not a trained therapist or doctor, what do I do this sense of feeling of either inadequate, or, like, what do I have to be responsible? And just, I just encourage you, if you have those thoughts, don't let those you know, stop you from just reaching out because just that very, the act of asking if someone's Okay, is going to will be a lifeline for them. Yeah.

Scott Benner 44:11
You know, we didn't talk too much about though, like, what if we're on the other side of that? What if we're not the person trying to help? Like, what if we're the person in in trouble? Are they able to make that leap? Normally, or do they need someone to come get them?

Erika Forsyth, MFT, LMFT 44:26
I think, you know, if someone's already in therapy, I'm thinking of just my personal examples. That's part of my questioning if I am noticing some depressive symptoms. So it's, it's kind of an automatic conversation. I think if it's a family member, and you're sitting there and you're the one who is suffering and dealing with some of these thoughts and feelings. I think it's really hard to reach out because depression is so connected to feelings of shame, which then leads to feelings of isolation and no one else feels this way, no one's going to understand no one's going to get me. And no one knows what this feels like those types of thoughts are really common. So when you're when you're swimming in that pool of shame, it's really hard to say, hey, and somebody, I'm Richard Hambrick, and somebody helped me here, I'm really drowning. Because the shame really prevents of doing that. No, this is not all, you know, all the time. But I think often, people do need someone else to ask, how are you doing?

Scott Benner 45:35
Yeah, I was really interested by the breakdown of the male to female because I, I generally think of men, as people who are more willing to ignore those cues and just push forward. But obviously, the numbers kind of say opposite, like maybe that maybe pushing through is, is stuffing down, not not not lurching forward all the time. I mean, obviously, for some people, it's different. But that threw me off the breakdown of the numbers a little bit. I don't know why

Erika Forsyth, MFT, LMFT 46:05
exactly stuff stuffing down. And then I think what we were talking about, on the other episode about the shame that perhaps there's stereotypically in a male mindset, I gotta be much, Oh, I gotta keep it all together, I get all of my, I feel good about myself about what I do my work, my family, these are all stereotypes, obviously. And so when a male might be struggling with depression, the shame is just right there. I should I should not be feeling this way I should be providing for myself or my family. How can I be stuck here in bed all day? I'm a bad person. Yeah,

Scott Benner 46:46
I can tell you is that having kids, you just you're always looking at them, like assessing things. They're assessing their health and their happiness and the things they are saying and the things they aren't saying, and what are they doing? And who are they around. And it's just, I don't know, like, I understand how it could be overwhelming to a person from the outside. But if you're seeing these things, obviously, if you don't know what to do find somebody that doesn't know what to do. I'll put I'll book in this episode with like phone numbers and websites and stuff like that. But anyway, the last thing I'll tell you about the person from my story at the beginning, is that one of the last things her mom said on the phone, when I said, you know, you can you can come on the podcast, if you ever want to, like I don't know, like, it's a weird thing to say to somebody, but she felt like she wanted to talk about her daughter. And she said, I said, just reach out to me when the time feels appropriate. And she said, You're gonna have to reach out to me, because I don't think I'm gonna remember this day. She said, It made me sad. And and I don't have the nerve to reach out to her. I can and I can't decide if I'm letting her down by not doing that or not. Like, does she really want me to? I don't want to be totally mean. Like, I don't want her to do this if she doesn't want to. And I? And I don't know, I'm lost as to what to do about that at the moment.

Erika Forsyth, MFT, LMFT 48:08
But I think, you know, she can always say no, and you could always say, right. I was hesitating to reach out. Right.

Scott Benner 48:16
Yeah, I think I might, because I feel like I promised her that I was going to do it.

Erika Forsyth, MFT, LMFT 48:22
But it is it is hard and painful. And I think if you if you are listening to this and feeling those feelings, you know, reach out 988 is the is the easiest thing to remember. Or you can plug it into your phone and save it. Because those are there 24/7 365 Someone a mental health professional is there to talk you can also text.

Scott Benner 48:44
Yeah, I think two of you. If something like this has happened, and you're left behind, I think you probably should seek out, you know, help as well. Right? Because I don't see. I mean, we I think anybody who has kids is spoken about this back and forth. Right? Like, if something happened to my kids, it wouldn't have to be you know, a suicide event. Just anything like I don't like I'm I'm really impressed by people who go on after they lose their children. Yeah, you know. So, anyway, just anyway, find help. You know, that's pretty much what I want to do. I appreciate you doing this very much. Am I leaving anything out?

Erika Forsyth, MFT, LMFT 49:22
No, I think we've covered covered it. Thank you.

Scott Benner 49:25
No, thank you. Once again, if you're having any suicidal thoughts or considerations around hurting yourself, please dial 988 Or go to Samaritans hope that org I want to thank Erica again and remind you that if you live in California, Utah, Oregon or Florida, Erica can help you at Erica forsyth.com Or you can give her a call at 626-344-2266 Thank you So much for listening. I'll be back very soon with another episode of The Juicebox Podcast

if you'd like to learn more about diabetes sisters, they offer a range of education and supportive services to help women of all ages with all types of diabetes to live fuller, healthier lives. diabetes sisters.org. Of course, if you're a listener, you know touched by type one they are a podcast sponsor and a longtime favorite of mine, touched by type one.org. And we are diabetes. At we are diabetes.org We help people living with type one diabetes and disordered eating. We are diabetes.org